The Health June 2020 | Page 15

| 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.