An overview of Malaysia’s healthcare system. A miracle or a disaster?

An overview of Malaysia’s healthcare system. A miracle or a disaster?

Part III of III – The Professionals and a Conclusion
Having discussed patients’ attitudes and the balancing act between the public and private healthcare sector, I imagine the next obvious discussion lies in the attitude and professionalism of the healthcare workers themselves. Before I go on, I wish to share my experience to readers, as an insider to the system:

“A young man, was admitted into the Intensive Care Unit (ICU) for a fatal overdose of paraquat (a type of herbicide); an obvious suicide attempt. With the patient critically ill, the family waited nervously outside the ward. The Medical Officer (MO) briefed the freshly graduated House Officer (HO) of what the priorities are in regards of treating the patient, before she left him to deal with this tremendous but seemly impossible task of treating this patient. Shortly afterwards, the patient arrests, and the HO attempts to resuscitate him, and calls for help from the available medical staff in the ward. In that instance, the nurses and an attendant immediately came to support the HO. Meanwhile, the patient’s family, who realised the sudden urgency in the medical staff, sensed that something was going horribly wrong, tried to force their way into the ward. The nurses and attendant, restrained them from entering the ward, and told them that they were only getting in the way of the medical team. So the nervous family, were forced to wait outside, and their only comprehension of the scenario, was the little they could see through the tiny window that connects the ward to the outside.

In ICU, the HO is tiring from performing the cardiac massage whilst the other nurses who crowd the ICU are discouraging the HO in what they believe is a futile attempt. I was in utter disbelief when a nurse muttered these exact words,

“Cukup la doktor, dia sudah mati! (That’s enough doctor, he’s already dead).”

I understand that given the scenario, the survival of a patient who had consumed a fatal dose of paraquat is practically zilch. But nowhere along my medical training have I encountered calling a living man, dead, and staff discouraging the efforts of another staff to attempt to save him, regardless of the odds.

The HO ignoring these comments persevered but eventually exhausted, requests for a nurse to take over. She reluctantly takes over, but with minimal regard and effort for the technique required for the cardiac massage, she ultimately renders the procedure useless. The HO pushes her aside to continue with the cardiac massage, whilst the attendant (who is also trained for the procedure) comments, that he would feel obliged to help only if he were paid to do so. The HO, losing the battle of resuscitating the patient, recognises the need for an urgent inotropic drug administration asks the nurse to titre the required dose. But at that moment, the HO realises, all the nurses had left, save one who was a student nurse and inexperienced and even she had to call for the other more senior nurses to help prepare the required drug.

Finally, the patient dies. The HO walks over to the family to break the news. They cried in disbelief as they hear the difficult and shocking news, but they were well within earshot when the MO yells in background from across the ward, calling for the HO hurry up with his ‘time wasting’ and carry on to complete his wards rounds because she could not be bothered to wait any longer.”

This actual event took place in a district government hospital in Malaysia during my attachment as a pre-medical student. In my brief time there, there were uncountable accounts of unprofessional behaviour ranging across all levels of medical staff. Doctor-patient relationship goes no further than the extent of providing a drug to cure the disease. Nurses constantly complain of having to deal with both the patients’ and doctors’ attitudes, yet demonstrate little ability in completing their chores at an acceptable standard. These problems that I have highlighted are merely the tip of the iceberg of hugely unprofessional behaviour amongst medical staff in public healthcare service. Having experienced the public healthcare sector from varying perspectives, I have enough reason to believe that anyone would be discouraged from seeking healthcare services from the public healthcare services, if one could afford the more professional private healthcare service.

And if readers realised, I have yet to even discuss the competency of the medical staff in delivering a healthcare service that consumers require and demand. We have reason to believe that medical malpractice and negligence in government hospitals happens, which is indicated by the number of legal suits that have been filed, many of which reputedly have been settled out of courts. With the furore surrounding the de-recognization of Crimea Medical State University and other medical schools from Ukraine, the Malaysia Medical Association (MMA) stated that it places the highest importance in standards of doctors which are allowed to practice in Malaysia, a claim that is used to support their move. However, there have been numerous rebuttals from various groups demanding that Malaysia Medical Association (MMA) reveal and standardize the criteria which are used to ‘recognize’ medical degrees issued from all universities, yet it fell on deaf ears. The inconsistency that MMA portrays is worrying, with medical graduates pouring into the country from various institutions worldwide. How are we to know if they really are qualified to practice in Malaysia? The MMA solution to the question is a separate qualifying examination, which medical students from non-recognized universities need to pass. I personally wonder how many of our local graduates would actually pass these examinations.

