REPORT FROM THE LAWAS FRONTLINE: RURAL SARAWAKIANS NEED ACCESS TO BETTER HEALTHCARE AND MOBILE SOCIAL SERVICES IN 2021
Agnes Padan
‘Rural Sarawakians are the victims of decades of hardcore poverty and systematic state neglect. This must change in 2021.’
I am a healthcare and social activist, working with severely deprived communities in Lawas, rural Sarawak. The COVID-19 pandemic has caused significant job losses and many families have spiralled downwards into worsening poverty. Our maternal health, women empowerment and social advocacy outreach work is providing a vital lifeline for this community, as evidenced by the high number of calls and text messages we receive from the local community each week. We are also extremely grateful to all our generous donors who have provided direct support and assistance to many B40 families and patients in Lawas throughout 2020.
Better Healthcare for rural Sarawakians:
Our campaign for better healthcare in Sarawak started 19 years ago after I lost my mother to maternal health complications following delivery of my youngest brother, Jordan. The people of Lawas, a population of around 40,000, have been waiting more than 25 years for a new hospital facility after being promised one in 1996, under the 7th Malaysia plan.
Three collapsed hospital tenders and hundreds of millions of ringgit later, the people of Lawas are still waiting. At present RM175 million has been allocated a third time to build a 74 bed hospital, surely making this one of the most expensive and prolonged hospital projects in the history of Malaysia. The project is meant to take 182 weeks and be completed by August 2023. At present the land where the hospital is meant to be erected is still a pile of mud with a few token tractors. There must be a full parliamentary enquiry into the reasons behind why this hospital has take so long to build and what has happened to the hundred of millions allocated through previous tenders. The people of Lawas need answers.
During the COVID-19 CMCO, healthcare access in Lawas has deteriorated further. The area is landlocked and transfer to Sabah has been very challenging as has transfers to Miri across the Miri border. My small team of volunteers and I have continued to focus on assisting cancer patients, kidney failure patients and those with severe disabilities to access the care they need.
Many Sarawakian patients are falling through the gaps:Jessica is a Stage 4 cancer patient who following surgery and chemotherapy treatment needed radiotherapy but was unable to return to Hospital Likas Women and Children’s Hospital in August 2020 due to the lockdown. We had to arrange for paperwork for a travel permit and provided her with some much needed welfare support and transport assistance for her to be able to eventually make her way to Likas. Another family with a child with Down Syndrome could not afford the flight ticket to Miri General Hospital for further follow up. We were fortunate enough to find a donor who sent money for the flight ticket.
Another gentleman, Christopher, approached us with worsening symptoms of his chronic kidney disease, unable to afford the RM250 flight ticket to Miri for further investigations at Miri General Hospital as Hospital Lawas does not have a renal specialist or facilities for further work up. This time we approached Miri Member of Parliament, Dr Teo, who kindly provided the fare for the patient and his wife to travel to Miri in late November 2020. After 2 attendances at Hospital Miri Accident and Emergency, he is now waiting for further investigations and a kidney biopsy in mid January 2021 (as local government services are over stretched and the waiting list is long).
During CMCO, we were also called to assist a local Lawas mother (undocumented migrant from Sabah) who needed emergency healthcare access following a serious complication after a home birth. The young mother in her mid twenties had given birth to her 5th child at home because she was unable to afford the hospital fees for delivery at Lawas General Hospital. She has swollen womb and was suffering from a fever. I recognised that she might be developing sepsis and my heart sank recalling my own mother’s situation that led to her death over 17 years ago. Despite her protestations I brought her to Accident and Emergency at Lawas General Hospital where she was hospitalised for 3 nights for intravenous antibiotics and fluids. The bill came to over RM1500 which she was unable to pay so we raised funds to settle the bill, knowing that life of a young mother is priceless.
Difficulty Accessing My Salam and JKM Welfare support:
Many patients and the differently abled faced barriers to accessing welfare support due to a lack of awareness, digital connectivity and poor patient navigation. One such example is former fisherman Mr Mopin Mardi who was paralysed in an accident a year ago where he broke his neck and subsequently lost his source of income as a fisherman. He used to earn RM50 to RM60 a day as a fisherman but after his accident he became totally dependent on his wife who sold homemade ice-cream, earning less than RM5 a day. He struggled to attend his follow up appointments Queen Elizabeth Hospital in Kota Kinabalu as return trips cost about RM500. When we visited him he had still not received assistance from Jabatan Kebaijan Masyarakat (JKM) although he had been waiting more than 6 months. We highlighted Mr Mopin’s story in the press with his consent. Shortly after he was visited by JKM and started to receive monthly income support payments which he was entitled to. This support has gone a long way to helping Mr Mopin and his family cope with their new circumstances.
Another heartbreaking case is that of Basar Arun and his son Peter.
My heart truly sank the moment that I stepped into 80-year-old Basar Arun’s dilapidated home at Batu Mulong in Lawas, Sarawak. Basar is a former Sarawak Border Scout and is still waiting for the Malaysia government to grant him citizenship and a blue IC despite having served in the Sarawak Border Scouts and defended and protected our country against communist invasion. Basar, from the Lun Bawang community, is among a number of former Border Scouts who do not have citizenship. Like many natives in the rural Sarawak from the 1930s/1940s , Basar was born at home and never possessed a birth certificate. He has only had a green identity card and was later given a red MyKad. As a result of not having a blue IC, he is unable to access welfare support for his son Peter, who had a stroke a few years ago and was left severely disabled. I was shocked to see the condition of their home, with Peter lying on a rickety old wooden bed which left him with bedsores. Generous donors have since come forward to donate a hospital bed and ripple mattress and a team of community volunteers have helped Basar Arun to repair his home through a ‘gotong-royong’ initiative in time for Christmas. We have also contacted Jabatan Pendaftaran Negara (JPN) and are waiting for follow up on his blue IC application.
Improving healthcare access and social services in 2021
These stories from the Lawas frontline share a unified theme: rural Sarawakians in places like Lawas are in desperate need of access to safe, quality healthcare closer to home as well as mobile social service units that are able to provide comprehensive needs assessment and services to vulnerable patients and the differently abled at the point of need. With a rural population of less than 1.5 million and boasting significant state billion ringgit reserves, health and social care transformation in rural Sarawak must be the state governments top priority for 2021. Sarawakians must demand no less.
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