Vaccination Challenges In Rural Sabah & Sarawak

Both federal and state governments should be well-poised to implement and execute a feasible delivery plan and according to schedule.

93 0
93 0
English

Published by Business Today & Code Blue, image from Business Today.

Although Malaysia has a plan to inoculate more than 80 percent of the population (nearly 27 million out of 32 million Malaysians) against Covid-19 by March 2022, there is no clear indication on how the vaccines are going to be distributed throughout rural Sabah and Sarawak.

This is a valid concern, as in the rural areas of Sabah and Sarawak, more than a third of the population continue to live beyond five km of any kind of health facility. Due to the lack of specialists and medical equipment, patients seeking treatments or follow up treatments are often forced to refer to another public hospital that could cater to their respective medical needs.

Even in the case of medical emergencies, they have to travel across state borders, which includes driving through muddy, uneven roads besides having a boat ride at their own expense, which is relatively cost- and time- consuming.

As the official ratio of doctors to the population is 1:856 and 1:662 in Sabah and Sarawak respectively, which shows much fewer doctors per people in both East Malaysian states than the nationwide average of 1:454, this poses further challenges for the rural hospitals to reach rural populations in both states.

Science, Technology and Innovation (MOSTI) Minister Khairy Jamaluddin stated that rural Malaysians would most likely to receive the AstraZeneca Covid-19 vaccine but as this type of vaccine is only available in the second quarter of 2021, it is unclear whether the government will include frontliners, senior citizens and people with chronic diseases who are currently based in rural Sabah and Sarawak to have the first dose of the Pfizer vaccine.

Even if the government decides to deliver Pfizer doses to rural Sabah and Sarawak, the delivery process would be much more complicated.

After ensuring these vaccines are stored at a relatively low temperature, the inter-warehouse transfer will be conducted through flights where these ultra-cold vaccines can then be delivered from the Klang Valley to the distribution centres in Sarawak and Sabah. Thereafter, the vaccines will be repacked from these distribution centres and deliver to remote areas in both states via land transportation within 48 hours.

Due to the storage and delivery challenges, the Federation of Malaysian Freight Forwarders (FMFF) President Alvin Chua indicated that Pfizer and Moderna vaccines are not suitable for East Malaysian states – Pfizer-BioNTech’s Covid-19 vaccine requires storage at minus 70 degrees Celsius whereas Moderna Covid-19 vaccine is stored frozen between minus 25 to minus 15 degrees Celsius.

Under normal fridge temperature (2 to 8 degrees Celsius), Pfizer-BioNTech’s Covid-19 vaccine only can be stored for five days whilst Moderna Covid-19 vaccine can be stored for up to 30 days.

Given that most of the hospitals in Malaysia can only store a maximum of up to minus 20 degrees Celsius, frontliners who are based in rural Sabah and Sarawak might have to fly over to Klang Valley to receive their first Pfizer shot during this quarter as the Moderna Covid-19 vaccine that can be stored at such temperature level for up to six months is not available in Malaysia’s market yet.

It would also be too costly for the government to purchase cold storage freezer for each hospital in East Malaysia. Given the estimated cost per cold storage freezer is RM80,000, the total cost of having a cold storage freezer in 24 government hospitals in Sabah and 21 government hospitals in Sarawak would be about RM3.6 million.

To guarantee the safety of high-risk groups in rural Sabah and Sarawak, the Ministry of Health Malaysia (MOH) has to re-evaluate whether senior citizens and people with chronic diseases can receive Pfizer-BioNTech’s Covid-19 vaccines as there are 33 deaths among those aged 80 and above being recorded in Norway in mid-Jan after being vaccinated.

MOH also needs to be aware of the more transmissible variants from the UK, South Africa and Brazil as it might impact the current vaccines’ effectiveness.

A study published in late January 2021 shows that Pfizer-BioNTech vaccine offers good protection against the UK and South African variants. While AstraZeneca vaccine offers 75 percent effectiveness against the UK variant, a recent analysis on Feb 8 indicates that it only offers 22 percent effectiveness against the South African variant.

As there is no information on how effective both Pfizer-BioNTech and AstraZeneca vaccines are against the Brazilian variant, MOH needs to take extra precautions to avoid more transmissible variants entering the country.

Therefore, to ensure the effectiveness of the vaccine distribution during this year, EMIR Research has several policy recommendations for the government to look into:

  • The Covid-19 Vaccine Supply Access Guarantee Special Committee (JKJAV) should coordinate the joint-efforts between the federal government and state governments to ensure the vaccines are distributed based on the logistics requirement from the vaccine providers. For instance, Pfizer-BioNTech vaccine has to be stored in lower freezing temperature during the delivery process;
  • The federal government perhaps could allocate at least half of the AstraZeneca Covid-19 vaccines (6.4 million out of 12.8 million doses) to both Sabah and Sarawak when the first batch arrives in the second quarter of 2021. This type of vaccine can be distributed using existing logistics and stored in normal refrigerators, which is relatively easy-to-store and easy-to-deliver compared with Pfizer and Moderna vaccines;
  • As the federal government is going to hire 3,500 extra healthcare staff to deal with the country’s worsening pandemic, some of them can be allocated to Sabah and Sarawak, giving extra helping hands in vaccine injection for the benefits of Sabahans and Sarawakians;
  • Both state governments could prioritise in providing vaccines to the rural areas that were identified as red or orange zones. Red zones are the areas with more than 41 confirmed Covid-19 cases whereas orange zones are the areas that have between 21 to 40 cases; and
  • Both state governments should provide flying doctor services in the remote areas of both states to shorten the delivery time of vaccines and allow the rural citizens in both states to receive vaccines sooner.

