Juggling multiple medications

 

Taking many drugs at one go may be necessary, especially for less healthy older adults, but we must be aware of the potential dangers.

There are times when it is necessary for a patient to take multiple drugs daily as they suffer from a few chronic medical conditions, but their regime should be regularly reviewed to ensure all the drugs they are on are still necessary. — Pexels

The Malaysian population is rapidly ageing, with over 11% currently aged 60 and above.

This figure is projected to rise to 17.3% by 2040.

The demographic shift has led to increasing healthcare demands, particularly in managing chronic diseases such as diabetes, hypertension (high blood pressure) and heart disease.

These conditions require long-term medicine use.

Alarmingly, studies indicate that nearly half of older Malaysians experience polypharmacy.

Many are also prescribed potentially inappropriate medications or fail to adhere to their treatment regimens.

This issue calls for coordinated care, increased awareness and targeted interventions.

Understanding polypharmacy

Polypharmacy is generally defined as the use of five or more medicines at the same time.

However, the number of medicines alone does not determine the impact.

The necessity and appropriateness of these medicines are equally important.

Polypharmacy can be both beneficial and harmful.

Appropriate polypharmacy occurs when multiple medicines are clinically necessary, carefully monitored and effectively managed.

For example, a person with high blood pressure, diabetes and heart disease may require several medicines to maintain stable health.

Problematic polypharmacy occurs when medicines are prescribed to treat the side effects of other medicines (a situation known as a prescribing cascade), or when the medicines themselves are potentially harmful.

Polypharmacy is common among older adults for several reasons.

Understanding these contributing factors is essential in order to design effective strategies to minimise medicines-related harm and improve overall patient care.

Some of the factors that can be attributed to the high frequency of polypharmacy among older adults are:

• The presence of multiple chronic medical conditions, for which the long-term use of medicines is necessary,
• Prescription of medicines on multiple different occasions by different healthcare practitioners, which increases the risk of duplication or drug interaction.
• Prescribing cascades, where medicines are prescribed to treat the side effects caused by other medicines.
• The absence of regular medicine reviews, which may allow unnecessary or outdated prescriptions to continue without reassessment.
• Poor communication between patients and healthcare providers, which can result in confusion or misuse of medicines.
• Widespread and accessible pharmaceutical promotions, which encourage patients to use traditional or over-the-counter medicines alongside prescribed medicines without medical advice.

Potential dangers

Polypharmacy carries genuine and significant risks, especially for older adults.Community pharmacists are one resource patients can easily access to ensure that their medicine regime is up-to-date and not causing any unnecessary side effects. — Filepic

Due to slower metabolisms and potentially impaired kidney function, the elderly are more vulnerable to the negative effects of multiple medicines.

Some of the most concerning consequences include emergency hospitalisations due to medicine-related complications, drug interactions that lead to undesirable side effects or reduced effectiveness, and adverse side effects such as dizziness, confusion or gastrointestinal issues.

In addition, when medicines impair alertness or physical coordination, they may contribute to falls, fractures and cognitive decline.

Several studies conducted in Malaysia also show that the majority of older adults do not take their medicines as prescribed.

Polypharmacy has a direct impact on medication adherence, which refers to how well patients follow their prescribed treatment plans.

As the number of prescribed medicines increases, the elderly often struggle with complex dosing schedules, leading to missed or incorrect doses.

This not only compromises treatment outcomes, but also increases the risk of hospitalisations and complications.

To address these, it is essential to provide patient education, simplify medicine regimens, and offer support through technology and caregiver involvement.

Reducing the risks

Healthcare systems around the world are adopting more proactive strategies to ensure the safe and effective use of medicines, especially in light of growing concerns about polypharmacy.

One important strategy is regular medicine reviews.

Patients are encouraged to inform their doctors and pharmacists about all the medicines they are taking, including prescriptions, over-the-counter products and supplements.

This open communication allows more regular medicine reviews, which helps healthcare providers identify medicines that may no longer be necessary or could be potentially harmful.

Another key practice is deprescribing, which involves gradually reducing or stopping medicines that are no longer beneficial.

