Kit Siang: Hold Minister and D-G responsible for health services scandals
Ng Kee Seng

PETALING JAYA (Dec 22, 2006): Parliamentary Opposition Leader Lim Kit Siang says it is time to hold the Health Minister and director-general responsible for the continuous bungling services at government hospitals.

"It is the only way to ensure that there would be changes in the system. They have failed in their duties and are personally responsible for failing to publicly respond to scandals and outrageous," he added.

Lim was referring to the Dec 13 incident when no ambulance from the Klang Hospital (Hospital Tengku Ampuan Rahimah) was despatched to an accident at the Batu Tiga toll booth.

Businesswoman Zara Davies Abdul Rahman (a mother of five children) spent more than a traumatic hour waiting for an ambulance which never turned up. The accident victim, Mohd Yusry died on the way to the hospital in a car.

He said three months ago health D-G Tan Sri Dr Ismail Merican said that "anything more than 15 minutes is unacceptable" with regard to the response times of Malaysian ambulances.

"Both (Health Minister) Datuk Seri Dr Chua Soi Lek and Ismail have yet to respond publicly to account for Klang Hospital's failure to despatch an ambulance to the accident scene.

"How can he (Chua) be pulling up the hospital for the scandalous emergency response time when his response is equally scandalous," he said in a statement released yesterday.

Here is Zara's harrowing account of the tragedy and the avoidable death of Yusry:

On the 13th of December 2006, at approx 1.30pm a road traffic accident involving a driver driving a dark blue Proton Saga and a highway road sweeper of Malay decent, male, approx mid 20s (the road accident victim).

The location of the accident was about 150m to 200m from the Batu Tiga toll booth, elite highway in the direction towards KLIA.

I chanced upon this accident which had just happened while on my way back to work (Ampang via KESAS).

As I approached the accident site it seemed the victim was already dead, the driver who had knocked him down was standing near-by and nobody dared approach to lend assistance to the victim, almost as if this was one time were an invasion of privacy was taboo.

I stopped my vehicle and approached, upon examining the accident victim I found him to be still alive but heavily concussed, his pupils were completely dilated.

Suddenly the victim grabbed my hand and tried with all his might to raise himself to his feet. I tried to calm him and asked by-standers if an ambulance had been called. I was told it had not.

In a firm tone I told the driver of the car that hit the victim to call for an ambulance. He dialed 999, it rang until it could not ring anymore. He rang again, again it was not answered, he rang again and passed the phone to me. Finally someone answered (a man).

I informed him that I am reporting an accident a few hundred metres away from the Batu Tiga Toll in the direction of KLIA. He asked me my phone number and my name and which hospital was nearest. I gave the info and added that the nearest hospital to deal with this kind of trauma is probably Klang.

At 1.57pm I received a call from 03 3371 7989 the ambulance control center at Klang Hospital. The guy in charge of the control centre asked to speak to me and asked for the location of the accident, which I gave adding that the victim was dying and that this was an extreme emergency.

The guy manning the control centre did not know my location, so I repeated it clearly and concisely. It seemed that he needed to understand it for himself otherwise he could not pass on the information and dispatch the ambulance. It was a frustrating conversation. I repeated the details of my location and he asked me if I was sure that Klang was the nearest hospital. I repeated firmly, yes!

I told him the injuries of the victim hoping he would feel the urgency, instead he wanted to know whether "dia jatuh motor ke...?" I told him politely that his question is completely irrelevant and hurry up with the ambulance plus I have to hang up and attend to the victim.

I called back at 2.06pm to ask if an ambulance had been dispatched. The same guy told me "belum". He asked me the same questions ... I answered them.

I warned him that the next time I make a call will be to the Mentri Besar's office to complain about his shoddy professionalism, so he'd better send out that ambulance immediately. I called Salamat Dollah at 2.08pm and he helped call Klang Hospital on my behalf to request they send out an ambulance immediately.

I waited and called the emergency control center at Klang Hospital at 2.36pm and asked the same guy if an ambulance had been dispatched, same answer, "belum".

He requested me to repeat the accident location again which I did. This time I told him that he need not understand it just write it down and give it to the ambulance driver along with my hp number.

