Sabah & Covid-19: 7 Observations How Poverty Has Affected The Health Of The State

The spotlight has been on Sabah in recent months due to the recent state elections and the spike to Covid-19 cases.

Voters waiting for their turn at a polling station during a state election — Source: The Straits Times

Sabah has contributed the bulk of cases nationwide from the end of September till now. Some days they have recorded up to 80% of the nation’s cases.

On top of this, there is an increase in the number of severe cases of Covid-19 patients in Sabah – patients requiring supplemental oxygen, according to an anonymous medical officer in Tawau.^[1]

Has Sabah as the poorest state in Malaysia exacerbated this health crisis?

Is there a link between poverty and the nation’s healthcare system? Here are 7 observations to consider:

#1 – Most Covid-19 patients coming from Semporna to Tawau hospital are worse off when they first arrive at the hospitals.^[1] Many of them end up being intubated and requiring a ventilator to support their breathing.

Drive-thru screening tent for coronavirus testing — Source: The Borneo Post

#2 – 54 out of 58 deaths due to Covid-19 between 9-22 October 2020 are from Sabah. The death rate of Covid-19 cases in Sabah is 7.3 times higher of the national average. The number of cases are 12.8 times more than the rest of Malaysia.

Re posting this as I was not clear in expressing the gravity of the situation:
Sabah’s mortality is 7x higher that rest of the nation.
Sabah’s infection rate is 13x higher that rest of the nation.@codebluenews @malaysiakini @aidilarazak @dririshsea @melisa_idris pic.twitter.com/ZyuN1fSscC
— Amar-Singh HSS (@DrAmarMOH) October 23, 2020

The cumulative Covid-19 death toll for Sabah has hit 114 – 89% of it is from October alone. Latest update on 28 October 2020 shows the gravity of deaths of Covid-19 cases in Sabah:

Sabah Covid-19 death — via: Malaysiakini Twitter feed

#3 – During one period, the Intensive Care Unit (ICU) was full and had to turn away patients to direct them to the Lahad Datu Hospital^[1] which was another 2 hours and 30 minutes drive.

#4 – Most patients arrive late to the hospital after symptoms are detected. Many would have to walk or take a boat from their home to the mainland before taking a vehicle to the hospital. The issue is compounded with hours of waiting in line before they are tested or treated.

Checking for fevers in Sabah — Source: The Straits Times

#5 – To show context of the vastness of Sabah, the Kinabatangan district alone is the same size as the state of Selangor.

#6 – Contact tracing is proving difficult because of logistical issues. Hypothetically, if there were sufficient front liners to go to the patient’s home to test their family or community, the spread will be more controlled. However, in this situation, even locating their houses is a challenge as many live off the grid.

Listen to Tan Sri Dr Hisham, Director General of Ministry of Health Malaysia, explaining the logistical issues faced in Sabah.

Masalah di Sabah adalah dari segi logistik iaitu dari satu tempat ke satu tempat..- Ketua Pengarah Kesihatan, Tan Sri Dr @DGHisham #NormaBaharu #DisiplinMalaysia #HapusCOVID19 pic.twitter.com/jpO7XmjDTP
— ????????Astro AWANI???????? (@501Awani) October 28, 2020

#7 – There are 50% less doctors in Sabah compared to the national average. According to the National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013^[2], Sabah has 33.4 doctors per 100,000 population compared to the national average of 67.1.

The pandemic has only magnified the issues surrounding the poor. Why do poorer states have to bear the brunt of this health crisis?

Explore our sources:

Ashswita Ravindran, Code Blue. (2020). Poverty, Sickness, And Death: Why Sabah’s Covid-19 Patients Are Ill. Link.
Ministry of Health Malaysia. (2015). National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013. Link.

latest update: 28 October 2020