Readers respond to the Good, bad and ugly of Selayang Hospital
Nathan PS: What you experienced at Selayang Hospital could have been far worse. But you were lucky because you have access to former minister Tan Sri Law Hieng Ding, and you were able to get the contact number of DG Tan Sri Dr Ismail Merican. You also have the guts to call, SMS etc...but what about the ordinary layman in this country? Say, someone from the estate or rural area, a Penan from Ulu Baram, illiterate, and totally lost in the system?
As a health professional who has served 32 years in the system (Ministry of Health), I can tell you that I too have had to suffer in the system that I was serving. I don't think the present DG or anyone in particular can be blamed for how the system works. Actually every one of them is just T-R-Y-I-N-G to keep the system functioning as best they can. But if you look around, it's not just the health system in this country but a whole lot of other systems that are simply crumbling!
Just like a Sarawakian feeling lost in the system in West Malaysia, West Malaysians too feel equally lost when posted (not out of choice!) to East Malaysia. While serving with the MOH, I was transferred to Sabah. There I was harassed by the immigration because I did not possess a work permit. I was later told that my wife who was teaching there also needed a work permit too. Then it was my children who were schooling there. None of us went there by choice. My children who are Indians were placed under the category 'Lain Lain' - same category as illegal immigrants! Mind you, the children of illegal immigrants got free text books but my children were not eligible for any!!
It took my wife six months to get her first salary in Kota Kinabalu after being transferred from Johore. It might have taken even longer had I had not moved the file from one table to another. My children's posting was another big hassle too. I was given two weeks to move from Johore to Kota Kinabalu, and the same two weeks on my return transfer!
While I was in KL as head of a dept, I was diagnosed with a 'retinal tear' and while the opthalmic surgeon was willing to operate they could not give me a bed on admission - not even a third class bed - while I was eligible for first class. I was given a trolley (with four wheels and a curved metal base) to spend the night on.
Just last month, I had to wait 10 hours at the admission room to get a bed in the University Hospital for a scheduled admission and operation. So it wasn't that much better at the University Hospital either! And to think I served in the system for 32 years!
Now let me tell you what happened to my father, who served as a hospital assistant in the Kluang Hospital for some 35 years, from the time he was a bachelor right up to the time I graduated and came to work in the same hospital as a dental officer.
My father was admitted to Johore Baru Hospital for high blood pressure and he was admitted to the Officers Ward (Ist Class B twin sharing). He was treated by the State Physician, his room-mate was a Senior Labratory Technologist from JB Hospital who had been admitted for a middle ear infection and he was under the care of the ENT specialist.
This laboratory technologist's wife was a staff nurse in the JB Hospital. For a few days, this guy's blood pressure was falling and they could not understand why. One evening while his wife was on a visit, she saw the nurse hand him his medication. She took it because her husband wanted to go to the toilet. She realised that something was not right and went to check....and found that her husband, an ENT patient, had been given the high blood pressure patient's (my father) medication for the last few days! Of course, my father's blood pressure never came down during those few days! And all this happened in the first class ward - and the patients were both medical staff.
I have many more personal horror stories to tell you about what goes on in my Ministry of Health - that is if you are interested in them.
This is truly " Di-Malaysia Boleh!"
Hong Teck Chua: I've read your article and your replies to some who have written to you. I am very glad to hear you mention that your article is not about making a complaint but to provide feedback to the hospital authorities and the Ministry of Health (MOH) as well as to let the public know about the workings of a public hospital.
I used to work in MOH and HKL and I know it is a very challenging task. The public demands and expects that everything is in "top form" in these hospitals but pays hardly "anything" to the hospital/MOH. The demand does not only come from the patients; the healthcare providers (in particular the doctors) also expect much better pay, rewards and conditions of service. These demands have put great stress on our public hospitals. The hospitals are seeing more and more patients every year, nearly two million inpatient admissions in 2006. This does not include about 13.4 million outpatient attendances in MOH hospitals, satellite clinics and special medical institutions. Under such circumstances, the workload is mounting in most of our urban hospitals, including Selayang.
While these have put great stress on the public healthcare delivery system, another pressure comes from people like you, the family and friends of patients. In general, patients do not complain much about the service. It is because they are too sick to complain or they just want to be treated and do not want much hassle.
