Something worthy of our eternal gratitude

WHEN faced with the term heritage in a book title, how many bibliophiles, I wonder, would not grab a copy and proudly display it in their study room or place the book on the coffee table of their company’s guest room?

It was with this sentiment that I held on to Heritage in Health (HIH) for the past week to flip through from cover to cover though I had read the drafts while the book project was in progress.

The book is a chronicle of the establishment and development of the health service in the state from the Brooke era (1850s to 1946) to the years after the formation of Malaysia.

With such a wide chronology and abundance of topics being introduced, HIH is a fairly slim volume. As such, this book does not detail the specific events and ideas of the past but rather why and how the history was written as the publisher said in the preface:

“We now realise that we were good at developing new things and implementing them at the right time and the right place but did not do enough in documentation. Our philosophy then was ‘just do it’. So we did not spare the time and effort to write about and share our experiences except as needed for programme monitoring and evaluation”

Nevertheless, this is an informative and enjoyable read with the authors and editors giving the work a lively and original tone.

It is an eye-opener for non-medical personnel, particularly journalists, to understand how many important programmes and concepts unique to Sarawak were introduced in the articles classified under ‘Sarawak’s unique health programmes’.

This should put on record as to how the State Health Department had to constantly develop new strategies to meet the challenges of providing equitable healthcare to rural communities because of the enormous physical and socio-political challenges posed by either inaccessibility to facilities and funding or a huge geographical and culturally diverse state.

The Kampung-style teleconsultation, involving photographing X-rays, scans and reports using digital cameras, and sending them by email to hospitals where specialists are based, may seem a fanciful name but it reflects the sorrowful state of our healthcare in ICT development.

It was recorded that only by the end of 2003, all hospitals, except for Rajah Charles Brooke Memorial Hospital and Sentosa Hospital (which are in Kuching), had been provided with the bare minimal necessary hardware, and were implementing what became commonly known as kampung-style teleconsultation, a term coined by Tan Sri Datuk Dr Abu Bakar Suleiman, the then director general of health, to reflect its technology at low cost (TALC) design (p 324).

Unique to Sarawak is the introduction of the Flying Doctor Service (FDS) in 1973, which is an important component of the healthcare delivery system in the state to strengthen healthcare services to remote communities.

The challenges faced by the FDS team were often daunting.

“For instance, in Kapit Division, there were occasions when the helicopter was grounded for a few days because of bad weather or other unforeseen reasons.

“The FDS team had no choice then but to put up with wearing the same clothes and underwear or tanchut for days, and even sleeping in the nomadic Penan’s huts, surrounded by their pack of hunting dogs.”(p 299).

So it’s appropriate to pay a timely tribute to the FDS team.

The State Health Department also created many firsts – innovative and effective in our unique land – which included introduction of Primary Health Care approach long before the idea was formally recognised in the Declaration of Alma-Ata, adopted at the International Conference on Primary Health Care, Alma-Ata, USSR (presently, Almaty in Kazakhstan) in September 1978.

Aptly enough, the team of writers and editors justify why they embarked on this book project: “Lest we forget to tell people how we did it and why we did it”¨

Indeed, the memoirs of state health directors from Dr Tan Yaw Kwang to Dr Andrew Kiyu on their different leadership styles could be a good recollection for journalists who associated with them during their tenure of office.

Their memoirs would answer many questions of one of my senior journalists, Peter Sibon, on how these directors dealt with him in the course of his work.

Peter described Dr Stalin Hardin as a very dignified person who did not like talking to journalists without proper procedure.

Hardin wrote: “I once had to appear before the Public Accounts Committee of Parliament, consisting of three Members of Parliament and the Accountant General, to answer questions relating to the tender for the Flying Doctor Service in Sarawak. The question was why was the government required to pay the FDS when the aircraft was not flying? It was a frightening experience”¨

Could this be the incident that made Dr Hardin insist on following proper procedure before meeting any journalist?

Peter’s experience with Dr Yao Sik Chi left an indelible impression of a man who is soft-spoken, kind and approachable – even during the SARS epidemic in 2003, hence making Peter’s reporting days much pleasanter and easier.

I was pleasantly surprised to read that one of Dr Yao’s administrative styles was maintaining a cordial relationship with the press. He reasoned,

“Good rapport with the press helps maintain a positive image of the Department and assists in public education efforts.”

Indeed, each medical personnel had contributed in their own right something of great value to mankind ¡V something worthy of our eternal gratitude.

Heritage in Health is the ideal present for those who are aware of their own mortality and wants to do something about it.

It is also a wonderful tribute to the healthcare personnel – past, present and future.

This article is written in conjunction with the launching of Heritage In Health by State Health Director Datu Dr Zulkifli Jantan today. The Borneo Post is proud to be a part of this heritage project.

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