Sarawak’s healthcare system is facing a silent crisis. It’s not a new one, but it’s getting louder — and heavier — for those shouldering it every day.
Imagine being a doctor in a government hospital, attending to double the number of patients you should, working 16-hour shifts, and still being told there’s no replacement coming anytime soon. That’s the reality in many of Sarawak’s hospitals today.
Deputy Premier Datuk Amar Dr Sim Kui Hian revealed recently that out of 540 medical officers (MOs) approved for the Sarawak Health Department under the Ministry of Health, only 249 actually reported for duty as of October 1. That means less than half of the allocated positions were filled — and far fewer than what Sarawak truly needs.
According to Dr Sim, the department had initially requested 650 officers because there are about 1,100 vacancies in the state. Yet even among those approved, more than half did not take up their postings.
“Our doctors are each currently doing the work of two people just to keep hospitals running,” Dr Sim said.
That one line captures the enormity of the strain. Behind the polite professionalism and quiet smiles of our healthcare workers lies exhaustion, frustration, and perhaps even a growing sense of abandonment.
Let’s be honest — this doctor shortage didn’t appear overnight. It’s the result of years of systemic neglect and centralised decision-making that fail to consider Sarawak’s vast geography and unique needs.
For decades, postings for medical officers have been decided by the federal Ministry of Health. Many young doctors trained in Peninsular Malaysia hesitate to accept placements here due to distance, limited facilities, or personal reasons. Some do come — only to leave after their contract ends.
Meanwhile, local graduates eager to serve at home often face uncertainty over permanent placements or limited slots in key hospitals. The result? A vicious cycle of understaffing, burnout, and resignations.
When the Deputy Prime Minister, Datuk Seri Fadillah Yusof, agreed to convene a high-level federal meeting under the Malaysia Agreement 1963 (MA63) framework to discuss this, it sent a strong signal: Sarawak can no longer be treated as an afterthought in national healthcare planning.
This is more than just about staffing numbers. It’s about fairness. It’s about recognising that Sarawak’s right to manage its own healthcare system — to decide how many doctors it needs, where they should serve, and how they should be supported — is part of the very spirit of MA63.
Behind the statistics are real people — men and women who continue to serve with courage despite crushing workloads.
Dr Sim was right to call them “the true heroes of Sarawak’s hospitals.” But heroism has its limits. Many of these doctors are stretched thin, managing wards that should have twice the manpower. Some are newly posted medical officers still finding their footing. Others are experienced specialists trying to mentor juniors while carrying their own full rosters of patients.
The consequences are not abstract. Fewer doctors mean longer waiting times, delayed diagnoses, and tired hands in operating theatres. In smaller hospitals and rural clinics, where one or two doctors may cover an entire district, even a single resignation can throw the whole system off balance.
Burnout is no longer a risk — it’s a reality. And when overworked doctors quit, migrate, or fall ill themselves, the system weakens further.
It’s easy to blame doctors for leaving, but who wouldn’t be tempted by better offers abroad? Singapore, Australia, and the United Kingdom are all actively recruiting Malaysian doctors.
This is not a reflection of disloyalty — it’s a reflection of our standards. Our doctors are highly trained, competent, and respected internationally. The tragedy is that while the world values them, their own country often does not.
We take pride in producing world-class doctors, yet fail to give them world-class conditions.
Competitive salaries, proper staffing ratios, clear career paths, and decent work-life balance — these are not luxuries. They are the foundation of a functional healthcare system.
Sarawak’s healthcare challenge goes far beyond hospitals. It extends into rural clinics, flying doctor services, and mobile outreach teams serving longhouses deep in the interior. When staff shortages hit these areas, it isn’t just inconvenient — it’s life-threatening.
Reinstating permanent placements for new medical graduates, as proposed by Dr Sim, is a good start. Stability builds loyalty. It gives young doctors the assurance that they can plan their futures, serve long-term, and grow within the system instead of hopping from one contract to another.
At the same time, Sarawak should be given greater authority to manage its own healthcare recruitment under MA63. If education and energy are already being devolved, why not healthcare? Localising postings, providing rural incentives, and forming partnerships with Sarawak-based universities and hospitals could create a more sustainable ecosystem.
We must also think long-term: invest in training, create better facilities, and make rural service a source of pride — not punishment.
Sarawak’s healthcare crisis is not just a matter of numbers or policy. It’s a moral issue. It speaks to how much we value the people who heal us, who stay up at night watching over patients, and who return every day even when they’re running on empty.
If we can find billions to build infrastructure and invest in new industries, surely we can find the will to fix the one system that touches every life — healthcare.
A healthy Sarawak begins with healthy doctors. Before we talk about building new hospitals, perhaps we must first heal the system that keeps them empty.
