Materia Medica Malaysiana

Mobile clinic to complement Flying Doc Service

The Health Ministry has decided to continue with the Flying Doctor Service given the still-not-satisfactory level of road communication in some parts of interior Sabah.
Its Minister, Datuk Dr Chua Soi Lek, the Ministry felt the service should be continued considering that many villages, albeit thinly populated, are far from hospital health facilities.
"The Sabah Flying Doctor Service had existed in Sabah since the seventies. We will continue to provide this service daily and during the daytime. For security reasons, the service will not be available at night.
"We are aware that this service requires a huge financial allocation. We spend about RM1 million to RM1.5m just for the rental only," he said.
Dr Chua explained that the scope of service covers treatment for outpatients and other areas of concern such as antenatal and postnatal care, immunisation, health education and assistance for contagious disease control. Such diseases are dengue, measles and malaria.
"Under the Sabah Flying Doctor Service, we have treated a sizeable number of diseases. Our records show that for 2003 alone, 23,660 people received outpatient treatment, 1,704 mothers had antenatal care, another 200 were given postnatal care and between 750 and 800 babies and children were immunised. Immunisation is important," he said.
The Minister, however, noted that service to villages is already on the decline as reflected in the reduction from more than 70 villages to only 45 that are being served by the service.
Dr Chua attributed this to improvement in infrastructure in the rural areas, particularly road communication. He also revealed that discussions are under way on how best to start the mobile clinic service in Sabah under the Ninth Malaysia Plan.
"The mobile clinic will move from one town to a smaller town in the rural areas, particularly in the interior." This vehicle would be equipped with facilities for immunisation, blood and urine tests and also medicines.
On the estimated cost of the programme, he said: "We have to look into the logistics of it."
On the shortage of oncologists (doctors who specialise in the treatment of tumours in the body) in Malaysia (as reported in the media), Dr Chua said the country faces a shortage of all doctors, not just oncologists.
Responding to the claim that very few opportunities are offered to doctors interested in taking up oncology for their Master degree programme in Universiti Malaya, in particular, he said:
"The number of training posts for this field of speciality is very limited. It does not mean that 20 postgraduate doctors apply and 20 will be accepted. It does not work that way.
"The money for training posts must be approved by the Public Service Department (JPA). It is not just a question of saying there is a shortage and we need to train, and then tomorrow, we have it.
"It does not work out that way in the medical line."
Asked how then the Ministry was going to meet the people's needs, he said:
"We want to train more. But the problem is, for medical training, we need the facilities for training. I can say I want to train 100 oncologists. But there are no facilities, not only in this country, for that matter, in the world. There is a shortage of doctors everywhere, not just in Malaysia."
On why all five psychiatrists in Sabah prefer to be at Hospital Mesra Bukit Padang (thus depriving hospitals in other major towns of the services), he said: "It is hard to answer your question."
Dr Chua said pensioners can appeal against having to buy medicines outside, which they cannot afford.
"You must understand that in one year, we spend RM7 billion in health but in return, we collect RM128 million from patients."
He was asked to comment on Sabah pensioners' complaint that while they receive free medical treatment, very often they are asked to purchase specialist drugs outside. The excuse is that there is no stock in the hospital pharmacy.
This was among the issues raised in a memorandum to the Chief Secretary to the Government, Tan Sri Samsudin Osman from the Sabah Pensioners Association headed by Dr Florentius Epin Banaik in January this year.
Most of the pensioners find it very difficult to make ends meet as they receive pension as little as RM380 per month and it is even lower for some others. Dr Chua said Malaysians are so used to everything free that when they are asked to pay for a nominal sum, they make a lot of complaints.
"Nowhere else in the world can you get medical treatment for RM1. And they have been having so good that they forgot that this cannot continue forever."
According to him, the Ministry of Health spent only about RM280 on drug supplies in 1996.
"Last year, expenditure on drugs alone soared to RM850 million for the whole country."
The Minister said the entire Ministry's operating budget is RM7 billion a year "but we collect only RM1 (registration fee) each from Malaysian patients and this amounts to RM128 million."
"Which means 98 per cent of the cost is subsidised. Therefore, Malaysians must also be aware that the Government cannot continue to subsidise at such a high level."
Dr Chua, however, assured that the Government would always give priority to the poor, government servants, schoolchildren, unemployed people and the pensioners.