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Perils of the fatigued and sleep-deprived doctor

May 13, 2017

A group of medical NGOs put together a proposal to prevent motor-vehicle accidents involving healthcare workers who put in long shifts.

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By Joint Medical NGOs

We would like to express our deepest condolences over the recent passing of Dr Nurul Huda Ahmad, a paediatrician in training who was involved in a motor-vehicle accident on May 9 in Kuala Terengganu.

The accident is the latest involving a medical officer driving home post-call, after completing nearly 33 hours of duty. Prior to this, we lost another of our colleagues, Dr Afifah Mohd Ghazi in a similar accident.

It is high time action is taken to prevent the loss of more innocent lives.

In relation to motor-vehicle accidents, we recognise that there are many contributing factors namely vehicle issues, poor road conditions and distraction among others. However, we cannot exclude the fact that fatigue and sleep deprivation is a recognisable and preventable factor in motor-vehicle accidents.

In 2015, the Islamic Medical Association of Malaysia (IMAM) and Pertubuhan Amal Perubatan Ibnu Sina Malaysia (PAPISMA) published a survey among healthcare professionals about post-call motor-vehicle accidents.

The survey which involved 440 respondents over 18 hours revealed that more than half of the accidents (54.8%) occurred after the victims worked for 25-36 hours. In addition, 64.8% of respondents admitted to suffering from psychological trauma following the accident.

Despite its limitations, the survey highlighted the need for further investigations into the correlation between motor-vehicle accidents and the preceding hours of duty.

The effect of healthcare workers’ fatigue and the occurrence of motor-vehicle accidents have been similarly studied elsewhere (CP West et al 2012, Arnedt JT et al 2005, Barger LK et al 2005).

After serving the compulsory 24 hours of duty, most medical doctors have to continue their duty for a further 4-10 hours. The stress of working combined with sleep-deprivation definitely results in exhaustion.

Sleep deprivation is one of the recognised factors contributing to motor-vehicle accidents and is comparable to the state of intoxication induced by alcohol (Kowalenko T.et al 2000, Barger LK et al 2005, CP Landrigan et al 2008).

In order to prevent the loss of another innocent life within the medical fraternity, we hereby urge the Ministry of Health and the respective stakeholders to do the following:

  1. Set up a dedicated task-force involving multiple stakeholders from the Ministry of Health, Ministry of Transport, universities and medical NGOs to investigate the incidents of motor-vehicle accidents among healthcare workers and its correlation to the duration of their working hours;
  2. Establish a “safe working hours” law or act to safeguard our healthcare workers and the public at large;
  3. Instil awareness in the form of campaigns and active engagements with healthcare workers on safety measures in the event of fatigue and sleep deprivation;
  4. Provide alternative transport facilities or shuttle services from hospitals to certain designated drop-off points;
  5. Provide compulsory “post-call off” or “day-off” for night-shift healthcare workers or on-call doctors.

With the consolidation of efforts from all parties, we can together ensure the well-being and welfare of our healthcare professionals and prevent another human tragedy from occurring.

Issued by:

  • Dr Jeffrey Abu Hassan, President of Islamic Medical Association of Malaysia (IMAM)
  • Dr Chew Chee Ming, President of Malaysian Medical Association (MMA)
  • Dato’ Dr Suhaini Kadiman, President of Pertubuhan Amal Perubatan Ibnu Sina Malaysia (PAPISMA)
  • Dr N.Thiyagar, President of Malaysian Paediatric Association (MPA)
  • Dr Muhamad Hazizi Bin Muhamad Hasani, President of Malaysian Integrated Medical Professionals Association (MIMPA)
  • Dr Muhammad Hakim Nordin, President of Malaysian Doctors Club (MDC)
  • Dr Abdul Halim bin Shibghatullah, YDP of IkramHealth of IKRAM
  • Dr Ahmad Firdaus Bin Mohd Haris, President of Medical Mythbusters Malaysia (M3)
  • Dr Zul Azlin Razali, President of Green Crescent Malaysia

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