Sunday, March 21, 2010

Orang Asli Hospital not fulfilling role

A hospital set up by the British to serve the Orang Asli in Gombak is not fulfilling its objectives in part because most of its patients are non-Orang Asli.

Dr Selva Vathany Kanapathi Pillai, recently transferred out of the hospital after publicly voicing her concerns, told The Nut Graph that more than two-thirds of the hospital's patients were non-Orang Asli.

"This is despite the fact that there is access to government clinics and hospitals nearby," she said in a phone interview.

Suhakam commissioner Datuk Siva Subramaniam (left) accepting the memorandum from
Orang Asli representative Sokyen Man

This complaint was one of several which the Orang Asli raised with the Malaysian Human Rights Commission (Suhakam) in a memorandum on 16 Mar 2010.

In their complaint, the Orang Asli said outsiders and foreigners were also going to the hospital, hence disadvantaging the indigenous communities.

Dr Selva surmised that non-Orang Asli patients came to the hospital's outpatient department because the waiting time was shorter and parking was more convenient.

"Some even use the emergency department for outpatient treatment. They come [to the emergency department] at night or weekends for blood pressure readings or dressings," she said, citing these as examples of abuse of the system.

Dr Selva said these patients received treatment at the expense of the Orang Asli's health, which the hospital was primarily meant to serve.

Changes needed

Dr Selva
Dr Selva said she had proposed for the outpatient department at Gombak Hospital to be shut down, without jeopardising long-term patients, since the majority of patients were not Orang Asli.

"There is more to improving Orang Asli health than just running the outpatient and accident and emergency departments," she said, citing for example the need to conduct regular trips into the interior.

"We can't just have [irregular] trips to the interior and just dispense some medicine on an ad hoc basis."

Other mismanagement

Dr Selva claimed that the Gombak Hospital also did not implement the Health Ministry's basic food basket programme for malnourished children.

"Once a child falls below their expected height and weight, after ruling out medical conditions, they are put on a programme where they receive a food basket every month," Dr Selva explained.

However, she said that there was a case of a malnourished Orang Asli child, living just behind the hospital, who was only given a one-off assistance of three milk tins.

"She was just drinking tea with milk. I reported her case to welfare. We were told our hospital does not [provide welfare assistance to] 'Orang Asli bandar', only those in the interior."

Original purpose

Dr Colin Nicholas
Centre for Orang Asli Concerns coordinator Dr Colin Nicholas said that the hospital was set up during the Emergency to improve Orang Asli health.

"When they tried to resettle the Orang Asli, about 7,000 Orang Asli died due to disease, malnutrition and mental depression," Dr Nicholas told The Nut Graph. "This prompted research into their health status [and] the establishment of the hospital in surroundings that [would] make the Orang Asli feel at home. [This included employing Orang Asli staff in the hospital]."

Dr Nicholas said the hospital was meant to provide a holistic approach to improving the community's health standards.

"When one person came to the hospital because he or she had tuberculosis or some other disease, they wouldn't come alone. The whole family would come with them. So, the hospital staff would take the opportunity to check the whole family at the same time," he explained.

Dr Nicholas, who has co-written a paper on Orang Asli health, said the hospital used to train Orang Asli as paramedics.

"They would receive basic health training such as how to detect and treat malaria and were then sent back to the villages with stocks of medicines. When there were serious cases, they would radio for assistance and they would be sent (by helicopter) to Gombak Hospital.

"It wasn't just a hospital. It was a centre for Orang Asli health and was connected to all the villages."

Dr Nicholas claimed that this holistic approach has no longer been practised at the hospital since the 1990s and that standards have deteriorated.

"A [Orang Asli] child recently died from kwashiorkor, [a severe condition caused by malnutrition] which occurs only in very poor countries." Nicholas said the hospital was supposed to have arranged for a medical evacuation by helicopter but this did not come about and the child died a few days later. "His death was not even recorded in the health statistics of the Orang Asli."

Health ministry needed

Orang Asli representatives with some members of the Malaysian Bar at Suhakam

Among others, the Orang Asli, in their memorandum to Suhakam, want the Health Ministry to take over the administration of the Gombak Hospital from the Jabatan Hal Ehwal Orang Asli (JHEOA). They also want the hospital to be made into a research centre for Orang Asli health.

Dr Nicholas said there was no reason for the hospital to be administered by the JHEOA, which is part of the Rural and Regional Development Ministry. "Before 1995, education was also under the JHEOA. People not trained as teachers ended up teaching Orang Asli children. Since 1995, the Education Ministry has taken over and is responsible for Orang Asli education and there has been a marked improvement in this field," he noted.

courtesy of Nut Graph

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