I waited again. The victim was rolling in pain on the road, his head had a gash about 10cm long on the back of his head, the skin on his head was beginning to peel off. His left leg was completely broken and hanging by the flesh but the main artery was not severed, he was not loosing much blood. His workmate was cradling him in his arms and asking him to mengucap kalimah syahadah.

I tried to stop further damage to his left leg by securing it to his right leg. I told the few people around that he is going to die if we don't get him to hospital. Everyone was reluctant to put him in their car, all kinds of excuses ... ada barang, kotor la, berdarah la ... Meanwhile the victim was grabbing on to my clothes and body in pain, unable to talk possibly due to his head injury.

Finally the driver who knocked him down allowed us to use his car to send the victim to the hospital. But he was too shaken-up to drive. Another gentleman offered to drive but did not know how to exit the Elite highway to get towards Klang Hospital. I asked him to follow me and so we drove off as fast as we could head towards USJ - Federal Highway - Klang. We had to go through so many toll gates, some paying, some after explaining briefly, let us through.

On the Federal Highway despite our attempts to notify motorist that we were in a state of emergency many blocked our path and only relented to give way when I practically sat on my car horn.

We arrived in Klang and I called the emergency control centre guy for directions to the hospital. I was by this time quite distressed and pronounced the name of the hospital wrongly. The guy in the control centre told me there was no such hospital in Klang, so I said to him. "Have you sent out an ambulance to the Batu Tiga toll accident site? No, right? So since you cannot understand where the accident is, we are sending the victim to you. This is an emergency can you give me directions to your hospital or not??""

Finally he did.

When we arrived at Klang Hospital I had a hard time looking for the staff to bring a trolley to remove the victim from the car. I asked for assistance from two nurses but did not receive a response. I took a trolley and pushed it to the car, suddenly a hospital aide appeared, then another, as we tried to remove the victims body from the car, it was then that the co-worker who had been cradling the victim in the car said that he has stopped breathing.

The hospital aides rushed the victim into the A&E room and I followed, as he was wheeled in there was no immediate response from the doctors, it was obvious this young man with his whole life ahead of him had died in the car on the way to the hospital.

I was so angry, my words were simple - "Kecuaian pihak hospital menghantar ambulance membantu mangsa ini telah mengecewakan rakyat."

The aide asked me to be calm. How could any human being be calm when face with such stupidity and total lack of regard for human life? The aide showed me the IC and asked me to confirm if this was the victim. I confirmed. I briefly saw the name Mohd Yusry and his age was somewhere in his mid- twenties.

As I walked away from the A&E room in disgust, I saw the control centre. A guy was sitting in it with a female nurse looking at a computer (very close and comfy).

I approached him and asked if he was the person who took my calls, he knew my name and I asked him for his, he declined. I asked him why he did not dispatch an ambulance to which he replied something brash.

I asked him if he was happy as the victim was unnecessarily dead and that I am going to ensure that his lackadaisical attitude to his job was brought to the public attention. I asked him for his name again along with the nurse who was sitting next to him "playing" with the computer. He refused to give it to me. Feeling very frustrated I called Salamat Dollah and informed him that regretfully the road accident victim a young Malay man had died in the car on the way to the hospital and that no ambulance had been dispatched.

This is not the first time I have called for an ambulance and used the 999 services. Every time I have called for an ambulance it has never arrived, never. Why??

This is the first road accident victim I have helped who has actually died. Everyone else I have helped before this has survived.

THE ISSUES THAT NEED TO BE ADDRESSED ARE:

1) The strategic location of a free government hospital able to deal with serious road accident trauma in Shah Alam (densly populated area with much traffic activity).

and/or

1.1) Emergency response centers created where the Balai Bomba have special ambulances and police squad cars for dispatching purposes only to accident / incident locations and to the nearest hospital / balai police (ambulances need NOT be parked permanently at hospitals).

2) Road signs giving clear and proper directions to hospitals (there are hardly any such signs).

3) Special Emergency Exits through toll gates. And signs declaring their existence + a phone number to call ahead so that they can be opened.

4) The name of the Highways, Elite, Kesas, Federal etc clearly advertised so that road users are able to identify their location under emergency circumstances.

5) Professionally trained personnel with various languages who have true empathy and value the human life, manning emergency response centers. Who consistently answer calls on the first or second ring.

6) An emergency station located at the emergency parking lot with a big sign above it (similar to the car jockey service at hotels) to receive patients. That is manned 24 hours a day, never ever left unattended.