The right for a healthcare service that meets the patients’ needs is a basic right that all citizens of Malaysia deserve. Anything short of that can only be perceived as an infringement of such a basic right. The earlier parts of my text discussed the growing trend of consumerism behaviour amongst healthcare users worldwide, but more prevalent in the developed country, a trend that is not currently widely observed in Malaysia, which could offer an explanation of the passivity of healthcare users in Malaysia with regards to the service that is being offered. This is a product of the paternalistic doctor-patient relationship, the elevation of the status of the doctor to somewhat mimicking a demigod: a doctor cannot do harm! Unfortunately, this is not true, and patients in Malaysia need to understand this, fast. We can preach about the unprofessional behaviour of the healthcare workers to limitless ends, but unless the patients adopt a new mentality, the arena of medical practice in Malaysia may never change.

Patients need to be more willing to assume a greater share of responsibility in their healthcare; be more willing to learn about the conditions which they suffer from and understand the implications of each treatment options. They need to discard their passive role and be more active with regards to the management of their own health, not merely absorbing the doctors paternalistic views, but instead challenging them to deliver the best of what the healthcare service has to offer. But this evolution will take time, and as for yet, it is impractical to introduce modern aspects of communication in medicine, such as informed consent and shared decision making, as patients are nowhere ready to take responsibility for their own health, and doctors likewise are nowhere ready to relinquish the authority and supremacy that they have been privileged to, all these years.

There are numerous areas in within the healthcare system that I have yet to discuss, such as healthcare delivery within the private sector, measuring patient satisfaction rates, and even expenses within the healthcare system. Also, I have not even approached the issue from the perspective of the medical staff, the limitations they face within the service, obstacles posed by guidelines, protocols and other red tape, inadequate facilities, poor opportunities for training, massive patient loads, horrendous working hours, and the list can go on. Other limitations in my text stemmed from the difficulty in accessing crucial statistics, such as exact figures of patients within each sector, breakdown of expenditure of the Ministry of Health, previous budget allocations, mortality rates, waiting times for patients in out-patients, waiting lists for medical/surgical procedures/investigations and others. Figures from the government allocations into the national budget and the 9MP, are in itself not useful unless we have figures from previous years to compare to and observe trends.

However, despite the numerous problems in the healthcare system that Malaysia faces, all is not lost. On the whole, as Ramesh and Holliday have said, Malaysia is truly a healthcare miracle, a miracle which has been made possible by the government who have created a system that is accessible by the multiple strata of the Malaysian society. For all the complaints, facts and statistics still prove that Malaysia possesses one of the leading healthcare systems in the Southeast Asia region, and a system that is the envy of many other developing countries. Furthermore, we can take some comfort in the recent efforts by the government with plans in place to show that things are definitely moving forward towards providing a better healthcare system for all. It may not be perfect, but it is definitely improving. However, the first step towards improvement lies in the ability to acknowledge the shortcomings within the system, such as some of the ones that I have discussed above. I self admittedly understand that huge chunks of my text have been critical of various parties, purely because I believe that there is much room for improvement.

As to the answer to the question that I put forward, ‘Is Malaysia’s healthcare system a miracle or a disaster?”…I believe that it is a miracle. It is an achievement that no one could have predicted with the numerous inadequacies and flaws at various levels. The existing system in far from being perfect, but it is undoubtedly a miracle that the healthcare system has succeeding in raising the overall standard of health (measured in terms of the variable mentioned above) of the mass population in Malaysia; a performance that deludes the circumstances under which the healthcare system operates on. However, as one who is within the medical profession, I too can appreciate and sympathize with the numerous problems that healthcare providers face: the lack of resources, support and protection. It is simply that, as patient, I would never give another the power to do harm, onto me.

An overview of Malaysia’s healthcare system. A miracle or a disaster?

An overview of Malaysia’s healthcare system. A miracle or a disaster?

Part II of III – Healthcare Economics and How it Affects Us

Statistics from the World Bank and the Harvard Team in 1999 revealed that in 1996, the total expenditure in healthcare services (public and private sector) amounted to only 2.9% of the Malaysia’s GDP of which 1.4% was in the public sector and 1.5% was spent in the private sector. At first glance these statistics may appear to demonstrate that the decentralisation of healthcare services was successful, but upon closer investigation it clearly shows that it the proportion of expenditure is hugely disproportionate relative to the population size these distinct sectors service.

Pharmabiz (an online news service) in a report in 2004 estimated that the private sector in Malaysia only accounted for 20% of the countries hospital beds, yet it employed almost 54% of the doctors in Malaysia. Marzolf (1996), also observed a similar trend in the mid-1990’s, estimated that 75% of beds in the country were provided by government services, yet it only employed 45% of all doctors in the country.

Therefore, self-admittedly by taking a large leap of faith, I assume that it is fair to conclude that almost an equal share of Malaysia’s GDP (if not more spent in the private sector) was spent on approximately 20-25% of all patients in Malaysia, who sought services from private healthcare providers and on 75-80% of all patients in Malaysia, who sought services from the public sector. Clearly no one can deny the huge disparity that exists between private and public healthcare services. It is no surprise that services provided by the private sector in most fields are almost unanimously superior compared to service provided by the public sector. But, surely the huge disparity in quality, standards, workforce and expertise portrays the government’s insensitivity towards the masses and their inept ability to exert control over maintaining the balance between healthcare provisions supplied by the public sector vs. the private sector.

