Embedded Files
Photo: At the Thailand-Malaysia border at Padang Besar (1969, archive ref. S13b/019)
After a month I received a letter from the Malaysian Health Department informing me that I had been posted to Kangar, Perlis. This is the north-western state of Malaysia. Perlis is a Malay state which is surrounded with wet padi (rice) fields, at the border with Thailand. Padang Basar, the border town, is a favourite spot for cheap shopping for Malaysians. This is also a place for men interested in cheap nights with Thai girls, as the border town was considered Ulu, or backward, by urban city people. Kangar, the capital of Perlis had only one main street with shops on both sides of the street. At the end of the street was an open market. I was not happy to be posted to such a place after returning from Melbourne, Australia. I had no choice, however; the Health Department held my destiny. Where they said you have to go, you went. In those days, they had all the power. To get what one wanted was to know friends of power or influence. I needed a job to earn some money so I had no choice. There were not many private hospitals to choose from in those days and also I did not have the money to pay back to the government for the so-called scholarship. I had signed the contract and I had to abide by it.
I took a taxi from my family home in Ipoh to Kangar for my first posting in Malaysia. I had to honour my contract and work for five years with the Health Department, otherwise I would have to repay the Government M$5000. I wondered whether the cost of the air-fare from Singapore to Melbourne than would cost more than M$5000. I had to look at the situation favourably. If not for the so-called scholarship, I would not have had the chance of travelling overseas to study with the financial situation of my family. My parents were supporting my elder brother in Medicine at Singapore University and my second brother for his studies at the University of Malaysia. I had two younger brothers who had expressed their wish to study abroad if they were not admitted to the local university and there were another two youngest brothers who were still in secondary school. Even if my parents had the money, I wondered whether my father would invest in me, seeing I was a daughter. My parents favoured their sons and education was seen to be an investment, whilst girls were seen as liabilities. It was also very difficult to enter into a university then. There was only one university in Malaysia and one had to be the cream of the crop, a Malay person, or one who had embraced Islam as their religion. Education was expensive in Malaysia so if there were a few children in the family to support, it would be difficulty for any middle class parents to have enough money for their children's education. This was unlike when one was studying overseas where one could get a job during the semester break to support oneself in their studies with little financial assistance from the family.
Photo: Lai Fun's six brothers, from left to right: Thong Mann (TM), Thong Ling (Philip), Thong Teck (TT), Toong Yeen (TY), Thong Sum (TS), Thong Cheng (TC), taken at Ipoh Airport on the occasion of TT's departure for medical training. (c. 1963, archive ref. 18W/03/033)
Photo: Padi fields in Kangar, Perlis (March 1967, archive ref. S14/011)
Kangar Hospital was a very small hospital. The capacity of the hospital was slightly over two hundred. It had an operating theatre, a male and female mixed medical and surgical ward, Tuberculosis (TB) ward maternity ward with a small labour room, a casualty department, and a pharmacy department. There was housing for the medical-officer-in-charge, matron and two nursing homes for nurses. When I arrived at Kangar Hospital with my two suitcases I was taken to the nursing home by the matron. I was told to report to her office on Monday for an orientation. The Ayah Mah (maid) showed me my room at the nursing home. I was given a room at the old ground level building as the two level brick building was full. I could request for a room in the brick building when there was a transfer of nurses out of Kangar Hospital. I had to share the room with another person. A dental nurse shared the room with me. There were two cupboards in the room, one each to store our personal things, and a table each. The room was big enough for two. We had to share the community bathroom which was at the end of the corridor.
Along the corridor there were open windows for the cool breeze to enter and cool the building. Each room had a ceiling fan. There was a large visitors lounge for staff visitors. It was quite an open room with a cool breeze circulating all the time. There were two ceiling fans for use if the room was too hot. Outside the compound of the nursing homes was a creek which flooded every year during the raining season. I remembered during my second year there, the rain was so torrential that the creek overflowed and the ground level nursing home flooded. Snakes, leeches, fish and other insects washed into the rooms and toilets. It was frightening to learn that one of the nursing sisters had a leech creep into her vagina whilst she sat in the toilet. She noticed the leech when she changed. It was lucky for her that leeches fall off the body when they are filled with blood.
Photo: Taken during flooding at Kangar, Perlis (c. February 1967, archive ref. S12/014)
Photo: Lai Fun in nursing uniform at Kangar Hospital, Perlis (c. February 1967, archive ref. S12/015)
I was given three white uniforms with blue belts for duty on Monday. We had to wear our own white shoes as part of our uniforms as shoes were not provided. There was no cap or veil with the uniform, only nursing sisters wore veils. A nursing sister wore a white belt and veil with their white uniform and a matron wore a blue uniform with a veil. The length of the uniform was above the knee. Laundry was provided for nurses' uniforms. Uniforms were usually well starched and ironed by the laundry staff.
Trained nurses were called staff-nurses until they were promoted to nursing sister. From nursing sister, one would be promoted to become matron. Each nursing position level took years of experience and post graduate training. To qualify for a nursing sister position, one had to have a triple certificate and a minimum of three years of post registration experience.
