Is freedom of expression a problem?

French comedian Dieudonné M’bala M’bala became an instant household name in France when he was banned from performing his anti-Semitic stand-up comedy routine. He is notoriously known for implying that a renowned Jewish journalist belonged in a gas chamber. 

Dieudonné may have become one of the most hateful personalities in France but many of his haters still believe that he should not be banned from performing.

It is not very often that the French court decides to restrict freedom of expression, a sacred institution in France. The other time it was done was when it prohibited the wearing of all religious headgear in public school, and more recently the wearing of a full-face veil in public spaces.

I found it interesting that France, a country that gave birth to Voltaire – known for his “I may disagree with what you say but I will defend to my death your right to say it” quote – appear  more willing to use court power to silent offensive speech and curtail the expression of religious identity.

I was told that the majority of the French disagree with the court’s ban on Dieudonné’s comedy show despite many who think he’s a hateful bigot and found his jokes extremely offensive and borderline violent.

I also learned that many French people believe that while the ban against hate speech is wrong, religious headgear isn’t (and other symbols for that matter) because they are two separate matters.

“Dieudonné’s jokes are more than just racist comedy. If you watch his videos online, you’ll see that he’s inciting violence and hatred against the Jew. What he does is criminal. But you [the court] cannot ban his show because that’s against freedom of expression. We cannot allow that to happen in France. It’s much too sacred,” Philippe, a French expatriate said when asked what he thought of the ban on Dieudonné.

“What the court should have done was to give him a prison sentence or a huge fine. There is sufficient evidence to charge him for inciting violence. But to ban his show, that’s just ridiculous.”

Philippe’s concern obviously lies in the protection of freedom of expression, something he considers sacred and cannot be violated.

I was told that the majority of the French are outraged by Dieudonné’s anti-Semitic jokes but like Philippe, they are more concerned that the judiciary may fall into a slippery slope.

“We couldn’t care less about Dieudonné M’bala M’bala. Who the hell is this guy anyway? If civil liberty groups are upset about the ban, it’s definitely not to defend what he did. It’s to defend our right to freedom of expression. We cannot allow the ban to happen because who knows what else will be banned in the future?” Philippe insisted.

“People need to understand this. Objecting the ban does not equate to defending racist behaviour. They are two separate issues,” he added.

Guillaume, another French expat, agreed with Philippe. Although he disagrees with Dieudonné’s racist behaviour, he wished people would stop giving him so much attention.

“I don’t really care about him. He did not exist in my life before but now because of this fracas, everybody knows him and they are giving him way too much importance.  He’s become so popular. Why? There are other more important things that deserve my attention,” said Guillaume.

What is true for Philip seems to hold true for Guillaume as well. According to both, freedom of expression must not be restricted. But what I find even more intriguing is that the duo feel that the French court’s consistent upholding of the ban on religious headgear (more prominently the face-veil worn by Muslim women) in the public sphere is completely justified.

What’s the difference?

“Well, for centuries we’ve suffered the imposition of the Catholic Church. France is a secular country now. There’s no room for people who want to impose their religion on others. You go to school to learn, not to practise your faith. We did not say you can’t have a religion. All we’re saying is religion has no place in the public sphere. You can do what you want in private. That’s your business,” Philippe asserted.

I argued that wearing a headscarf does not mean a person is imposing her religion on others. It is well within one’s right to express one’s religious identity and to practise one’s religious teaching.

“I really doubt that these people are merely expressing their religious identity. I think they are trying to Islamise the country. They are deliberately provoking the public with their religious attire,” Philippe said.

I looked at Guillaume to hear what he had to say about this. He remained silent and appeared to be in deep thought. Perhaps he may disagree with Philippe this time.

Philippe meanwhile continued to express strong feelings against the wearing of religious headscarf in public. He said that those who insist on practising their religion openly should live elsewhere. France is not a country for them.

As I am familiar with such sentiment, often expressed by those who think we (the Malaysian minority) are complaining too much and should leave the country, it dawned on me that freedom of expression wasn’t really the issue here. It was the fear of France losing its secular identity and Islamaphobia that had prompted such different opinion.

I had an epiphany - there are people who are equally as afraid of the threat of converting into Islam as much as the threat of converting out of Islam. I begin to see some sort of a resemblance between religious and anti-religious fanatics.

When I pointed this out to Philippe, he argued vehemently that it wasn’t just the Islamic headscarf that he has an issue with, but all religious headgear and symbol.

“Do you know that Muslims are now demanding public schools in France to serve halal food? I mean, what next?” Guillaume finally broke his silence and that was sufficient for me to deduce that he shared the same sentiment as Philippe.

