Orang Asli Open Own Medical Post As Public Clinic Inaccessible

The Pos Lenjang government clinic lacks medicines and the doctor isn’t always there, Orang Asli complain.

KUALA LIPIS, Oct 1 — Arman Busu takes an hour and a half to travel a 7km track by motorbike from his home in Kampung Chang, an Orang Asli village in the jungles of Kuala Lipis, Pahang, to the nearest public clinic.

So the 50-year-old Semai was ecstatic when the Federation of Private Medical Practitioners’ Associations Malaysia (FPMPAM) opened Malaysia’s first Orang Asli Medical Post in Kampung Dayok that is nearer to him than Klinik Desa Pos Lenjang.

Arman said even though staff from the Ministry of Health (MOH) clinic visit villages here every week, sometimes the Semai people are out in the fields planting red paddy, corn, or pepper, or gathering food from the forest like pucuk ubi, pucuk bayam, and bamboo shoots, toiling from 7am to 6pm every day. Even if the indigenous people are informed earlier about the medical visits, they will still prioritise working in the fields.

“If we don’t have food and the Ministry comes, food is number one, medicine is number two,” Arman told CodeBlue at the opening ceremony of the Orang Asli Medical Post in Kampung Dayok, Pos Lenjang, last Sunday, where FPMPAM’s DRSforALL team ran a busy clinic that saw over 200 patients from surrounding villages.

Arman said the Orang Asli Medical Post in Kampung Dayok — which will be run 24/7 by Semai youths trained by FPMPAM in first responder aid for medical emergencies — was about 5km from his home, accessible via motorbike on a road that were dug up by residents themselves from his village and Kampung Kenderong.

The DRSforALL physicians, aided by the newly-trained Orang Asli Medical Team, treated mostly children and females at the Medical Post’s first clinic last Sunday for cough and cold, skin infections, diarrhoea, and head lice, among others. Pos Lenjang was previously struck with a malaria outbreak in two villages here last July, the first in the area since 2011.

Arman was waiting for the afternoon crowd to ease before registering in hopes of collecting pain relief, diarrhoea and cough medicines, not for immediate consumption, but to save for an “emergency” because of the distance of the government clinic.

“Malaysia is developed, but our people are not developed,” he said.

“Malays, Chinese and Indians eat easy outside; we want to eat like them too.”

Arman Busu, Orang Asli from Pos Lenjang, Kuala Lipis, Pahang
An Orang Asli Medical Post volunteer shows a patient how to bend her back for examination by a DRSforALL physician at the Orang Asli Medical Post’s first clinic in Kampung Dayok in Pos Lenjang in Kuala Lipis, Pahang, on September 29 2019. Picture by Boo Su-Lyn.

FPMPAM president Dr Steven Chow said his association’s DRsforALL programme has trained 22 Orang Asli from Kampung Dayok and surrounding villages in their late teens and 20s in first responder treatment and basic first aid, four of whom have been sent to Kuala Lumpur to be attached to St John Ambulance of Malaysia’s ambulance service, Dr Chow’s and another clinic for two weeks.

First responder treatment covers situations like physical injuries, chest pain, drowning, choking, a child suffering from fever, fits, vomiting or diarrhoea, or how to give a child oxygen.

The Semai young adults have also been trained on telemedicine so that the Orang Asli Medical Post can consult FPMPAM on the phone in Pos Lenjang, which is 30 minutes away by motorbike, as that village has a phone line unlike Kampung Dayok. When Kampung Dayok finally gets network connectivity, FPMPAM will stock the Medical Post with essential medicines like antibiotics, pain relief, and drugs for fever and asthma.

As Kampung Dayok lacks electricity, the Orang Asli Medical Post runs on solar power, with its solar panels and batteries set up by teenagers volunteering with DRSforALL.

“This will be a beacon of light and hope in the jungle,” Dr Chow told CodeBlue in an interview.

“The Federation will still be coming here every month, so they’ll always be in touch with us. We’ll keep training them on telemedicine with mock medicines. Eventually, they won’t need us.”

FPMPAM will also give the Orang Asli Medical Post volunteers a community fund to cover their traveling expenses, with the team organised into a society structure comprising a leader, deputy leader, secretary, and treasurer. FPMPAM’s budget this year for setting up the Medical Post is about RM100,000.

“It’s community empowerment,” Dr Chow said.

Orang Asli Medical Post volunteers record patients’ weight and height at the Orang Asli Medical Post’s first clinic in Kampung Dayok in Pos Lenjang in Kuala Lipis, Pahang, on September 29 2019. Picture by Boo Su-Lyn.

Bekraheed from Kampung Kenderong, who housed the FPMPAM team in bamboo huts during their mission, said more than 3,000 Semai people live here in Pos Lenjang (11 villages) and Pos Titom (five villages), comprising Christians, Bahai, and Muslims.