When I was in MOH, I told the management that they have to put greater emphasis on the management of family and friends of patients. If there are two million patients, can you imagine the number of family and friends MOH hospitals have to deal with? If each patient has five family and friends visiting them, we are talking about 10 million visitors to these hospitals. These "healthy" visitors will scrutinize everything (from car park, lifts, toilet, food, lights) and everyone working in the hospital. As a result, public hospitals become the most frequently visited and scrutinized public institutions.
The expectations from these visitors are very high and they like to compare MOH hospitals with private hospitals and hospitals shown in the many medical tv series. The immediate family members are very stressed when they come to these hospitals because for many of them, this may be the first experience where their loved ones become very sick and need to be hospitalised. In the wards, many of these nurses who are on night duty are very young and housemen are usually on call duties.
In many instances, the family members are not told about the condition of their loved ones. Whenever questions are asked, the explanation provided may not satisfy them. There may also be communication problem especially if the family members do not communicate well in Bahasa Malaysia or English. The doctors may also underestimate the knowledge of these "ordinary people". With the Internet now, people can easily access any medical condition and treatment. Therefore, the days when the doctors have all the knowledge and the rest just have to listen is no longer relevant.
Therefore it is time that the management of patients include the management of family and friends too. They play an important part in the complete treatment of the patients. This is what you have been doing. Stay healthy and best wishes to you and your aunt.
Devindran Muniandy: Hope your aunt's surgery went well and I wish her a speedy recovery. You should take it easy and don't be too harsh on the doctors. They too carry quite a baggage!
Grace Line: Thank you for sharing your experience at Selayang Hospital. I am a nurse working in a hospital too.
You have my sympathy for your ordeal in Selayang. Yes , it is really out of the question to ask your aunt to fly back to Kuching for the operation as she had already flown all the way to KL for the surgery at a date which was promised to her. That promise should be kept by Selayang Hospital.
I came to know from your article that your Aunt Lucy had her operation on Oct 5. I take this opportunity to ask how is she now after the surgery. I will pray for her good heath and may God bless her.
In my work, I regularly come across patients from Sabah and Sarawak. It's rather sad that they have to be so far away from their loved ones just to seek treatment. I think the least we, nurses, can do is to take good care of them and to always serve them with a smile.
Mr W: I am from Sungai Petani and after reading your article regarding the treatment you received at Selayang Hospital, I actually understood what you've been through.
I had a similar experience when my late father was a patient. He was diagnosed with liver cancer in Feb 2004. He was referred to Penang GH for observation as Sungai.Petani GH at that time lacked the facilities and specialist. In Penang GH, my father was treated well by the nurses, doctors and surgeons even though we are from a poor family. After spending almost one month in and out of the Penang GH, the surgeons referred my father to Selayang Hospital to insert a stent in one of the veins.
We arrived at Selayang Hospital in early April 2004. My brother went to see the surgeon to seek an appointment for the operation. We approached the surgeon's assistant, a young Chinese man with a cocky and arrogant attitude. My brother asked him when the operation could be carried out, but without looking at my brother and with his head held up, the surgeon's assistant replied "when the operation theatre is available
la...
if you can wait
la,
if cannot wait then..." without giving a definite date. During that time, we were clueless as to when the operation could be carried out or will there be any at all. The attending surgeon, a Sikh, was however more humble and polite and gave us an operation date. The operation was successfully carried out two days later.
My father was later brought back to Sungai.Petani GH, nearer to my house after the operation. By that time, he was very weak and needed much help to eat or urinate. My mother and sister volunteered to look after him in the day while my brother and I attended to him at night.
We were confident the nurses there would help out when we needed their assistance. But we were so wrong. Despite calling out to the nurses on several occasions, they treated us as if we were not there. The nurses in the ward were predominantly Malay and we soon noticed that they would only help out the Malay patients. For example, they would only change for the Malay patients. For my father, they would just leave his change of hospital wear on the bed or they would give it to my mother to change him.
My father passed away on 29th April 2004, Before he died he was coughing and vomiting and none of the nurses dropped by to check on him despite my mother calling out for help. It was one harrowing experience for my family.
I have no intention to pursue this matter as my father had already passed on. I've resigned to the fact that telling the hospital staff their mistakes would be like talking to a wall.
I write this to let you know that you are not alone and I'm sure there are many others who were ill treated in our public hospitals. I can only hope that the situation will improve.
Madam Joyce Lim: I read your article on the service accorded to your aunt at the Selayang Hospital. Thank you for bringing this problem to light because you also mentioned the quick response you had from the higher authorities. It was after reading your article that I felt encouraged to write to the Director General of Medical Services, Tan Sri Dr Ismail Merican himself. Thank you.
