As I look back into the past, I recall walking down the corridors of a government hospital in Malaysia, brimming with passion to one day serve my country as a doctor. I proceeded to take a history (verbal account) from a patient who had a very rare diagnosis. As far as medical students are concerned, rarity is superiority, for it laid the framework for an interesting presentation to the medical professors later that evening. As I completed the history, I was stopped in my tracks by the patient's mother. She was rather inquisitive. “When do you finish medical school?" she asked. “Just a couple of months to go”, I replied with a wide grin.
“That's great”, she remarked. “I hope you become a passionate doctor, not like the useless junior doctors who are protesting every now and then and planning strikes. After all, you chose this profession and you know what entails- SACRIFICE. So, I hope you are prepared to do just that- sacrifice." I was taken aback and rather dumbfounded by this statement. I wonder if she would have said the same had her son/daughter been in the position of a junior doctor. This is however, the reality of the job back home in Malaysia, for there are sections of society who think Malaysian doctors are Deadpools or Spidermen, possessing superhuman powers, and adept at pulling off multiple all-nighters on the trot.
However, the jarring truth is that doctors are human too. They have their limits and they have their desires for a well-balanced life. Just last April, a group called the “Mogok Doktor Malaysia” orchestrated a strike for contract doctors. The aim was to deliver a knee-jerk to the government and behove them to absorb all contract doctors. The strikes fell short in magnitude, not because of a lack of support, but rather because of fear of ramifications by those higher up. Our Health Minister, Dr. Zaliha Mustafa, remarked with a great amount of gratification that she was very pleased that the planned strikes had fallen through. What she and the government failed to realise is that the only reason the strikes failed was fear: Fear of the minister's statement that striking doctors would face disciplinary action for breaching the public service code and fear amongst contract doctors that seniors would mark them as recalcitrant should they choose to strike. In this regard, the Health Minister and the government should reflect on the words of William Arthur Wood: “Leadership is based on inspiration, not domination, on co-operation, not intimidation”. Successive governments claim to “value the sacrifices of Malaysian doctors”, who are toiling hard on a daily basis at work, but thus far, it all appears to be mere lip service.
Coming back to my story, the time soon came for my friends and I to decide where we would choose to ply our trade: “Home or Abroad”. Despite the ominous clouds that loomed over entry into the Malaysian healthcare system, many of my comrades valiantly chose to serve our “tanah air”. A handful of others, like myself, chose to go west instead, setting up bases in the UK. Though thousands of miles apart, many stories reach me of the lives of my friends as junior doctors in Malaysia. I hear stories from friends who work 16-17 hours a day, whereas I work a maximum of 10-11. I hear stories from friends who have only 4-5 hours of sleep on a daily basis prior to work, whereas I consistently get to have 8/9. I hear stories of friends who are humiliated and called “bodoh” by seniors, whereas I am encouraged by seniors to ask, learn and develop into holistic doctors. I am also told that “no question is stupid”. Ultimately, this highlights the gulf of difference in attitude towards junior doctors in Malaysia versus a country like the United Kingdom. How do you expect a doctor to remain a passionate, bright flame when you keep piling sand on it? Ostensibly, even the brightest and most zestful of flames would be fully doused.
From a personal point of view, does this mean I have stumbled upon the holy grail and would not like to return to Malaysia? No. Malaysia will always be my only home, and I hope to return and serve the “rakyat” someday. I also hope to be an instrument to correct the frailties in the healthcare system, but all one person can do is write an article like this one, in order to make sweeping changes to our healthcare system, a coordinated and synchronous response is required from multiple people covering all hierarchies (from top to bottom).
Doctors are meant to be treating ailments, but in Malaysia, they themselves are ailing. So, what can Malaysia do to come up with an antidote for this issue?
Many branches of our country's governance are modelled after the UK. For starters, we can remodel our handling of junior doctors to mirror the practices of the UK towards their own junior doctors. The National Health Service in the UK, like the Malaysian healthcare system, is far from perfect, with junior doctors striking from time to time demanding equitable pay. The difference between the two countries is that strikes in the UK are supported by law and take place under the jurisdiction of the British Medical Association(BMA). The BMA acts as a third party between doctors and the UK government, acting as the voice for doctors, running negotiations and demanding action to resolve their plight. In Malaysia, the actions of intermediary associations, such as the Malaysian Medical Association(MMA) are very much muted in comparison to the BMA. The first step that Malaysia should take is to empower and provide more countenance and funding to organisations like the MMA to support the needs and rights of doctors in the country. Secondly, the government should actively lend an ear to the plight of doctors and the issues they are trying to bring up; and not be dismissive about them.
For instance, previous issues brought up by doctors such as an untenable hourly on-call wage of RM 9 per hour, low absorption rates of contract doctors and unsustainable working hours are substantial and should be provided due attention, with a view towards rectification. Back in 2021, at a staged walkout by junior doctors, then Health DG Tan Sri Noor Hisham made a plea for doctors not to forget the oath they had taken when graduating (in reference to the Hippocratic Oath). Isn't it ironic that the Hippocratic Oath was born as a conception of the West, yet none of the Western nations reference it when their doctors stage strikes/protests? Rather, it is us, all the way down in Southeast Asia who use the Oath as a scapegoat to instill fear in junior doctors and suppress their right to protest and voice concerns.
Many of you may ask, why only doctors? How about engineers, accountants, lawyers? What about the tribulations faced by them? Don't they have problems too? As someone from the medical profession, I am only qualified to speak of mine, but in my opinion, we should definitely address shortcomings in each and every profession in our country so that we can produce a truly productive and happy working-class society. For wherever there is happiness, there is success. Wherever there is success, there is fame. And wherever there is fame, there will be pride- not for any individual, but rather, for our beloved nation, Malaysia.
Thillak Sekaran is a content creator under the Newswav Creator programme, where you get to express yourself, be a citizen journalist, and at the same time monetize your content & reach millions of users on Newswav. Log in to creator.newswav.com and become a Newswav Creator now!
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