KUCHING: The Flying Doctor Service (FDS) remains essential for remote communities with no other means of accessing healthcare, but greater emphasis should be placed on developing permanent and sustainable healthcare access in rural Sarawak.
Public health medicine specialist Associate Professor Dr Neilson Richard Seling said while the FDS had served rural communities well for decades, reliance on helicopters for routine primary healthcare should not become a permanent solution to accessibility problems.
“The FDS was originally a practical solution to a geographical problem. It enabled healthcare to reach communities while roads, clinics and other essential infrastructure were still lacking.
“But such a service should ideally have been a transitional measure, rather than becoming a permanent substitute for infrastructure development,” he told Sarawak Tribune.
Dr Neilson, who previously served with the Ministry of Health (MOH), said the FDS remains important for communities that currently have no viable alternative.
However, he said the longer-term goal should be to address the underlying accessibility issues faced by rural communities rather than relying indefinitely on helicopters to deliver routine primary healthcare.
As healthcare falls under the federal government’s purview, he said this would require long-term planning by the Ministry of Health (MOH), alongside cooperation with the Sarawak government where roads, connectivity and other supporting infrastructure are concerned.
“This could include strategically located rural health facilities, better connectivity between remote settlements and larger service centres, improved road and river access, as well as alternative ways of bringing healthcare closer to communities,” he said.
Dr Neilson said communities that choose to remain in their traditional settlements should not be disadvantaged simply because of their geographical location.
“Using helicopters indefinitely for routine primary healthcare is expensive, logistically demanding and may not be the most sustainable model for the future.
“FDS remains important where there is currently no alternative, but our ultimate objective should be to reduce communities’ dependence on FDS by solving the underlying problem of accessibility,” he said.
Dr Neilson pointed out that while helicopters could bring healthcare teams into a village for several hours, they could not replace the continuity of care needed by patients with chronic illnesses, pregnant women and those requiring regular monitoring.
He suggested mapping communities still dependent on the FDS and developing accessibility plans according to their individual circumstances.
“These could include new or upgraded roads, strategically located clinics, improved river transport and mobile land-based healthcare teams, complemented by telemedicine and digital medical records,” he said.
Dr Neilson said the FDS helicopter crash near Long Lellang, Baram, which claimed the lives of all five onboard, should also prompt reflection on how healthcare is delivered to communities in the interior.
“Behind every flight are healthcare workers leaving their homes and families to serve communities that may be hundreds of kilometres away.
“Alongside them are pilots and crew members carrying the responsibility of transporting those teams through some of the most geographically challenging areas of Sarawak,” he said.
Without prejudging the cause of the crash, Dr Neilson said the tragedy should prompt MOH and other relevant authorities to examine whether safer and more sustainable ways of delivering routine healthcare to remote communities could be developed.
“The best tribute to those who have served, and particularly to those who have lost their lives in the course of service, is not only to remember their sacrifice. It is to improve the system,” he said.
Dr Neilson stressed that this did not diminish the importance of the FDS or its contribution to rural healthcare.
Rather, he said its future success could ultimately be measured by how many communities no longer need to depend on a helicopter simply to access healthcare.
“Perhaps the greatest measure of its success in the future would be reaching a time when fewer and fewer communities need a helicopter simply to see a healthcare professional.
“Healthcare should reach every Sarawakian — but wherever possible, it should be through a system that is permanent, accessible, safe and sustainable,” he added.