The French courts may try their best to apply restrictions on constitutional rights as consistently as possible, the French public are quite split on the two issues. This is precisely what makes freedom of expression an extremely grey area. No matter how it is being applied, there will always be someone who is unhappy somehow, somewhere.

To me, freedom of expression is not the problem. What becomes problematic is the hypocrisy of human being – “I will defend my right but not yours”.  

Freedom of expression must be for everyone which is why, it should only be restricted when it is absolutely necessary and within the law. There is no fast rule on what entails necessity. It must always be judged contextually and from both sides of the perspectives.

What could potentially be a solution to address polarity is the emphasis on critical thinking by our society, a faculty so lacking these days.

For many centuries, the Socratic Method or what is commonly known as critical thinking has been the pillar of the finest teaching institutions in the world. Famous for his quote “an unexamined life is not worth living”, Socrates distinguished intellectual and free minds from ignorant fools although he was sentenced to death for making a mockery out of the ancient Greek Gods and the Athenian ruling elite.

His student, Plato, created the first institution of higher learning in the Western world and wrote Dialogues, a book where characters argue a topic by asking each other questions.

The Socratic Method further inspired Plato to expound on his theory of dualism, separating perception from idealism. He illustrated this theory using the cave metaphor – people living in a cave can only see the light within the parameter it is projected upon, hence depriving them from seeing the big picture or external realism as he would call it. Here lies another reason why freedom of expression must not be restricted to allow peripheral points of view.

Plato’s Academia and Dialogues are both famous for promoting critical thinking. The presiding philosophy was that all school of thought must be given equal opportunity for discourse so that students and readers can make their own judgment after careful analysis.

The American Association of University Professor agrees with Plato’s philosophy and thus adopted a Freedom of Expression and Campus Speech Code which says:

“Freedom of thought and expression is essential to any institution of higher learning. Universities and colleges exist not only to transmit knowledge. Equally, they interpret, explore, and expand that knowledge by testing the old and proposing the new. This mission guides learning outside the classroom quite as much as in class, and often inspires vigorous debate on those social, economic, and political issues that arouse the strongest passions. In the process, views will be expressed that may seem to many wrong, distasteful, or offensive. Such is the nature of freedom to sift and winnow ideas.

On a campus that is free and open, no idea can be banned or forbidden. No viewpoint or message may be deemed so hateful or disturbing that it may not be expressed.”

The code went on to prescribe measures that can be taken to address incivility, intolerance, offensive and harassing behaviour, all short of banning free speech. Click here for the full code.

Freedom of expression can be both empowering and disempowering at the same time. To me, it should not be restricted whenever possible because it can be used to empower more than it can disempower.

As a woman, I may be offended by a disempowering video objectifying women as sex symbols but as a human rights activist, freedom of expression is an inviolable right that must be defended at a reasonable cost. It is because of freedom of expression that human rights values are imparted and upheld all over the world on a daily basis. Finding a balance between these competing interests is not easy and requires time and wisdom to understand. 

To me, it is easier to correct a harm caused by an expression than to correct one that is caused by a ban on expression. For example, the public can challenge an offensive expression through criticism and counter argument when there is space which allows freedom of expression but it becomes extremely difficult to expose and correct wrongdoing in an environment where freedom of expression is being curtailed.

Plato’s theory of dualism explains the inevitability of two opposing views which makes it difficult to judge an issue as simply black or white. As such, the solution should never be to restrict the expression of these two opposing views, but to encourage the audience to think about the views as critically as possible and come to their own conclusion.

Shielding an adult from distasteful or offensive form of expression is not a heroic act. In fact, it can be disempowering and it can perpetuate ignorance. Not only are you treating the adult like a child, you’re saying that you know better. This is an offence many Malaysian politicians are committing on a daily basis. 

Fighting injustices and human stereotypes is not about restricting offensive or distasteful content. It’s about educating and empowering men, women and children on a daily basis to think critically about such content so that they can learn to make informed judgment on their own.
Freedom of expression is not the problem. The lack of it is.

This article was first published here on 13 February 2014.

Technorati Tags: Dieudonné M’bala M’bala,Voltaire,Socrates,Plato,Socratic Method,Academia,Dialogues,dualism,American Association of University Professor,Freedom of Expression and Campus Speech Code

Stop feeling happier

If one of your New Year’s resolutions is to feel happier about the world, I have got news for you, buddy. It is not happening.

Misery is here to stay and unfortunately, you are part of it.

The truth is, I have been unhappy for a while. There you go, I finally said it.