This is Mdm Joyce Lim's letter to the DG.
Dear Tan Sri,
I write to express my deepest appreciation and gratitude to your medical staff at the Cardiac Unit of the Sarawak General Hospital (SGH)
My husband went to the A&E on Sept 14 for a 'slight discomfort' at his epigastric (below his sternum) but further investigations through ECG suspected a heart problem instead. We were of course taken aback because he has no previous history of hypertension nor high cholesterol. His last routine medical examination, done at a private cardiac clinic, showed his ECG as normal albeit a slight BP which (according to the specialist) did not require any medication.
He was immediately warded and in fact was pushed to the Cardiac Unit by the Sr Registrar, Dr Allan Fong, himself. He was immediately attended to by the Consultant Cardiologist, Dr Liew Houng Bang, who scheduled him to do an angiogram that very afternoon. He was found to have five narrowings on both his left and right arteries and stenting was done on three spots on the left artery while the right artery was attended to on Oct 5.
The excellent service and attention accorded to my husband changed my previously biased perspective of a government hospital. We were deeply touched by the tender loving care he received from the specialists (Dr Liew and Dr Fong), the MOs and even right to the nursing and support staff both at the CCU and the CRW.
In fact throughout his two short stays in the hospital, we noticed that the doctors worked late into the night. He was visited by Dr Liew and Dr Fong as early as 7 am and as late as 10 pm. Inside me, I felt sorry for their spouses and children as the hospital seemed to be like their second home. I would like to commend them for their dedication to their patients and calling as doctors.
I write this to you, Sir, to express my desire that all Units in all hospitals would emulate the excellent service of the Cardiac Unit of the Sarawak General Hospital in Kuching. Even the nurses and attendants were friendly, caring and nary a complain when handling difficult patients (yes, we witnessed one difficult patient). We are honoured to be served by them.
Yelverton Tavistock: Sorry to hear about the run around they gave your aunt. But despite your temperature cooling and your Xanax, you are fortunate you knew a few big guns. The rest of Malaysia are not that fortunate. The MOH is a gone case. But you can help yourself because you are from Sarawak. This is a land of untold riches (provided of course it reaches the people..but that's another story). You have Tan Sri Law Hieng Ding and now, you must get his good ear and campaign that Healthcare in Sarawak breaks away and be completely INDEPENDENT of those jokers at Putrajaya.
Sarawak, like Brunei, can be creative and bring in the best doctors and nurses for their people and state. There isn't any need to beg. Even if you go down to Edinburgh or even Devon, people remember Sarawak, and the British will ensure you get a first class healthcare system.
The disease in Malaysia is called CENTRALISATION. The fact that you had to call in the DG and the minister only shows to prove my case. The system should work on its own clockwork without the prime minister having to come down to make certain the Whipple's/ bypass surgery they are probably going to perform on your aunt gets done and doesn't get cancelled.
We in Peninsular Malaysia are a gone case. But Sarawakians and Sabahans have that special agreement. Tell the MOH here to fly kites and set up your own healthcare system. Believe you me, medical standards in Sarawak will then soar.
I personally feel the people of Sarawak are too gentle and they have been bullied and robbed. I think they were better off with the Brookes. ( Photo: Sir James Brooke, First White Rajah, Sarawak ) Every time, I see their graves at Sheepstor I feel very sorry for Sarawakians. There have recently been so many articles on this subject in the blogs and I thought your story was just too much. We West Malaysians are used to being pushed around, caged, ISAed, etc....but Sarawak had the opportunity to go it alone and perhaps they joined the federation in good faith. But I am not sure if it is paying off for them now.
The wards at Hospital Umum Sarawak are far worse then the ones I have seen in some Thai and Indian hospitals. This...the people of Sarawak do not deserve. Take care and best regards and I hope your Aunt Lucy has recovered. I remain yours truly, A friend of the good people of Sarawak.
Francis Siah: I must respond as most of you have asked about my aunt. The operation went well on Oct 5. Cancer cells have not spread to the liver but unfortunately, a main blood vessel has been infiltrated.
Hence the tumour could not be wholly removed, A by-pass was done. Chemo is the next course of action. As with most cases of pancreatic cancer (or any cancer for that matter), full recovery is almost impossible save for a miracle.
Aunt Lucy returned to Kuching on Oct 13 and we're now doing our best to allow her to live life to the fullest with whatever time there is left. Spare her a prayer if you can.
God bless you all for your well wishes and kind thoughts,
