Tuesday, July 28, 2015

Sleeping With A Mosquito

"Doktor, buat la dengue notification cepat. Patient dah 2 hari dalam wad takde orang pon buat"

In the midst of my hectic day, with a few CT-scans to request, a patient who wants 'at own risk' discharge, another demanded to change beds, I grudgingly did the dengue notification, and sent it.

It seems like a mindless act. Tick a few boxes, put in some numbers, and send it. For us as housemans, it feels like a mundane and repetitive procedure.

But today, listening to lectures on global health diplomacy made me reflect. What I love about attending these global public health lectures is that it makes you learn something that you already know, but not realize.

In all these big conferences at the WHO, or even at the UN, delegates will almost always start with statistical data to prove their point: "In 2014 the WHO stated that the mortality caused by dengue is...etc etc etc"...the "the UN estimates the lives loss by Malaria is...etc etc etc"

We quote the WHO, other research organizations, but to think of it, do these data come them? No. It comes from us, the ones even at the ground most level of the Ministry of Health.

In my current situation, it feels like I'm walking along the river, then hearing a person shouts for help because he's drowning. So I jumped in and pulled him out. Successfully resuscitate him back to life. Then I hear another person shouts for help and saw another one in the river. I went in again. Then there is another one...and another one. I was too busy saving the drowning ones, I forgot to wonder, who the heck is up the stream pushing all these people into the river?

The drowning ones could be the ones affected by dengue, it could apply to other diseases as well.  The ones pushing them in, are the social determinants...it could be the environment, it could be the economy, the governance etc etc. Right now I am busy saving the drowning ones, but someday hoping I can be the one going upstream to see 'who the heck' is pushing them in'.

Malaysia is trying to put the dengue epidemic higher on the global agenda, and we all play a role in this, even you, houseman! Even the staff nurse who reminded you to do the dengue notification. Without reporting we have no data to speak of, and it will never be on the global agenda. We all in the Ministry of Health play a significant role, no matter what your position is. So never feel your role is too small for the betterment of the nation's health. As an African proverb goes: "If you feel that you are too small to make a difference, try sleeping in a closed room with a mosquito"

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