However is it fair to expect taxpayers and consumers of the public healthcare service to accept substandard care from the public services?

In March 2006, the Ministry of Health started a pilot project in Selayang and Putrajaya government hospitals, where these centres will remain open after normal working hours to provide private specialist care for full-paying patients. This project was designed to last for 6 months with the aims to reduce waiting lists for specialist care, with the hope that patients who can afford this option will choose to pay and avoid the long queues. At the end of the 6 months, it will be decided that if deemed successful this project would be expanded to other government hospitals as well. This ‘full-paying patient’ scheme have received mixed responses from various parties. The Coalition Against Health Care Privatisation (GMPKK) which is made up of various NGO’s, political parties and trade unions is amongst the key opposition of this project. Their arguments revolve around the fact that only 30% of specialists in Malaysia are employed by the public healthcare sector and have to deal with about 70% of the patient load in Malaysia. With these specialists burdened with a massive patient load, these extra hours for cash incentives will only over-work them and may affect the quality of care than the non-paying patients will receive. Also, patients may be threatened, pressured or even manipulated into paying for their treatment for ‘better’ care by specialists.

Prior to the introduction of the project, Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said it was introduced to prevent government hospital facilities from being abused by people in higher income groups:

“For example, a patient who can well afford it, only has to pay RM3,000 for surgery as has been set now in government hospitals whereas he is capable of paying up to RM15,000...This will affect the chances of lower income groups from obtaining similar surgery or treatment.”

What I fail to understand is that the public healthcare sector which is funded by the government should cater for all income groups indiscriminately; simply because all income groups are taxed accordingly. Although the government has insisted that this project is only a pilot project, to determine its feasibility, it demonstrates the governments’ inability to continue its funding of its patients requiring specialist care and also insensitivity towards tax payers. This full-paying patient scheme can only be perceived as a system that imposes a ‘double-tax’ on patients who seek quality care from the public healthcare system. However, the project should have ended in September 2006, but what does the verdict say on the feasibility of the ‘full-paying patient scheme’?

As of now, the percentage of GDP spent by Malaysia on healthcare services still stands well below the 5% of GDP recommendation by WHO. Mafauzy M. in an editorial in January 2000 stated that Malaysia’s expenditure in public healthcare services in 1994 was about 2% of the GDP, compared to the US who spent 14% of their GDP and the G-7 who spent between 5-8% of their GDP. Meanwhile Phamabiz projections estimate that Malaysia’s healthcare expenditure may eventually reach 6% of GDP only by the year 2020

N.B I am obliged to inform readers that the statistics from Mafauzy M.’s editorial and Phamabiz did not cite their sources and therefore I caution readers that the inclusion of these statistics in my text is purely to triangulate the various sources in hope to gain a differing perspectives of our healthcare system.

Although these projections seems reasonable, we must understand that in this space of 15 years there will be tremendous changes within the healthcare needs of the Malaysian population, mainly due to changes in the population demographics as a higher proportion of our population will be older, evolution of diseases and medical advances, just to name a few. Furthermore, by consistently spending less than recommended, we can almost be certain that the Malaysian healthcare system will soon fall much further behind other developed countries (who is consistently spending a higher percentage of their GDP) and over this space of 15 years, I can only foresee this gap multiplying itself. By year 2020, which has been earmarked as the time to announce Malaysia as a developed country, I predict our healthcare system to be nowhere closer to one worthy of a developed country.

According to the Human Development Report in 2006 prepared by the United Nations Development Programme (UNDP), Malaysia was ranked 61/177 based on the Human Development Index which takes into account factors involving life expectancy, literacy and standard of living. The report revealed that in 2003 Malaysia also spent 3.8% of the GDP for healthcare services of which 2.2% was allocated to public health expenditure which ranked Malaysia at 124/175 based on percentage of GDP on public health expenditure. Private health expenditure amounted to 1.6% of GDP which ranked Malaysia at 123/175. Therefore I found it surprising that Malaysia ranked 75/175 in terms of total health expenditure (public and private sectors) per capita amounting to US$374 (adjusted for purchasing power parity).

N.B. Health expenditure per capita was adjusted for purchasing power parity (PPP) in US$ to allow a more valid comparison between countries and does not represent the absolute amount of expenditure per capita in RM.

However, there are signs of improvement in recent times. Although during the 1990-2004 period there were only 70 physicians per 100,000 population in Malaysia; ranking Malaysia at 101/175 in the UNDP 2006 Report, trends show that the ratio has improved greatly compared to those released by the World Bank, 1999 that show there were only 14 physicians per 100, 000 people in 1960 and 44 physicians per 100, 000 people in 1995; more than a 60% increase presently, in ratio of physicians to per 100, 000 people since 1995. Another crucial statistic that strengthens the claims of signs of an improving healthcare delivery is the population’s life expectancy since birth. The World Bank, 1999 showed that life expectancy in Malaysia since birth at 1962 and 1997 stood at 55.8 years and 71.6 years respectively. The UNDP 2006 Reports measured Malaysia’s life expectancy since birth at a hugely improved 73.4 years, ranking Malaysia at 58/175!