In conclusion, vaccine distribution in rural Sabah and Sarawak poses a logistical challenge but at the end of the day, both federal and state governments should be well-poised to implement and execute a feasible delivery plan and according to schedule.

Amanda Yeo is Research Analyst at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research.

Bahasa Malaysia

Diterbit oleh Malaysia Now.

Walaupun pentadbiran negeri Sabah yang baru hanya berkuasa selama lima bulan, kesediaan mereka untuk segera melaksanakan projek infrastruktur dan meningkatkan pertumbuhan ekonomi telah mencetuskan harapan membara rakyat Sabah yang senantiasa berhasrat menikmati pembangunan sosio-ekonomi yang lebih baik.

Ini dapat dilihat apabila Ketua Menteri Sabah Hajiji Noor komited untuk memperluas liputan 4G dan meningkatkan kelajuan internet di negeri Sabah di bawah Pelan Jalinan Digital Negara (Jendela).

Hajiji juga menubuhkan Majlis Penasihat Ekonomi Sabah (SEAC) yang terdiri daripada usahawan industri, ahli akademik dan badan bukan kerajaan (NGOs) bagi menarik pelaburan langsung asing (FDI) ke negeri Sabah.

Bagi merealisasikan potensi ekonomi negeri, Hajiji bekerjasama dengan kementerian-kementerian persekutuan sambal memfokuskan penekanan dalam sektor pertanian, perindustrian dan pelancongan yang sejajar dengan Pelan Pembangunan Sabah Maju Jaya (SMJ) 2021-2025 yang akan dilancarkan tidak lama lagi.

Memandangkan sektor pertanian dan perindustrian hanya menyumbangkan sebanyak 16.1% dan 7.6% Keluaran Dalam Negeri Kasar (KDNK) Sabah pada 2019, ia merupakan langkah strategik bagi kerajaan negeri memberi tumpuan penuh kepada sektor pertanian dan perindustrian.

Ia juga satu langkah bijak kerana mengikuti jejak kerajaan persekutuan dalam merealisasikan agenda hijau dalam Belanjawan Negeri Sabah 2021. Dengan bantuan teknologi pertanian hijau dan moden, ia dapat meningkatkan nilai pengeluaran selain memberi peluang pekerjaan bagi rakyat Sabah dalam sektor tenaga diperbaharui.

Walaupun Covid-19 dan banjir pada awal tahun 2021 telah menimbulkan kesan negatif kepada rakyat Sabah, tindakan segera Hajiji dalam meluluskan peruntukan kecemasan sebanyak RM150 juta bagi memperbaiki 41 jalan yang rosak akibat banjir di seluruh negeri Sabah sangat dialu-alukan oleh rakyat Sabah.

Timbalan Ketua Menteri Sabah Bung Moktar Radin juga berjanji akan memperbaiki jejambat Luyang yang retak dengan segera demi memastikan keselamatan pengguna jalan raya.

Walaupun kes Covid-19 dapat dikurangkan di negeri Sabah selama beberapa minggu (iaitu, dari 404 kes pada 17 Februari ke 85 kes pada 2 Mac), penutupan sekolah secara berterusan telah memberi cabaran besar terutamanya di kalangan pelajar yang tinggal di kawasan luar bandar. Mereka masih bergantung pada tempat tertentu untuk menerima akses internet bagi pembelajaran dalam talian.

Guru di kawasan luar bandar juga menghadapi rintangan dalam pelaksanaan sesi Pengajaran dan Pembelajaran di Rumah (PdPR) kerana pelajar mereka mempunyai akses terhad dalam peranti digital atau memilih untuk melangkau pelajaran dalam talian.

Lantaran itu, peruntukan kredit data and komputer riba oleh kerajaan, korporat dan NGO mungkin tidak akan menyelesaikan masalah akses pendidikan di kalangan anak-anak dari luar bandar Sabah secara berkesan.

Tambahan pula, Perintah Kawalan Pergerakan (PKP) di seluruh negeri sejak pertengahan Mac tahun lalu telah menyebabkan banyak pemain industri pelancongan mula risau atas kesan buruk PKP 2.0.

Walaupun Pakej Perlindungan Ekonomi dan Rakyat Malaysia (Permai) akan memberikan potongan bil elektrik sebanyak 10% bagi pengusaha hotel, pejabat syarikat penerbangan tempatan dan agensi pelancongan dari Januari hingga Mac, Persatuan Pelancongan Sabah (STA), Persatuan Hotel Malaysia dan Persatuan Hotel Bajet Malaysia menyatakan bantuan tambahan kerajaan masih tidak mencukupi untuk mereka menghadapi iklim ekonomi yang kian mencabar.

