Private Clinics Shutter, Health Workers Recycle And Tailor Protective Gear Amid Shortages

By CodeBlue | 23 March 2020

A government doctor says some housemen were told to make their own personal protective equipment (PPE).

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KUALA LUMPUR, March 23 — Private and public health care workers have complained about a serious shortage of face masks, forcing the closure of some private clinics and driving others to recycle or make their own personal protective equipment (PPE).

The Malaysian Medical Association (MMA) said health care professionals in the private sector — general practitioners, specialists, dental surgeons, nurses, pharmacists, radiographers — are all exposed to possible Covid-19 infection.

“The Ministry of Health which is already overwhelmed, is also helping in sourcing this item — a job that should be top priority now and handled by the Domestic Trade and Consumer Affairs Ministry given its urgency. What has this ministry been doing to address this issue?” MMA president Dr N. Ganabaskaran said in a statement.

“Some doctors have gone to the extent of recycling their masks while seeing patients and some had chosen to close their clinics because there are no face masks and hand sanitisers to protect themselves and their patients,” he added.

“MMA wishes to reiterate that combating Covid-19 is a collective responsibility and not solely the responsibility of our Health Ministry.”

A government doctor also told a CodeBlue survey that she and her colleagues working in the frontlines handling possible severe acute respiratory infection cases were not given full PPE, just a surgical mask with a blue gown and gloves. Only when Covid-19 cases were confirmed in her public university hospital were their PPE upgraded slightly with N95 masks.

But she said this still lacked a complete PPE.

“Feels like our protection is not important for those leading the hospital. Even some of my housemen said they were instructed to perform screening and told to make their own PPE,” the medical officer in the medical department said on condition of anonymity.

“One of my colleagues had to escort a Covid-positive patient to HKL (Hospital Kuala Lumpur) without wearing a full PPE.”

Medical officer in the medical department at a public university hospital

She called for additional equipment to manage the coronavirus outbreak, like face shields, goggles, N95 masks, and head and boot covers.

Unverified videos have also gone viral on social media of government health care workers tailoring their own PPE in Lahad Datu, Sabah, and creating personal plastic covers. Channel News Asia reported that government health care workers at a Kelantan hospital have turned garbage bags into protective suits.

Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM) said since the end of January, the private sector has been unable to obtain further supplies of the masks that were imported into Malaysia by the two regular suppliers.

“Similarly, we believe that out of four local manufacturers, the production of masks by the biggest two manufacturers were not designated for sale and distribution to the private sector.

“So what is left for the private clinics and their patients?” FPMPAM president Dr Steven Chow said in a statement.

He noted that the previous ceiling price of 80 sen per piece for face masks had deterred local manufacturers from selling their products in Malaysia as the cost price exceeded the previous ceiling price.

Local manufacturers had faced purported difficulties in securing raw materials from China, especially the filter layer for the three-ply surgical masks, forcing them to source from Europe at a much higher price.

Dr Chow pointed out that some pharmacies and at least once clinic have been fined between RM10,000 and RM15,000 for selling face masks at RM1 each, just 20 sen above the previous ceiling price.

After the government banned the export of face masks on March 20 and raised the ceiling price for three-ply face masks to RM2 per piece, Dr Chow said this might give temporary relief for private sector demand, but only if there were available supplies.

“Of course, this will further change as the cost of raw materials will keep on going up in view of the current worldwide shortage,” FPMPAM said.

“As at press time, our doctors have confirmed that they are still not able to obtain any ready stock of masks from local suppliers.”

Dr G. Shanmuganathan, a private GP working in the central business district of Kuala Lumpur, said he has often come into close contact with patients to examine throats, nose and chest for those presenting with upper respiratory symptoms.

He said some “paranoid” Malaysian patients wanted PCR tests for coronavirus despite not fulfilling the criteria for them.

“The foreign worker patients were a mix of college students and various sector employees, many of whom had just come to the country. They had poor knowledge of hygiene and history-taking was a challenge, as was explaining the treatment after that. When I scanned their foreheads for fever, they would remark, ‘Is my corona scan ok?’

“So I was now dealing with ignorant patients who would cough right in your face and would smear their nasal secretions on their shirts or pants,” said Dr Shanmuganathan.

When the national partial lockdown came into effect on March 18, he said he realised that with the lack of face masks, patient ignorance of the Covid-19 pandemic, and “ever-changing information on protocols to manage Covid-19”, he was endangering his staff, himself, and his family if he continued operating. So he closed his clinic on March 19.

“I told my staff that I would re-open the clinic if I had the Personal Protection Equipment.

“I saw an email from [the Ministry of Health’s] Medical Practice Division. It was a curt letter, informing practitioners to inform the Division of any change in working hours. That was all. No compassion, no help offered, no recognition of the demands imposed on us to cope with the Covid-19,” Dr Shanmuganathan said.

Malaysian Dental Association (MDA) president Dr Leong Kei Joe also told CodeBlue about a shortage of face masks for dentists in the private sector.

Works Minister Fadillah Yusof said Saturday that the government would purchase and import 10 million masks from China. The National Disaster Management Agency (Nadma) would work together with local pharmaceutical company Pharmaniaga to distribute the face masks, prioritising frontline health workers first.

Foreign Minister Hishammuddin Hussein said yesterday that a separate shipment of 100,000 face masks contributed by the China-Asia Economic Development Association would be given to Malaysia’s Ministry of Health.

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