Chapter 8: 1970-72

I was posted to Kampar District Hospital, Perak, in my home town. Kampar was about 10 miles from my home in Ipoh, so I decided to stay in the hospital quarters. There were four rooms at the nursing staff quarters. The medical officer had a house down the hill in the hospital. At the time of my arrival there was nobody staying in the staff nurses' quarters. I thought it was a luxury to have the whole place to myself. There was a maid (ayah mah) who came to clean up the quarters for me everyday. She changed the bed linen, swept the floor and even cooked for me if I wanted it to be done. The stay at the quarters was quiet. There was nobody around to have a conversation with. At the beginning of my posting I had no friends and did not get to know the nursing staff around the area. It was rather lonely with a big place to myself. On my days off, I took a bus home to Ipoh. It was good to be with my parents more often; after all I had been away from home since I left my secondary schooling at eighteen. However, after a couple of months at the nursing quarters, my room was ransacked every time I returned from my days off at home to Ipoh. There were nothing that the particular person took except my underwear. My bras or panties were often taken from my room. I noticed sometimes that my underwear was also taken from the clothesline. I reported the theft to my superior; they reported the matter to the police, but the culprit was not caught. Begin alone at the place, and at night, my imagination overcame me. I was so scared that I even thought one night the person might appear in my room and might do something drastic. I thought this person must have a psychiatric disorder. Since the authorities could not do anything for me and the person still appeared to take my underwear from my room when I was away, even though I ensured that the place was securely locked, I decided to move back to Ipoh. I hated the thought of commuting back and forth from home for work, but I had to even though I had to drive the 10 miles. I did not wish any harm to be inflicted on me.

The staff-nurse in a small district hospital was expected to play many roles. She was a telephone operator and receptionist besides being in-charge of the ward and all the other personnel under her supervision. After office hours, she would have to take on the role of the dietician and medical officer. I remembered I had to attend to minor suturing, see to patients with minor ailments and emergencies and treat them. A medical officer was only called when the nurse was unsure of the case and procedures which she could not perform. I remembered I had to take on the duties of the midwife too as I was a double certificate nurse. If there was a problem in the maternity ward which was beyond the midwife's knowledge, a double certificate nurse would be consulted. I remember the medical officer in charge of the hospital did not have any obstetrics experience and I was called to help him and instructed him on how to perform a low forceps delivery. I had to even help him performed an episiotomy. He was very humble and honest, admitting he did not have any experiences in midwifery and asked if I would help him out if he did not send the patient to Ipoh General Hospital, which was over ten miles away. I assured him that I would if he would take full responsibilities if anything went wrong. He said he would. For the patient's sake, I dared take the risk and relied on my knowledge and experiences from my midwifery training.

When I assisted the doctor during delivery the baby's head was engaged and the baby would be at risk if the mother was driven on a bumpy road to Ipoh General Hospital. I could see the mother was too exhausted to push. The doctor only needed to do a low forceps and assist the baby's birth. I instructed him on how to perform an episiotomy and he applied the Wigley's forceps and gave a little pull with the mother's weak help in pushing down. The many experiences I had at my midwifery days gave me the knowledge of how it was done. I saw the satisfaction on the doctor's face when the baby was born and the baby gave the first cry. He was very thankful for my help with the birth and he often asked whether I was on duty when he was on call. I was teased by other staff-nurses afterwards that he favoured me. It was an honour, but the responsibilities were great when one was on duty with a medical doctor who did not know his work or had little experience. This was a fact of life in Malaysia then as there was a shortage of doctors and the Health Department had to recruit doctors from other countries and Malaysian doctors did not like to go to rural areas for work.

Another incident at Kampar District Hospital occurred when I was on duty after office hours. As usual I was on duty alone, with one assistant nurse in the general male and female wards and one assistant midwife at the maternity ward. It was a great responsibility to be overseeing all the wards, looking after the outpatients who came after hours for their "emergency" treatments, attending to real emergencies and non nursing duties like diets for patients, answering calls from patients' visitors, as well as being a telephone switchboard operator. I remember one evening when I was on duty running my feet out on the busy wards and a visitor came to ask for a particular patient. I told him where he could find the patient outside the ward. He ventured out to locate the patient. I thought everything was fine and I continued on with my work. I was at the telephone answering a phone call. He walked up to me interrupting my duty and demanded whether I knew who he was. He accused me of being rude to him. I was shocked and I told him I did not know who he was. He claimed he was one of the hospital's board of directors. Therefore, I should have addressed him as "sir" and accompanied him in locating the patient. I said I was sorry that I did not realised he was one of the hospital's board of directors, and perhaps he should have introduced himself to me, or maybe next time wear a name tag if he wished to be seen and noticed. He thought I was bold and rude for telling him so. He then threatened me that he would make sure the authorities would be made aware of the incident and he would make sure that I would be transferred to the "ulu" (rural) area. I boldly told him that I would also make sure that the authorities would know of the incident. The man was furious and livid with me for being so bold in speaking out.

