I refer to the letter Let's have equal healthcare for all .

 

Way back in the year 1978 the World Health Assembly adopted a resolution: ‘Health For ALL by the year 2000'. In adopting that resolution, the assembly had also enunciated five basic guiding principles in the implementation so that the goals can best be attained.

These five guiding principles were aimed at delivering 'Equity in Health'... not equal health. There is a clear important difference in that the 'equity' principle required that healthcare be delivered to 'those communities most in need' as a priority, when ‘all’ cannot be served.

Now some 30+ years later, we see the vast differences in the delivery of healthcare between the 'haves' and the 'have nots' in both rural and urban communities. This discrepancy is even more noticeable between healthcare delivered in Sabah and that in Semenanjung or even Sarawak.

Where did we go wrong, in the implementation process? Lack of understanding of 'equity in health' or just simply lack of commitment?

Some 50 years ago an expert committee of the World Health Organisation recommended that all public water supplies be fluoridated (optimisation of fluoride levels in water) to reduce the ravages of dental caries (tooth decay) among the population.

The committee also noted that 'fluoridation' of water supplies was ‘the most cost-effective public health measure known to man’ and yet for reasons best known to the politicians in Sabah, the then state government suspended the 'fluoridation' of public water supplies in 1989.

And it remained suspended for the last 20 years to this day while the whole of Semenanjung and Sarawak have continued to enjoy this most cost-effective public health for decades now.

To make things far worse, not only is the rate of dental caries (tooth decay) double that of urban areas in Semenanjung and urban Sarawak, Sabah also has always had the worst dentist to population ratio in the whole of Malaysia! Actually, for the entire period that Sabah has been in Malaysia!

In the year 1980, the Federation Detaire International (the World Dental Federation - FDI) adopted the goal - ‘Oral Health for ALL by the year 2000' and yet I estimate that some 300,000 permanent teeth have been extracted among Sabah’s school-going population alone over the last 20 years since fluoridation was suspended in Sabah.

Don't we owe the children of Sabah better 'smiles'? And stop this very destructive dental health care. Can we hope that the minister of health and the director-general of health services would re-visit the original goal of ‘health for all by the year 2000'?

And retrace the original 'road map'  which enunciated the basic guiding principles of implementation among them 'when all cannot be served, those most in need should be served first'. That would  lead to greater ‘equity in health in Malaysia.