If you think I’m another self-indulgent writer who is taking advantage of the media to whine about how unhappy I am, you’re absolutely right. But I will tell you now that I take no pleasure in doing so because I would rather be the bearer of good news on this New Year if I could.

Well, it began to dawn on me how unhappy I have been when the media recently reported that a French company has successfully produced the world’s first self-regulating artificial heart transplant. Instead of being thrilled with the technological marvel, I scorned at it.

I scorned at it because seriously, do we really need human beings to live longer?

Here are some words to describe human beings – capitalist, authoritarian, hypocrite, sadist, fanatic, xenophobe and racist.  I mean, look around you. Misery is everywhere and we, the human beings, are responsible for it.

For those who truly know me, I usually have a sarcastic or cynical comeback for most things. People who constantly post positive things on their Facebook or say only positive things about the world make me feel uncomfortable. Do not get me wrong, it is not that I do not want to share their positivity, I just do not buy it. I wish they would just cut the crap and stop pretending that everything is okay.

I had a conversation with a colleague about what it means to save the planet. This is what he said, “The term saving the planet is so deceitful because the planet does not really need saving. It has the ability to heal itself. If we are really concern about saving the planet, then we must be rid it of ourselves because our mere existence is harming the planet. So people should stop using the term ‘save the planet’ because what they really mean is to save human beings, not the planet.”

I appreciated him for cutting the crap.

I have been unhappy for a while because I know the world is not getting better and I do not have to look far to see this. Just look at what we’re doing to each other in Malaysia and how our government is intent on making us unhappy.

You see, the general rule is that many of us have to slog away at least five days a week for many years before we can live the lifestyle we want, unless we are born on a silver platter, win the lottery or steal.

On top of paying our home loan, car loan, electricity bill, water bill, sewerage bill, service and maintenance fee, tuition fee, legal fee, sinking fund, pension fund, insurance, road toll, road tax, assessment tax, service tax, and income tax, a part of our hard-earned income will eventually be stolen to benefit a few people while we pinch here and there just to save up for the things that will make us happy. So let me tell you now that as a taxpayer, I am extremely unhappy but what can I do?

If I refuse to pay my taxes in protest, I will be punished by the very same government whom I’m protesting against.

When things look bleak and if I want to turn to God for wisdom, I am told by people who simply have no business in my personal life that I cannot address God the way I want to.

If I want to express my unhappiness out loud, I am reminded to leave the country.

If I am serious enough and decide to lobby for mass support, I will be accused of overthrowing the government.

If I decide to seek legislative change through the ballot, I may never see change because the politicians who share my sentiment will not have fair access to the media and resources to reach out to the majority of the people.

I had dinner with an NGO partner this week and we talked about how to run successful awareness campaigns. I could tell he was not impressed with street protests and thought the original Occupy movement failed to maintain the momentum it garnered from the beginning. He was convinced that public satire will pressure the authority into respecting human rights and democracy.

The sad truth is, shaming does not work in this country. Believe me, many people have tried.  Satire has no place in this country. It is like those offending drivers who stick their middle fingers at you just because you honk at them for cutting into your lane without signaling. That is who we are. We reward the bad guys and punish the good ones. 

I have been unhappy because this government has never lifted a finger to help NGOs that promote human rights, democracy and good governance. For years, these NGOs are made the enemy of the state while groups propagating racial hatred are allowed to flourish.

The Auditor General’s report will tell us that the wastage generated by our civil servants year after year would have secured the funding of many NGOs for many years. As I often say, their spare change would have made these NGOs millionaires. Instead, many are forced to depend on irregular sources of funding through the goodwill of people other than this government.

So my fellow Malaysians, we cannot afford to be happy now. If anything, we need to be extra unhappy and continue to express that unhappiness because I know what the top people are doing. Do not think I have been fooled for a second. Creating religious and racial polarity among us is a classic example of trying to distract us from focusing on how they have led this country and its people into ruin.

My fellow Malaysians, please do not be fooled by the people who tell you that you should be happy, that things are not that bad. To these people, I will tell them to wake up and smell the rotting flesh before they are turned into carcasses.

Here is an Unhappy New Year message to all – stop trying to feel happier about the world. Instead, make it happier.

This article was first published in The Malaysian Insider on 9 January 2014.

“How to stop corruption like that?”

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Accidental lessons

This article was first posted on The Malaysian Insider on 21 November 2012 and LoyarBurok on 11 December 2012.

It was 1991. My classmates and I were punished for being noisy in class. We were told to stand up and remain silent for the rest of the lesson. The silence was deafening until Cikgu stormed towards the back of the classroom and barked, “Why are you smiling?! Is this supposed to be funny?”