The next day I told the Medical Officer-in-charge of the hospital about the incident. He told me to put my concerns in writing and not to be afraid as he knew the man I was referring to. He was a local timber company owner's son. Being a wealthy man's son he thought he had the power and status and liked throwing his authority around, being on the hospital board of directors. I put my concerns in writing and waited for a summons from the authorities but none came so I left it as such and trusted my superior to look after the incident. I was thankful that I could get along with the authorities and that they liked my work performance and competencies. If I was not liked, I am sure it would have been another story.

Eventually I had to leave the Kampar District Hospital to go to Tanjong Malim District Hospital. A senior staff-nurse had an official letter that she was to be transferred out of Kampar District Hospital. She did not like the transfer so she went to the Ipoh Health Department to ask for a rejection of her transfer. The authorities knew her and she knew some of the authorities, being at the service for a number of years. The senior staff-nurse managed to pull strings and got to stay at the hospital. However, someone had to be transferred as the Health Office wanted a nurse with a double certificate to serve in another district hospital at Tanjong Malim. I was given the letter of transfer. Of course I did not want to be moved further away from home since I had only been at Kampar District Hospital for less than one and a half years. I was at Kangar District Hospital for more than two years before I got my transfer to Kampar. Why should they have to transfer me instead of another staff-nurse who had been there for more than two years?

I brought my protest to the Ipoh Health Office authorities but my protest was rejected. I had to take my transfer. What seemed important in these matters was who you knew, rather than what you knew and what your rights were. I felt alienated by the system. I could not fight with the system and felt like I was hitting my head against a brick wall. I made up my mind that I would go but as soon as I finished my contract which was only three more months away I would leave the country.

I took the transfer and left for Tanjong Malim District Hospital. The setup of the hospital was the same as Kampar District Hospital. There were male, female and maternity open wards. The staff-nurse had to look after the patients and emergencies after office hours. There were two medical officers at the hospital who took turns to be on call. The medical officers were from India since there were not enough local doctors to fill the vacancies in Malaysia. It was a shame as I believed some of the overseas doctors could buy their qualifications. I remember one evening when I was on duty with a particular female Indian trained doctor. There was a mother who brought her child with a high temperature to the emergency department to see a doctor. She saw the child and diagnosed him as having pneumonia. She prescribed Penicillin for the child. I gave a test dose to the child and there was no reaction. The child was then admitted to the ward and was started with a course of Penicillin injections. The first full dose was given with no reaction but when a second dose was given during the night, the child developed a reaction. He collapsed with anaphylactic shock. I realise what had happened and gave the child a dose of adrenaline to counteract the reaction. He was revived with the injection very quickly. I then rang the doctor on call to further assess the child. She came and assessed the child but did not believe that the child had suffered from an anaphylactic shock. However, she still changed the antibiotic from Penicillin to Erythromycin injection. I told the doctor again that the child had had an anaphylactic shock from Penicillin and that he should not be given a drug which had the properties of Penicillin. She took her stand as the doctor-in-charge and stated that I should give what she had prescribed. I refused and told her to administer the drug herself if she wanted the child to have the antibiotic. The Hospital Assistant was then asked to give the injection through the infusion drip. Soon after the drug was given, the child collapsed again. The doctor ordered then Digoxin 0.25 mg. to be given. I told her it was an adult dose that she was giving. She gave the injection intravenously. The child was never revived. I believe he died of ventricular tachycardia or fibrillation inflicted by the drug. There was no health education for the public and most patients were ignorant of health. The doctors were seen as "gods", had complete authority, and were assumed to know what they were doing. As a nurse I needed to be professional and ethical. I was faced with an ethical dilemma: should I tell the mother who was crying her eyes out for the loss of the child that it was the fault of the doctor that her child was dead? Or should the arrogance of the doctor be allowed to put the patient's life at stake? A nurse's maturity in dealing with such dilemma was incredible. We needed to learn how to keep our emotions at bay. Inner strength had to be strong and lips needed to be sealed to survive in such a world, especially if one was a local nurse and required to support the family financially and the job was the only livelihood. So the doctor got away with the "murder". I could not fight the system alone and be the only one who spoke out all the time.

I was frustrated with the health system. I hope these incidents would only happen in 1971, and that such crises would not happen in this day and age. At the time I felt I needed to leave the system before I was totally stressed. So before my contract was finished I applied to go to England to further my nursing career. I was accepted at the St George Hyde Park Corner for my Cardiac Thoracic Course. It was a nine months course. When my contract was up I handed in my resignation.

Continue to Chapter 9

Back to Chapter 7