Assunta Hospital’s charity team is taking small steps to make medical care accessible to the poorest of the poor in Malaysia | Malay Mail

KUALA LUMPUR, July 22 — Working in a mobile clinic in six different locations six days a week is no easy task as it means traveling to 24 different locations, with only four days off a month.

Although tiring, Edeena Marcellena Engel looks forward to each new day as a staff nurse at the mobile clinic under Assunta Integrated Social Services (ASSISS), the charity arm of Assunta Hospital that provides medical assistance for patients whose gross household income is RM2,500 and below.

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“There are two teams. We are Team A — a doctor, and four nurses. The four nurses will rotate tasks between registration, screening and giving medicine.

“For me, I joined the team because of my interest in medicine. I want to handle medicine,” the 27-year-old told Malay Mail in a recent interview.

Edeena Marcellena Engel, 27 during Assunta Mobile Clinic services at PPR Kampung Baru Air Panas in Kuala Lumpur July 12, 2023. — Photo by Firdaus Latif

However, she said that when she was a nurse based in a hospital, she did not have the authority to administer medicine.

“So the mobile clinic experience is very different,” he added.

For Edeena, a Sabahan, every day at the mobile clinic brings a different kind of “adventure”.

He recalled a particular case that made his and another colleague’s hearts skip a beat.

While on duty in a residential neighborhood, two staff nurses were asked to provide cardiopulmonary resuscitation (CPR) to a nearby person who suddenly lost consciousness.

“The person who passed out was not a patient of the mobile clinic, but we were the only ones closest to them at the time, and they came to us in a panic.

“We dropped everything and ran to where the man had passed out and under the scorching hot sun we gave the man CPR,” he said.

Edeena said the incident taught them that they should be ready to provide medical help at a moment’s notice because they are frontline medical staff.

Edeena Marcellena Engel, 27 (L) and Valarmathi a/p Magendran, 26 while servicing the Assunta Mobile Clinic at PPR Kampung Baru Air Panas in Kuala Lumpur July 12, 2023. — Photo by Firdaus Latif

Runs a mobile clinic

One of the more difficult parts of running a mobile clinic is interviewing patients to determine if they are eligible to receive treatment at the mobile clinic, Edeena said.

“It’s not easy to start a conversation about someone’s household income, it’s a very sensitive question, and it’s difficult to explain it in some languages ​​that we’re not familiar with. These are some of the screenings that we have to do before someone actually sends to the doctor for a consultation.

“At the same time, I feel bad about turning people away. But we have to turn people away if their condition requires special treatment. The mobile clinic only treats minor illnesses,” he said, adding that his team will refer patients who need more complex procedures such as an operation to a hospital for treatment.

Edeena says her team’s day starts at about 7am and even though the mobile clinic is packed by noon, their work doesn’t end there.

His colleague, staff nurse Valarmath Magendran said the team returned to the office to prepare for the next day.

“That includes packing the medicine, checking the next day’s location, and when we’re done it’s about 5pm.

“It sounds tiring, but I’ve been working at the hospital for four years, and I think it’s time to get out and interact with the outside world.

“I wanted a less routine job, as when we are in the hospital, we are responsible for the long-term care of a patient, we see the same patient every day.

“However when we are out there, there are new stories and experiences being shared every day, I like that,” said 26-year-old Valarmath.

At the age of 23, Muhammad Anif Fathi Abdul Rahim is not only the youngest teammate but also the newest and eagerly looking forward to being part of the mobile clinic crew.

He said Malay Mail that dealing with different patients outside the hospital grounds every day gave him a different perspective on how he could contribute to the medical fraternity.

But he was forced to take a break from the mobile clinic just a month after joining because he had an accident.

“This did not prevent me from being part of the team even though I was in office. Although I was in office, I was put in charge of finding deserving recipients of ASSISS medical assistance.

“It keeps me motivated, and even when I’m not on the ground, I help the team in different areas,” he said.

Muhammad Anif added that he likes the regular hours that come with the ASSISS team because there is no shift work.

“Some individuals prefer working shifts, I didn’t enjoy it. So when I heard about it, I applied for it.

“I wanted a less chaotic sleep schedule but at the same time still be able to contribute to the medical industry as a nurse,” she said.

