Anwar Ibrahim has been suffering from a serious spinal injury since 2000. As much as they try, local doctors are not able to cure his affliction. Physiotherapy and medication cannot solve the problem. Only surgery can. And this is the unanimous decision of all the specialists and surgeons who have examined Anwar.

But Anwar refuses to place his fate in the hands of Malaysian doctors in a Malaysian hospital if he has to be put under the knife. It is not that he does not think that Malaysian doctors are capable. He, in fact, has high regards for Malaysian doctors. It is the system he does not trust.

And Anwar has good reason to feel so.

When he was first suspected to be suffering from arsenic poisoning, his blood, hair and urine samples were smuggled out of prison and sent to Australia. The Australian Coroner's office confirmed the suspicion.

Anwar was then admitted to the Hospital Universiti Kebangsaan Malaysia (HUKM) for further testing. HUKM, too, confirmed what Australia had discovered. Anwar was suffering from arsenic poisoning.

However, the HUKM report was rejected by the government and was sent back to the hospital to be redrafted to say that there was no conclusive proof Anwar had been poisoned, and though some traces of arsenic was present in Anwar's person, it could have come from any unknown sources.

Malaysian prime minister then, Dr Mahathir Mohamad, explained that the arsenic could have come from seafood like lobsters. Since when did the Sungai Buloh prison serve lobsters to its inmates was not explained though.

Then, when Anwar first experienced back pain, he was sent to the Selayang Hospital for an X-ray to be done. The X-rays proved he was suffering from a spinal injury. Anwar then asked for a copy of the X-ray so that he could get a second opinion but he was told that the hospital had destroyed all his medical records.

Hospitals (or even private doctors for that matter) never destroy a patient's medical records, especially of one who has not even started his treatment yet and is yet to be cured of his aliment. And this, the Selayang Hospital doctors confirmed. They were perplexed how the hospital could say it had destroyed Anwar's medical records when it is not the policy to do so.

Clearly local doctors, no matter how capable and sincere they may be, have no control over matters. They have to do the bidding of the powers-that-be.

Anwar asked the specialists and surgeons who examined him whether they can guarantee his safety. Not one would dare give Anwar that guarantee. They can only guarantee they would do their best.

But they have no control over others aspects of the surgery such as pre-surgery or post-surgery care, or even whether Anwar will be given oxygen or some other gas as anaesthetic.

In fact, some of the best surgeons in Malaysia who examined Anwar refuse to undertake the surgery. They are worried that an element of sabotage may exist and they would have to bear the blame if the surgery fails or, worse, if Anwar dies.

If the experts, who should be the ones to undertake the operation, refuse to do so, who then does Anwar turn to? Anwar spoke to the best brains in the business but none were prepared to guarantee his safety. In fact, they refuse to carry out the operation on Anwar and would prefer some other surgeon do it instead.

It is not that these specialists and surgeons do not trust their own skills and capabilities. It is that they, too, do not trust the system and are worried about sabotage. How, then, can Anwar trust the system?

The specialists and surgeons who examined Anwar are also unanimous about one other thing, and that it is may be best that Anwar arrange to have the operation done overseas, in a 'safe' country where the hands of the powers-that-be in Malaysia cannot reach.

As they say, one must do what the doctor orders, and this is what the doctor has ordered.