Ramesh and Holliday, 2001 in their article titled, ‘Healthcare Miracle: East and Southeast Asia’ applauded Malaysia (amongst Hong Kong and Singapore) for having achieved a remarkable health care status are a modest cost. The paper argued that the financing of the healthcare system is not the key factor for the performance, but rather concentrating the provisions on in-patient care, an expensive component but of considerable efficiency. Whereas on the whole, there was less importance placed on out-patient care; a feature common to the three healthcare system discussed. However, the paper was exact in recognizing its limitations and acknowledging that the improved markers of health status in Malaysia are not solely attributed to the contributions of the healthcare delivery system. On a separate note, I also believe it is worthy of mention that the paper also recognize and warn that with increasing efforts to privatisation, it will increase inflation and the cost of healthcare to the society as a whole, as discussed above earlier. In summary, Ramesh and Holliday marvelled at the manner how Malaysia continued to demonstrate improved health status markers despite contributing well below the 5% of GDP recommended by WHO.

The governments’ stand and approach to the future of the healthcare system in Malaysia also shows greater intent towards improving the healthcare system than previously. Mafauzy M. claims that the government allocates approximately 5% of the national budget to the Ministry of Health amounting to approximately RM2.6 billion, which I presume was true at the time her editorial was published. However, the Federal Government Budget in 2006 through the Operating expenditure Estimates by the Treasury Department of the Ministry of Finance, revealed that approximately RM7.4 billion was allocated to the Ministry of Health, which amounts to almost 7.3% of the entire budget. Of which, RM1.3 billion is allocated purely for development expenditure amongst which RM85 million to complete construction of hospitals in Alor Setar and Cameron Highlands, RM 229 million for building and upgrading clinics nationwide, and RM 131 million for upgrading hospital laboratories and equipment.

Also the Ninth Malaysia Plan 2006-2010 (Rancangan Malaysia Ke-sembilan) states that the Ministry of Health will continue to be the leading agency and main provider of health services and together with other healthcare service provides and NGO’s will receive an allocated 5.4% of the budget amounting to almost RM10.2 billion, of which RM3.3 billion will go into public health care, RM5.4 billion into patient care services, which includes building new hospitals and renovation and RM1.4 billion into other healthcare services, which includes training of staff. The 9MP also outlines a broad plan to cover areas of weakness within the existing system such as greater efforts into development, primary and secondary prevention, and improving the efficiency of the delivery. Also it shows greater sensitivity towards a more equal distribution of healthcare services and with aims to improve healthcare services delivery to rural areas.

However, before we marvel at statistics that have led to Ramesh and Holliday lauding Malaysia as ‘Southeast Asia’s Healthcare Miracle’, we must be aware that the healthcare system in Malaysia, as previously mentioned, focuses mainly on in-patient care, or tertiary care. Therefore by implication, it means areas of medicine such as primary care, primary and secondary prevention which often utilises out-patient services are less pronounced and less successful in terms of implementation. These areas of medicine usually involves long term management dealing with numerous chronic medical conditions, as opposed to the in-patient setting which can only deal with acute conditions.

Therefore, patients who suffer from conditions that are more often prevented or controlled via careful long-term monitoring which is not plausible within the in-patient setting, often are left to manage their own conditions, until an acute event which requires hospitalisation occurs. This often leads to a drastic disruption to the patients’ life, and can also lead to a poorer quality of life following recovery after the acute episode of the disease. Furthermore, cost-benefit analysis of numerous conditions have demonstrated that long-term management of chronic conditions with primary and secondary prevention methods are often more cost-efficient than treating the acute complications of these diseases within the in-patient setting. By failing to control these chronic diseases, numerous hospital beds are unnecessarily occupied and unavailable to other patients who might need them. The management of such acute-on-chronic conditions are mostly otherwise preventable, and avoids unnecessary incurred costs of treating them within in-patients.

The most successful form of primary care in Malaysia relies heavily on private general practitioners (GP) clinics that have mushroomed throughout the country. These are easily accessible in most parts of the country by anybody at all, requiring only a quick registration process and the GP is at your service. Unfortunately, the GP service is ultimately a privately owned business that provides out-patient care for anyone willing to pay. These clinics by large, are poorly regulated with huge amounts of ongoing concealed malpractice, out-dated medical practice, unprofessional behaviour, and conflicting interest between doctor and patient. Therefore, it is shocking that these privately own GP clinics are the only form of out-patient healthcare service that ‘reliably’ provides a long-term management of chronic conditions with the concept of continuity of care, allowing the patients and doctor to forge a relationship that allows the doctor to appreciate the individual needs of the patients and cater for them in a manner that the public healthcare service is unable to do. Although, this is not necessarily guaranteed because with the increasing competition amongst private healthcare providers, there is also a huge disparity within the standards of service provided by GP clinics, and consequently a shift of patients from one GP to another for better service and value for their money. Unfortunately, this disrupts the concept of continuity of care and thereby the most valuable service provided by the GP itself.

