Can one mother’s tragic death inspire overdue change to rural Sarawak healthcare?

A government hospital in Lawas, in rural Sarawak. People here have to travel far to get critical medical care.

PETALING JAYA: Kam Agong was an ordinary mum from Long Semadoh in rural Sarawak.

In 2002, she bled to death in her village a month after giving birth by C-section at Lawas District Hospital, the nearest maternity facility, five hours away.

Her daughter and son-in-law sued the hospital for medical negligence and won.

Ever since, pregnant mothers from Long Semadoh have been redirected to Miri hospital instead, which is around 10 hours away by four-wheel-drive and bus.

The 400-km journey to Miri involves driving through horrendous traffic, mountainous terrain, multiple checkpoints in Brunei, and being checked throughout by immigration authorities.

The cost is around RM240 per person for a return journey. This is not easy to come by for these villagers, especially when it comes to multiple hospital visits with family members tagging along.

“And if they don’t have a bed at Miri hospital, they send you to Kota Kinabalu in Sabah instead,” said Kam Agong’s son-in-law, Lawrence Jayaraj in an interview with FMT.

“Who will take care of them in Sabah? They don’t know anyone there,” he lamented.

He and his wife, Agnes Padan, insist that the Sarawak state government can no longer keep quiet about this state of affairs, especially in Lawas, where just 24 beds are available.

“The government doesn’t consider this an important issue,” Lawrence told FMT.

Agnes Padan (left) and Lawrence Jayaraj.

“When my mother-in-law died, no one helped us. She left eight children, three of them still at school, and a one-month-old infant.”

In Sarawak, healthcare and education are important issues, given that the poor development of both is affecting everyone.

For villagers in Sarawak’s interior, poor maternal healthcare often takes a tragic toll. Specialist facilities here are scarce, and most hospitals are far from home – usually hundreds of kilometres away.

Taking the state government to task, Lawrence questioned why Limbang division, which is almost as big in area as Selangor, has only two hospitals, with no specialists and scant medical equipment.

“This is a common problem in Sarawak and Sabah, but surely it is a constitutional right for all mothers to have proper maternity care.”

Agnes, a mother herself, told FMT that she is no longer optimistic about a better future for mothers from her village.

In the past, another district hospital in Lawas was promised, but the project never materialised.

The Lawas federal constituency, the last of the 222 parliamentary zones in the country, includes the Ba’kelalan and Bukit Sari state seats.

All three seats have traditionally been Barisan Nasional (BN) strongholds, except Ba’kelalan where the Long Semadoh village and eight other rural settlements are, which is now with PKR.

The Lawas MP is Gabungan Parti Sarawak’s Henry Sum Agong. Bukit Sari is currently held by BN’s Amar Awang Tengah Ali Hassin, while Works Minister Baru Bian is Ba’kelalan assemblyman.

Baru, who is a Lun Bawang, is the first federal minister from the community.

Agnes said now mothers like her must try to get the authorities to address the issue. And if things do not improve, then people should vote their elected representatives out and push for their basic healthcare rights.

For Lawrence, if Malaysian politicians are capable of financing lofty projects like the Petronas Twin Towers then there is no real reason why vital hospital care and equipment should be so scarce.

He added that when their elected representatives turn up during election campaigning, most of the time they are oblivious to the issue of poor healthcare and how it affects rural Sarawakians.

Misplaced priorities?

In 2013, Muhyiddin Yassin, who was the education minister under the BN administration then, visited Lawas to give a town talk. But he was said to have spent most of the time talking about the expansion of the Lawas Airport.

Muhyiddin is now the home minister under the Pakatan Harapan government.

“This is the problem. Everyone’s agenda here is on the Malaysia Agreement 1963 (MA63) and highway projects, but what needs to be done is to improve basic healthcare facilities in Sarawak first.

“First comes health, then everything else.”

He said there is a lack of political will in addressing the issue, and trained his guns once more on the state government, saying that they were guilty of ethnic cleansing if they allowed such a deplorable standard of maternity care to continue on their watch.

He added that in 1990, the maternal mortality rate (MMR) in Sarawak was for every 100,000 live births 90 mothers died.

“No current MMR statistics are available for Sarawak and Sabah,” he said, adding that only certain platforms like Radio Free Sarawak and Sarawak Report are highlighting the problem.

He questioned why the national and state statistics departments are so reluctant to disclose the maternal mortality rate in Sarawak.

He said that in light of Malaysia Day last weekend, he was hopeful the issue would be better understood in West Malaysia now, expressing concern that such local problems are not understood by Sarawak’s peninsular counterparts.

Sixteen long years have passed for Lawrence and Agnes since Kam Agong passed away.

Things have not been easy, but they are doing all they can to ensure her death was not in vain.

“Now, we’re worrying about a girl living in my wife’s village who is carrying twins. In five months she will deliver. Where will they send her and how will her family care for her?” he asks.

The duo have made a short film, “The Story of Kam Agong”, to highlight the issue.

It will be featured at FreedomFilmFest, an international human rights documentary film festival held annually in Malaysia. This year it runs from Sept 29 to Oct 6 at PJ Live Arts in Petaling Jaya.

FreedomFilmFest will travel to Georgetown, Muar, Johor Bahru, Manjung, Kuching, Kota Kinabalu and Singapore between October and December 2018. Full details can be found at their website: https://freedomfilm.my