Jailed former deputy premier Anwar Ibrahim today refused the surgery option offered by the Hospital Kuala Lumpur (HKL) but instead sent a 25-page reply to its director, Dr Abdul Razak Syed Kechik, stating that his right to his choice of treatment has been politicised and denied.

Anwar's wife Dr Wan Azizah Wan Ismail, accompanied by lawyer Sankara N Nair, neurosurgeons Dr Richard Veerapen and Dr Halili Rahmat, today read out excerpts from the reply at a packed press conference.

Wan Azizah said her husband was responding to a letter by Abdul Razak stating Anwar will be returned to the Sungai Buloh prison if he does not sign a letter of consent permitting the hospital's surgeons to operate on his slipped disc.

"The political meddling in the issue of my medical treatment has been uncalled for. On April 25, I received your letter asking me to agree to surgery. On April 26, the minister summoned all members of your panel, including neurosurgeon Dr Kazem Djavaadkhani, to receive instructions at a briefing for foreign missions and the media.

"On April 24, there was a briefing in which Datuk Chua Jui Meng (Health Minister) again raised the issue of alleged special treatment and as usual, made some remarks before the briefing proper, on the choices of treatment being offered." stated Anwar.

Chua claimed Djavaadkhani has the expertise to treat Anwar using laser treatment but Azizah stated the surgeon himself had said laser treatment is not suitable for her husband's condition.

Puzzling ultimatum

"Your letter says my reluctance to sign the letter of consent means I will be sent back to prison. That is very much in line with the Health Minister's statement.

"I stress again that I do not want to delay surgery. From the start, I have wanted to undergo endoscopic surgery. Your letter indicates the risks of microdisectomy which I am trying to avoid.

"It also explains the risks of delaying surgery. I therefore question the wisdom of the ultimatum. However, having considered the fact that I have received excellent treatment and supervision at HKL, I submit to the decision taken," wrote Anwar.

Anwar, who is serving a 15-year jail sentence for corruption and sodomy, has been hospitalised at KLH since November last year. He had requested for German spine specialist, Dr Thomas Hoogland, to perform his surgery but the specialist has ruled out operating on Anwar at HKL.

Anwar also stated that he was puzzled by Abdul Razak's decision to give the ultimatum when the hospital panel had also informed the court that he was unfit to attend court on April 28 for five outstanding charges.

"It puzzles me, considering that you are the same person who approved my return to prison in Sungai Buloh, which will involve a longer and more difficult journey.

"As a patient, I choose the procedure which I think is best for me. Your panel, in their initial report, did not oppose my choice," stated Anwar.

Wan Azizah said that her husband thanked all the surgeons, doctors, nurses and hospital staff of HKL for rendering efficient service throughout his five-month stay there.

Legal right

Meanwhile, Sankara said that his client has a legal right to the doctor and treatment of his choice although he is convicted and incarcerated.

"In law our client has a definite right to the preferred treatment and doctor of his choice and Section 37 of the Prisons Act 1995 is no bar to his rights given his particular medical complications and given that EMS is not available locally. Any move to do away with his entrenched rights would be deemed unconstitutional," said Sankara.

Sankara also said they are looking into legal action to press for the right of his client but he refused to reveal any further details on that.

Wan Azizah also said the International Intradiscal Therapy Society, which has 300 of the world's best spine surgeons among its members, had written to her stressing Hoogland's expertise. IITS Executive Director EJ Nordby stated that Hoogland's variation on endoscopic procedures for removal of a herniated disc has been most successful and he has done more of these cases than anyone in Europe.

Neurosurgeon Veerapen said that there is no one best method for any one medical condition."If Anwar does not undergo surgery, there will definitely be a progression of his problem and an exacerbation of what he is suffering from now. He will most certainly develop weaknesses in his feet and legs."

'Political decision'

On the statement by Prime Minister Dr Mahathir Mohamad who stated that many people had undergone the same surgery as offered to Anwar locally, Veerapen said that is true but it is only logical that the best results will be in the hands of one who is a dedicated spinal surgeon, which Malaysia does not have.

Veerapen said that a dedicated spinal surgeon, if he operates in his own environment, could provide the best results and the best turnaround time.

Halili, who had treated Anwar when he fell off a horse several years ago, said that as a surgeon, even he would not force a patient to undergo treatment under him if the patient refuses to do so.

Wan Azizah said that the government's decisions on the medical case of Anwar "seemed like a political decision".

"The cost is much cheaper if we take him to Munich - about RM25,000 - but if we bring Hoogland here plus his equipment, it might come to half a million ringgit, which we definitely cannot afford," said Wan Azizah.