Alarmed, we all turned around to find out who had the misfortune of inciting Cikgu’s sudden outburst. It was Lee, the boy who hardly spoke during lessons. If anything could be said about Lee, he stayed away from trouble and wore a pleasant demeanour on his face.

Cikgu repeated her question. This time with greater force. Puzzled, Lee had no choice but to answer, “Err… no. But, but, but is it a crime to smile?”

I was stunned because I didn’t know Lee had it in him to speak up against a figure of authority.

“Ohhhhh… you think you’re so smart, is it? Stand on your chair now!” Cikgu decided to play the power card. They always did when they had no answers to smart questions.

Lee did as he was told and the smile disappeared from his face.

Many of us still remember this incident and Lee will always be remembered as the guy who got punished simply because he smiled.

Recently, when my husband got into a minor fender-bender with a taxi driver, I was reminded of this story. As the article unfolds, I hope it will serve as a cautionary tale for all.

It’ll serve you well to know that if your car has been hit by a vehicle used for carriage of passengers for hire or reward (or what is commonly known as a taxi, rental car, public bus, school bus and factory bus) to be referred to as “public vehicle” hereafter, you are not entitled to make a No-Fault Own Damage (ODN) or Knock-For-Knock (K-F-K) claims, even if you have a police investigation report proving that the other party is at fault.

The only claims you can make are of your own insurance, which will then affect your No Claim Bonus (NCB) or to claim directly from the perpetrator’s insurance, which can be an insurmountable task if the latter is not co-operative.

Now, this is alarming news to me because I did not know, as I suspect many of you don’t either, about this. It got my husband and I very concerned. How and where can we find out more information? Could this be an explanation why taxi and bus drivers drive as recklessly as they do here?

Dissatisfied with my motor insurance company’s response, I’ve since then made multiple enquiries to different insurance companies, the Road Transport Department, the General Insurance Association of Malaysia (PIAM), Bank Negara and even three motor workshops.

The calls and Internet searches I made generated a lot of frustration and failed to answer satisfactorily why public vehicles are exempted from ODN and K-F-K claims. Only one person came up with a direct response (although not necessarily plausible or reliable) in an online public forum.

According to this person, the measure was taken to discourage people from driving private cars. See it as some form of vice tax, if you like. I’m not entirely sure whether this is indeed the rationale behind this ridiculous policy but at least someone offered an opinion other than just re-iterating what has suddenly become an obvious policy.

The Road Transport Department said that they are not responsible for insurance regulation and referred me to the Ministry of Finance. I did not pursue with the latter.

I had to make four telephone calls to obtain a written policy stating the exemption from AXA Affin Malaysia. The first call was answered by someone whose standard response seemed to be “cannot.” Period. My husband and I have taken to calling these people Ms/Mr Cannot and they seem to dominate the service industry in Malaysia. Before you can even explain what you’re asking for, they’ll tell you with great certainty and conviction that you cannot.

Kurnia Insurans Malaysia and Etiqa Insurance have the same policy on their websites. AIA Malaysia’s telephone operator said that this should not be true but was unable to confirm. She also said that all motor insurance policy should apply across the board because they are being regulated by Bank Negara. When I called Bank Negara, there was no one who could answer my query. They promised to call me back but they haven’t.

Zurich Insurance Malaysia Berhad informed me that they, too, practise the same policy. According to their officer, the policy is a result of an agreement made by all the insurance companies. Although I was disappointed by the answer, I was pleased that they were helpful enough to explain what I could do instead.

“You can claim third party insurance directly from the taxi. If you don’t want to go through the hassle of doing this, some workshops will help you. You just need to obtain the police investigation reports,” she said.

“How do you make a claim directly from the taxi? I don’t have his insurance details?”

The taxi driver had conveniently claimed ignorance when I asked for his insurance details. He said he had to call his company to find out and until today, I haven’t managed to get an answer from him. I was told by several people that this is to be expected.

“I hope you have his registration number. As long as you have it, you can find out from JPJ.”

“Does the workshop charge a fee for this service and if yes, how much?” I asked.

“Yes, I think they charge a fee but I really don’t know how much. What I can do is to give you a contact. You can call them and enquire.”

I called the number and to my great surprise, the lady who answered the phone said they don’t charge anything if I can furnish them with all the relevant documents. If I am unable to do so, they will charge a runner fee of RM150.

I’ve also talked to another workshop recommended by someone else and according to the workshop, as long as I send my car to my insurance panel workshop, I can make a KFK claim.