Medicine reconciliation is also essential.

This process ensures that any changes to a patient’s medicine list, such as during hospital admission, discharge or transfer to a nursing home, are accurate and appropriate.

Technology also plays a helpful role.

Electronic health records can alert healthcare providers to potential interactions or duplicate medicines.

Most importantly, a patient-centred approach is needed.

When patients are involved in decisions about their treatment, it builds trust, improves adherence to medicines and leads to better health outcomes.

The most effective strategies to manage polypharmacy involve active participation from both patients and their caregivers.

Several steps are encouraged to support safe medication use:

• Maintain an updated medicines list, including over-the-counter products, supplements and herbal remedies.

  Bring this list to every medical appointment.

• Ask your doctor or pharmacist about the purpose, benefits and possible side effects of each medicine.
• Inform your doctor or pharmacist when you experience side effects, especially if they are suspected to be caused by a medicine.
• Get help from pharmacists for medicine reviews, especially after hospital stays or when there is a change in the medicine regimen.
• Use adherence devices or tools to help take medicines correctly, such as pill boxes, mobile apps or mobile alarms.

The role of pharmacists

As the number of elderly individuals taking multiple medications daily continues to rise, the role of pharmacists has become increasingly vital.

While doctors are responsible for diagnosing conditions and prescribing treatments, pharmacists ensure that medications are used safely, correctly and effectively.

With specialised knowledge in pharmacology and drug interactions, pharmacists are often able to detect issues that may be overlooked by others.

These include overlapping therapies, potentially harmful drug combinations, and unnecessary or duplicate prescriptions.

Community pharmacists, in particular, are in a unique position to support patients directly.

As the most accessible healthcare professionals, they can offer personalised counselling, conduct routine medication reviews and help patients understand the purpose and proper use of each medicine.

They can also identify early signs of adverse effects or non-adherence, and refer patients for further medical attention when necessary.

Addressing polypharmacy requires a coordinated approach that centres on the patient.

As the population grows older, providing safe, effective and individualised treatment is crucial.

Balancing illness management with quality of life is key to delivering better and safer care to older adults.

For any inquiries regarding medicines, please call the National Pharmacy Call Centre (NPCC) at the toll-free number 1-800-88-6722 during weekdays from 8am to 5pm, except on public holidays.

By PAYAL CHOUDHURY

Payal Choudhury is a pharmacist at Hospital Tengku Ampuan Najihah in Kuala Pilah, Negri Sembilan. This article is courtesy of the Health Ministry’s Pharmacy Practice and Development Division.

For more information, email starhealth@thestar.com.my.

The information provided is for educational and communication purposes only, and should not be considered as medical advice.

The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The

Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Juggling Multiple Meds: Doctors and the Ninth Prescription

https://www.linkedin.com/pulse/pills-should-more-than-color-day-alan-pitt-m-d-/

Several years ago, when prescribed a single medication to be taken daily for several months, I found it very difficult to remember to take it every day. I knew it was important and I knew why I was taking it, but even then I forgot. That experience got me thinking about the many people who are asked to take six, seven, ten drugs a day…forever. I have no idea how they remember to take all of these drugs correctly, and the fact is, most people don’t. This was made clear to me as early as my residency, when it was not uncommon for people to bring in garbage bags full of medicines. When asked how they determined which ones to take and when, these patients often seemed to go by the pill color of the day rather than any set schedule or plan. 

In fact, the data on this issue—known as medical compliance—reveal an abysmal record of patients’ taking medications “as prescribed.” Reportedly less than one third of diabetic patients take metformin correctly. And only half the patients with high blood pressure take even 80% of their medications as prescribed. The end result is a multi-billion-dollar expense with unpredictable and often dangerous outcomes. How does this happen? 

Unfortunately, when it comes to prescriptions, providers are required to be compulsive. We are trained not only to address every problem with a solution, but also to do so on an individual basis. If you have asthma, there's a treatment for that. If it’s heart disease, here’s another pill. Diabetes? Take three more. The list grows quickly, adding expense and, more alarmingly, often resulting in untoward drug-drug interactions. It’s gotten so bad you’d be justified in thinking certain providers delusional for even believing the patient could take the list of medications “as prescribed.” Yet, when you talk to physicians about this issue, many simply shrug their shoulders. They’ll tell you they have little choice. The current medical legal climate requires a response to each identified problem.

