Tuesday, May 27, 2008

Disease lurking in our house/ 潜伏家中的疾病危机

It is estimated that there are around 1.5 million legal workers in this country. Only God knows the number of illegal workers. Figure tossed around was above 800, 000. The medical examination of foreign workers in the country of origin is a contentious issue especially from Indonesia. Strictly speaking, patient will be rejected if unfit in country of origin. However, they can easily change their identity and get their medication examinations done by a different doctor in a different place, from unfit to become fit. When random checking was done in Malaysia at the point of entry, it was found about 4.5 percent medically fit legal workers found to be unfit at entry point in Malaysia

When I was still the Minister of Health, I made changes and decided that it is compulsory to have medical examinations on the first month the workers arrive since examination in some country of origin cannot be trusted. The influx of foreign workers have resulted in re-emergence of infectious disease in Malaysia. Glaring examples are tuberculosis, malaria, syphilis. TB is usually associated with people from poor economic background with lack of sanitation. However, it is not uncommon to find TB in Malaysia among the middle income and rich as well as children because the source of infection comes from the maid who lives in the house.

Medical examinations in Malaysia while it is coordinated by Fomema, some of Malaysian doctors are also not fault free. Laboratory tests are known not to be stringently conducted, X-rays done but not read, the range of laboratory tests are also restricted so that they save on laboratory expenses. While some of these black sheeps had been identified, nor all the problems are solved. Doctors should not just be blacklisted if found to be unprofessional, but should be referred to MMC for disciplinary action because of unprofessional conducts.

The laboratory fees paid to Fomema is suspected to be bloated (RM60 – 75) because of Fomema’s passing this job thru a trading company. Sometime in December last year when I was still the Minister, I managed to persuade Fomema (lab operator) to bring down the price of laboratory tests to RM40 and Fomema to abolish collection of laboratory fees through 3rd party. To be honest, I don’t know why this decision is still not implemented by Ministry of Health although it was agreed then by the Ministry, Fomema and the laboratory operators. Laboratory should be subjected to the Pathology Act so that they become more professional in their conduct of business. The laboratory test must be reliable and accurate. Once the Pathology Act is implemented, they too can be fine and deregistered.
------------------
根据官方统计,我国有约150万名合法劳工,至于非法劳工的确实人数则无从估计,我想不会少过80万人。

外劳在来源国所进行的医药体检一直备受争议,尤其是来自印尼。严格来说,无法在祖国通过第一关体检的外劳将被拒绝录用。不过,他们却通过其他管道让其他医生鉴诊并取得体检合格证,瞒骗输出国和聘请国的官员。这就是为何执法当局对抵境的外劳展开抽样调查,仍会发现有约4至5%的外劳带病入境。

由于来源国的医药体检受置疑,我任职卫生部长期间,曾更改体检程序,强制所有外劳抵达我国的首个月内,须接受第2轮体检。这些年来,我国劳工市场对外援的需求日益增加,而外劳大量涌至也导致许多在我国已绝迹的传染疾病再度出现,肺痨、疟疾、梅毒是最明显的例子。尽管肺痨只发生在严缺完善卫生系统的贫穷或非发展国家,但在我国,却常闻那些来自中上和富有家庭的幼儿被家庭女佣传染的病例。

我国的外劳体检是由外劳体检公司(FOMEMA)负责,坦白说,这些指定的体检诊所医生也会有失误。我们常发现体检诊所没有严格进行指定的化验室测试、没有检阅X光扫描报告、为节省开支而局限化验室测试的项目等。虽然有关的害群之马被揪出,上述问题还是继续发生。我认为,这些违反专业操守的医生不该只被列入黑名单,也应交由大马医药理事会审讯,以对他们采取严厉的纪律行动。

外劳体检公司相信是由一家商业公司来执行其特许权,因此有传目前化验费的化验费已飙涨至60-75令吉之间。2007年12月间,我曾和外劳检验公司高层面谈,并成功说服该公司以及化验室经营者把化验收费降至40令吉,该公司也同意废除征收3令吉中介费。

有关收费的问题,卫生部、外劳体检公司及化验室经营者既已取得共识,我不了解为何卫生部至今还未落实。化验室的测试结果必须准确可靠,因此,所有化验室应受到病理学法令约束,只有在法令的监管下,国内各私人化验室才会遵守专业的商业准则。一旦病理学法令落实生效,违法的营业者将面对罚款及被吊销注册。

7 comments:

Jason Wong said...

The figure given by the Internal Minister is 3 millions. We have seen every couple of years, we have different foreign worker policy. People in charge do not know how to manage foreign workers. We do need the contribution of foreign workers to give some sectors competitive, but we should increase the quality of these workers. Many parties are at fault, i even seen case when a illegal Indonesia worker went back through connected channel, changed passport and came back again. Not only the fish head of MCA is spoiled, but the fish head of our government also spoiled.

Funniman1965 said...

A well known dermatologist told me some years ago that leprosy had made its emergence amongst the population at large.