(to be cont.: Part III of III – The Professionals and a Conclusion

An overview of Malaysia’s healthcare system. A miracle or a disaster?

An overview of Malaysia’s healthcare system. A miracle or a disaster?

Part I of III – Consumerism and a Dual Health Care System

“…First do no harm. What is implicit in this simple precept of medicine? An awesome power. The power to do harm. Who gives you this power? The patient…because he trusts you. He trusts you the way a child trusts. He trusts you to do no harm…”

~Dean Walcott; Patch Adams, the movie~

The 1998 movie, Patch Adams (based on a true story) which was set in the early 1970’s accurately captured the paternalistic relationship between a doctor and his patient. Historically, for many years, doctors and other medical staff alike have imposed their thoughts, ideas, and beliefs onto their patients in a paternalistic manner under the guise of maintaining professional distance, preventing transference and a superiority complex stemming from specialised inside medical knowledge. These elements have been deemed necessary to deliver the most appropriate and unbiased healthcare service to the patient.

But the medical profession is no longer as untouchable as it once was before. Patients in the developed countries, in the wake of consumerism are currently rejecting these traditionalistic approaches by healthcare providers.

Over the years numerous medical scandals have shook the foundations of a once unquestionable medical practice; the distribution of Creutzfeldt-Jakob disease (CJD) contaminated growth hormones in France (1985), the Apotex Drug Trial scandal in Toronto (1995) are amongst two scandals which have received wide media attention. More recently are the tragedy of Dr Shipman and the horrifying truth about the Bristol hospital scandal, the two most recent medical disasters in the UK which has contributed tremendously to the tarnished reputation of the formerly sacred profession and consequently lead to an increased medical awareness and consumerism amongst patients in the UK.

Patients worldwide are slowly but surely beginning to gain awareness of their rights as consumers with regards to healthcare services, and especially with the severely inflated costs that is being incurred by these healthcare providers. There is an increasing demand amongst patients from their healthcare providers for better overall services apart from a simple prescription to cure the disease; patients are demanding to be more informed regarding the disease itself, treatment options, and psychosocial problems stemming from the impact of the disease on the patients.

Simply put, patients now expect a healthcare service that is centred around the patient and his/her life rather than traditional practices where it revolved primarily around the disease, an idea which Dr Patch Adams brought forth and startled many at the time. It is no longer acceptable for a medical practitioner to merely provide a cure for the disease, but instead is expected to investigate the patients’ symptoms to form a definite diagnosis and offer the patient a number of treatment options in which the patient can choose by means of making an ‘informed consent’ and a ‘shared decision making process’ of the best treatment for the symptoms the patient experiences in view of the particular patients’ lifestyle, taking into account of the psychological and social impact the disease process and its treatment has on the patient, his/her lifestyle and social circle. Not to mention that all this has to be achieved in confidence between the medical practitioner and the patient with the ultimate goal of improving the patients’ quality of life or to regain as much function as prior to their morbidity.

How much of all these are actually practiced by healthcare providers in Malaysia?

It is difficult to appreciate the effectiveness of the healthcare system in Malaysia due to its complex structuring, which can be (at simplest terms) described as dominated by the public sector with increasing decentralisation to the private sector.

As a former colony of the UK, it is no surprise that Malaysia’s public sector is loosely based on the highly successful National Health Services (NHS) which forms the backbone of the public healthcare services of the UK. However, with the increasing burden of disease, patients’ expectations, patient load and financial constraints, the public healthcare system in Malaysia now faces a struggle to deliver healthcare services to the public and seeks to lighten its burden by the process of decentralisation; increasing privatization of healthcare services to mainly to reduce the patient load in the public sector. Whilst the actual intention of the government to promote the private sector is genuine to improve the delivery of healthcare services to the masses, it underestimated the waves of repercussions produced by the blossoming of private healthcare providers.

The initial push towards promoting private healthcare providers was intended to offload the burden from the public sector, in hope with increasing privatization, the standards of healthcare services delivery will improve tremendously. This indeed proved true, but at the cost of severely inflated medical costs causing many to revert back to seeking services from the public sector whose costs by large were relatively unaffected by the inflation that beset the private sector, and thereby still managing to sustain its services at minimal costs. However, the shift of patients from the private sector into the public sector proved that the governments’ actions were made redundant as the decentralization efforts failed to create the impact they had hoped for and consequently the public sector were once again beleaguered by the same problems they faced prior to the promotion of healthcare privatisation.