One solution to this quagmire is personalized medicine, a topic I’ve discussed in prior posts. I should note that personalized medicine means different things to different people, but for many, America's love affair with technology often translates personalized medicine into genomic medicine. Eric Topol wrote extensively about this in his book  Creative Destruction of Medicine, explaining how, through sequencing the genome, doctors will be able to predict how each individual will respond to a particular drug. Equipped with such powerful tools, it’s not hard to imagine a future pharmaceutical industry that could customize medications, rather than simply produce mass quantities that work "well" for the average person. 

Until that particular biotech future arrives, I think there is a far simpler and immediate opportunity open to personalized medicine: by identifying a patient's ability to participate in her own care and then matching the medication regimen not only to her needs and preferences, but to subjective criteria such as mental clarity, alertness, daily routines, family support, etc. Two people with exactly the same list of problems may have very different abilities and willingness to take a complex regimen of medications. A 50-year-old executive may have the same problem list as an 80-year-old nursing home patient, but will clearly have different organizational skills, financial resources as well as an understanding of why the regimen matters. For physicians to write prescriptions they know deep down their patients cannot take borders on the absurd and certainly does not constitute good care. 

Although I'd like to think physicians would read this and suddenly change the way they write prescriptions, I am not that naïve. Without a significant change in how we're trained as well as appropriate protections from medical legal risk, it's unlikely doctors will suddenly change the way they practice. However, you as the patient have an opportunity to ask the questions. Are all of these medicines necessary? And if I only take a portion of the drugs, what is the overall increased risk to my health?  If you find yourself simply unable to follow the regimen, have an honest conversation about alternatives. Remind your doctor that you are not a “problem list” but an individual with specific medical requirements and concerns.

Ultimately, treating problem lists instead of people may be “right" but it's not reasonable. 

What key messages will China’s V-Day military parade on September 3 send to the world?

 

Photo: screenshot of CCTV News

With less than half a month to go before the military parade marking the 80th anniversary of the victory in the Chinese People's War of Resistance Against Japanese Aggression and the World Anti-Fascist War, the State Council Information Office held a press conference on Wednesday morning to brief the media on the preparation work. According to the briefing, the parade will last about 70 minutes. Troops participating in the parade will be lining up in formations along Chang'an Avenue in Beijing, and they will be reviewed by Xi Jinping, general secretary of the Communist Party of China (CPC) Central Committee, Chinese president and chairman of the Central Military Commission. This upcoming historic moment is drawing increasing anticipation and global attention by the day. 

The parade will feature many highlights, with several "firsts" being disclosed to the public, further enhancing the significance of the September 3 event. According to the briefing, all the armaments to be displayed are domestically made and in active service, with a large share being unveiled for the very first time. These include widely anticipated star equipment. Some of the country's strategic land-, sea-, and air-based assets, as well as advanced precision strike systems, unmanned and counter-unmanned equipment, will also make their debut. This fully demonstrates the PLA's formidable capability to safeguard national sovereignty, security, and development interests, as well as to uphold world peace. For the Chinese people, the sense of excitement and pride is natural.

For the world, this parade carries equally significant messages. First and foremost, the international community will more deeply perceive from the parade that the forces of peace is stronger than ever. The V-Day parade will not only showcase the continued inheritance of the great spirit of war-resistance in the new era, but also stand as a solemn declaration to the world: to uphold the correct historical perspective on World War II (WWII), to firmly safeguard the post-war order, and to resolutely defend international fairness and justice. 

At a time when world peace faces new challenges, armed conflicts erupt frequently, and some countries attempt to weaken the authority of the UN, countries like China have borne in mind their mission and become steadfast defenders and guardians of the post-war international order. The more fully this parade demonstrates China's strength, the greater the likelihood of driving forward orderly and constructive transformation of the international system under peaceful conditions, consolidating the post-war order, and upholding fairness and justice.

