Making surgical and anaesthesia care affordable in Malaysia

The Global Surgery Initiative (GSI), a first-of-its-kind Public-Private Partnership initiative for corporate social responsibility aims to provide access to safe and affordable surgical and anaesthesia care in underserved areas of Malaysia.

The Malaysian Society of Anaesthesiologists (MSA) proposed the GSI in order for the anaesthesiology community to provide additional services to the country and community. The MSA will collaborate with the Malaysian Ministry of Health (MOH) and Subang Jaya Medical Centre (SJMC) for the initiative.

The GSI was officially launched at SJMC on February 15 in conjunction with the 60th Anniversary of the Malaysian Society of Anaesthesiologists celebration. This is just the beginning as the MSA looks forward to collaborate with other like-minded NGOs and private institutions to further this initiative. 

“In conjunction with the 60th Anniversary of the MSA, the representative body for anaesthesiologists in Malaysia, we are proud to be part of such a meaningful collaboration. We are grateful for the growing support towards establishing a safe and a patient centred anaesthesia in the underserved areas”, said Professor Dr Ina Ismiarti Shariffuddin, President of the Malaysian Society of Anaesthesiologists (MSA). 

The event was attended by Yg Bhg Tan Sri Dato’ Seri Dr Noor Hisham bin Abdullah, Director General of Health Malaysia, Professor Dr Ina Ismiarti Shariffudin, President of the Malaysian Society of Anaesthesiologists, Professor Dr Marzida Mansor, President of the College of Anaesthesiologists, Academy of Medicine Malaysia, Dr Ooi Choo Huck, Director of Sarawak State Health Department, Dr Gunalan Palari Arumugam, Chairman of the Medical Advisory Board, Subang Jaya Medical Centre, Mr Bryan Lin, Chief Executive Officer of Subang Jaya Medical Centre (SJMC), and Mr Peter Hong, Group Chief Executive Officer, Ramsay Sime Darby Healthcare (RSDH). 

“The 60th Anniversary of the Malaysian Society of Anaesthesiologists celebration will be a great platform to discuss global health disparities and brainstorm innovative solutions, particularly the role of anaesthesiologists to assist in rebuilding a resilient health system nationwide following the COVID-19 pandemic,” said Yg Bhg Tan Sri Dato’ Seri Dr Noor Hisham bin Abdullah, Director-General of Health Malaysia.

Tan Sri Dato’ Seri Dr Noor Hisham added that the Global Surgery Initiative has been established throughout the country through creative ideas and innovative partnerships, with the main focus of strengthening the provision of primary and essential surgical, obstetric, trauma, and anaesthesia (SOTA) care at district hospitals.

“Moreover, the implementation of the Global Surgery roadmap embracing Lean Management, the Cluster Hospital concept, the Mass Surgery Initiative and outsourcing management will further enhance access and equity of surgical services in Malaysia. The Ministry of Health urges everyone to rally behind these initiatives to improve access and equitability for surgical services and brings life-saving essential surgical treatments closer to communities. Together, we can make it possible” Dr Noor Hisham added. 

MOH to lead the local Global Surgery agenda

The Global Surgery Initiative has identified certain parts of Malaysia to receive support in surgical services and anaesthesia care, especially in East Malaysia. Globally, 9 out of 10 people do not have access to basic surgical care in the low-income and middle-income countries. Untreated surgical conditions have exerted substantial but largely unrecognised negative effects on human health, welfare, and economic development. 

Bellwether operations such as emergency laparotomies, caesarean sections, and treatment of an open fracture are universally covered in Malaysia, however, there still exists inequity. In order to offer access to surgical and anaesthesia treatment in underserved parts of Malaysia, particularly in East Malaysia, the surgical and anaesthesiology services in MOH Malaysia have been leading the local Global Surgery agenda. 

Since 2019, this Global Surgery framework has been deployed gradually through partnerships with MOH district hospitals and their nearest lead specialist and training MOH hospital. This CSR project, introduced by MSA and supported by SJMC will be one of the first few projects locally where surgeons, anaesthesiologists, nurses, and other allied health care professionals from the private sector are joining forces to work together with the public health system to identify district hospitals where the need for surgical services has not been completely met. 

“Despite advancements in access to surgical care with the training of surgeons and anaesthesiologists over the years in Malaysia, under the Global Surgery Initiative, there are five issues identified and must be addressed for equitable access to affordable and safe surgery – the patient factor, lack of facilities and human resource, lack of human resource in available facilities, tackling long queues with the available facilities and human resource, and logistic and transport issues delaying access,” said Dr Gunalan Palari Arumugam, Chairman of the Medical Advisory Board, Subang Jaya Medical Centre. 

Dr. Gunalan added that strategies to address these issues have been developed and implemented on the ground, with improvements in access to safe surgical care seen in rural hospitals that have participated.

Through this CSR project, two outreach programmes are planned. The first outreach programme will coincide with the 1st Global Surgery Conference in Kuching, Sarawak in March 2023, followed by the second one in July 2023 prior to the MSA College of Anaesthesiologists Annual Scientific Congress, also in Kuching, Sarawak.

The district hospitals, preferably with less than 100 beds and with minimum access to specialist-level care will be identified together with the Sarawak State Health Department. 

“This is the first of its kind Public-Private Partnership in Malaysia and a meaningful one to bring much-needed attention and effort to improve surgery and anaesthesia in areas that have limited access to good surgical care in our country. SJMC is proud to be a part of this meaningful initiative and play an active role in closing the gaps,” said Bryan Lin, CEO of Subang Jaya Medical Centre.