My insurance panel workshop offered us two solutions: 1) submit a ODN claim but our NCB will be forfeited and our insurance will cover the cost of repair, or 2) submit a third party claim but we’ll have to pay for the NCB adjuster fee and cost of repair first. We may be able to get it reimbursed by the taxi’s insurance later but it is entirely up to the latter’s discretion.

My husband and I haven’t quite decided yet what to do with our car. Although no injuries were inflicted (albeit a huge bruise to our morale), the simple principle of justice remains that we shouldn’t be paying for other people’s mistake. It isn’t just about the cost of repair but the time spent on dealing with it.

In my attempt to find answers, I’ve remained utterly confused and defeated. My French husband has cheekily asked me, “Why didn’t I marry a Swede? Why do you have to be Malaysian? It’s the first time I’ve heard of such stupid policies.”

Just like my friend, Lee, who shouldn’t have smiled, we shouldn’t have rejoiced so quickly with the knowledge that it was someone else’s fault when the accident happened. Just like Lee who asked the question “Is it a crime to smile?” and was then punished without any clear reason whatsoever, we are being punished in a similar fashion.

How safe can you be on the road if the rules do not punish those who inflict damage and injury to others? I can be a responsible and safe driver but it doesn’t protect me against those who aren’t. Something’s clearly wrong and how do we get to the bottom of this?

If you ever encounter an accident with a public vehicle (which I sincerely hope you won’t), it’ll be wise to obtain the vehicle’s insurance information immediately.

Meanwhile, do stay safe on the road.

Technorati Tags: AIA Malaysia,AXA Affin Malaysia,Bank Negara,Etiqa Insurance,General Insurance Association of Malaysia,Knock-For-Knock,Kurnia Insurans Malaysia,Lim Ka Ea,Loss Adjustor,Loss of Use,No Claim Bonus,No-Fault Own Damage,Road Transport Department,third party claims,Zurich Insurance Malaysia Berhad,Road accident+Public Transport

The sickness of our private healthcare services

“If I keep this oath faithfully, may I enjoy my life and practise my art, respected by all humanity and in all times; but if I swerve from it or violate it, may the reverse be my life.”
– The Hippocratic Oath

Mary was entering her mid-thirties when it finally dawned on her that she is reproductively challenged. The thought of her own infertility did play in her mind when she was much younger but her suspicion was only confirmed recently when she was diagnosed for polycystic ovarian syndrome (POS). The strange thing was, the diagnosis did not come from her fertility doctor, who had then been too eager to start her and her husband on the notoriously expensive and invasive in vitro treatment, without first examining their health.

The diagnosis for POS had come up through her own initiative. Once she and her husband decided that they would try to conceive through artificial insemination, Mary thought it would be prudent to go through a full medical check-up, “just to make sure my body is ready for the baby, you know. We’ve read that in vitro is very stressful and we want to make sure that we’ve tried everything possible to make sure that the conditions are conducive,” she said. 

When her blood work came back, her thyroid function tests were elevated. Later, it was her endocrinologist who told her that in addition to hypothyroidism, she might be suffering from POS too. He told her that the sudden and continuous weight gain, increased cholesterol level, development of fatty liver, irregular menstruation, and acne are some of the symptoms of POS.

Mary had initially thought that these symptoms were attributed to her bad eating habits and sedentary lifestyle but it now explains why these unflattering conditions remain unchanged even after her vigorous attempts to eat and exercise better.

“The funny thing is, no one told me about it. The GP (General Practitioner) at the hospital where I did the full medical check-up did not alert me to anything after he examined my test results. All he did was to make me feel bad about my weight and asked me to take another test in three months’ time to see whether there are any changes to my thyroid functions. All this while, I had been wondering why I’ve been battling bad skin and weight gain. If only I had known earlier, I would have been less depressed and feeling hopeless all the time,” Mary said.

“You have most of the POS symptoms. Go home and do a search online. Read up and learn as much as possible about POS and then go see a gynaecologist to seek treatment. You need to solve all this hormonal issue first before you even try to get pregnant. There are other options before you start considering in vitro. Let’s get you fixed up first, ok?”

That was the most honest and reassuring conversation Mary have had with a doctor so far.

After reading up on hypothyroidism and POS on the Internet, Mary discovered that the chances of having a problematic pregnancy would have been high if she had become pregnant either through natural or artificial means. She confessed that much to her disappointment and great horror, she felt that the renowned fertility specialist she saw at a highly recommended infertility clinic in Kuala Lumpur should have informed her of this vital piece of information.