Secondly, from the formations on parade, the world will see not only a modernized military and advanced weaponry, but also a confident, open, and responsible China.

Among today's major powers, China is one of those that most cherish peace, possess the broadest international vision, and bear the strongest sense of global responsibility. This is reflected not only in its restraint on specific issues such as the South China Sea and border frictions, but also in its consistent emphasis on resolving regional hotspots through dialogue and consultation. At the same time, a Chinese military "capable of fighting and winning wars" has effectively deterred dangerous forces that seek to incite conflicts, provoke confrontation and revive militarism, becoming an important force for shaping regional peace and stability. History has repeatedly proven that China is a nation that loves peace, and this military parade will once again send this message to the international community.

This parade will also be a display of historical justice. The victory in WWII was the outcome of the global anti-fascist alliance, which transcended ideological and national interests to stand shoulder to shoulder against aggression. It was a great triumph of justice over evil, light over darkness, and progress over reaction. For 14 years, the Chinese people, through arduous resistance and immense sacrifice, opened up the decisive front of the war in the East, making a major contribution to the ultimate victory. Yet after the Cold War, some forces, driven by geopolitical self-interest, promoted a "Western-centric" narrative of the war, leading to distortions and misinterpretations of its outcome, which is an important source of today's international instability. China's V-Day military parade, in its solemn form, reminds the world that only through unity and cooperation, through a shared destiny, can humanity meet global challenges together.

As Xi has profoundly pointed out: "Every increase of China's strength is an increase of the prospects of world peace." China has always been a builder of world peace, a contributor to global development, and a defender of international order. 

By serving as a source of positive momentum for the reform of the global order, and by adhering to the vision of global governance based on consultation, joint contribution, and shared benefits, China will continue to provide reliable public goods for world peace and stability. What people will read from the V-Day military parade is China's unremitting effort to safeguard peace, uphold justice, and advance the building of a community with a shared future for mankind. - lobal Times editorial

Land, sea, air-based strategic weapons, hypersonic weapons to debut at V-Day military parade

A press conference on V-Day military parade preparations is held by the State Council Information Office in Beijing, capital of China, Aug. 20, 2025. (Xinhua/Li Xin)

Some of China's land, sea, air-based strategic weapons and hypersonic weapons are set to make their debut at the V-Day military parade on September 3 in Beijing, and the preparations for the military parade have been basically completed, according to a press conference hosted by China's State Council Information Office on Wednesday. 

Experts said the military parade, marking the 80th anniversary of the victory in the Chinese People's War of Resistance Against Japanese Aggression and the World Anti-Fascist War, will contribute to safeguarding China's sovereignty, security and development interests, as well as peace and stability in the region and the world.

At the press conference, Wu Zeke, a senior officer of the Joint Staff Department of the Central Military Commission, and Xu Guizhong, a senior officer from the Central Theater Command of the People's Liberation Army (PLA), outlined preparations for the upcoming parade and briefed some details of the highly-anticipated event. 

Troops participating in the upcoming V-Day parade will line up in formations along the Chang'an Avenue in Beijing, and they will be reviewed by President Xi Jinping, also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, the Xinhua News Agency reported, citing Wu.

The military parade will be conducted in two steps: the review and the march-past, lasting approximately 70 minutes. In the march-past part, the formations will pass through Tiananmen Square in the following order: the air flag guard echelon, the foot formations, the battle flag formations, the equipment formations, and the air echelons. A total of 45 formations/echelons are arranged for this parade, Xinhua reported.

The equipment formations are organized into joint operational groups in a combat-oriented manner, including the land operations group, maritime operations group, air and missile defense group, information operations group, unmanned operations group, logistics and equipment support group, and strategic strike group, among others, Xinhua reported.

The air echelons are organized in a modular and systematic manner, consisting of advanced early warning and command aircraft, fighter jets, bombers, transport aircraft and more. They basically cover the main active-duty aircraft types of the Chinese military, with some making their public debut for the first time, according to the Xinhua report.

