The System Is Collapsing: Admit And Fix It! — Dr Tachdjian

It is indeed CodeBlackMY now, not only for contract doctors, but for the nation’s health care system.

I am a government doctor and am writing this to tell the hospital administrators and the Ministry of Health to get their act together.

It is indeed CodeBlackMY now, not only for contract doctors, but for the nation’s health care system.

Perhaps the words “health care system collapse” has been used too many times that you are immune to it? This article is a wakeup call to you, and also to the administrators who release statements and responses to calm the public down, telling us that the situation is “under control”, “oxygen levels are adequate”, and other lies.

Your statements are cold and heartless, refuse to admit system failures, and have absolutely no empathy towards those who are fighting valiantly.

Here are pictures from Hospital Tengku Ampuan Rahimah (HTAR) Klang and Hospital Selayang. Health care workers will immediately recognise the horror of it all.

One oxygen wall supply meant for a single patient is used for seven or eight patients! It is obvious that the pressure is not high enough to supply adequate oxygen to all the patients.

Multiple Covid-19 patients at the emergency department in Hospital Tengku Ampuan Rahimah Klang share an oxygen supply wall that is meant for a single patient. Picture taken from an anonymous doctor at HTAR in the week of July 5-9, 2021.

These videos will also give you an insider’s view of the nightmare going on at the emergency department at Hospital Tengku Ampuan Rahimah (HTAR) in Klang.

Intubated patients are kept in the emergency department for seven days; beds are not enough, and patients have to sit upright on chairs. Patients are literally overflowing until beds have to be set up outside the hospital.

A source working at the emergency department has said that the situation has directly caused the death of patients that could have survived.

The doctors at HTAR have warned the hospital and state director multiple times over the past months and weeks, but as usual, the response has been slow, causing the level of care to sink to such depths.

Here are some suggestions:

1. Equipment

Shut down non-essential services in hospitals that are in low-hit areas, even from other states. Send beds, oxygen tanks, concentrators, etc. to help ease the burden. Expedite paperwork that needs to be done to “transfer assets” which, in government hospitals, can take forever.

Send actual hospital beds, because canvas beds will not work if CPR is needed — and then you will have another CPR-on-the-floor scene like in Hospital Kuala Lumpur (HKL). Find out from the receiving hospital what exactly is needed, so as not to send redundant aid.

2. Manpower

Beds and equipment are no good without manpower. Deploy non-medical, non0Covid-related staff to HTAR (and other Klang Valley hospitals). Look beyond the Klang Valley.

Deploy staff with adequate experience that are able to function immediately — senior medical officers, specialists, etc. Please do not transfer junior contract doctors randomly, just because they are easy to move around.

Even if the existing manpower in the badly hit hospitals are deemed “adequate”, manpower help is needed in order for the health care workers to provide optimal care to the patients, without jeopardising their own physical and mental health.

3. Field Hospitals And Quarantine Centres

With the available equipment and manpower, set up temporary field hospitals in car parks or open areas, with the help of the army, if necessary. We need a holding area for all these extra patients.

Temporary quarantine centres need to be set up in community halls or in major living spaces that can accommodate Categories Two and Three patients. Formulate a plan and liaise with a neighbouring hospital to transfer those who become Categories Four and Five patients.

4. Unite And Pool Resources

The situation at the major university hospitals are not as bad as HTAR or HKL. Some are worse hit than others — we need to sit down and either divide the burden between hospitals, or pool resources to be shared among those hospitals that are bearing heavier burdens. Do not plan in silos.

What affects one hospital will affect all the neighbouring centres, i.e. neighbouring district hospitals, associated referral centres, government clinics and Covid-19 Assessment Centres.

5. Speed Up

Donations of equipment become an issue when, for example, they are blocked by bureaucracy, paperwork, tenders, contracts, etc. All these are hurdles that we must remove.

CodeBlue is publishing this letter anonymously due to the government’s gag order on civil servants.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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