How ASSISS started

Head of medical services at Assunta Hospital which heads ASSISS, Dr Darshinia Ballasingam said the charity arm was established to reach out to the poor with programs, including free healthcare for the poorest of the poor.

These include pastoral care, mobile clinics, social welfare inpatient or outpatient, wound care services, stroke ancillary programs, geriatric enrichment services, and palliative services.

The mobile clinic, which started in 2019, is one of the eight components under ASSISS that provides health consultations and monitoring of chronic medical conditions like diabetes as part of basic primary care.

“Initially, ASSISS focused on providing holistic medical care, covering various aspects such as wound care, palliative care, geriatric care, in-patient surgeries, outpatient consultation, and mobile clinics.

“This comprehensive approach ensures that individuals receive the necessary support to meet their medical needs,” Dr Darshinia said in an e-mail interview with Malay Mail.

However, he said that the Covid-19 pandemic and the increasingly high cost of living have moved in the direction of ASSISS.

Dr Darshinia said the pandemic highlighted the critical importance of community care and underscored the need for accessible medical services outside the hospital setting.

“This change in economic conditions has made ASSISS even more necessary, as a large part of the population needs support for their medical expenses.

“To meet these emerging challenges, ASSISS has adjusted its priorities and standards. The organization recognized the need to focus on supporting the medical expenses of those in B40 who are among the most economically vulnerable in the community.

“By doing so, ASSISS ensures that medical services remain accessible to all, regardless of their financial circumstances,” he said.

That said, Dr Darshinia said there is equal demand for the various services offered by ASSISS.

He explained that patients often need many types of help at once, such as wound care, palliative care, physiotherapy, and more.

“The diverse needs of patients and the interplay between different medical conditions require a holistic approach to health care.

“Patients may need wound care for healing injuries, palliative care for managing pain and symptoms, and physiotherapy to improve mobility and physical function, for example,” he said.

Tomorrow of ASSISS

Dr Darshinia said ASSISS is trying to fill the gaps that may arise in the medical sector even though the future is difficult to predict.

“The ultimate goal is to work toward reducing the need for medical assistance through improvements in public health and accessibility to health care.

“We hope to contribute to broader efforts in the health care sector to address systemic issues, promote preventive measures, and improve overall health outcomes.

“Ideally, as the health care system develops and evolves, there will be advances that result in better access to holistic medical care for all individuals, regardless of their socioeconomic status. This will involve addressing the underlying factors that contribute to health disparities and working toward a more equitable health care system,” he said.

He added that it is important to recognize that challenges and gaps within the medical world may persist due to various factors such as economic disparities, limited resources, and complex social issues.

“In this context, programs like ASSISS play an important role in filling these gaps and ensuring that the most vulnerable members of the community have access to the medical assistance they need.

“While the long-term view is to see a reduced need for medical assistance as a sign of improvement, the reality is that there may always be individuals and communities in need of additional support and specialized services.

“We will try our best to meet these needs and provide essential medical assistance to those who need it most, regardless of the broader health care landscape,” he said. Working with ASSISS was a transformative experience, Dr Darshinia said and recalled a case that significantly changed his perspective on how to provide medical care.

This is a senior citizen who has experienced fourth-stage venous ulcers on both legs for seven long years. She is a widow and has no immediate family and relies on a small pension for her basic needs.

A venous ulcer is an open wound that takes longer than usual to heal due to blood circulation problems.

“His mobility was severely limited due to prolonged illness, and for dressing procedures, he relied on the kindness of neighbors and compassionate individuals willing to take him to the nearest government clinic.

“Unfortunately, the availability of help is not consistent, which makes the healing process very difficult for many consulting doctors who have previously tried to help,” said Dr Darshinia.

But with four months of dedicated wound care provided by ASSISS, Dr Darshinia shared that the patient’s venous ulcers have completely healed, allowing the latter to regain his mobility.

“However, this whole journey of consultation and treatment has constantly reminded me of the harsh nature of life for the unfortunate.

“This humbling experience made me appreciate the blessings in my own life more. It also opened our eyes to the needs within the community and increased our attentiveness to those needs,” said Dr Darshinia.

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