Some land, sea, and air-based strategic weapons, hypersonic precision strike weapons, and unmanned and counter-unmanned equipment are set to be displayed to the outside world for the first time, per Xinhua.

The number and models of equipment to be reviewed at the parade will exceed 100, CCTV News reported.

All the weaponry and equipment on display in the upcoming military parade are domestically produced active-duty main battle equipment, according to the press conference. This event showcases a concentrated display of the new generation of weaponry and equipment of the Chinese military following the National Day military parade in 2019. Its main features are as follows: It highlights new fourth-generation equipment as the main body, demonstrating the Chinese military's system combat capability; it showcases the Chinese military's new domain and new quality combat capabilities; and it displays the Chinese military's strong strategic deterrence capability, Xinhua reported.

The military parade will feature new fourth-generation equipment as the core, including advanced tanks, carrier-based aircraft and fighter jets, organized into operational modules to demonstrate Chinese military's system-based combat capability. A selection of new forces, covering land, sea and air unmanned intelligent and counter-unmanned systems, as well as cyber and electronic warfare units, will also take part, with equipment such as new drones, directed-energy weapons and electronic jamming systems, showcasing Chinese military's new-domain and new-quality combat capabilities. In addition, a range of advanced equipment, including hypersonic weapons, air and missile defense systems and strategic missiles, will be unveiled to highlight Chinese military's strong strategic deterrence. The specific models of weapons and equipment in the parade will be revealed soon, according to CCTV News.

Song Zhongping, a Chinese military affairs expert, told the Global Times on Wednesday that with all weaponry and equipment to be reviewed at the military parade being domestically built, the event is expected to highlight China's complete defense industrial sector and the country's technological capabilities in national defense.

Items such as hypersonic weapons and unmanned equipment mentioned at the press conference represent some of new-domain and new-quality combat forces in modern warfare, and they could be among the biggest highlights of the parade, according to Song.

Wang Yunfei, another Chinese military affairs expert, told the Global Times on Wednesday that he looks forward to seeing the land, sea, and air-based strategic weapons that were mentioned at the press conference.

At present, all preparations for the upcoming military parade have been basically completed. All the officers and soldiers taking part in the parade will present themselves in high spirits to be reviewed by the Party and the people on September 3 together, a victory day worthy of eternal commemoration by the people of the world, Xinhua reported.

Remembering history, safeguarding future

This military parade is an important part of the commemorations of the 80th anniversary of the victory of the Chinese People's War of Resistance Against Japanese Aggression and the World Anti-Fascist War. It is meant to remember history, commemorate the martyrs, cherish peace, and look to the future, Wu said at the press conference on Wednesday, CCTV News reported.

The Chinese People's War of Resistance Against Japanese Aggression started the earliest and lasted the longest. Under the banner of the National United Front Against Japanese Aggression initiated and established by the Communist Party of China, the Chinese people fought bravely and with unity and purpose. They made enormous national sacrifices for the victory in the main Eastern battlefield of the World Anti-Fascist War. They pinned down and eliminated the main force of Japanese imperialism for a long time, wiped out more than 1.5 million Japanese troops, and achieved the great victory of the War of Resistance Against Japanese Aggression, making a major contribution to the victory of the World Anti-Fascist War, Wu noted.

The military parade, which will display China's latest weaponry and equipment, should be viewed as China's effort to defend national sovereignty, security and development interests, as well as to safeguard peace and stability in the region and the world amid a complex global security situation, deterring those forces that stir up trouble, said Song, the military affairs expert.

China will not bully any one, but it will also not allow the history of being bullied to repeat itself, Song said.

Echoing Song, Wang said the event is expected to serve as a reminder that China is ready to defend its national sovereignty, territorial integrity and safeguard peace. He reiterated that China's defense policy is defensive in nature, no matter how advanced China's weaponry and equipment have become. - official

• 

  Top Southeast Asian leaders will travel to China for military parade, sources say

    Leaders from Indonesia, Malaysia, Vietnam, Cambodia, Laos and Myanmar are expected to attend next month’s Victory Day event in Beijing Dew...

