Kathy Melotte (LEH 2000-2011)
In July 2017, I was fortunate enough to travel to Kuching in Malaysian Borneo to participate in the medical elective programme at Sarawak General Hospital (SGH). Kuching is located in the Malaysian state of Sarawak, which boasts a population of 2.47 million people and tropical weather year round. Similar to UK NHS hospitals, SGH is a government funded hospital and provides free healthcare to Malaysian citizens. While most utilise the state funded healthcare system, some still choose a private insurance system. The hospital opened in 1870 and serves as the main tertiary centre in the region and over the years has become one of Malaysia’s major teaching hospital.
My main objectives during this overseas placement was to gain an understanding of a healthcare system outside of the United Kingdom as well as exploring the challenges doctors face practicing in a country with fewer medical resources. During my stay at SGH, I spent the greater portion of my time in general medicine, as this post allowed me to experience and witness a wider range of medical practices in Borneo.
The majority of my placement was spent on the busy wards of SGH. Unlike the United Kingdom, multiple patients were packed in singular bay and at times this lead to significant overcrowding and lack of patient confidentiality. I saw first-hand the effects of a hospital that is just too busy, patients who needed intensive care had to wait in standard wards for intensive care beds to become free. This situation presented stressful situations and difficult working conditions.
English was spoken as the primary language in the hospital, this meant I was able to gain a good understanding of each patient’s situation as well as the overall problems the hospital faced. The hospital itself provided many modern care capabilities and test centres such as advanced imaging and a blood test laboratory. However, the overcrowding situation meant that such facilities were experiencing severe lack of availability. The doctors I shadowed often has to rely on their clinical training and judgement to make decisions. Situations such as this showed me how reliant UK doctors have become on medical facilities.
In the final days of my elective in Borneo, I had the opportunity to shadow our placement liaison and Malaysian tutor, Dr. Wong. Dr. Wong worked in a private hospital just 5km away from SGH. The differences between a public and private hospital were striking. Simple decisions became financial conundrums as medication or certain procedures may only be administered if a patient (or their insurance) can afford it. I personally could not ever imagine, being in the moral situation where as a doctor I would not be able to carry out a lifesaving procedure or general medical care – due to patient funds. This experience alone made me grateful for the NHS and the healthcare systems we have in place in the UK.
My time in Malaysia was not only unforgettable, it was weeks of valuable experience. The skills learned are ones that I will take forward into my own clinical practices. I would like to thank the LEH Alumni Award for allowing me to have this amazing opportunity.