Universal Healthcare For All In Sabah

It is a system that delivers good-quality medical care to all citizens and residents, regardless of their ability to pay should be a right and not a privilege. The World Health Organisation (WHO) Constitution envisages “…the highest attainable standard of health as a fundamental right of every human being.”1 Quality, affordable and accessible health care is the foundation for individuals to lead productive and fulfilling lives and for countries to have strong economies.

Key Issues Affecting Healthcare in Sabah

Not Enough Doctors In Sabah

Sabah ranked the second highest in the population of doctors in the country, however despite the laudable standing, the doctor to patient ratio stood at 1:865 in 2018³. This is much higher than the national average of doctor to patient ratio of 1:454 and even further from the recommended ratio by WHO at 1:225. Going by the WHO standard, Sabah doctors are doing nearly four times the recommended workload.

  • The rural health sector in Sabah is one of the largest funded by the government4. The Ministry of Health has been deploying healthcare workers to both rural and urban hospitals in Sabah, however there remains a lack in the supply of specialists especially to the rural areas.
  • A report revealed that west coast states in Peninsular Malaysia had between three and 33 times more specialists compared to Sabah across the anaesthesiology, surgery, orthopaedic surgery, medicine, paediatrics, and obstetrics and gynaecology departments5.
  • From an economic perspective, government subsidies and initiatives for public healthcare workers have been decreasing over the years. While government medical facilities are overbooked, doctors are opting to work in private hospitals for better pay packages6.
  • As many of the hospitals in Sabah are understaffed and medical staff are forced to work extra hours continuously for more than 24 hours to compensate. This is commonly the case for Kota Kinabalu, Sandakan, Lahad Datu, Semporna and Tawau Hospital.

Difficult Getting To Healthcare

Currently, there are 24 state hospitals and 300 government health clinics throughout Sabah to accommodate all 27 districts³. Unfortunately, this is not enough to cover the state’s population. Accessibility to these medical facilities is an added challenge, for example poor road conditions, dangerous terrain and unpredictable weather

  • 6.5% of Malaysia’s population live more than 5km away from any healthcare facility 7. This number is much higher for states like Sabah and Sarawak 8. With more rugged terrains, one-third of their population is far away from a hospital. A 2015 study from the Ministry of Health found that the average time to reach a hospital for rural residents was 30.65 minutes compared to 16.71 minutes for urban residents 8
  • In order to accommodate emergency situations, government-managed ambulances which also includes airlift capacities for remote sites are provided. There are also non-government organizations (NGOs) that have taken the initiative to provide these rural communities with necessary healthcare.

Lack Of Medical Supplies & Poor Infrastructure

It takes twice the effort and time to get medical supplies and equipment to hospitals and clinics in Sabah. The majority of these government clinics are stocked with only basic medical supplies and often lack large equipment like X-Ray Machines, lab testing facilities, etc. This has led to some patients with chronic diseases unable to receive proper diagnosis let alone desired treatment⁸.

..land transportation to remote areas from Kuching and Kota Kinabalu, Sabah, can take up to 12 hours. The situation in Sabah and Sarawak is different compared to West Malaysia, especially when you talk about climate change, the flood, rain, landslide, that will affect land transportation.”
 

– Ts Hj. Ramli Bin Amir, president of The Chartered Institute of Logistics & Transport (Malaysia) 9

 

For this very reason, rural communities in the state are facing a delay in their COVID-19 vaccinations. The rugged terrain and poor infrastructure of medical facilities make it difficult to store the vaccine doses8.

Healthcare For The Stateless

Sabah has a large population of stateless (undocumented) people – but they do not receive the same medical benefits as Malaysians. As the stateless fall under the foreigner community, they are expected to pay 24 – 100 times more than a Malaysian citizen when in need of medical attention¹⁰.

  • The Bajau Laut, a prominent stateless residing in Sabah, cannot afford hospital visits, thus are prone to skin infections, hookworms, or skin lesions, as a result o f poor sanitation standards and lack of hygiene practices. More serious medical cases include malaria, typhoid and tuberculosis, which they ‘bear with’ to avoid going to hospitals 11
  • Giving birth from home is another common practice of the Bajau Laut community. This not only puts the newborn and mother at risk of multiple labour complications but also continues the cycle of statelessness11.

Changemakers

Movers and shakers who are making a difference through healthcare in Sabah

Infographics

Visually designed data for you to share, be informed and start conversations with your friends.

Universal Healthcare For All In Sabah

Equal Education Opportunity For All In Sabah

Better Employment Opportunities & Advancement In Sabah

Challenges In Restoring The Identity Of The Stateless In Sabah

Closing The Digital Divide In Sabah

Explore Our Sources

  1. World Health Organization. (2017). Human Rights & Health. Link. 
  2. NUMBEO. (2021). South-Eastern Asia: Health Care Index by Country 2021. Link.
  3. Ministry of Health. (2018). Bilangan Doktor Mengikut Negeri, Sektor & Nisbah Doktor Kepada Penduduk, Malaysia Seperti Pada 31 Disember 2018. Link
  4. N. S. Ahmad & N. A. Johan. (2018). Accessibility to Health Care Services and Other Facilities in Malaysia. Link. 
  5. Code Blue. (2020). Sarawak Specialists Up To 18 Times Fewer Than West Coast Peninsula: SUPP. Link.
  6. AIA. (2017). 6 things you should know about healthcare in MalaysiaLink.
  7. N. M. Noor, J. R. Khalidi, P. M. M. Muzafa. (2020). The State of Households 2020 Part III. Khazanah Research Institute. Link.
  8.  A. Yeo. (2021). Vaccination Challenges In Rural Sabah & Sarawak. Emir Research. Link. 
  9. WHO. (2020). Going the extra mile to protect children against polio during the pandemic. Link.
  10. Ministry of Health. Laws of Malaysia. Link.
  11. W. Hassan, W. S., & Peters, D. (2020). The Vulnerability of Bajau Laut as stateless people in Sabah. Jurnal Kinabalu, 183. Link.

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