There is no doubt that the increasing competition within the private healthcare sector has led to a tremendous improvement in the delivery of services which ties in nicely with the patients’ consumerism. Areas which has benefited largely with this improvement in delivery are things such as, improved doctor-patient relationship, better communication, shorter waiting-lists for investigations allowing prompt diagnoses, more generous time allocation per patient, more comfortable stays at hospitals and better patient adherence to treatment, just to mention a few.

But what shadows all the benefits that I had mentioned above is the concomitant inflation that accompanied privatisation has lead to it being a highly lucrative business. Facing stiff competition, private sectors seek to hire the best medical practitioners and expertise in their respective fields to improve their own standards, and do not hesitate to offer irresistible salaries to those who they deem as valuable assets to their service [business]. Although this improves the ability of private healthcare providers to deliver better services, it regrettably forces a brain-drain of expertise from the public sector to the private sector. It does not take a genius to understand that the public sector is by no means able to compete with the private sector in terms of offering better financial wages, benefits and working environments; whilst appreciating the priority of the government: to provide a sustainable public healthcare service at an acceptable standard to the masses and attempting to keep the bill down to a minimum.

Unfortunately, as the masses revert back to the public healthcare services, many find themselves dissatisfied and wanting for better services having experienced the luxuries of the private sector. The demands of modern medicine and consumerism of patients impose a significant pressure on institutionalised healthcare services such as the public healthcare service in Malaysia to deliver. However it is vital to understand that from the governments’ standpoint, the aim of the public sector is to provide a healthcare service that is accessible to the majority population and often this is only possible by compromising the quality of individual services to cater for a larger population. Thereby this creates a disproportion between the actual needs of the patient, the demands of the patients (or perceived needs), and the delivery of the healthcare service by the public sector; rendering patients to deem the public sector as unsuccessful, ineffective and seek better services from the private sector.

Ultimately, this dual healthcare system consisting of a public sector employing efforts of decentralisation via promoting the privatisation of healthcare services has lead to a gaping inequality between the two sectors. This is characterised by the huge swing of patients, especially those belonging to the middle-class between the public sector and the private sector, having left with the difficult choice of choosing between a much higher quality of healthcare service or settling for the cheaper option.

(to be cont.: Part II of III – Healthcare Economics and How it Affects Us)

The 'typical' Malaysian Indian

The ‘typical’ Malaysian Indian

Part II of II: An Explanation

Treading along the lines of racism, can we consider it possible that these ‘negatives’ can be accounted for by the genetic composition of Malaysians of Indian ethnicity? Surely not; a phenotype of any given individual is utterly impossible to predict even if given a fixed genome. I believe that the genome of the Indian population is in no way defective or even inferior to of any other race population in this world, and there are many outstanding Indian individuals who can testify to that claim. This underlines the importance of nurture over nature within the varying environments one is subjected to. Therefore if these stereotypes on Malaysian Indians are true, they indefinitely must be of a direct consequence of a complex environmental-nurture component revolving around the majority of Malaysian Indians.

The role of religion and culture are hugely traditional and are of grave importance to many Malaysian Indians. These have been embedded deep into the nurture of most members of the Malaysian Indian community in Malaysia. Unfortunately, a by-product of this traditionalism is the concomitant conservatism that exists amongst the Malaysian Indian community. Globalisation has increased the boundaries of social interaction and allowed the influx of different cultural and religious elements. In order to survive within the era of globalisation with a mind to protect one’s own traditionalistic values, one can only do so by adopting a conservative mindset.

I hypothesize that many conservative Malaysian Indian families are unwilling to actively engage in social mobilization as this largely remains the only way they know to impose and instil their cultural and religious beliefs into their children and simultaneously warding of cultural ‘pollution’. Whilst this often guarantees the traditional continuum that by large the conservative Malaysian Indian hopes for, it comes at a cost of falling behind their contemporaries. The end-result is a closed-community who is naïve to the evolution of modern society and ultimately the reality that surrounds them.

The conservatism of Malaysian Indians can account for (to a certain degree) their marginalization in Malaysia. They have failed to evolve sufficiently to allow the community to thrive. Taking this into context of stereotyping, many Malaysian Indians now have failed to keep up with their counterparts of other ethnicities, and now struggle to even ‘fit-in’ leading to alienation when thrown into the fray of a mixed group. Therefore, their only option of maintaining viability within the mixed group is via forming a ‘clique’ and hence the ‘out-group’.

However the Malaysian Indian conservatism in not the sole contributory factor to basis of these negative stereotypes. Years of living under difficult discriminatory conditions have lead to the inability of the general Malaysian Indian community to engage in modernization effectively.