Although it can be cured, the problem is the disease would remain embedded in the skin, affecting all the nerves and become numb. A person would discover it many years later. The only symptom is some discoloration of your skin in patches and if you are a dark skinned person, there's nothing to see until it is too late.

Illegals do not have proper documentation would not seek medication at hospitals and they are allowed to roam freely amongst the locals. Same goes for some maids too where medical reports might be compromised.

Because it is such a hideous disease, people often do not want to talk about it or they are totally ignorant. The younger generation don't even know what it is. By the way, it is also called Hanson's disease.

ras said...

Dr.,

A few months ago I was shocked to learn that an Indonesian woman with permit as a maid, who broke the law by marrying a Bangla and got pregnant, got her permit renewed without going through the medical check up. She paid Rm1500 to circumvent the legal requirement. I therefore assume there must be thousands of similar cases of pregnant or diseased foreign workers not undergoing the medical check up thereby breeding corruption and spreading diseases.

AmyDoll said...

Dr Chua,
i may not know much about the "complexities" of malaysian politics la, but enough to know that it takes ages to discuss and approve a policy, and once approved, they hardly follow through. Its very typical, hardly a surprise there.

Why is there an influx of illegal immigrants entering the country and worse still they get same benefits as the rest of our malaysian citizen by possessing fake ICs. MyKad supposed to be have all these great features of being an all-in-one card, but frankly not even ONCE my card was used for the intended purposes. It's so easy to fake a card, but what if the information inside that card is the one that is vital, not just for the picture and address? I am sure when Malaysia implemented the MyKad system, there must have been the devices that could actually READ the card, but just being redundant. at the end of the day, i feel it's all about money. malaysia wants to do great stuff, but if the politicians and beneficiaries do not get the desired amount of benefits, they'll scrape it off and leave it hanging. Half-baked job as usual. What can many malaysians do? just accept it as a way of life to be half-baked.

I know I digress from the main topic of Foreign Workers and Diseases... but from what I have written, it boils down to the fact that at the end of the day, malaysia will change... but not as quickly and as progressive as we potentially can because of this "talk now, think later" attitude that malaysians have.

i wonder if there's still hope for the country given the fact many politicians cannot take criticism gracefully and stop and think for a second of reasons why these criticisms came to be instead of dismissing them to be slanderous, seditious and a whole big bunch of BS.

Dr Chua, despite your scandal, I thought you handled it gracefully. Kudos to you on that.

Funniman1965 said...

Datuk Seri,

Although many a times, I am quite a critic of your actions but as a Health Minister, you had done a very good job. You do not mince your words in all these health issues within your own principles.

Sex scandal is just another episode in life except it is amplified when you are a public figure. So it is not a huge issue for a commoner like me.

What remained to be seen is how the Government is going to handle all these social pains contributed by these illegals.

We have subsidised health care in some very good hospitals. I went to the Selayang Hospital was surprised to learn that some top orthopedic doctors were lured back into service in recent years.

However, what is the use of these health care plans when the uncontrolled carriers are spreading diseases around? It may sound scary but STD, Tuberclosis, Leprosy are all over the place. But unfortunately no politicians are willing to raise these unpopular topics.

Pearls said...

Again... this is another case of our authorities/administrators aka gomen/enforcement bodies having no INTEGRITY and ACCOUNTABILITY! FULL STOP...

What I cannot accept is the fact that other countries such as Singapore and Hong Kong are able to handle these problems efficiently and minimise the risk involved but we, the country that has so many impressive things such as the Cesar Pelli's Petronas Twin Towers, are not able to. WHY?!

We can all talk until the cows come home and shit, we are not going to get anything done if the administrator aka government, enforcement authorities of this country doesnt want to admit that they are hopeless and useless! Oh! dont forget greedy too!

It pisses me off so much to hear Badawi saying that we are doing good, everything is honky dory, that his administration is doing a good job and therefore, we, the ungrateful citizens should stop complaining, our inflation is ONLY 3 fcukking percent! blah blah blah...Nah! like that la.. we are doing good.. got free exposure to all sorts of life threatening diseases and illnesses la.

If you are asking how to make this right, I say sack the government, get a new bunch of people in, send the relevant people for training in Singapore to learn how they do everything efficiently, come home and implement. No need to talk so much! No need to waste time! As it is, a lot of time has been wasted..

NEIL said...

Dr Chua, This is a true encounter.I was in Pontian the other day and I heard that there are many indon workers who have diseases and when they go for blood test they can use others clean blood in order to pass the test.Just pay a bit more and they can stay longer.No wonder there are all types of sickness these days.

Welcome to my Blog

As a concerned MCA member, I am trying my best to help in the process of rebuilding and repositioning of the party.

Therefore, I welcome party members and members of public to post your constructive suggestions and opinions on my blog on how to rebuild and reform the party, eventually enabling MCA to regain support from all party members and the community.


Thank you for your suggestions.