Mary and her husband initially reasoned that the specialist would have alerted them to her condition if only he had bothered to look at their medical records, which they had brought along with them during their first consultation, having thought pre-emptively that the doctor would have asked for it.

“It was going to cost us about seventeen thousand ringgit for the whole procedure and that doesn’t even cover the cost of a second treatment if the first one doesn’t work. With hypothyroidism and POS, the chances of having a miscarriage would have been great.

"Can you imagine how devastating it would have been if we hadn’t known?” Mary asked and added dejectedly, “The thing is, the doctor didn’t even bother looking at our medical records, you know. They just wanted to make money out of us.”

Mary said that on hindsight now, she is not even sure whether the doctor would have warned them of the potential complications if he had known of her conditions. Mary insisted that her endocrinologist is the minority.

“There are definitely good doctors out there, but they are extremely rare,” she said.  She revealed that she no longer trusts the medical service and would turn to her trusted online sites for all her medical diagnosis and query.

“You wonder why we should pay these useless doctors so much when we can find reliable answers online!” She laughed scornfully.

Mary is not alone when it comes to being at the receiving end of bad medical services and not trusting our medical practitioners. It would appear that more and more private hospitals are abandoning the Hippocratic Oath for personal gain.

A medical practitioner revealed that the price of medicine at a private hospital costs a lot more than an external pharmacy. He often advises his patients to buy their medicine from external pharmacies because it makes no sense for them to pay “cut-throat” prices for the same medicine. However, when Kelly tried to do precisely that, the doctor treating her apparently did not take it too well.

“Instead of giving me a prescription for six months as he had recommended, the bastard only prescribed me a month’s worth of medication. In other words, he was ‘forcing’ me to go back to him for a follow-up prescription and that would have meant paying him ninety ringgit for just a bloody piece of paper. Can you imagine that?!”

The Department of Pharmaceutical Services at the Ministry of Health informed that there is currently no law to control the prices of medication at private hospitals. However, it is encouraging when the Head of the Medicine Pricing Unit wrote, “As a patient, you have the right to obtain a prescription from your doctor to buy your medicine from any pharmacy even though it displeases the doctor. I believe that empowered patients can change the current bad habits practised by medical professions so that we can all guarantee affordable medication for the people.”

Vikram, another unhappy patient, shared the experience he had with his doctor when he was undergoing treatment for Hepatitis C. He said that he was mortified when the nurse asked about his treatment in front of other patients while he was waiting for his doctor in a clinic. He understood that the nurse probably asked out of customary politeness but he did not appreciate the fact that in the course of her doing so, other people had learned about his medical condition.

He said that patient information management is lacking in many healthcare facilities and was shocked that this clinic is part of a hospital that has received an accreditation from the Malaysian Society for Quality in Health (MSQH), the national accrediting body for healthcare facilities and services. 

“On top of that, my doctor failed to inform me of all the side effects of the antiviral medication I was taking. There was no counselling or support for me and my spouse. The repercussions of the medication was so great that I felt as if the treatment had ruined an important part of our lives. 

"For each visit, I paid ninety ringgit for a five-minute consultation where the doctor did practically nothing. Thankfully I had a good insurance coverage because the medication cost an arm and a leg. To be honest, I wish I had not undergone this treatment if only I had known of the repercussions. I wasn’t informed properly,” Vikram said regretfully.

As of June this year, 75 percent of public hospitals have received the MSQH accreditation while only 25 percent of private hospitals have. At the international level, only eight hospitals have received the Joint Commission International (JCI)’s accreditation.

The JCI is created by the Joint Commission on Accreditation of Healthcare Organisations, a US government agency, aimed to improve the safety and quality of care in the international community through the provision of education and advisory services, and international accreditation and certification. 

The assessment criteria used by the MSQH is quite similar to the one used by the JCI, except the latter provides additional components such as patient and family education, staff qualifications and education, medication management and use, and the assessment and care of patients; elements which seem to be sorely lacking in our own private healthcare services.

Previously, the government has made several attempts to make it mandatory for all public and private hospitals to obtain MSQH accreditation but these attempts have been put on hold thus far. Although having some sort of national or international accreditation by a recognised and credible agency does boost public confidence, alongside minimising and mitigating clinical and safety related risks, these accreditations do not take into account public rating. The application submission for accreditation is done by the hospital in question and the assessment is then carried out by a panel of surveyors appointed by the accreditation agency. 

There is no consideration for public opinion on how the hospital has fared.

“As a patient, I would like us to have some sort of a scorecard for all the hospital in Malaysia. Something simple for a start and it can be done by civil society, someone independent and done from the patient’s perspectives. 

