By Annabelle Lee

As the Klang Valley suffers its worst-ever Covid-19 surge despite being under lockdown, the healthcare system is on its last breaths dealing with a non-stop stream of patients.

On one hand, admissions are far outpacing the number of patients being discharged.

On the other hand, hospitals are running low on beds, oxygen supply, solutions and morale.

Despite reinforcements, frontliners at four public hospitals gave Malaysiakini first-hand accounts on why they are losing hope that the situation will improve.  

They spoke on condition of anonymity due to a strict gag order that bars Health Ministry staff from making unauthorised public comments. One did not even dare to reveal the name of their hospital for fear of reprisals.

Despite these threats, the frontliners felt compelled to inform the public of the painful truth.

Below is a compilation of their accounts, edited for clarity and brevity. Comments are being sought from the Health Ministry and hospitals mentioned.

Tengku Ampuan Rahimah Hospital, Klang

Frontliner who treats Covid-19 patients

Our Emergency Department and wards look like a disaster movie. Our clinics have been shut down. We are coping badly.

Doctors have been warning about rising Covid-19 admissions for a few weeks and kept asking for more beds, but the hospital management did not help until newspapers showed pictures of canvas beds outside the Emergency Department.

We have run out of beds and ventilators. Even oxygen supply is not enough. We have too many Covid-19 admissions, too many preventable deaths but not enough resources.

In the past few days, medical officers have resigned with 24 hours’ notice. They were committed and worked hard but they were exhausted with this crisis and they lost hope.

We are grateful the Armed Forces stepped in to help but their help should have been sought much earlier.

The number of nurses and doctors brought in from other departments or other states is so low that our non-Covid-19 clinics had to be shut down to move nurses to look after Covid-19 patients.

Morale is low and there is no leadership or sympathy. I feel tired, angry and helpless.

Our government hospitals have been starved for too many years due to poor funding, and a starving person cannot fight infection.

Ampang Hospital

Frontliner who treats Covid-19 patients

I feel quite overwhelmed as our patients have tripled or quadrupled in a short span of time.

We just have to make do and add more beds. We opened up a corridor and added beds there. The corridor was actually meant to be a walkway towards the lobby, it is not even part of the Emergency Department.

We don’t have enough ventilators, not at all. It comes to a point where more and more patients are deemed “do not resuscitate” because there are not enough ventilators.

It is a really sad state. I did not think we would come to this point where we choose who lives and who dies. But because the ventilators and ICU beds are not enough, we have no choice.

I feel lost. Now I just have no emotions, it is what it is. You just accept it. And death has become so frequent that you become numb. Because it happens so fast and so frequently.

You just feel helpless. You want to help but you can’t. They deteriorate very fast.

Selayang Hospital

Frontliner in a non-Covid-19 department

Patients from other hospitals are coming to us so we are overloaded. But our wards have been reduced to make more room for Covid-19 patients. So, the waiting time now takes longer.

Oxygen ports are being shared by several patients at the moment. It should be one port to one patient.

We have no idea what else to do, we do not have enough oxygen for patients. And patients do not have beds so everyone is just trying their best. We know this is a breach of protocol, but things are that bad. Better we try to do something than not do anything. Otherwise, we are already going in the direction of becoming like India.

Everybody is fed up with everything, but they do not have a choice. If we do not do what we are doing, no one else is going to do it for us.

The other day, contract nurses and contract medical assistants walked out of the Emergency Department. Doctors ended up doing nursing jobs and their jobs, it was very difficult.

They protested because of their salaries. You will get tired when you are being forced to work a lot and you are giving your best, but you still do not have a guaranteed job. You really feel like you are being squeezed dry.

I have been quarantined several times after contact with Covid-19 patients. That is the only break you get. It is not really a break, but you get to have physical rest. It is not really a break because you can’t see your family or do a lot of things.

So you just wait until your results are out and when you are ok, you have to go back to work.

Photo posted by former health minister Dr Dzukefly Ahmad (hospital unknown)

Teaching Hospital in the Klang Valley*

Frontliner who treats Covid-19 patients

(*further anonymity requested for fear of reprisals)

Family members are coming in together and one by one they need organ support like ventilators, infusion pumps and dialysis. Most of them die together.

The Emergency Department is flocked with patients waiting to be admitted and almost a third need organ support.

Now I am seeing patients coming in sicker. They need breathing tubes from the moment they come in.

Non-Covid-19 patients also have limited access to healthcare as most resources are focused on Covid-19 patients. They come in late because they are scared of Covid-19. As a result, their mortality rate is higher.

Every day when I come to work, I have to think of who I can give a better chance to live. I cannot choose anymore because there are too many whom we want to help but are unable to due to limited resources.

Every day when I come to work, I have to think of who I can end treatment for due to the futility of medical therapy, to give way to patients with a better prognosis. Now it has become more frequent than before and it takes a toll on my mind and my soul.

Morale is very low. We are providing care at the maximum limit but more patients are dying now than before. We are tired of working in personal protective equipment (PPE).

We do not know how much longer to persevere. Some of us cry, many of us are angry.

Association of Private Hospitals president Dr Kuljit Singh

Private hospitals

Association of Private Hospitals president Dr Kuljit Singh

Most private hospitals are fully stretched because we only have a certain amount of patients we can take. We are already extending beyond what we promised to do.

Right now, we are opening up ICU beds without official permission from the Health Ministry. We are informing the ministry, but the beds are not being inspected. We are opening up as many ICU beds as we can. Even then, we are full.

Our staff have been utilised for vaccine administration centres (PPVs), we are sending a lot of our staff to the mega centres. We also run our own PPVs in our hospitals. We need to put staff there.

We are using our staff as much as we can to treat Covid-19 patients in Categories 1 to 5.

Private hospitals are committed to send staff to the government. We are also prepared to accept more non-Covid-19 patients from the government. So, if you look at the staff, we are actually stretched to the maximum.

The most important thing is not to create more spaces but to get to the root problem, which is to stop the cases from increasing by really vaccinating people and confining those spreading it.

We can keep opening up space after space, but if the case numbers keep increasing, it is not going to achieve anything.