Mostly Unseen, Not Unknown

I went, I saw and I experienced. No i did not conquer :P

In the past if you had talked to me about the Orang Asli tribe, my knowledge about their origin, distribution, socioeconomic background and current status would be limited to the few malnourished children I saw in Hospital Teluk Intan during my medical school years. I knew they were not well off, but that was all.

Venturing into their houses and talking to them while they tell me about their ailments gave me a better idea. In many ways their conditions resemble some of the bumiputera people in the deep rural parts of Sarawak that I meet in Hospital Sibu.

I had expected to meet mostly aches and pains. Hence the load of painkillers I brought with me.
However, to my surprise, there were quite a number of poorly controlled or undiagnosed non communicable diseases among them as well!

So here you go, on my take of my past four days in Kahang, Bentong, Pulau Ketam and Carey Island. :P

1. The hypertensive folks
first reading: 170/100. confirmed by a near second reading. no anxiety, claims Pak. No symptoms. Pak cik slalu makan ikan masin/telur masin? Taakk.... jarang jarang... OR Ye... kalau tak, nak makan ape? (and there u go, unable to ask them to cut down on salted food bcz poverty is a limiting factor for them to eat healthy). however, one cannot let BP this high go uncontrolled. Referral letter to the PK it is. I could advise lifestyle change, advise him to get to the nearest PK in a week with the letter, but I could not take over a PK's ability to supply him with 3 months of anti HPT and monitor kidney function and complications. Nearest PK being 30mins/1 hour away on a borrowed motor vehicle for him.

the second type of HPT would be those who are known cases, diagnosed few yrs back, but defaulted treatment due to lack of awareness and logistics. Met a number of BP 200-220/120-140. Gave them Nifedipine and begged their kids or neighbours to shoot them to the nearest PK for proper Management.

Little did they know that the imminent risk of stroke, heart attack and kidney failure lurk at their door. Knock, knock who's there.

2. The long standing infection
Whether diagnosed or undiagnosed, they pose a huge threat to immediate contacts.
There were several highly suspicious of Pulmonary Tuberculosis (TB). Chronic cough for months that get relieved short term by Benadryl from PKs or OTC without TB workup. One fella had matted cervical lymph nodes, was cachexic and had even developed gastrointestinal symptoms.

The Hygiene Issue
Bcz of lack of proper tap water supply, they drink rain water, worst case being river water. The River, number one culprit in seeding potential deadly diseases among the folks. The rivers run through the oil palm plantation and reaches their homes, where water is used for any purpose you can possibly think of.
Now imagine a baby drinking river water. NoooOoooOoooooo

Scabies, Fungal infections, Infected wounds were common.

3. The Malnourished
There was a whole bunch of children on Carey Island and Pulau Ketam all below the 5th centile for height and weight to age. They were so tiny. They were no doubt the most adorable bunch of children i came across, huge starry eyes, toothy grin (they need serious dental intervention), frizzy hair. but their state of nourishment breaks your heart.
Referral for Food Basket!!!

3, The Unknown or Lesser Seen
Now among the few hundred we saw, one or two cases stood out.
One was what we thought was a cystic hygroma.
Another was a little girl with skin lesion that looked like warts.
Another was a 15 year old boy weighing 29kg and 130cm tall. (this one was less of a mystery but still warranted investigation)

My general thoughts and take backs?

- IT IS NOT EASY to be a General Practitioner. These guys are most important first liners in seeing patients and referring them to the upstream line when indicated.
Walao... Day 3 into the project and I was exhausted. Mentally, physically, emotionally. PK (polyclinics) need more support then you know.
And maybe I need to exercise to build up my stamina. hehe.

- There is still a lot of ground work required for the marginalised in society.
Look at you and me. Tech gadgets, proper homes, clean drinking water, hot showers, air conditioned rooms, the availability of the magic Panadol (grins) in nearby local stores to cure the headache and pains.

A villager's home (a self built hut on stilts) just got destroyed by a gust of strong wind 1 week ago, leaving him homeless. :(

Where the government refuse to provide, (or rather there is so much red tape that it takes 10 years to give someone a brick house) our compassion will have to provide.

- No one is less equal than another.
You, me, him. We all deserve education, security and love.

This trip gave us some food for thought for further improvement. In future, I think I would stock up more on antibacterial cream, anti hypertensive medication and deworming pills. :P

Who are we? We are called My3K (short for Pertubuhan Kebajikan dan Kesedaran Kesihatan Malaysia). We are an NGO pioneered by ppl in the healthcare line (pharmacists, doctors, audiologists, optometrists, dentists) in our university days with the primary goal of helping the Orang Asli ppl in unreachable areas. We are still small, starting up new and require volunteers and funds to get better equipment and medication for future projects. Equipments include dental treatment set for extraction/cleaning/patching (dont mind me for wrong term usage, i'm a doctor not a dentist hehe), eye check sets, glasses and lenses etc. We;re on facebook as www.facebook.com/ngomy3k

Let me know if u r interested to volunteer or contribute :) it will change your life.

Managed to throw in a bowl of Super Kitchen's Chilli Pan Mee before i left KL. :D owh the magical chilli flakes!

A short excerpt on the last four months of my HOship. Surgical department. I think those 4 months were filled with more drama than my entire past year of hoship could gather. hahah. There were ups and downs, but they made me stronger. No doubt I left with many lessons learnt, and many individuals that i am thankful for. :) Up next, emergency department. :P