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These frontliners have gone beyond and above for their local communities affected by the pandemic

DR KULDIP KAUR, SUNGAI BULOH HOSPITAL 

Dr Kuldip Kaur is a dedicated medical professional who comes with a wealth of experience having previously served as Kuala Lumpur Hospital’s deputy director. When she was appointed to act as the hospital director of Sungai Buloh Hospital (HSB) in 2019, it was a huge step forward for her.  

Stepping into this role was something she had always envisioned taking on, and she has done well leading HSB during the Covid-19 pandemic. The hospital has been at the forefront of Malaysia’s fight against Covid-19 which has stricken the world since early 2020 and serves as the country’s main dedicated pandemic centre.

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“With great power comes great responsibility, and I took on this challenge in my stride,” the 59-year-old director says. According to her, she drew on her experience dealing with other infectious diseases and leveraged the specialists at HSB to manage the surge in Covid-19 cases that flooded the hospital. 
She expresses her utmost gratitude to all who have generously donated essential equipment to HSB, from the Ministry of Health as well as various non-governmental organisations and corporate sponsors. Their generosity and the hospital’s effective utilisation of resources ensured that every single patient received the best possible care and treatment.

During the first wave of the pandemic in 2020, she recalled how HSB was designated to be the foremost Covid-19 management centre in the country.   
The arrival of the Delta variant (of the virus) had truly tested HSB, but the hospital prevailed under Kaur’s leadership. She expresses her gratitude and thanks to her colleagues and all Malaysians for their unwavering support in fighting the virus. “I think that all leaders have doubts, but I always believe in talking and communicating with others in order to make the best leadership decisions,” Kaur adds. 

However, the war is far from over, she notes. The reality is Covid-19 is likely here to stay, and she advises all Malaysians to strictly adhere to standard operating procedures and take all necessary precautions as the country transitions into the endemic stage. 

According to Kaur, holistic care is not only reserved for patients, but it also extends towards members of her staff. “All of our staff members sacrificed a lot, including deferring professional advancement. Some have not even seen their loved ones in person for months on end,” she says.

To prevent burnout among HSB’s frontliners, the hospital employed their psychiatry unit to provide psychological first aid and counselling services. Even the hospital’s spirituality unit was out in full force to help comfort families of the bereaved and offered their services to frontliners. In addition, there were designated rest areas along with food and accommodation if the staff had to relocate. “We continue to make sure our staff have adequate time to rest and recuperate in between their gruelling shifts,” she adds. 

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Always one to look for the silver lining in any situation, Kaur says the pandemic has resulted in increased access to healthcare for all Malaysians. She adds that new technologies like telehealth virtual clinics have been catalysed by the growing need for doctor’s consultations by patients from the comfort of their homes, without the risk of exposing themselves to the virus. 

In closing, Kaur shared some advice for young medical professionals, saying they must always be prepared to face challenges like the one posed by Covid-19. “You are the ones holding the line between your patients and death. To all healthcare workers, I would like to encourage you to embody these virtues: courage, selflessness and being truthful,” she says. 

SU-MING THAM, HOSPIS MALAYISA 

The philosophy behind palliative care, says Su-Ming Tham, the general manager of Hospis Malaysia, is behind its etymology. Derived from the Latin word ‘pallium’—which means ‘to cloak’ or ‘to shield’—this specialised medical care aims to shield a patient from suffering.

It was founded by the late Dame Cicely Saunders, who noticed that the cancer patients she cared for endured physical suffering as well as emotional trauma. As her colleagues looked for ways to treat the illness itself, the patient’s suffering went by the wayside. And because progressive diseases like cancer are perceived to be incurable, many patients are sent home from the hospital to live out the rest of their days.

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“Palliative care, contrary to popular belief, is not just limited to cancer patients,” explains Tham. “It is applicable to all serious progressive diseases, which can lead to many symptoms. Such as pain, which sometimes can be excruciating, breathlessness, loss of appetite, and the anxiety of not knowing what lies ahead could lead to insomnia as well as distress. 

“That distress can pass on to those around them, especially when the caregivers themselves have no support and lack advice. Now, imagine if there was someone who could help with all of that. Who can help you manage the pain, prescribe appropriate medication, help with the breathlessness, and walk you through the process of your illness so that you can know what to expect and how to better prepare for it. Someone who can teach your caregivers how to properly support you—that is what palliative care is. It is not just end-of-life care. It is about helping patients, as well as those around them, by improving their quality of life, so that it alleviates their suffering and their journey will not be as painful and is dignified.” 