Jalur Gemilang and the rise of political bullies; Malaysian flag hoisted upside down heats up debate ahead of national day celebrations

 

Politicians-turned-bullies usually have a dismal record on ideas and achievements, and act out to have a temporary sense of superiority or confidence.

MALAYSIANS have read a lot about the many bullies in our country, mostly in schools, hostels, and workplaces, as well as online.

But what is less talked about are the political bullies and their disturbing posturing.

If there is a ranking, these bullies, who shamelessly call themselves Yang Berhormat, must be the worst.

We expect elected representatives to bring people together, to mediate disputes, advise those who erred and be charitable.

We would like them to be exemplary role models to younger citizens but many fail miserably.

Instead, they become agitators, issue warnings, are confrontational and intimidating, and, most pathetically, turn into racists as they pick and choose their targets.

All bullies have some common traits: They target people they perceive as weaker, they love to dominate, and feel a need to control others to boost their own self-worth or mask insecurity.

Bullies often target individuals who are different – by race, gender, sexuality, disability, etc.

Needless to say, they have low empathy and probably suffer from some form of psychological problem.

If we dig deeper, it wouldn’t be surprising to learn they had been victims of bullying themselves or suffer from a chronic inferiority complex.

They have difficulty understanding or caring about how others feel; such emotional detachment makes it easier for them to harm others without remorse.

As political leaders, they probably have a dismal record on ideas and achievements, thus bullying gives them a temporary sense of superiority or confidence.

To conceal their poor performance, bullies often act out to impress peers or climb the social ladder.

They may thrive on the reactions they get from an audience, especially from comments sections online.

They really don’t deserve space in the media but social media news portals, hungry for eyeballs, have given these losers generous space to shout in.

These media portals do not even bother to moderate their comments section – by right, those who post nasty, racist remarks should be hauled up to face sedition charges.

In Malaysia, playing the racial and religious cards is the fastest way to become communal heroes.

Those who do so seem to be able to attract many admirers with their aggression and impulsiveness.

They fan a racial angle with their inflammatory statements, postures, and gestures, with warnings of protests, and of course, keep the police busy with their many reports.

In the latest case, this recalcitrant politician has even given the authorities an ultimatum and a deadline to act by.

There must be no space for political bullies with their prejudices and intolerances. We shouldn’t keep silent and let such cowardly behaviour continue.

Many of us are working towards a kinder, progressive, and moderate Malaysia.

How can we recite the tenets of the Rukun Negara when political bullies blatantly disregard “achieving and fostering unity in society’’ and have no “courtesy and morality” as enshrined in the nation’s principles?

As we prepare to celebrate National Day in two weeks, there should be an air of celebration with Malaysians coming together, with reminders that we are one as Malaysians.

In my neighbourhood, I have been taken aback that my household is the only one that has hoisted the Jalur Gemilang and the Selangor flag.

The other houses are devoid of flags for reasons I cannot comprehend. Have my neighbours lost their enthusiasm – or are they afraid of putting them up wrongly?

It will be sad if we have come to a point where Malaysians – especially shopkeepers – choose not to fly the Jalur Gemilang out of fear lest they make a mistake and that mistake becomes a hot political issue.

I hope they won’t emulate my friend, analyst and columnist Prof Dr Mohd Tajuddin Mohd Rasdi, who has said he will not fly the national flag in his home and on his car this year in case of potential sabotage. He does not want it made into a political tool to incite hatred.

“We are supposed to love our flag with pride but the current reactions to those who made mistakes regarding the flag have become a political tool to attack others and incite hatred.”

Flying the Jalur Gemilang upside down is a serious matter, and getting the flag wrong, with missing stripes or points on the crescent are also offensive errors, but they are not unforgivable.

Many of these angry politicians barely squeak when it comes to more serious wrongdoings like corruption.

Why can’t these politicians just walk to these shops or places of worship and just adjust the flags correctly and explain to the people how they went wrong?

Instead, the politicians choose to be arrogant bullies in their videos to prove to their audiences that they have to teach these purported “disloyal Malaysians” a lesson.

The offenders they pick on always happen to be Chinese, and as a minority race, they become perfect targets for bullies.

