Lockdown Upends Lives Of Ordinary Malaysians

By Kanmani Batumalai | 04 December 2020

Movement restrictions have also impacted private health care facilities, including GP clinics and community pharmacies, leading to late detection of chronic diseases.

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KUALA LUMPUR, Dec 4 — Vimala Balakrishna was laid off as a domestic assistant at an old folks’ home in July, a few months after a strict nationwide lockdown during the Covid-19 pandemic.

After losing her regular monthly paycheck of RM1,200, the 45-year-old single mother — who lives in a low-cost flat in Petaling Jaya with a 17-year-old daughter — is now struggling to make ends meet with a part-time job as a cleaner that earns her just RM500 a month.

“I did not expect this. I have to pay a rental of RM400. So, I am forced to take up multiple jobs and I am stressed at times to handle my daily life,” Vimala told CodeBlue via a phone interview.

Vimala has also been suffering from heavy and prolonged menstrual bleeding for the past few years, but is unable to seek medical treatment now due to her informal work.

“The problem gets worse whenever I am stressed. Unlike my previous days, I could not go to hospitals to get my medicine because I am working based on a daily wage.”

Lockdowns have severely disrupted businesses and employment, including the Conditional Movement Control Order (CMCO) that was implemented in the Klang Valley since October 14. Although movement restrictions in Selangor, Kuala Lumpur, and Putrajaya are scheduled to end on December 6, the Klang Valley CMCO may be extended, possibly till the end of the year, as the Covid-19 outbreak in the country’s economic centre shows no signs of abating, and has even worsened, seven weeks into lockdown.

Vimala is staying in Mentari Court, a low-cost flat located in Bandar Sunway, and her 17-year-old daughter, Joanna Jeyanthy, is studying at a public secondary school in Petaling Jaya.

Joanna, who scored 8As in PT3 examination, is now having difficulties to undergo online classes as she does not have internet access at home. Schools have been closed nationwide from November 9 during the CMCO until the end of the school year on December 17, as the government instructed school administrators to continue home-based learning.

“I am supposed to sit for the SPM examination this year. But the exam has been postponed. I couldn’t keep in track with my school studies. I am unable to go to tuition classes as well.

“I usually will join the online classes when I follow my mother to her workplace. While she cleans the office, I will use the free Wi-Fi facilities there to join the classes. Sometimes, I will miss some important classes,” Joanna told CodeBlue.

When CodeBlue contacted Joanna’s school teacher, Thilagavathi Arichanan, she pointed out that not all students are able to join online classes during this CMCO period in Selangor.

“Studies of the students have been impacted. But as teachers, we are trying our best to teach them using various online platforms,” Thilagavathi told CodeBlue.

“When they are unable to join the classes, I’ll assign some activities through WhatsApp and monitor their submission and update their progress.”

Lockdowns have completely transformed Vimala’s daily life. Her daughter Joanna hopes movement restrictions will be lifted soon in order to return to school.

“I want to be a teacher and take care of my mum,” Joanna said.

Lockdowns Lead To Late NCD Detection, Raising MOH Burden

Alpha Specialist Centre consultant obstetrician & gynaecologist Dr Milton Lum asks a question at the Malaysian Healthcare Conference 2019 in Kuala Lumpur on March 7, 2019. Picture from fb.com/ksinsti.

At the same time, a few health experts have also cited the impact of lockdowns on private health care facilities in the country. Sabah, the Federal Territories of Kuala Lumpur, Putrajaya, and Labuan, and half the states in the peninsula — Selangor, Negeri Sembilan, Penang, Perak, and Kelantan — are currently under CMCO that is scheduled to end on December 6.

Former Malaysian Medical Association (MMA) president Dr Milton Lum said lockdowns have led to the late detection of non-communicable diseases (NCDs), which will increase the burden on public health measures in the country.

“Worse still, many have not sought health care at all, thus increasing medium to long-term complications in non-communicable diseases like diabetes, high blood pressure, and cancer.”

The Social Security Organisation (Socso) recently reported that almost 90,000 job losses have been reported so far this year and stated that these would hit more than 100,000 by the end of 2020, if the same trend continues.

“The economic contraction due to the MCO had resulted in decrease or loss of income, thereby leading many to seek medical attention from MOH health facilities where treatment is provided for a nominal fee.”

A survey conducted by the MMA Sabah branch — which involved 209 private doctors comprising 68 per cent general practitioners (GPs) and 32 per cent specialists — revealed that 70 per cent of private GPs and specialists nationwide have seen reduced patient loads of over 50 per cent or more during the nationwide Covid-19 lockdown in March and the implementation of CMCO in Sabah and most peninsular states during the third wave of the epidemic.

“The patient load improved somewhat with the recovery movement control order (RCMO), but it has gone on a downward trend again with the imposition of the CMCO on October 14.

“Some doctors have closed their clinics for good. An MMA survey reported that only 25 per cent of Sabah’s private clinics can sustain their operations for a year or more,” said Dr Lum.

According to MMA, there are 7,000 over MOH trained general practitioners (GPs) and around 3,000 over private specialists serving in more than 200 private hospitals nationwide. It is estimated that around 200 clinics nationwide will close by year end.

Drugs In Clinics Are Nearing Expiration Date

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah in Kuala Lumpur on February 21, 2020. Picture by Vinodh Pillai.

Dr Raj Kumar Maharajah, president of the Medical Practitioners Coalition Association of Malaysia (MPCAM), highlighted the looming expiration date of drugs which are unable to be used soon in private clinics if lockdowns are prolonged.

“Many medicines are lying on the shelves, nearing expiry, especially paediatric syrups. Pharmaceutical companies are not accepting return medicines as there is no demand for them to dispose the medicines to other hospitals or clinics,” Dr Raj Kumar told CodeBlue.

“New GPs who have just started off have been forced to close and they are unable to sustain their clinics. Established clinics have taken a severe beating. Everyone has been forced to take a pay cut and tighten their belts.”

Dr Raj Kumar also noted that child visits to clinics have decreased tremendously because when the children did not go to school, the tendency for them to get infected with communicable diseases is also less.

Shorter Business Hours Affecting Community Pharmacy Operations

Malaysian Pharmaceutical Society president Amrahi Buang speaks at the Health Ministry’s town hall meeting on February 13, 2020, in Putrajaya on the Poisons (Amendment) 2019 Bill. Picture from Facebook @BPFIPKKM.

Malaysian Pharmaceutical Society (MPS) president Amrahi Buang said that most community pharmacies are having a drop in business from 30 to 70 per cent during the implementation of movement restriction orders.

“Less customers are going to community pharmacies due to lack of buying power,” Amrahi told CodeBlue.

News of Medical Science, a medical site based in the UK and Australia, stated that community pharmacists are key health professionals who meet patients more often. They play a significant role in ensuring continued health care and check-ups for patients.

“Community pharmacies provide essential service to the community. A shorter business time during lockdown is affecting operations. Community pharmacies, especially independent ones, are having problems paying monthly rentals, utilities, and loans,” Amrahi said.

“Community pharmacies having problems with cash flow and having problems paying their suppliers.”

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