"What we need is someone who will disguise as a patient to test out the hospitals. So you have this person who goes to several hospitals and says he’s got liver problem, for instance, and then he assesses how the hospitals handle him based on selected key criteria. The problem has to be the same though, so you can compare apple for apple,” Vikram suggested thoughtfully.

Kelly said the hospital’s ability to deal with complaints is something left to be desired.

“No point. I’ve written to a hospital before to express my dissatisfaction over their service. I haven’t received any response from them. This was last year. It’s like as if the hospital doesn’t really care if you’re unhappy with them. They have patients lined up anyway. So why should they care?”

Sumitra, who is married to a doctor, revealed that medical practitioners often tend to close an eye when their colleagues commit a medical error. This culture is deeply rooted on the notion of solidarity akin to the “I have your back now so that when I need you, you’ll have mine” philosophy.  

This makes it virtually impossible to have a doctor testifies against the other, even when a grave error occurs at the expense of a patient’s life.

Perhaps what Malaysia needs is a patients association such as the one in the United Kingdom. The UK’s Patients Association provides a platform for the people to rate their National Health Service (NHS). The association also runs educational campaigns such as the Speaking Up Complaints Project which encourages patients to speak up against poor medical services and the NHS to improve the way it deals with patients’ complaints. The NHS is ranked as one of the top 20 best healthcare services in the world by the World Health Organisation.

Not all is lost. Malaysia seems to be doing remarkably well in the area of medical tourism. A private hospital in Kuala Lumpur is recently recognised by the Medical Travel Quality Alliance as one of the world’s top ten best hospitals for medical tourists. By taking advantage of the weaker Malaysian currency, foreigners from the Middle East, Europe and Japan are flocking to Malaysia to enjoy better medical treatment.

It would have cost the local patients an arm and a leg to receive treatment in these hospitals but Mary said, “If the service is compatible with the amount I pay for, why not? The problem with the private hospitals here is that I’m not even getting the value for my money.”

While our private hospitals continue to nurse tourists with top notch care, in order to stay competitive alongside South Korea, Thailand and Turkey, have they forgotten our own illnesses along the way?

This article was first published at The Malaysian Insider on 9 October 2013.

 

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“Don’t let your friend come. Don’t want her to go through all this.”

My first memory of her was how small she was. Her pale and blemish-free skin looked as if they had not seen a day of light. Her colour-treated hair was always held back neatly in a high ponytail.

She was well-groomed as how aestheticians should be - her eyebrows were shaped perfectly and her eyes enhanced with kohl and eye shadow. I was pretty sure I had the right visual when her name was brought up by Megan, my aesthetician.

"Poor Kathy. She looked the type who never had to do a day of hard labour. This must be really hard for her," I said to Megan. I was lying flat on my back with my eyes closed while Megan performed my monthly facial treatment in her home in Petaling Jaya.

I normally loath the idea of participating in perfunctory conversations with my hairdresser and manicurist but for some reason, I like talking to Megan. Perhaps she comes across as someone who is sincere and not exploitative like many other professionals relying on commission. That day's conversation was particularly interesting and I couldn't take my mind off it.

"She told me that short of being whipped and chained at the ankles, it was exactly like those slaves you watch on the movies. I mean, can you imagine this happening now?" I could sense repulsion in Megan's voice as she moved on to give me a shoulder massage while the mask on my face slowly hardened.

Kathy and Megan used to work together at a beauty spa in an affluent neighbourhood in Kuala Lumpur. I got to know Megan when I used to patron the spa and she was my aesthetician. Slightly more than a year ago, Megan made a leap of faith by leaving the spa to set up her own beauty parlour at home. She said she had enough of slogging away six days a week for someone else. Her former boss used to go around asking all the commissioned aesthetician what they thought of the five-digit Rolex watch she had just bought on a shopping trip to Hong Kong.

I left the spa and followed her.

The conversation about Kathy came about when I asked Megan whether she had heard of those farming programmes in Australia where people go pick strawberries and apples. "They seem to be really popular," I said.

She gave my face a quick inspection after she completed her usual cleansing routine. "You're not getting enough sleep and you need to drink more water," she said before she proceeded to answer my question. "Uh-huh. Why? Are you interested?"

"Oh no. I have a friend who's thinking of taking a year off from work to do this. Someone else I know wants to do the same thing too. It's just funny that two people said the same thing to me in less than a month." I grimaced as she extracted the acnes on my forehead.

"Do you remember Kathy? She was one of the aestheticians at the spa. The really small girl, fair skin? She's working in a strawberry farm in Australia now."