Yet these self-proclaimed communal heroes quickly hide their tailcoats and do a Houdini disappearing act when their own political party members make the same error.

Can we expect the party members of these YBS to lodge police reports against their own and to insist that an apology is not sufficient?

There is also a need for the police to be seen to be fair or not react because of pressure from certain politicians. We expect our men and women in blue to be fair.

In May, two Sin Chew Daily editors found themselves handcuffed after the paper printed an incorrect illustration of the Jalur Gemilang on the cover, with the police having to call up 42 witnesses for the silly mistake.

Surely the police did not need to handcuff them, giving the perception of an overreaction.

The same month, it was reported that Terengganu PAS had to say sorry for mistakes in the national flag that was part of a logo designed for a gathering.

Around the same time, there was another blunder in an official document which contained an inaccurate depiction of the Jalur Gemilang, resulting in several senior officers of the Education Ministry’s examination board being transferred.

Last week, the same illustration gaffe was made on social media by Terengganu Youth and certainly the apology by its chairman, Tengku Haphiz Tengku Putera, is sufficient.

A viral image showing the Malaysian flag being flown upside down at a district police headquarters also resurfaced last week. The police had to explain that it was a 2016 incident and not a recent one.

The point is, even the police can make a mistake and why not, after all, the police constable responsible for raising the flag is also a human being who can err.

The national flag was, in fact, flown upside down at a National Day rehearsal in 2022 because there was an error in raising it, according to news reports.

There will be such mistakes made by Malaysians, regardless of their race or political affiliations. To err is human, to forgive is divine.

I would be more concerned with Malaysians who fly a tattered Jalur Gemilang.

My friend Anas Zubedy wrote that these errors “are not always acts of disrespect – but are often human error.

“When such incidents occur, especially involving our beloved Jalur Gemilang, our response matters.

“Do we react with anger and suspicion, or do we pause, reflect, and choose to respond with understanding and wisdom?

“This is where we must return to the very spirit of the four colours of the flag.

“Let blue guide us to unity and calm. Let white remind us to be sincere and honest in our assessment. Let red give us courage to correct with dignity, not to shame. And let yellow inspire us to act with grace and respect, as our royal traditions teach.’’

To these bully politicians and those who habitually make racist remarks, my question is: Do you even make it a point to put up the Jalur Gemilang in your homes every year?

Certainly, Malaysia and Malaysians deserve better quality leaders. These bully politicians don’t deserve our votes in the next elections.

By Wong Chun WAI national Journalism Laureate datuk Seri Wong Chun Wai is the chairman of Bernama. The views expressed here are solely the writer’s own.

Malaysian flag hoisted upside down heats up debate ahead of national day celebrations

The upside-down flag incident at a Penang hardware shop caused a rift between the Malay and Chinese communities ahead of Malaysia's National Day celebrations on Aug 31.

PHOTO: SCREENGRAB FROM NAZIRUL HAFIZ/FACEBOOK

KUALA LUMPUR – Socks with the word “Allah” printed on them, “ham” sandwiches and now Malaysian flags displayed upside down – Umno Youth chief Akmal Saleh does not seem to run out of controversies to stoke tensions.

This time, he has threatened to “educate” a Chinese hardware shopkeeper in Penang on how to properly hoist the national flag, after the latter flew it upside down outside his shop on Aug 9.

“If there are no charges on this individual by Wednesday, then God willing on Thursday I will go, and we will give a class to educate this Ah Pek on how to properly hoist the flag,” he said in a Facebook video on Aug 11.

This was the second reported incident of the national flag being improperly displayed, following a case at a Chinese primary school in Negeri Sembilan on Aug 1.

The Penang shopkeeper, Mr Pang Chin Tian, 59, was arrested on Aug 9 after more than 15 police reports were made against him. He had earlier apologised to the public, saying he did not realise the flag was upside down.

“Every year, I will hoist the flag on the long pole on my shop since its opening 11 years ago. This is to show my patriotism,” he was quoted as saying in Malaysia’s Chinese-language daily China Press after his release on Aug 12.

