Sep 5, 2008: Having worked in Kota Marudu as a government medical officer has shown me how lucky I am. I am lucky to be educated. I am lucky that I have access to information. I am lucky to have a stable job that pays. Unfortunately, I cannot say the same about many of the poor people who live in the remote areas of Kota Marudu.
I’ll give an example of a housewife, whom we shall refer to as Mrs P, who came to me at 38 weeks of her sixth pregnancy. She is from Paitan, a remote district in Sabah.
Kota Marudu is the nearest township that could provide obstetric assessment for her pregnancy. At the 38th week of pregnancy, that was the first time that she could afford to seek medical attention. Mothers should be seen in the first trimester of pregnancy. Mrs P was in the final trimester of her pregnancy.
Mrs P was at full term and she had never been seen by a doctor. She had three living children. Two died full term at birth. Mrs P delivered all her children, she delivered the placenta and she even cut the umbilical cords.
All on her own. The nearest midwife (non-medically trained) requires a thirty minute walk from her home. There are no medically trained midwives near her area of residence.
Mrs P's husband works at a small farm, earning RM50 a month while some of us have RM50 lunches. RM 50 for a family of five when many of us can afford to don RM250 shirts. In Kota Marudu and many districts in Sabah, transportation is a serious and material obstacle, preventing the people from gaining medical access.
It is not made any easier for these people when the local private transportation 'service' charge these financially poor people exorbitant fees for a ride to the nearest township (where a medical facility should be present). Mrs P came all the way from Paitan with the whole family, having to pay RM50 for each member of the family.
She is not the independent city woman who can drive herself to the nearest clinic. She is not the independent bourgeois who can travel in unfamiliar territory without her husband. She is the lady from the village who does not how to read or write. She is the lady who totally depends on her husband. Her husband who earns RM50 a month.
Mrs P and her family are a part of the many residents of Kota Marudu who are subjected to such paucity. The people's predicament does not stop at exorbitant travel fees. We have not even discussed the problems faced with road access. We have villages in Kota Marudu with roads that cannot be accessed during rainy seasons.
Transportation is extremely important in assisting this country's medical services. When sick people cannot travel due to distance, inaccessible roads or lack of financial funds for them to travel, this would delay their access to medical services.
This would in turn cause them to continue to deteriorate in their sickness in the village and by the time they reach the nearest hospital, there is nothing much that the doctors can do. This is very true for patients from the district of Kota Marudu.
If we are able to manage the problem at it's roots (and since the government continuously reminds the people the need for austerity, in the health sector included) the country will be able to cut medical costs in so many ways.
An example is antibiotic usage. The more critically ill the patient is, the more likely that the patient will need stronger antibiotics which is obviously more expensive. The more critically ill the patients are, the more likely that they will need intensive care support, which may include mechanical ventilation.
The education of the people of Kota Marudu would make them more aware of their need for medical services. There is no doubt that the wireless Internet service in Kota Marudu would benefit the students, teachers, lawyers and government staff who live in the town of Kota Marudu.
But it appears that our system, be it health, education or transportation, tend to target and benefit the people who already have access to modern facilities. Why can't we develop the society as a whole? What are we doing for the people of Kota Marudu who do not live in the town and other people of this country who live in remote areas?
We have 16-year-old school drop-outs who are mothers of two and pregnant with their third child. We have a real problem of illiteracy in Kota Marudu. Do you blame these people for being ignorant of their rights as citizens of this country when they don't even have access to education?
Knowledge is power, and I believe the people of Malaysia have begun to realise this. Are we, those who are more fortunate and educated, going to remain ignorant about the existence of these people?
It has been 45 years since the formation of Malaysia and the fundamental rights of the citizens have not been addressed properly. It is embarrassing and a failure of this country to have these conditions exist.
We should stop trying to break records by baking the biggest curry puff and whatnot. We should stop people from constructing the national flag from dried chillies and sago and then complain about food shortage.
We should stop sending people on travels to infinity and beyond when the people of Kota Marudu, the people here on earth are dying of tuberculosis, malaria and other diseases. We talk about wireless Internet service, but, there are far more important issues to deal with. Our first world facilities do not compensate for the suffering of the people.