Forget about failed state debate, our healthcare system is failing

 

“Our government hospitals have been starved for too many years due to poor funding, and a starving person cannot fight infection.”

– Anonymous frontline health worker

The debate if Malaysia is a failed, failing or going to fail state is a distraction. The existential threat facing Malaysia at this moment is that our healthcare system is failing, right before our eyes but more importantly the political will to battle this pandemic is directed at the conflict within the establishment.

For years, our healthcare system was riddled with the usual afflictions associated with the ethnocentric rule, which meant that incompetent management, corruption and a general malaise towards the rakyat were debilitating but the country and the healthcare system managed to limp around like a befuddled patient wandering the halls of a general hospital.

What this pandemic has done, what healthcare professionals and competent leaders the world over had warned, is that this pandemic exposes the structural weakness of any given system. At any other time, even under Umno or Pakatan Harapan rule, we would have at least managed to put up a good if compromised fight. However, with this backdoor government, all we have are a bunch of brigands more interested in political survival than running this country, even if in a flawed manner.

Due to the political instability brought upon by the Sheraton players, the political establishment has been unable to mount an effective defence against this pandemic. And let us not let the rakyat off the hook either. When the rakyat sees political operatives breaking SOPs, or when the government rolls back restrictions, it makes the pandemic less serious and it becomes a partisan issue rather than a health emergency.

Reaching out to a political operative involved in healthcare policies, I was inundated with calls from healthcare professionals ranging from specialists to nurses to hospital cleaners, who painted a picture of gross incompetence and an apathetic attitude from superiors and the political class. All of them believed that the system was going to buckle soon and they were terrified that they could not speak out in the open for fear of reprisals. As one of them said, not only do we have to look after patients, we also have to think about ourselves.

Another, speaking in a whisper because she was calling from ground zero, claimed that the situation was much worse than portrayed in the press and she was worried because she claimed that everyone was avoiding responsibility. Supplies were running out and frustration was turning into anger. “Nobody listens to me, because I am just a nurse,” she said.

There is a strong mistrust for what the government is doing and the statements and strategy coming out from the occupants of Putrajaya do nothing to allay those fears and mistrust. 

The fact that Dr Jemilah Mahmood, the special public health adviser to Prime Minister Muhyiddin Yassin deleted her tweet agreeing with Brigadier General Dr Mohd Arshil Moideen, who said - “What I see is a lack of top-down unified action and coordination” - is an indictment, considering the lives lost and the economic devastation that this pandemic has wrought but also how people are generally afraid to speak up, which creates more problems for the healthcare system.

Dr Jemilah Mahmood, the special public health adviser to Prime Minister Muhyiddin Yassin

And the general’s words were not a partisan statement, because the general also refers to the chaotic implementation of policy and strategy on a state level. When frontliners have to anonymously warn the public about the ravages of the pandemic and the situation on the ground, this should tell us something about how the healthcare system is failing and what kind of political system we have in place.

Furthermore, when healthcare professionals do speak anonymously, the establishment, whether PN or Harapan, seems more interested in covering up or deflecting from the issue at hand rather than dealing with the problem, as we witnessed in the “confusion” at the Shah Alam Melawati stadium.

Indeed, Dr Rafidah Abdullah, a consultant physician and nephrologist at Putrajaya Hospital, diagnosed the current situation accurately when she said - “As a professional, we cannot lie. Even stating ‘not true’ is not right. Don’t fall into the game of putting up a show. There is nothing wrong with confirming that many government hospitals and health facilities (including universities) around the Klang Valley are paralysed... it’s a fact and a reality.”

Social media is flooded with commentary by health professionals on how dire the situation is. Their rejoinders point to systemic dysfunction, which is not only the fault of the current regime but rather the indifference of the political class and how they prioritise issues when it comes to reforming the country or maintaining the system in place which has been going on for decades.

The reality is that any rational person would not trust what is coming out from Putrajaya at this moment. This, in no way, means that they trust what is coming out of the opposition either. Selangor, an opposition-controlled state (for example) is handling the pandemic in the worst possible way.

Even though partisans would love to blame Putrajaya for this, the reality is the Harapan state government has failed Selangor. In this situation, there is, unfortunately, more than enough blame to go around.

However, what this Malay uber alles government has demonstrated is that there is no leadership when it comes to battling this pandemic. There is no political will to mitigate the vagaries of this pandemic. There is no centralised plan working with state governments and in bipartisanship, to bring us all together to fight this pandemic, but most importantly, Putrajaya is not listening to the grunts on the ground.

However, this is an issue that can be fixed. While bringing in the military and reprioritising the handling of the pandemic as a security threat is a good strategic move, more needs to be done in a transparent manner. As it is, everyone is using the handling of this pandemic as political talking points.

The federal government has to work in a bipartisan manner with all political operatives and the frontliners have to be listened to instead of the usual kakistocracy strategies applied to deflect and gaslight the rakyat. More frontliners have to come out and openly question the handling of this pandemic because even making noise anonymously results in actions being taken, if only to cover behinds.

This is really a situation where everyone can play their part. The rakyat have to understand that we are in the midst of a dress rehearsal for a future pandemic which could be worse. There is this rather naïve argument that successive governments of Malaysia have no idea on how to handle issues like these. It is the same with running this country, which is why we get this failed state debate.

This is the problem with Malaysia’s political terrain. We have the expertise and the commitment to handle almost any situation. We have competent people but they have always been sidelined. We have the laws and the tools necessary to deal with situations like these but they have never been applied consistently and rationally. Only someone who is ignorant of the realities in Malaysia would claim otherwise.

The issue has always been that the political establishment lacks the political will, choosing instead to wallow in racial and religious policies to maintain power but more importantly they have never been held accountable.

The most important first step is to listen to your troops on the frontlines. - Mkini

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S THAYAPARAN is Commander (Rtd) of the Royal Malaysian Navy. Fīat jūstitia ruat cælum - "Let justice be done though the heavens fall."

The views expressed here are those of the author/contributor and do not necessarily represent the views of MMKtT.