| Hot Topic |
rgeons to the fore
fighting Covid-19
rnessing the leadership of Malaysian surgeons
ey to our success
ROF DATO DR HANAFIAH
UNARASHID (Director, HCTM) left and
USYAIRI HARUNARASHID (Clinical
emiologist, HCTM)
REVIOUS epidemics or
outbreaks in Malaysia, like
dengue, tuberculosis or HIV/
AIDS, could be handled “only”
by physicians, infectious
diseases specialists or public
health experts, due to their
smaller scale. However, the
nse scale of the global Covid-19
emic meant that Malaysia required
onse from our entire health system,
nment as a whole and entire society.
ysia pulls together
sia’s first cases of Covid-19 came on
5 with a few foreign patients. This later
ded after a religious mass gathering
rch, leading to one of the largest
ct tracing exercises ever conducted
laysia. With the help of the police and
a cooperative community, we could
ge the unfortunate spread of Covid-19
one mass gathering, although it went
e generations of transmissions.
e to an unexpected political
ition, Malaysia went without a Health
ter for 14 days in Feb-Mar 2020.
g that time, the battle-hardened
try of Health (MoH) technocracy
tially ran the show. The new Prime
ter declared a nationwide Movement
ol Order (MCO) starting March 18,
sia’s first movement restrictions
1969 when racial riots occurred.
re draconian measures called
nced MCOs were imposed to further
ct movements in hot-spot areas of
transmission rates. Taken together,
as effectively the largest securityced
curfews during peace times.
ar to other countries, such restrictions
necessary but carried an economic,
l, psychological and political cost.
we write, the MCO is still in force.
te, the government has issued three
mic stimulus packages to protect
oor, the vulnerable, the unemployed
under-employed and the small and
um enterprises (SMEs) that form the
f Malaysia’s economy. These stimulus
ges prove that this pandemic isn’t
edical or health, it’s economic, social
olitical.
rhaps the most important thing
te from the Malaysian Covid-19
experience is that despite a political
transition, the public health services
remained intact and continued fighting
Covid-19 at a national level. This supports
the principle of a professional technocracy
in the Health Ministry being the “stable
foundation” that survives any political
transition or uncertainty.
Harnessing the natural
leadership of surgeons
Right now, an endocrine surgeon is leading
the Malaysian national effort against
Covid-19, rather than the more commonly
expected infectious diseases specialist or
public health physician. As the Director-
General of Health, Datuk Dr Noor Hisham
Abdullah, an Endocrine and Breast surgeon,
leads the entire health apparatus of the
Malaysian government as the senior-most
technical civil servant.
Although not a communications expert,
epidemiologist or pulmonologist, his
factual, calm and predictable demeanour
during the daily Press conferences is
reassuring to Malaysians. Described as “the
quintessential civil servant”, he played his
part in managing the challenge of Malaysia
going through an unexpected political
transition.
It’s not only the Director-General of
Health that is a trained surgeon, but also
directors of several large hospitals and
academic medical centres. At least five
academic medical centres in Malaysia are
helmed by trained surgeons (a vascular
surgeon, an orthopaedic surgeon, a
neurosurgeon, a plastic surgeon and an
eye surgeon. Indeed, the leadership of
surgeons is needed during these trying
times. Surgeons head both the Ministries
of Health (MoH) and a majority of higher
education hospitals.
“Surgeons are born leaders. We are
taught to make difficult decisions,” says
Professor Dr Tunku Kamarul Zaman,
Director of UMMC and a Consultant
Orthopaedic Surgeon.
Surgeons are not trained
epidemiologists or administrators but
fighting this pandemic recalls familiar
surgical concepts. Decisions are made
under pressure and with scarce resources.
Strict infection control saves lives on the
operating table and in the health system.