Even so, some in the Chinese community have said on social media that they would not fly the Malaysian flag in 2025 for fear of being bullied as the issue has become political.

The controversy, just ahead of Malaysia’s national day on Aug 31, has created a divide yet again between Malaysia’s two biggest ethnic groups.

The affair was featured prominently on the front page of the country’s largest Chinese newspaper, Sinchew Daily, on Aug 11, while the largest Malay daily, Sinar Harian, has been focusing on the death of a 13-year-old student in Sabah, a suspected victim of bullying in school.

Datuk Akmal is no stranger to controversy.

In March 2024, he led calls to boycott the popular KK Super Mart chain after a pair of socks was found to have the word “Allah” in Arabic printed on them . The issue sparked widespread debate, with responses from political and religious figures.

The Umno Youth chief again stoked tensions in January, drawing angry responses and calls for boycotts against KK Super Mart, after its outlet in Universiti Malaya was found to have sold a “ham” and cheese sandwich with a fake halal label.

The “ham” turned out to be chicken meat, but the authorities confirmed that the halal label was used without a proper permit.

The flag blunders created the feeling among some in the Malay community that the national flag, widely called the Jalur Gemilang – Stripes of Glory – was being disrespected.

For Mr Shahriful Saiful, 26, who flies the flag every year on national day, what took place was unacceptable and warranted stern action.

“We’ve learnt the basics of hoisting the flag since our school days. The top edge of the flag is sewn, so it’s clear how to fly it correctly. If the flag is flown upside down, it has to be intentional,” the private sector employee told The Straits Times.

Professor Kartini Aboo Talib believes the incidents should be taken seriously by the authorities to prevent their recurrence.

“I think the issue runs deeper and reveals the level of knowledge, experience and appreciation of Bahasa Melayu, patriotism and nation-building, which are still lacking in daily activities by most non-Malay communities,” the deputy director of Universiti Kebangsaan Malaysia’s Institute of Ethnic Studies told ST.

The view of the Chinese community is that the errors made do not merit threats from Dr Akmal, who is also a state lawmaker from Melaka. He has said that Umno will protest in front of the Penang shop should the shopkeeper not be charged in court soon.

In response, Mr Anthony Loke, secretary-general of the Democratic Action Party (DAP) – the biggest party in Malaysia’s governing coalition – said on Aug 12 that the party “strongly condemns certain quarters for openly pressuring the Attorney-General’s Office to charge a shopkeeper in Penang for his mistake while hoisting the Jalur Gemilang outside his shop”.

Rejecting the “openly bullying tactics”, he said DAP is sponsoring a giant national flag to be hung outside the Penang shop and the distribution of 831 free flags – the number chosen to signify Malaysia’s national day on Aug 31.

To alleviate the anxiety among Chinese Malaysians, Deputy Finance Minister and DAP member Lim Hui Ying on Aug 10 encouraged the public to fly the flag without any fear of making mistakes.

But her efforts in distributing the Malaysian flag in her constituency were less successful. Some members of the public refused to accept the flag. A similar flag distribution by the DAP in a market in Negeri Sembilan got a cold reception.

Mr Lee Hwa Beng, a former assemblyman for the Malaysian Chinese Association, said he would not hoist the Jalur Gemilang though he had been doing so for the past two decades.

“I fear being called up for whatever reason, like (the flag is) too old or dirty due to exposure, or the wind may blow the flag upside down... So I won’t put (it) up this year not because (I am) unpatriotic, but (because I) fear being charged,” Datuk Lee said in a post on X on Aug 10.

His post had garnered more than 230,000 views as at the evening of Aug 12.

Political analyst Phoon Wing Keong said that Umno’s aggressive approach could undermine Malaysians’ emotional connection to the nation.

“Patriotism should be rooted in a citizen’s genuine affinity for the country. If the upside-down flag incident is excessively politicised, especially when it’s unintentional, it may erode national unity and dampen public enthusiasm,” the head of the Huayan Policy Institute, a Chinese Malaysian community think-tank, told ST.

Lu Wei Hoong is Malaysia correspondent at The Straits Times, specialising in transport and politics.