Long live the Queen.

Something to write before I leave Sabah at the end of this month... Because I feel sorry about it and also because other than this, I can't do much. Also, take note that I'm NOT bashing. I'm just lamenting.

Anyway...

6 months since the declaration that the building is no longer save for occupation with its cracking ceilings and walls, nothing has happened. The building still stood like a sore thumb, waiting for God knows what. Waiting to be declared as a heritage perhaps? Queen Elizabeth Hospital, Forever In Memory, RIP.

And so...




I watched as the doctors and paramedical staffs scramble around, from SMC to Bukit Padang to Likas to escort patient for CT scan, to operating theatres and for ward transfers.

I watched the health personnel and patients alike suffer and suffocate in the crowded war zones called the wards.

I was the one who had to tell the bloated boy with nephrotic syndrome to switch beds with the breathless elderly man on the makeshift bed on the floor because his bed has an oxygen tank attached to it and the ward's oxygen tanks were nowhere to be seen, and because that's the fastest and easiest way to get the uncle on oxygen.

I was accidentally kicked by a houseman who nearly tripped over me who was taking blood for Culture and Sensitivity on the floor. Luckily I had not uncap the needle yet. That was a VERY close call. Why on the floor? The poor lad with suspected malaria was placed on a floor bed and wow, the spaces between these beds are about only 1 - 2 feet.

I was there when 20 new admissions came in within 3 hours, and watched as makeshift beds were unfolded on the floor to accommodate the patients. And had to tell many patients that the ward had ran out of blanket, but it’s freaking hot anyway.

I watched harried nurses rushing off to photocopy Pathology forms when the Medical wards became swamped with feverish patients, while the housemen tore the carbon copies apart to make do. Then they tossed the syringe and hundred blood bottles to willing medical students. If there are 10 patients (In your dreams...), 3 basic tests each plus additional tests. You do the math. (BTW, the labs insisted on specimens with at least 2 ml of blood per bottle, and use green needle for taking BUSE and creatinine)

I entered a ward where all field of surgical patients are lumped together; General Surgery, Orthopedic, ENT, Dental, Urology, Plastic. If this is a merely district hospital, it’s quite acceptable, but for a tertiary referral centre?

I listened as doctors tell patient that they have to wait in line for 3 – 6 months for an ultrasound of the suspicious breast lump, or pay themselves to get it done faster at private centers.

I followed the rounds where Specialists rushed through the many patients while housemen frantically try to trace results from the miniature labs in Queen that not only cater Queen itself, but some of Likas’ specimens too. Or the housemen will toss the phone and directory to medical students to help them while they rush off to a breathless patient or to deliver the forms themselves before the labs closed at 5. Or else, goodbye LFT and others.

I sutured 4 cases in 1 hour time in A&E while the health personnel scrambled around to handle the congested A&E. But they still pushed me away and allowed the Russian elective students instead to perform CPR with crooked arms. Hoh... And nobody said anything.


BTW, for better information and a delicious dose of sarcasm, you can visit the links below.

• How to overcome health crisis
• A newspaper article on this blog
• How to Make Easy Money In A Healthcare Crisis
• An Open Apology To The Health Minister
• Health Minister: Quality health services assured

My foot

Literally that was exactly what I would like to say yesterday except that the irony of the whole situation made it unsuitable.

I strained my right foot ligament. Even the doctor who gave me such diagnosis looked doubtful but by the given history of no trauma, no insect bite/sting, no nothing happened there directly…

Let me go through again… on Friday night around 9 pm (God forbid I do this again till I graduate) I returned to the Medical ward in QEH to copy a case note of a patient for my case presentation due on Tuesday (since I rather not waste petrol and time to come back again on weekends). Upon entrance, my senior who was a houseman there greeted me with a relieved exclamation and straight away ushered me to help him with the new admissions. So there I was, a student, doing a houseman job of clerking and blood taking and filling forms then later blood C&S plus informing the weary nurses that this patient need this and that patient need that and so forth and later to be informed that the ward run out of blankets thanks to the 14 new admissions within 3 hours. Not to mention that the floor is covered by folding beds and a suspected pneumonia/TB patient was wedged in between others.

So by the time I left it was 2.30 am… reach college by 3 am to be let in by the sympathetic guard… drop off to bed with sore feet by 4 am. Then I woke up at 9 am with excruciating pain in my right foot which made standing and walking as something to be done only when necessary. And so I was off to the collage clinic where the doctor was baffled by what that seemed like a torn / strained ligament in sports injury turned out to be a non – traumatic one. Mind you I was wearing flat shoes.

God I can’t imagine how it is after I graduate later… I think I should consider Tawau Hospital instead now…

Of hospital and ideals

Last week saw a column in The Star depicting a picture of our Health Minister talking to a patient in Queen Elizabeth Hospital (referred as Queen in this post). I refer to this particular picture because it’s showing what that is really happening in the main referral hospital here in Sabah. The picture showed a cardiac patient on a typical folding bed on the floor commonly used here in Queen whenever the wards are filled beyond their capacities. The patients’ files are then strewn somewhere on the crowded table stands supposedly used for patients to take their meals.

This is a typical scenario in Queen, the main referral hospital in Sabah. Everyday there is pressure to discharge near – stable patients or to refer back to district hospitals in order to make room for more patients and referrals. On any evening it’s no surprise to see the previously empty beds from morning or noon to be filled with new patients, or numerous folding beds to materialize on the floor until walking through the maze of beds and doctors and nurses and medical students becomes an obstacle trekking. The male wards especially, are in fact nick – named by medical students and many doctors as the war zone area. That’s the ward for you.

Accident and emergency (A&E) is no different. The moment you are just to heave a sigh of relief, a torrent of patients crashed into the Green, Yellow and Red zones. Then the frenzy of ECG, x – ray, IV lines and needles begin amidst the small area clogged up with medical personnel, equipments and patients. Mass accident is a nightmare for every doctor here. There is no such thing as 30 minutes wait. Even upon entrance patients would still end up in another waiting area.

Clinics mostly are spilling with patients till past lunch hour. A standard room of 5x5 m contains 2 tables and chairs for 2 doctors, 2 chairs for patients, a rack or shelf and a nurse’s table maybe, and a single examination bed. Extra furniture further cramped up the leftover space available. The lack of doctors paved a path for medical assistant (MA) to specialize and perform various high – level procedures such as echocardiography and Holter study in the cardiology clinic. Mind you, it’s not just technical handling but also medical results analysis and reporting. There are no other states, except maybe Sarawak, where you can see MA specializing in not only cardiology but anaesthesiology, psychiatry, orthopaedics, ophthalmology and various other high specialties especially in district hospitals.

Did I mention that Queen does not have a CT scan machine? Or at least a functioning one.

Thank God they shifted the Pediatrics and the Obs & Gyne wards to Likas hospital.

Note: the post is not meant to be degrading but a shout out to the public of the awful condition and reality here in Sabah.