The Economist in an issue on February 2003 published that 60% of urban squatters and 41% of beggars in Malaysia are Indian. Economically, the national equity holdings of Malaysian Indians are significantly low relative to the proportion of the Malaysian Indian population in Malaysia, and there is much reason to believe that there is a huge intra-group variation in individual earnings as demonstrated by Perumal (1979) and Snodgrass (1980) which showed that the median earning of Malaysian Indian household decreased from RM228 (1957/58) to RM192 (1970) and was lower that the mean income of the Malaysian Indian population; a phenomena not observed with the other races in Malaysia. Critics may rightly observe that the household earnings of Malaysian Indians were at the time higher than of the Malays. But this was prior to the implementation of the NEP, and assuming these trends continued combined with the policies of the NEP, there is every reason to believe that the Malaysian Indian population is relatively ‘poorer’ now.

The level of education amongst Malaysian Indians is also on a decline. The employment of Malaysian Indians in most occupational fields, namely professional and technical workers declined between the periods 1970 to 1995. University intake percentages of Malaysian Indian students have also experienced a drop from 10% in 1970 to 5.2% in 2003. Malaysian Indians students also have the highest dropout rates in the country when compared to the other races (although literacy rates are still highest amongst Indians at 89% according to a UN report in 2002).

There are numerous other statistics to quote to prove the marginalization of Malaysian Indians as a direct consequence of discriminatory national policies and inappropriate distribution of opportunities and wealth. But I believe that I have underlined that with simply the two examples I have provided above: education and economics. Without any active intervention, via means of extrapolation there is no doubt that these figures will continue to deteriorate and by no means of choice, the average Malaysian Indian will find himself excluded from the general population as an ‘out-group’, which ties in nicely with the theories I proposed regarding the origin of stereotypes of the ‘typical’ Malaysian Indian.

The more difficult task lies in scrutinizing these stereotypes and understanding the foundations on which they lie on. Here I hope to offer a few explanations for some of the stereotypes that are most prevalent and commonly encountered:

1) Indians dress in bright colours and often look mismatched – Indians have always associated bright colours with good fortune; an esoteric significance of light in Hinduism as opposed to darkness/dim colours which is associated with barriers, ignorance, misfortune or evil. The aesthetic appreciation of bright coloured clothing is almost unique to the Malaysian Indians and does not necessarily appeal to what mainstream fashion dictates: that bright colours and a dark complexion do not always match well. However, combined with the Malaysian Indian conservatism, indulging in mainstream fashion to appeal to the general population is less important compared to cultural symbolism that these colours represent.

2) Indians look and smell funny – The cosmetics industry is undoubtedly experiencing huge growths in market in terms of demand despite the ballooning inflation. The increasing cost of cosmetics is far beyond what the average Malaysian Indian can afford. Therefore many Malaysian Indians eventually end up relying on cheaper tried and tested traditional cosmetic remedies such as Shikakai, Turmeric, Coconut oil, Attars and Henna that have passed on through numerous generations. These products however are hugely unpopular amongst other groups of people who remain unfamiliar with its uses, application and even scent. I believe this unfamiliarity is the basis of the stereotype that Indians look and smell funny. But do consider: would anyone use Attar perfume if they could afford a Dolce and Gabbana?

3) Indians are gangsters – There are statistics to show that Malaysian Indians make up a huge proportion of arrests made by the police demonstrating a high crime rate associated with Malaysian Indians. But I believe this correlates quite nicely with the fact that these proportion of Malaysian Indians are also amongst those who live in areas of deprivation. The combination of poverty, poor education and lack of accessibility to opportunities are well established reasons for high crime rates in any given population irrespective of ethnicity. It is no mere coincidence that Malaysian Indians have been stereotyped as delinquents; not by choice, but instead as a consequence of marginalization. The high crime rate amongst Malaysian Indians, I believe is merely a crude measure of the poor living conditions and quality of life that many Malaysian Indians suffer. Furthermore, let me remind readers that the crimes that are these Malaysian Indians are arrested for are usually petty crimes involving the under-educated population of Malaysian Indians. What if we measure crime rates amongst the well-educated population? What if we measure crimes rates for those involved in white-collar offences, organized crime, corruption, money laundering, piracy, loan sharks, assault, and sexual abuse/assault? I admit that Malaysian Indians heavily contribute to the numbers of petty crime rates, but we must understand there are examples of more serious offences to which there is less association with the Malaysian Indians and perhaps more closely linked to other ethnic races.

4) Indians are drunks – Alcohol problems in often described as solely an ‘Indian issue’. However examining most of the researches that has come to this conclusion will reveal the methodology used to sample participants was based on the hospital seeking behaviour of individuals in urban hospital settings. This therefore leads to an over-sampling of lower income urban groups; mainly the Malaysian Indians. Projecting the findings of these restricted researches onto the general Malaysian population is not plausible and fundamentally flawed. As a matter of fact, the Chinese are the largest consumers of beers (Carlsberg estimates that 80% of its customers are Chinese) and distilled spirit; the high-end products of the alcohol market. Whereas, most Indians can only afford ‘samsu’ or toddy, most of it which are illegally brewed and potentially dangerous. Whilst I admit that the numerous researches has demonstrated that Malaysian Indians of mainly lower income groups contribute to a huge chunk of alcoholic problems in urban Malaysian hospitals, it has proved little otherwise. Without obtaining a larger and more representative sample of the general population and stratifying the results for ethnicity and income groups, the generalization that Malaysian Indian are mostly drunks and that it is solely an ‘Indian issue’ is unjust.

