I refer to the article Malaysia's rural health service second to none. It forgot to add that it was referring to the year 1965, when you had to worry, essentially, about cholera, typhoid, malaria and hookworms.

The Health Director-General, Dr Ismail Merican ebullient statistics indicate that one health clinic exists every five kilometers and that more than 95 percent of the rural population has access to a doctor. There are also 2,965 clinics and 151 mobile clinics in rural areas. And there is one health clinic, or centre, for every 20,000 people, while there is one community or rural clinic for every 4,000 people.

These look like impressive statistics until one actually walks into one of these clinics and realises that there is only a nurse or hospital assistant to attend to today's epidemics of hypertension, diabetes mellitus, heart disease and cancer. Their duties include checking your blood pressure, sugar levels, etc. and dishing out enough 30-year-old medications for the next six months.

If patients return alive on follow-ups, repeat the above. Any complications, refer to ‘Hospital Besar’ and join the queue, where the rest of Malaysia will also be waiting to see not a specialist, but a medical officer in the specialist clinic, who could have been just transferred from the same district in which the patient was seen. This has been the modus operandi for the Malaysian healthcare system for the last 50 years.

Forget about obesity or even dengue fever, HIV/Aids, hepatitis or the re-emergence of tuberculosis - all of which have already claimed thousands of lives. Access to a doctor? Yes, try waiting three months if you are lucky. And, incidentally, how many of these clinics, especially the mobile ones, comply with PHFSA rules?

How is it that nurses are responsible for neonatal care, family health, dental care, nutrition and dietetics, health education and promotion, home nursing, care of the elderly, rehabilitative services, environmental sanitation, adolescent health and community mental services? How is that medical assistants still merrily provide general anesthesia in Sarawak in the year 2008? Don’t all these practices violate the PHFSA?

Oh, right. There’s one rule for Merican and one rule for Basmullah. Silly me. Nurse kill government patient, okay. Basmullah no pay RM1,500 for private clinic, go to jail.

Merican even appears to take credit for the healthcare provided for the Orang Asli. The Orang Asli Affairs Hospital in Gombak is run by the Orang Asli Affairs Department. And Parliament was informed in May of last year that it is so well-run by the Orang Asli Affairs Department (JHEOA) that the Health Ministry has no intention of taking over the management. Much of the base work and credit for Orang Asli healthcare must surely go J Malcolm Bolton and subsequent British officers who improved Orang Asli healthcare, even throughout the Emergency.

There are enough publications to confirm that healthcare among the Orang Asli has been in terminal decline after independence, with the Health Ministry itself having the distinct notoriety for scapegoating the Orang Asli's themselves whenever disasters, such as hepatitis, break out among them. As recently as last year, Nicholas and Baer reported that the crude death rate and maternal mortality rate is still twice as high among the Orang Asli than it is among all West Malaysians. (Healthcare for the Orang Asli: Consequences of paternalism and colonialism).

But the Health Ministry goes further. They use that horrible phrase ‘telemedicine and teleconsultation’. We have to take it that Amrin Buang, the auditor general, must have clearly failed to delve into this rip-off. Merican must be quite oblivious to the death of the KUB Malaysia-linked Medical Online in July 2003. Tasked with developing telemedicine, Medical Online died a horrible death when it couldn't pay suppliers because of the insidious learning curve associated with this project. Its troubles in Ipoh said a lot about jumping the gun. How do you install a multi-million ringgit IT system comprising expensive hardware and software when there is no electricity supply?

Worse still, no one in the Health Ministry realised that technology waits for no one. While billions were spent on both hardware and software (all courtesy of the tax-payers and, probably, Petronas), no one in the ministry actually grasped that if they didn't learn it fast enough, the equipment and software would be as worthless as trash.

Just a little research would have shown that even the National Health Service (NHS) in Britain was sliding into a £20 billion (RM120 billion) IT disaster. British taxpayers till this day have been unforgiving and have threatened to punish Labour for its miscalculation in trying to implement electronic patient clinical records without studying, in depth, its feasibility. The basic problem was that clinicians, whose support was essential in the introduction of IT to clinical care, were unconvinced and the costs and benefits for the NHS were unclear from day one.

Today, Malaysia will have to deal with the financial calamity arising from civil servants at the ministry whom the government chose to believe. Woefully, the main officer responsible for this mess is still, apparently, at the Health Ministry and is even expecting a promotion. And, apparently, this person even lets the suppliers keep the source codes after paying millions for the software. Such are the brains that run the Health Ministry and squander what must be meager resources by now.