Gua Musang Measles Outbreak Red Herring, Doctors’ Group Says

FPMPAM says other causes of death in Kuala Koh must be investigated too.

KUALA LUMPUR, June 21 — The measles outbreak announced by health authorities in Kuala Koh may distract from examining other factors behind the deaths of 15 Orang Asli, a doctors’ group said.

Dr Steven Chow — president of the Federation of Private Medical Practitioners Association of Malaysia (FPMPAM) that runs a “Drs for All” programme to provide medical services for the Orang Asli — pointed out that the first two confirmed deaths in the Bateq tribe involved adults whom authorities claimed had succumbed to lobar pneumonia.

“The usual presentation of measles affecting the lungs is interstitial pneumonia and not lobar pneumonia,” Dr Chow said in a statement.

“I believe this measles outbreak is a red herring. Other causes of death must be looked into as well,” he added. “Concomitant infections are also a possibility, and so also is the important pre-determinants like malnutrition and possible chronic toxic degradation of their living environment, water and compromised food supply.”

He added that although this was the first documented measles outbreak in Kampung Kuala Koh in Gua Musang, Kelantan, it did not mean that the extremely contagious disease did not happen there before.

“The index case could have been anyone. A full clinical-epidemiological study of each and everyone in the village could provide the answer.”

Dr Chow said health authorities should also be looking for fungal pneumonia and fungal septicaemia, noting that his medical team had observed an unusually high incidence of fungal skin infections and evidence of decreased immunity during their visit to Kuala Koh last April 28.

A measles outbreak is suspected of killing 15 people from the Bateq tribe in Kuala Koh after 43 measles cases were detected in the Orang Asli village as of yesterday.

Among the 15 Orang Asli deaths, health authorities confirmed that a severely malnourished toddler died from measles, while two adults died from pneumonia. A total of 113 people, or 61 per cent out of 185 residents in Kuala Koh, have reported respiratory-related illness as of June 18.

The Malaysian Medical Association (MMA) expressed concern with reports that state health department nurses did not treat Bateq people with respect.

The doctors’ group said such incidents would further isolate the Orang Asli from government departments entrusted to care for their health.

“Such attitudes and unprofessionalism is unacceptable. We urge the Ministry of Health to investigate these incidents,” MMA president Dr Mohamed Namazie Ibrahim said in a statement today.

New Straits Times reported Health Minister Dzulkefly Ahmad as saying yesterday that his ministry would investigate allegations by a Tok Batin, as reported by the paper, that nurses from the Kelantan State Health Department “made faces and heckled” Bateq people during their health visits. Pos Aring 5 Tok Batin Raina Anjang reportedly said the Bateq tribe was treated “only slightly better than animals”.

MMA also called for more regular visits by the state health departments to check Orang Asli’s health status, besides implementing more structured vaccination programmes in Gua Musang.

MMA, citing a news report, noted that the Orang Asli were forced to go into farming after the Kelantan state government under PAS sold 10,000ha of forested land around the village in 2009 to oil palm plantations, leaving settlements like Kuala Koh with only about 8ha of land for its 300 residents.

The Orang Asli had traditionally relied on hunting and gathering in the forest for their food source.

The Bateq people reportedly complained that loggers and farmers destroyed their land and crops, causing many of them to eat less and suffer from poor nutrition.

“This is worrying as poor nutrition can lead to lower resistance to illnesses.”

MMA also noted that Kuala Koh had no running water and that Sungai Balai flowed through a catchment area used for logging, 1,000ha of oil palm plantation, and an active manganese mine.

“Consistent monitoring must be done to ensure that rivers that flow through areas there are not exposed to contamination from chemicals, insecticides and pesticides from any commercial agricultural activities there.

“We hope the authorities will carry out an extensive assessment of the areas around these Orang Asli villages,” said Dr Namazie.

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