Health care services in Malaysia comprise tax-supported and government-regulated primary health care centres and hospitals, and thriving private services, mostly located in urban areas.
The improvements made by our health care system in the last decades are exceptional enough to be commensurate with well-developed countries. These achievements can be attributed to well-trained and skilled medical staff, and top-notch hospital facilities.
The Malaysian health care system is advanced due to substantial backing from the Malaysian government through investment in the country’s medical infrastructure. This has culminated in the country receiving numerous accolades, such as being listed as the “Best Health care in the World category of the 2019 International Living Annual Global Retirement Index”.
Workplace Violence towards Health Care Workers
With our health care system making strides of various kinds, time and time again, it would only be fitting to be appreciative of health care workers (HCW) as they have contributed profusely for the benefit of Malaysians all around. One can only imagine how much more demanding the jobs of HCW have become during the pandemic and the daily adversities they face.
Despite this, recent revelations in figures concerning violence towards HCW are appalling. The World Health Organization (WHO) reported that between 8% and 38% of HCW suffer physical violence at some point in their careers, with some being threatened or exposed to verbal aggression, and that the majority of these were perpetrated by patients and visitors.
Violence towards HCW during the Pandemic and Its Impact
While we applaud heroic HCW for battling the Covid-19 pandemic, it is undeniable that violence towards HCW does not come to a halt even amid the pandemic. The violence is classified into physical assault, emotional abuse, verbal abuse or even through social media which affects HCW physically, emotionally, and mentally.
The Women, Family and Community Development Ministry’s post-Movement Control Order (MCO) Covid-19 guidelines proposed that isolating frontliners’ children from other children at day care centres, as they were considered “high-risk” of getting infected by their parents.
A doctor who is a frontliner screening Covid-19 patients said her facial appointment was cancelled upon learning that she worked in a hospital because she was considered “high-risk”.
In Petaling Jaya, one of the health care workers staying in a condominium was infected with Covid-19. Consequently, the condominium management decided to segregate one of three lifts for medical and essential service workers whilst barring other residents an access pass.
In other news, a 29-year-old Manila nurse said that his wife’s parents isolated him in a room. There are several cases reported in Manila where health care workers are suffering abuse by being attacked due to panic and fear over Covid-19 infections.
As a consequence, HCW lose their job motivation and this subsequently compromises our own standard of care. Are we aware of how serious these discriminatory practices issue can be if measures are not taken to solve the issue?
Interviews with FrontLiners who are Fighting Covid-19
We had an interview with Associate Professor Dr Mohd Idzwan, a consultant emergency physician and medical lecturer in University Malaya Medical Centre, and conducted a survey on workplace violence among HCW.
What are the most common forms of workplace violence that you have experienced throughout your career?
With 24 years of working experience, Dr Idzwan said that verbal abuse is the commonest form of workplace violence that he had experienced. According to our survey, most of the respondents encountered verbal abuse as well. A staff nurse who has been working in the Emergency Department for more than five years stated that she experiences workplace violence approximately three to five times per month.
Besides violence caused by patients, health care workers also endure abuse by their superiors or seniors. One of our respondents who is a houseman stated that he encountered verbal abuse from his superior at least twice a week.
What coping strategies would you apply when you encounter workplace violence?
Filing in a report to their head of unit or turn a deaf ear to the perpetrators. Dr Idzwan would distance himself from work and spend quality time with his family to cope with stress encountered.
What are the hardships that you went through during this pandemic? Do you face any discrimination from people around you?
During this Covid-19 pandemic, our frontliners had braced themselves to work tirelessly, although they are only one suit away from the virus to provide care for the patients. One of the respondents said that he constantly faced discrimination from his neighbours as they are concerned that he may carry the virus from the hospital to the neighbourhood.
One of the respondents also mentioned that she does not have the time to rest and recover due to this pandemic. Some of them also stated that this pandemic had affected their time and relationship with their family.
What is your advice or message you would like to convey to the public?
Most of them urge that the public could be more courteous and give full cooperation to the HCW when utilising the health care facilities. They also wish that the public could appreciate their effort and immense sacrifices, putting themselves at the front line for the benefit of the nation.
Dr Idzwan also hopes that more financial support could be provided to the emergency departments from the government to improve the health facilities available for the public. He wishes that the public would value the health care services provided in our country and not taking them for granted.
Lessons Learnt during this Pandemic
Our health care facilities, especially in the government sector, are currently understaffed but they often have to face crowds far beyond their limited capacity, leading to extremely long waiting times. This situation will further tilt the balance between supply and demand in the health care delivery system.
Frequent acts and cumulative effect of violence against health care workers will not help them to provide better care for the public, but instead it can affect their morale over time, which could further harm the patient-provider relationship and generate a higher likelihood of future violence or extreme behaviours.
Violent behaviour towards HCW is very pernicious as it can increase the psychological stress and creates burnout among the medical personnel. This will reduce their enthusiasm at work, drive individuals away from the medical profession, thus further reducing the health care workforce and making it harder to meet patients’ demands resulting in poorer treatment outcomes.
If the tense relationship between patients and health care providers can be improved, psychological pressures on HCW may be relieved, burnout rates can be reduced, and we can create a sustainable environment to ensure the quality of our health care service delivery.
In a nutshell, our HCW have been working very hard and we are beyond grateful to them who have been serving our nation bravely and tirelessly during this Covid-19 pandemic. We cannot deny that the Covid-19 pandemic has been challenging, and it has put significant pressure on our HCW. This pandemic has impacted them both physically and psychologically.
Nevertheless, they still continue to devote their time and energy to contain this pandemic. They have the right to be safe at work as well, just like other employees. Hospitals should be places that provide care and hope, not violence.
However, despite the sacrifices of HCW in recent events, violence against HCW has not shown any improvement. We need to explore more on the reasons as to help develop better policies, regulations, and interventions to eliminate the normalisation of violence faced by the HCW.
All human beings deserve to be treated with dignity, but it is a two-way thing. To the public, you are the primary determinant in stopping these violent behaviours towards HCW. Please help them so that they can help you to ensure the best of care is given to you and your loved ones.
It is our ardent hope that the public will appreciate the health care workers’ unwavering efforts and immense sacrifices by utilising the health care services effectively and to refrain from any misuse or abuse to the health care services we have.
Written by Chua Chong Win, Chunying Selvakumaran, Heng Woon Theng, Kayrel Nielhan Bin Awang Bakar, Manisha Sekaran, Nooreen Nasuha Binti Md Nahar, Nur Amalia Hazwani Binti Halid, Teh Yi Ting. (Group 4A Community Posting, Final Year Medical Students, University of Malaya).
Supervised by Prof. Dr Victor Hoe Chee Wai Bin Abdullah from the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.