I was expecting Megan to tell me how Kathy was enjoying the farm fresh air and stuffing herself with strawberries as big as cikus while plucking them. I was wrong because for the next hour or so, Megan revealed the harrowing story of how her friend had left Malaysia to work like a slave in a foreign country.

According to Megan, Kathy left with a group of friends. She wasn't alone. Like Megan, Kathy was probably fed-up with her work at the beauty spa and wanted something more lucrative. An agent told them they could each easily earn RM10,000 a month by just picking fruits from a farm in Australia. Such opportunity seemed too good to pass and they weren't really convinced until they were shown photos of the farm and accommodation. Everything looked lovely and sounded easy.

Working in Australia meant they had to obtain a working visa and this was where the agent came in. Apparently, each of them paid about RM7,000 to the agent to sort out their paperwork.
It seems that a few days before they were to depart to Australia, they were told that their working visas were not ready and they would have to leave on a tourist visa while their agent would continue to work on getting them the correct paperwork.

Perhaps they did not want to waste their plane tickets or perhaps they did not want to postpone an opportunity for a good income, as many of them had by then presumably quit their jobs and were left with no income. I could only presume such an investment might have cost some of them their life savings. Whatever reason it was, they left for Australia more than four months ago. Before leaving, they were told to delete the agent's phone numbers from their phones.

"Kathy told me she has muscular legs and her skin is tanned now. She said she's ugly now. She has to squat on her feet to pluck strawberries for about ten hours a day without much break and under the hot sun. She sent me photos of the farm and you can't see the end of the strawberry beds. It's that far. She said it's very tough for her. She cried every night for a month when she first started," Megan told me. "Kathy said she never thought something like this would ever happen to her."

I know. Normally you only hear of such abuses happening to Cambodians, Indonesians and Burmese. Not Malaysians.

Kathy told Megan that when they arrived at the farm after hours of driving from the city, they were brought to their accommodation. They were shocked by the condition of the place. It was filthy, smelly and filled with all sorts of junk. It was obvious that decent living condition wasn't part of the deal. They spent days cleaning and clearing up the space to make it habitable. By then, the thought of being victims of a scam had slowly crept in since the reality of the place did not match the photos that were shown to them back at home.

For the first month or so, they could not pick the strawberries because it wasn't time for harvesting yet and because they would only be paid for each basket of fruits picked, they were not able to earn any income right away. On top of that, they had to pay for their own lodging and food. Apparently, mattresses were rented out at A$3 per night by the farm owner. Kathy said that this information was never disclosed to them by their agent. With no income, their expenses accumulated quickly and soon enough, they found themselves in debt. On a tourist visa.

"Why don't they report this?!" I sounded angry and to be honest, a tad judgmental.

"Kathy said she doesn't want trouble. In the beginning, when they complained to the owner, he told them that they are free to go as long as they pay off their debts. Kathy said she has no choice but to wait and pick as much fruits as she can so that she can earn some money, clears her debt and leaves the farm. Also many of her friends want to earn back the money they had spent to pay the agent," Megan said.

"Kathy told me that most of the workers there are Malaysian, Chinese and Thai. Apparently, the owner doesn't want to take anyone from Hong Kong because they are known to be vocal and they will stand up and fight. You knowlah, we Malaysians are quite submissive. Always too scared to cause trouble."

I couldn't help but think that the combination of not wanting to worry her family and the fear of humiliation and being judged by them could partly be some of the reasons why Kathy had kept this from the authorities. I wondered whether I would have done the same if I was stuck in a situation like this.

Before we ended my facial session, I asked Megan to get information from Kathy on the agent and the farm. "I want to warn my friends about them," I said. Megan nodded in understanding.

On the same night while at home on the internet, I found out that the Australian High Commission is aware of such scam. They had posted a warning against fruit picking/harvesting scam on their website. According to them, you can detect a scam if you are promised a quick working visa, if you receive an email (especially one that does not address you specifically) offering you either a guaranteed income or job, if a job advertisement requires you to send a fee to receive your start-up materials, if an advertisement only gives you a post office box address, and if the fruits do not coincide with the harvesting season.

Later that night, I received a message from Megan. Kathy had given her some vague information on the agent and the address of the farm, which appears to be situated in Western Australia. No useful information turned up when I did a search of the agent's company and the farm address on the internet.

Before I called it a night, I received another message from Megan. It read "Kathy said don't let your friend come. Don't want your friend to go through all this."

If you suspect you might have been a victim of such scam, please report to the local police or at www.scamwatch.gov.au.

*All names have been altered to protect the identity of the individuals mentioned on this article.

This article was first posted on The Malaysian Insider on 13 August 2013.

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