The Klinik Desa Pos Lenjang only has one four-wheel-drive. So if it’s stuck in the better equipped Klinik Kesihatan Pos Betau along Jalan Ringlet-Sungai Koyan that is about an hour away from Kampung Dayok, the entry point into the whole area, then there are no vehicles to ferry patients during an emergency. According to Dr Chow, traversing the logging route’s difficult and stony terrain through the jungle can even take three hours if road conditions are bad.

“The clinic always lacks medicines,” Bekraheed told CodeBlue, referring to the Pos Lenjang facility. “Sometimes, they only have Panadol.”

The 46-year-old claimed that the medical assistant was not at the Klinik Desa Pos Lenjang every day, which meant that antibiotics were not available. Neither can serious wounds be treated there. The public clinic sometimes offered Bexraheed RM100 to transport villagers to the Pos Betau facility.

“Sometimes I was paid for the petrol, sometimes I wasn’t.”

Besides lacking electricity and a phone line, the villages also lack piped water, forcing the Semai people to buy their own pipes to source water from the river. One Kampung Dayok villager, Bahsingin Datok, told CodeBlue he spent over RM1,000 to buy four rolls of rubber pipe, equivalent to 10 months’ wages. There are some months when he can’t sell any farm produce.

Bekraheed urged the government to build proper roads into the Orang Asli villages to ensure better health and education access. A “roti canai” road of poor quality to Pos Betau, he said, was constructed in 2011, but fell into disuse in 2017.

According to him, the Semai people even used to push patients on raft across Sungai Jelai during floods to Kampung Dayok, with a bridge only constructed a few months ago.

“Houses are not as important as roads, electricity, communications networks, and clean water.”

Bekraheed, Orang Asli from Pos Lenjang, Kuala Lipis, Pahang
Orang Asli Medical Post volunteers help a DRSforALL physician dispense medicine at the Orang Asli Medical Post’s first clinic in Kampung Dayok in Pos Lenjang in Kuala Lipis, Pahang, on September 29 2019. Picture by Boo Su-Lyn.

Reaching Those Left Behind

Deputy Health Minister Dr Lee Boon Chye, who officiated the opening of the Orang Asli Medical Post, acknowledged that MOH could not reach certain areas.

“Even though Malaysia is considered advanced in health care; we spend 4 per cent of our GDP on health, but some are left behind,” Dr Lee said in his speech.

When asked at a press conference when the government would build a road in Pos Lenjang and provide the Orang Asli access to piped water, electricity, and telecommunications, Dr Lee said he could not specify a timeline because those matters were beyond the purview of his ministry.

“We’ll convey the message to Jakoa,” he said, referring to the Orang Asli Development Department.

When asked about the Klinik Desa Pos Lenjang medical assistant’s occasional absence and patients’ transport difficulties owing to the clinic only having one vehicle, Dr Lee simply said: “We’ll look into the issue.”

Dr Chow urged the government to provide wireless access to the villages here as soon as possible to enable DRSforALL’s teleconsultation service to Pos Lenjang and Pos Titom.

“This should be a priority as it will greatly improve accessibility to medical care for the people in these remote areas,” he said.

The partners of the FPMPAM-DRSforALL initiative are MOH, Hospital Orang Asli, Raleigh KL, Center for Orang Asli Concern, St. John Ambulance Pahang, Raleigh KL (International), Impian Malaysia, the Malaysian Relief Agency, Bulan Sabit Merah Kedah, UKM Medical Alumni 85/86, Malaysian Medical Students & Alumni of Victoria (MAMSA), Selangor & Wilayah Family Reproductive Health Association (SWTFREHA), Nanyang Press Foundation, Big Pharmacy, Addiction Medicine Association Malaysia (AMAM), Private Medical Practitioners’ Association Selangor/Kuala Lumpur (PMPASKL), and Private Medical Practitioners Society Pahang.

Patients queue up at the Orang Asli Medical Post’s first clinic in Kampung Dayok in Pos Lenjang in Kuala Lipis, Pahang, on September 29 2019. Picture by Boo Su-Lyn.

Rozita Ramli, one of the four Orang Asli Medical Post volunteers sent to Kuala Lumpur for further training, expressed happiness with the launch of the community’s first facility for emergency aid.

“They’re running the medical post near Pos Dayok, which is near the villages that are far away from Pos Lenjang, so the Dayok people can get help like medicines,” the 27-year-old woman told CodeBlue, after interpreting for patients at the Sunday clinic who can only speak the Semai language.

“I want to learn more and more and more,” Rozita said. “I’m excited.”

Bekraheed said he had arranged for two four-wheel-drives to transport the Semai people to the Orang Asli Medical Post’s Sunday clinic that saw a stream of patients from 9am to 4pm, interrupted only by the opening ceremony when the deputy health minister arrived.

“Who says the Orang Asli don’t want medicines?”

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