Health care is not a privilege. It’s a right. It’s a right as fundamental as civil rights. It’s a right as fundamental as giving every child a chance to get a public education.
– Rod Blagojevich, American politician
Once again I find the need to touch on the chronic shortage of doctors, specialists, nurses, and medical support staff as well as healthcare facilities in Sarawak. For decades now, we have been grappling with this unrelenting issue that keeps resurfacing with no resolution in sight.
It is a tale as old as the Malaysia Agreement 1963, yet still as unresolved today as it was years ago. While Malaysians in other parts of the federation debate 5G coverage, tech startups, and digital transformation, in Sarawak we are still begging for the most basic human necessity – accessible healthcare.
Deputy Premier Datuk Amar Dr Sim Kui Hian has been among the loudest voices lately highlighting this long-standing malaise. Since the beginning of this year alone, he has spoken no fewer than four times about Sarawak’s dire need for more doctors and medical professionals.
Unlike many politicians who make ceremonial remarks, Dr Sim speaks with the urgency of someone watching a ship slowly sinking beneath the waves, desperate to plug the holes before it is too late.
Let us be clear: Sarawak’s healthcare problems are not merely administrative hiccups. They are structural failings, stemming from a mismatch between federal policies and the unique geographical, demographic and logistical challenges we face in Borneo.
Our clinics in rural outposts function without doctors. Our urban hospitals are overstretched. Patients queue for hours, sometimes days, for treatment; only to be told to return another day or be referred to private hospitals where costs are prohibitive.
According to Dr Sim, Sarawak faces a shortfall of at least 2,000 doctors. That number alone should set off alarm bells, but it only scratches the surface. We are also short of approximately 2,000 hospital beds.
Many of our clinics are manned solely by medical assistants who are now being empowered to prescribe basic medications for fever, cough and diarrhoea. These are stop-gap measures, not long-term solutions.
The real problem lies in the system’s structure. Healthcare is a federal matter. Yet, despite the persistent calls from Sarawak’s leaders, the Health Ministry in Putrajaya has not responded with the seriousness the situation demands.
The issue of decentralising healthcare management to allow Sarawak to run its own medical affairs has been brought up time and again but remains buried under bureaucratic red tape and political hesitance.
Why is this so difficult to resolve? Sarawak is not asking for privilege, only for fairness. Putrajaya, and of course Prime Minister Datuk Seri Anwar Ibrahim, should recognise that our healthcare needs are unique.
We are geographically vast, sparsely populated in many areas, and challenged by terrain that is unlike anything found in the Klang Valley or urban Johor. The “one-size-fits-all” national standards do not serve us – they fail us!
In early 2025, the situation took another turn for the worse. More than 240 doctors and specialists left Sarawak for better opportunities in Malaya. While the federal Health Ministry offered 200 replacement postings, only 20 individuals took up the offer.
This isn’t just a numbers game; it’s a reflection of deeper systemic neglect. Why would young doctors choose to serve in rural Sarawak when they can practise in better-equipped hospitals with better infrastructure and urban comforts?
And what about the 861 Sarawakian nurses and medical assistants currently serving in Malaya who have expressed their desire to return home?
Dr Sim rightly highlighted this issue and urged the Health Ministry to facilitate their transfer. But even this simple act is treated with the caution of a diplomatic treaty negotiation. We are losing our people because the system is not agile enough to accommodate our own returning talent.
Sarawak is too dependent on non-Sarawakian doctors and paramedics. This is not an issue of regionalism – it is about sustainability. We cannot build a resilient, long-term healthcare system if we are forever reliant on temporary imports from other states, many of whom will understandably want to return to their home regions at some point.
Even the Universiti Malaysia Sarawak (UNIMAS) medical faculty – one of our key hopes for developing local expertise – produces only about 150 doctors a year. Do the math, as Dr Sim did!
Even in a decade, that’s only 1,500 doctors, and that assumes none of them retire, migrate, or move to the private sector. And it assumes, unrealistically, that every graduate will choose to stay and serve within Sarawak’s public healthcare system.
The time has come for Sarawak to be entrusted with its own healthcare governance. We have talked, negotiated, and pleaded for long enough. Anwar must act, not out of political obligation, but out of moral responsibility.
Our people deserve better. We deserve hospitals that are not overcrowded. We deserve clinics that are not empty of doctors. We deserve access to quality healthcare without having to travel hours or incur crippling costs.
Premier Datuk Patinggi Tan Sri Abang Johari Tun Openg has long championed the idea of devolution of power, especially in areas critical to the wellbeing of Sarawakians like education, health, and development. This vision must not be allowed to wither in the face of federal indifference.
We need urgent negotiation and decisive action, not empty lip service. It is high time the Malaysia Agreement 1963 is honoured not just in theory, but in real, tangible governance.
And let us not ignore the private healthcare sector either. As public hospitals become overwhelmed, more Sarawakians are turning to private clinics and hospitals; often at great personal cost.
Healthcare should not become a luxury available only to the middle or upper class. The growing reliance on private healthcare reflects a widening inequality gap, one that Malaya must address before it deepens further.
The shortage of medical professionals is not just a Sarawak issue, it is a national crisis with local consequences. It reflects a broader problem of manpower planning, distribution and retention.
Malaysia has no shortage of medical graduates, yet many remain in limbo without permanent placements. Others leave the country altogether in search of greener pastures. This brain drain is avoidable, but if only we had a more regionally responsive healthcare governance model.
We owe it to our rural communities, our elderly, our children and our front-liners to fix this broken system. We owe it to the countless medical assistants, nurses and doctors who continue to serve under immense pressure, often going above and beyond their call of duty. We owe it to the next generation of Sarawakians to build a healthcare system that they can depend on – not just survive with!
Sarawak is not asking for handouts. We are asking for control over our own future. Healthcare is a basic human right, not a federal favour.
Let us not have to wait another decade, another election cycle, or another task force. Let us act now while we still can.
The views expressed here are those of the columnist and do not necessarily represent the views of Sarawak Tribune. The writer can be reached at rajlira@gmail.com
