Sabah urged to use every doctor in the state in anti-polio effort

Sabah’s public healthcare department has said that all children five years old and below, regardless of citizenship status will be vaccinated. (AFP pic)

PETALING JAYA: The Malaysian Medical Association has called for the mobilisation of all doctors in Sabah to ensure the success of the state’s mass immunisation programme against polio.

The association’s president, Dr N Ganabaskaran, told FMT he feared that a shortage of manpower might be an obstructing factor.

The Sabah government launched the programme late last month following a report on Dec 8 that a three-month-old boy had been infected with polio. But last Jan 10, two new cases were reported.

Dr Christina Rundi, who heads Sabah’s public healthcare department, has said that all children five years old and below, regardless of citizenship status, would be vaccinated.

Ganabaskaran said he believed the manpower needed to carry out the mass vaccination was inadequate and noted that primary healthcare providers in the state had a heavy work burden.

“They are bogged down with too many programmes,” he remarked..

He suggested that the government make use of every available doctor in the state as well as housemen and ward managers.

He also said the government should ask NGOs to help in the work of primary care nurses and doctors.

“One concern is accessibility to the children, particularly the immigrant children,“ he added.

Many in the health industry have said problems would arise in tracing stateless children in Sabah, many of whom are members of nomadic tribes. Others are children of migrant workers and those born out of wedlock to foreigners and their local partners.

The government is hoping that the mass vaccination would increase the herd immunity in Sabah. The apparently low rate of immunisation in the state has been cited as one of the possible factors for the return of polio after an absence of 20 years.

Through herd immunity, a population is protected from a contagious disease after vaccination even if a proportion remains unvaccinated. This is achieved by stopping the virus from being transmitted between people.

However, a large proportion of the population would still need to be immunised. To achieve herd immunity for polio, 80% to 85% of the population would have to be vaccinated.

More than 20 countries that had declared themselves free of polio saw a resurgence between 2002 and 2005. Since then, some regions in Africa and India have been reporting infections of the wild polio virus.

Malaysia and the Philippines recently joined the list of countries with active cases of the infection.

Malaysia currently administers the inactivated polio vaccine (IPV), which is injected, but is now contemplating supplementing it with the oral vaccine (OPV).

Studies have shown that IPV, which uses an inactive strain of the polio virus, does not lead to herd immunity. The OPV uses a weakened strain of the virus. Its use may result in herd immunity.

Representatives of several medical and research organisations recently urged the government to pass a law to protect the health of non-citizens, saying this would help Malaysia achieve universal health coverage.

In an article published in a local newspaper, they said such a law should ensure basic health services such as vaccinations and post-natal care to undocumented non-citizens.

“These services must be provided free or nearly free, alongside effective education and decriminalising non-citizens’ attendance in public health facilities,” they wrote.

“The funds can come from a combination of existing levies on foreign workers, private insurance or taxation.”

They suggested that the law remove the obligation for health professionals to inform the immigration department whenever they treat undocumented people.