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How hard is it to get treatment for dengue?

Last week, my friend fell really ill and was diagnosed with dengue on the sixth day after his fever started. The experience of trying to get him tested and treated for dengue left me surprised and disappointed with how our public health care system deals with a deadly and contagious disease. Below is the chronology of events.

1. On the first day of his fever, he developed all the symptoms of a viral fever - backache, fever, joint pains and headaches.

2. On his second day of fever, we were very worried as he had never been so ill before. Since we have been to a variety of locations including in the forest, rural areas as well as in the city area over the last week - we were worried that it was something more serious. We went to the University Hospital in PJ at 9.30pm and got to see the doctor at 12.30am.

The doctor said they could not test his blood there (for real?) and they would need to send it elsewhere for testing. Which means we would need to wait many hours to get the results back. The doctor also said it didn't look like dengue case which we can only test for on the fifth day of his fever. He sent us home with some Paracetamol.

3. On the sixth day, his fever was gone but he started to develop a rash symptomatic of dengue fever. We immediately rushed to the Emergency Department at the Hospital Putrajaya to check him in. The doctor said that they cannot test his blood at the Emergency Department and instead we need to go to a clinic despite the fact that he was showing clear symptoms of dengue.

I asked the doctor, ‘You mean you can't test his blood here? In a hospital?!' and the doctor insisted that we had to go to a government clinic. When he found out that we drove all the way from KL, he was very irritated saying we should had gone to somewhere nearer to KL.

Reluctantly he directed us to the the Klinik Kesihatan which is a five-minute drive away.

5. The blood test result at the Putrajaya Klinik Kesihatan tested positive for dengue, with his platelet level at 74 (normal platelet count is 150). He was put on IV drips for an hour and the doctor said to come back again tomorrow to test again to see if the platelet level drops.

6.The next day, his platelet level dropped to 56. The clinic doctor panicked and said it is very dangerous already and scolded us for coming to Putrajaya instead of going to Hospital Kuala Lumpur (HKL). He went on and on about how there are only 250 beds in Hospital Putrajaya while there are 2,000 beds at HKL and that they would prioritise patients by locality.

He also added that we should go to a hospital nearer to where his parents stay because they would want to visit him. After all that grumbling, the doctor finally wrote us a referral letter and shortly an ambulance came and took him to the Emergency Department at Hospital Putrajaya , the same place we first went to yesterday.

Why did we choose to go to Hospital Putrajaya?

1. A friend working in a Klinik Kesihatan (KK) in KL informed me that KKs around the area can only draw the blood, which we'll need to take to Kinrara for testing. And when we're in Kinrara, expect to wait another two hours for the results.

2. Waiting hours at busy hospitals such as Hospital Kuala Lumpur and University Hospital (UH) are very long. Since it's a suspected dengue case, I knew that time was critical.

3. We were advised by someone working in the field to go there as Putrajaya is a less populated place, therefore the hospital is not very busy plus it is very new and nice.

I am shocked that despite such strong public awareness campaigns about how dangerous dengue is, attempts to get tested and treated for dengue is so difficult.

In my opinion, it was very irresponsible and arrogant for the doctor in UH to rule out dengue on his second day of fever, as that might have left many people less cautious.

I also cannot believe we were rejected treatment at the Emergency Department at Hospital Putrajaya, especially after the Health Ministry declared 'war on dengue' in January following a steep rise in dengue cases and deaths.

On top of that, I am appalled by pettiness about things such as which hospital we should go to. Since this is ‘1Malaysia', we should be able to get equal treatment regardless of where our home address on our IC is. And I would think that priority for treatment should depend on how critical the patient's condition is.

The only good things I have to say about the experience is that it was very quick and efficient to get his blood tested in the Klinik Kesihatan at Putrajaya and treatment in the Putrajaya Hospital was very good after finally getting admitted.

It is fortunate for us that we had people to advice os on what symptoms to look out for and we were persistent and could travel easily since I have a car and can drive. I wonder how others in less fortunate circumstances are able to get treated before it is too late, not just for dengue cases but as well as other medical conditions.

Clearly there is a lot of room for improvement and I hope this letter will encourage hospitals across the country to take action now.

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