It does not only amount to “exceptionally good nursing care” either. According to Tham, who joined Hospis Malaysia in 2012, palliative care is also a global medical speciality. In 2014, the World Health Assembly passed Resolution 67.19, which sought to “strengthen palliative care as a component of comprehensive care throughout the life course”. Malaysia was a signatory in that resolution. In fact, in Malaysia, it was recognised as a medical speciality in 2005. However, 16 years later, many still do not consider it as medical care. And for a community hospice like Hospis Malaysia, they are often seen as only a [medical] equipment provider for terminally ill patients. 

While Tham observes that most patients with serious progressive illnesses from across the globe prefer to be cared for at home if their local healthcare channels provide them with adequate support, many in Malaysia are often discharged from the hospital and are left to cope with their condition at home with no support. 
Ultimately, what this means for the patient is that when they end up in distress, their caregivers will have to rush them back to the hospital, usually at the expense of a lot of effort and at a substantial cost.

Run by only 23 clinical staff, including Tham herself, Hospis Malaysia soldiered on, regardless of the challenges imposed by the lockdown, making it a point to keep their 24-hour emergency service running.  

“To take a page from Dame Cicely Saunders, ‘you matter because you are you, and you matter to the end of your life,’” said Tham. “We [palliative care professionals] do all that we can, not only to help you die peacefully, but to also be able to live a good life, one without suffering, up till the very end.” 

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KENNY LIM, BEFRIENDERS KL 

In 1970, concerned about those left in the wake of the riots that erupted on May 13th, 1969, a group of pioneer Malaysians sought the help of professional psychiatrists from the University of Malaya Medical Centre (which was previously known as University Hospital then) to establish Befrienders KL, a non-profit organisation that provided a helpline for those in emotional distress, or are contemplating suicide.

“Empathy is important when it comes to the subject of mental health,” states Kenny Lim, a volunteer of over 20 years and the executive director of Befrienders KL. “What we do is to offer support however we can, taking the time to listen to those who are struggling and accept them as they are.

“Unfortunately, the general misconception is that bringing up the topic of suicide while speaking to those who are suicidal is dangerous, as it exacerbates the issue. In reality, most find it hard to open up about their troubles, as they feel like they would either burden others or be ostracised by society. Therefore, they need a safe space to express their pain freely and talk about their suicidal ideation. It allows them the chance to open up and be vulnerable without fear of being judged. It shows that we, even as strangers, care.” 

This year, the number of calls their helpline received had skyrocketed. Compared to the earliest phases of the lockdown, which saw a hefty 6,858 calls in between March and May 2020, a staggering total of 10,412 calls were made to Befrienders KL in that very same period this year.

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According to Lim, the increase in calls involved pandemic-related issues. Compounded by the loss of livelihoods, the social isolation due to travel restrictions, the difficulties of coping with work-from-home or online study arrangements, and the stressful environments at home, whether it’s caused by the separation of family members or the extended amount of time spent cooped up with one another, those with pre-existing mental health conditions faced extraordinary stress levels. 

Despite being run by only 125 trained volunteers and two paid administrative staff, including Lim himself, the organisation remains steadfast in their mission. They even went so far as to reactivate their telephone since April 2020 with the help of Microtel Technology after realising that not all of their callers were able to dial in via Skype.  

“It got to the point where some of our volunteers opted to work extra hours. They joined us for different reasons. Some were motivated by their past experiences, be it their own struggles or those of their loved ones. Some wanted to help the community. Others offered because it was something to do in their spare time, but stayed because they found it meaningful and worthwhile. 

“People say volunteers give a lot. But for me, I gained so much in return. I got to know the wonderful group of people at Befrienders KL. I grew a lot as a person as well.”

While Lim says that there has been a positive shift in attitudes towards people who have mental health conditions and are suicidal, he hopes that in the future, conversations about emotional vulnerability become normalised instead of being seen as a weakness, so as to encourage help-seeking behaviour rather than stigmatise it. 

“It’s not about telling people what to do, because it doesn’t help,” he explains. “It undermines one’s ability to find strength in times of adversity. Most of our callers just need a listening ear. By talking to someone, it can help them be more aware of their situation, and with that, hopefully, they will be able to understand what it is they want to do and can do.” 

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