Penutupan sempadan antarabangsa dan tempatan secara berterusan mungkin juga akan memaksa lebih banyak hotel dan agensi pelancongan di negeri Sabah  menghentikan operasi secara sementara atau kekal.

Selain pengusaha hotel dan pelancongan, sektor runcit dijangka tetap terkesan. Atas ketakutan dijangkiti virus, ramai rakyat Sabah mengurangkan kekerapan mereka pergi ke pusat membeli-belah sejak akhir September.

Dengan pembeli yang terhad, ramai peruncit tidak dapat beroperasi dengan kapasiti penuh atau pada tahap pra-Covid-19. Sebilangan peruncit berasa pesimis atas prospek perniagaan mereka kerana pusat membeli-belah yang kosong dapat dilihat di negeri Sabah semasa Tahun Baru Cina.

Oleh kerana kerajaan negeri tidak membenarkan ‘dine-in’ atau makan dalam premis kedai makanan pada tahap awal PKP 2.0, sebilangan pemilik kedai kopi di negeri Sabah menyatakan perniagaan mereka telah mengalami kerugian sekurang-kurangnya 60%. Pelaksanaan PKP 2.0 secara berterusan mungkin akan mengakibatkan lebih banyak pemilik kedai runcit dan kedai kopi menamatkan perniagaan mereka secara kekal kerana mereka tidak mampu membayar perbelanjaan operasi harian seperti gaji pekerja dan kos utiliti.

Bukan hanya majikan, pekerja yang berasal daripada keluarga berpendapatan rendah boleh dikatakan lebih susah pada hari ini berbanding pada Mac lalu. Dengan kehilangan pekerjaan dan pendapatan, mereka akan jatuh miskin dan berhutang. Mereka mungkin tidak mampu membeli barang keperluan harian untuk menampung kehidupan mereka.https://917f63a2408ccfaff0dfd2ee0d8e5553.safeframe.googlesyndication.com/safeframe/1-0-37/html/container.html

Daripada semata-matanya bergantung pada pakej Permai yang diperkenalkan oleh kerajaan persekutuan, kerajaan negeri Sabah harus memperkenalkan pakej rangsangan tambahan – memberikan bantuan sementara untuk para pemain industri pelancongan, peruncit, pemilik kedai kopi, golongan berpendapatan rendah dan golongan rentan di negeri Sabah selain menangani masalah pengangguran.

Di samping itu, kerajaan negeri Sabah perlu memperkenalkan lanjutan moratorium secara automatik, subsidi gaji, pengecualian sewa dan pelanjutan Program Pengekalan Pekerjaan (ERP) selama tiga hingga enam bulan lagi kepada sektor ekonomi yang terjejas dalam PKP 2.0 ini. Hal ini dapat memberi ruang bernafas bagi sektor ekonomi yang terjejas dan golongan rentan untuk menghadapi iklim semasa yang tidak menentu ini.

Seperti yang disarankan oleh bekas menteri komunikasi dan multimedia, Salleh Said Keruak, Kementerian Pendidikan Malaysia (KPM) dapat bekerjasama dengan penyiaran swasta untuk melancarkan program TV pendidikan secara berkesan.

Ini bukan sahaja dapat menyelesaikan masalah capaian internet di kawasan pedalaman atau keluarga yang mempunyai peranti digital dan data kredit yang terhad, tetapi pengajaran juga dapat diulang siar 24 jam.

Beliau juga mencadangkan KPM supaya menyediakan bahan pengajaran yang dirakam kepada sekolah demi memastikan pelajar di kalangan keluarga B40 dan M40 tidak ketinggalan dalam pelajaran mereka semasa penutupan sekolah.

Walaupun kerajaan negeri Sabah sekarang mempertimbangkan penyediaan alat elektronik kepada pelajar yang kurang berkemampuan di negeri ini, guru juga haruslah mewujudkan hubungan rapat dengan pelajar dari keluarga kurang mampu melalui pengedaran bahan pembelajaran secara fizikal serta mengadakan lawatan ke rumah secara berkala.

Meskipun negeri Sabah akan berada dalam Perintah Kawalan Pergerakan Pemulihan (PKPP) mulai 5 Mac ini, kerajaan negeri masih perlu meneruskan bantuan kewangan dengan sewajarnya bagi sektor perniagaan yang terjejas mengatasi kegawatan ekonomi, selain menekankan betapa pentingnya semua rakyat Sabah mematuhi SOP.

Apabila kerajaan negeri Sabah mementingkan keperluan rakyat Sabah, negeri ini akan dapat mengatasi krisis kesihatan dengan lebih berkesan dan mewujudkan lebih banyak pembangunan sosio-ekonomi di negeri ini.

Amanda Yeo merupakan Penganalisis Penyelidik di EMIR Research, sebuah organisasi pemikir bebas yang berfokuskan kepada pencernaan saranan-saranan dasar strategik berteraskan penyelidikan terperinci, konsisten dan menyeluruh.

In this article