When I reported at the matron's office on Monday, I was oriented to the hospital and introduced to all staff members who were on duty then. I was told to work at the male mixed medical and surgical ward. I was oriented to the running of the ward by the staff-nurse on duty on my first day. I was given five morning shifts to work with the staff-nurse before beginning left alone. There was another nursing-aid, two male ward attendants working under the staff-nurse during the morning shift. In the evening shift there was one ward attendant less and during the night shift, the staff-nurse only work with a ward attendant. The morning shift was from 7am to 3pm, afternoon shift was from 2.30pm to 10pm and night shift from 10pm to 7am.
The duties of a trained staff-nurse were heavy. During the morning shift a staff-nurse was expected to attend the doctor's ward round. After the ward round, treatments were carried out. Duties also included the supervision of ward attendants and nursing-aids on duty and non-nursing duties including that of dietician, doctor, ward manager, clerk, messenger, and councillor. These duties were in the context of expectations from doctors that “overseas trained staff-nurses were not worthy of tying their shoe laces”.
Trained staff-nurses were expected to diagnose and treat minor ailments and refer patients to doctors at their discretion. Procedures conducted by trained staff-nurses included minor suturing, inserting intravenous therapy, and prescribing select medications to non- emergency patients after hours. A fresh overseas trained nurse who had no teaching or training for these procedures would find it difficult from the beginning of their role until skills were learnt on the job. I was fortunate in a way that I was posted to a small hospital at the beginning of my nursing career and worked with nurses who were willing to share their knowledge. They had gone through the same experiences as a first year staff nurse. Three quarters of the staff-nurses were overseas trained staff-nurses. It was believed that the Ministry liked to send overseas nurses who were single to remote areas to serve their contracts, especially if these nurses possessed a double certificate in midwifery. It was not good news to me that I might have to be at Kangar Hospital for my five years of contract.
A nursing sister had to have been a staff-nurse with at least five years experience before being eligible for promotion. Generally when a nursing sister was awarded the position, a transfer to another state was agreed upon at the interview. Their duties included the supervision of the ward staff-nurses and attendants, the general running of the wards, and answering to the matron. It was an interesting sight to watch the nursing sister counting dirty linen with the attendants for laundry everyday. I often saw the nursing sister walking up and down the ward. There were times when orders were given to the staff-nurse to order items for ward use by the nursing sister. Generally ward inventories were the duties of the nursing sister. As far as I can remember, the nursing sister was not involved in the caring of patients, regardless of how busy the ward and staff nurses were.. However, the smooth running of the ward was overseen by the nursing sister and there was only one nursing sister for the whole hospital.
Photo: With colleagues in nursing uniform at Kangar Hospital, Perlis (c. 1967, archive ref. A02/028)
Photo: Heading to treat patients during heavy monsoon flooding (c. 1967, archive ref. A02/025)
Photo: In nursing uniform, staff quarters at Kangar Hospital, Perlis (c. 1967, archive ref. A02/053)
The matron was responsible to the medical-officer-in-charge of the hospital. The nursing staff rosters were made by the matron. Any requests of annual leave and days off were directed to her. Often, staff-nurses would not get the leave they requested unless the matron favoured them. It was a shame that staff members had to contend with these politics. It seemed to be a power game the matron liked to play with the staff. At times the days at Kangar Hospital could be very miserable if the matron had the mood to make it so. I observed that conflict among staff-nurses was often created or initiated by the matron. Tales were told which were not facts but simply perceived. I hated the politics.
The other members of the nursing faculty were male nurses. In those days, male nurses were given more recognition than female nurses even though males and females went through the same training. Male nurses were given the title of hospital assistant and a more superior status than a female trained nurse. Generally male nurses worked in the casualty and outpatient department assisting the doctors. Their role was very much like a medical officer assistant. Male nurses were allowed to diagnose, treat and administer certain medication, but they were expected to refer the patient to a doctor when the patient was in a serious condition. I observed male nurses treating and suturing patients. At one time I was shocked that a hospital assistant even performed an incision and removed a sebaceous cyst! I often felt male nurses were having an ego trip when they were on duty. I was sure they did duties which were not allowed. I believed they were treated as "bare foot doctors" who worked in China. The Ministry recognised them as such because of the shortage of doctors in the country. Often they were posted to remote regions of the country where doctors were not interested.
Image carousel: Federation of Malaya Nursing Board registration papers issued 9 December 1966 and registration pin #4091 issued along with certificate.Although the modern country of Malaysia commenced in 1963, its nursing board continued to use the old name of Malaya until several years later. (archive refs. P7/14a-c, Z25/08a-b)
Image: Letter of appointment as a regustered nurse from the Malaysian Ministry of Health. (27 March 1967, archive ref. P7/16)
English translation:Miss,I am instructed to inform you that after considering the certificate submitted to the Secretary of the Ministry of Health, Malaysia, that the Ministry has confirmed you in your position (as a registered nurse) starting from 5 January 1967, and you are eligible to receive a pension starting from 1 April 1967 providing you are not married at the time.You are informed that you may be dismissed at any time under the provisions of section 10(e) of (employment and pension legislation) and that you are not entitled to a pension if you cease employment before reaching the age of 45 years.I am at your service,Zulkifli bin Abdul, on behalf of the Public Service Commissioncc/ Secretary, Ministry of Health, Kuala Lumpur
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