7) An ISO response time from the time you send out an SOS call to 999 you will receive the assistance you need within 15 min.

These are my simple suggestions. Life is precious and should be preserved above all else. Without regard for one another what kind of country are we leaving for our children to inherit ??

Thank you.

Zara Davies Abdul Rahman resident of Bukit Jelutong, Shah Alam

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Lim said he had received emails expressing doubt and skepticism that any positive changes in the health services can stem from from the latest incident because "the rot in the system seems to have gone too deep".

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The following is one email which Lim received from a retired professional in the national health service who stays in Petaling Jaya:

Thank You for raising the issue about Zara Davis' experience in trying to save the life of that young accident victim Mohd. Yusry-

I doubt very much if anything can be changed, or will change in the system as a result, because I think that it is too far gone!! ... Sorry if I sound so negative, but its the whole wide, wide system in place - from the school system, the recruitment practices, the people who are promoted inspite of being known to be inefficient etc.

Basically all emergency systems should function 24/7- but what does one see in practice?... let me give you a few examples:

1. We were robbed by 4 parang wielding chaps at 6.00am, and we kept calling and calling 999, as soon as they left in a car but no one answered. We had to call PJ Police headquarters, to get them send some help, but when they finally came they just told me to go to the 'balai to make a report'... they were not at all interested in going after the robbers car! ... When we got to the Police station and I complained about our futile attempts at calling 999 and getting no response - the policemans answer was "Lain kali jangan pangil 999, memang tiada orang jawab!! ... terus pangil nombor Balai"... my question is are we all expected to know the telephone number of the nearest 'Balai Polis' all the time?

2. A former Senior specialist in GH KL after retirement he was re-employed in Trengganu, but had chest pains in the early hours of the morning, when he was home in KL for the weekend. He had asked his wife to call for an ambulance,but though she kept trying for quite a while, no ambulance ever came until he passed away at home.

3. Recently my friend who had previously been operated for cancer of the pancreas had severe abdominal pain at night at home in PJ, when the wife kept calling for an ambulance she was told to take a taxi to the University Hospital! ... he was later diagnosed as having a perforated stomach and operated in Selayang hospital-it was just as well that the wife took him to the place where he had had the operation earlier and where all his records were kept!

4. Not too long ago when I was away in Johore I came back to find a few double storey terrace houses in Damansara Kim SS 20 burnt!! ... this is a row of houses facing the Taman Tun Dr. Ismail Fire Station!! ... so are we safe from a fire even if we are living next door to a fire station?

I have given you an example of Police response to an emergency, two hospitals' responses to an urgent call for ambulance, and houses facing a fire station getting burnt down!

These examples are not rare in this country, gradually such instances are becoming the 'norm'...it is going to take a herculian effort of the whole system, to really identify the root causes, and have the POLITICAL WILL to DO WHAT IS RIGHT and TO PUT IT RIGHT- realise that it is more important to:

DOING THE RIGHT THING before , DOING THE THING RIGHT!

I know it sounds a little confusing, and even teachers of English get confused, if you ask them which is more important - 'which one first?'

Let me give you a simple example:

When an accident victim is brought to the hospital - doing the Right thing would be to seek to do everything to keep the patient alive - doing the Thing, right would be to ask for the persons I/C to register him/her,ask for guarantee letter, look for the next of kin etc;...if we focus on the second thing - doing the thing Right - most emergencies entering the hospital will leave the hospital through the mortuary!! Having spent 32 years of my life with the Ministry of Health,(my late father spent 38 years of his life with KKM) I find that many senior officers can't see the difference and in many situations, they often focus on the second as if it was more important! ... in our culture beautfying hospitals is deemed more important than ensuring that the system works 24/7 even without the VIP's around!

Is there hope that somethings might change?... going by whats been going on in the Parliament - I don't see the glimmer of hope!! My friends keep telling me "Why Bother?"... but I got a nice quote form that last line in your blog today-

"Our lives begin to end the day WE becoime silent about the things that matter" ... Martin Luther King. ... I think that WE still owe our Children something - don't WE? ... TO PUT IT RIGHT!!

Nathan

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Lim said: "Malaysians have a right to expect and demand prompt and meaningful response time from the Chua and Ismail to these scandals happening under their bailiwick.