Tea Bags In Hot Water — A Medical Officer

The ICU is always full even in normal times; Covid-19 has forced the postponement of cancer patients’ surgeries and other patients’ regular follow-ups.

Dear Malaysians,

Like tea bags in hot water, the country’s health care system is being put to the test. Kudos to those who are abiding by the Movement Control Order (MCO). But truth be told, I do not think things are standing the test very well.

We all thought we are containing it, “we have got it” we said, when the first wave of the virus swept over. Recoveries, discharges were reported as gospel truths.

Then things took a dark turn, much worse when a tabligh gathering happened and like wildfire, it spread across the globe. Cases multiplied by tenfold in ten days. If we cannot build hospitals faster, we may have to build cemeteries faster soon.

The current health care system that we have, rated as one of the best in the world in terms of its affordability and accessibility, is hardly able to stand the test. In peacetime, on average, a medical ward in the general hospitals with an occupancy rate of 120 per cent is considered “acceptable”.

Anyone who visits the general wards would be able to tell tales of horror. Bed-to-bed, sometimes you cannot even push the blood-taking trolley through.

How is that even a safe distance to prevent contamination or spread of disease from patient to patient? Let alone any privacy for history, examination, procedures.

The Intensive Care Unit is always full, and that is not even an exaggeration; there are always “no beds available”.

Patients on regular days that require ventilators, inotropes are manually bagged by staff nurse in general wards; critical care patients are cared for by overworked staff nurses. Doctors in general wards are not trained for intensive care.

Remember some time ago, a nurse was reported using her phone while bagging the patient? She had no choice, she is not meant to bag the patient in the first place. Blame the system, not the individuals. The limiting factor is the system incapability.

Are we not compromising the patient safety by ignoring these issues? There is little, if any, political will in changing the situation. It gives them little reward to do anything of such.

After all, it is not the powerful who needs these; it is the voiceless, the powerless who needs the most basic things in the general public hospital.

Remember the ICU that burnt down four years ago with six patients killed? Until today, it remained the same, it remained burnt, untouched, just sealed and hidden.

Four years is a long time of inaction. Promises of new hospitals, better safety measures were just empty promises. Pacify the families of the victim, that is all.

The root cause, the system failure is left untouched. Fire alarms still beeping every few minutes, reminding that the battery is to be changed in many hospitals, and symbolically, the system that needs to be changed.

The patients did not die from the fire; the patients died from the ignorance of the authority. “If it ain’t broke, don’t fix it,” they say.

Many have died and many more will die because of this blissful ignorance.

Each visit of the VIP to the general wards is always sugar-coated. “Hurry, put the alcohol hand wash on every bedside,” the ward staff says, when an important person is about to come.

Who is the important person? Is it not the very uncle or aunty lying in bed awaiting treatment from you?

Why the showmanship when the YB enters, knowing full well the YB will never require what your service or ward provides?

When the important people’s relatives or friends require admission, they could very well afford first class or private institutions. Something is seriously wrong with this country.

“The true measure of any society can be found in how it treats its most vulnerable members.”

Gandhi

And now, ICUs are closed, hospitals are evacuated to make ways for the ever-increasing number of Covid patients.

Many other patients who warrant a surgery (bearing in mind some are cancer patients who needed their tumours removed) have to have their surgeries postponed. More still patients who need their regular check-ups and follow-ups are not getting their fair share of treatment because of the current issue.

Why? Because we have always over-listed the number of appointments, surgeries, and admissions on regular days.

Imagine if your father has cancer and requires intensive care unit backup, but must have the operation postponed because of the pandemic, how would you feel? What was resectable back then, could be unresectable later, and who is to be blamed for it?

And the staff, the staff nurses, pharmacists, doctors. Read about the contract issues and how the government had, in this time, sent out love letters, saying that the last two-year contract is given, and no further contracts will be given.

“After this, you are not our responsibility anymore,” we read that in between the lines of the letter from our dear Ministry of Health, while the young doctors, wearing their multilayered protection under the hot sun, swab the nose and throat of the suspected public and many others, bearing the risk of contact with patients who are dishonest about their history of Covid-19 contacts.

Not just the doctors, the staff nurses, the medical assistants, even cleaners, continue to work despite the MCO, and will have to work even harder later, given the backlog and postponement of cases. We need a revamp.

God knows why these naïve junior doctors still stay and serve. In fact, many have left and many of those who can leave, will leave.

Our country has just been taking things for granted far too long. Ministers fighting over non-essential matters too long, politicians fighting for their own power rather than the country’s good.

Mere distractions that delay solutions. They do not feel the pain, as they are not the ones seeing their patients, loved ones, die one by one, not because of the incapability of doctors or nurses, but the lack of the rightful basic resources deserved.

We see patients dying every day and we feel helpless because there is really nothing more we could offer.

I hope that even when we get through this, the ministry will seriously investigate the issues of overwork, overload and resource limitations, and not just get by the day and receive their salaries in office.

“We are not to simply bandage the wounds of victims beneath the wheels of injustice, we are to drive a spoke into the wheel itself.”

Dietrich Bonhoeffer

At the very least, stay home, dear Malaysians. That is already doing a great favour to your neighbours for now.

Yours sincerely,
A Medical Officer from a Malaysian public hospital who sees patients dying every day

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue. CodeBlue is publishing this anonymous letter because of a government ruling that prohibits civil servants from speaking to the press.

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