At the risk of being accused of denying reality, I stand firm that I am not offering excuses for the condition that the Malaysian Indians exists in, but instead providing reasons and arguments for readers to understand the nature of some of the negative stereotypes, why they exists, the origin of these stereotypes and whether or not they are true. More so, is the importance to appreciate that some of these stereotypes are unfair or misunderstood, and ultimately have created barriers towards the integration of Malaysian Indians with the other races.

The lists of stereotypes, explanations and theories behind all these are limitless and I acknowledge the numerous limitations and constraints that lie in my text. What I hope to achieve is to educate readers into understanding that the ‘typical’ Malaysian Indian is a product of subjugation by his own conservatism and socio-economic marginalization. Therefore the next time you encounter the derogatory term ‘typical Indian’, please question, be it with yourself or others, the appropriateness of the context in which it was used in, with a view of the arguments that I have presented above. Things may not always seem to be as straightforward as they appear to be.

The 'typical' Malaysian Indian

The ‘typical’ Malaysian Indian

Part I of II: Stereotyping and Prejudice

I recall many years ago during my attachment with the state athletics team, I collected numerous sports memorabilia from Perak, who had shamelessly splashed all their sporting apparel with bright yellow. I would proudly wear a bright yellow tee bearing the words ‘Perak’ written in bold across the back, but I began to realise that I was turning heads in my direction for the wrong reasons. I was a little bemused until an Indian friend commented in disgust that I looked like a ‘typical’ Indian. A little apprehensively I asked her in return to describe what a ‘typical’ Indian would look like. Her answer was:

“Greasy hair smelling of coconut oil, shabbily dressed in bright coloured clothing that could probably blind you if you stared long enough, foul mouthed, looking scruffy and dirty.”

I laughed and shrugged of her words, but I never wore my bright yellow tee outdoors afterwards.

Skip a few years; during a visit to my former college during its alumni weekend, I was most unfortunate to be caught by a former teacher (who was also a good friend) whilst playing sports, not looking my usual best: dressed in a dirty cap, a worn out tee and shorts. His first words to me at our reunion were, “You look like you came straight out of the estate,” which I presumed was referred to the ‘typical’ Malaysian Indians who in masses used to live in estates under the British rule. It took me a while to appreciate that there was not a hint of malice in his words, but only misplaced humour by drawing comparison to a ‘typical’ Indian.

The word ‘typical’ itself is defined as, ‘of the nature of, or serving as a type, or representative specimen; distinctive or characteristic’. Taking the term ‘typical Indian’ and translating this into statistics (accepting that ‘typical’ meant a representative specimen) would be the equivalent of a scatter of characteristics, around a defined set of racial stereotypes towards Indian which serves as a mean (or median) sample of the given Malaysian Indian population. Simply put, the term ‘typical Indian’ when used to describe a certain pattern of (usually undesirable) behaviour or character refers to the fact that it is consistent with their stereotypes and views of the general Malaysian Indian population; a pattern which they recognize and pertain to the average Malaysian Indian.

I acknowledge that racial stereotypes are inevitable in any given multiethnic society, even more so in Malaysia where ethnic ties are constantly at friction with each other. Whilst these stereotypes may not necessarily be true, it provides us with a crude idea on how a particular race is viewed or perceived by the others, regardless if it is justified or not.

There are many explanations and theories behind why stereotypes exist. I choose to highlight two which I believe are relevant in most cases in Malaysia: 1) to predict the social world by which one accumulates several distinctive characteristics of a number of individuals belonging to a particular group, and then projects these views into a broader generalized picture of what one perceives or expects this group to be. 2) is the ‘in-group favourability bias’ which by belonging to a particular group, one believes that he/she is part of group that one views positively, and the others (out-groups) negatively; a phenomenon (closely related to ethnocentricity) that is observed predominantly in groups that lack social mobility e.g. the divided multi-ethnic Malaysia in its early years.

The need of the ability to predict the social world is easy to understand. It dictates our approach in social situations at the most basic level; the way one talks, dresses, behaves in front of a particular type of audience. This can be achieved by numerous ways, such as experience of encounter or more significantly imposed beliefs by an influential person such as parents, family or close friends. Erving Goffman (1959) wrote:

“…when an individual enters the presence of others they commonly seek to acquire information about him or bring into play information already possessed… information about the individual helps to define the situation, enabling others to know in advance what he will expect of them and they may expect of him…”

The ‘in-group favourability bias’ is somewhat more subjective. In Malaysia (and Malaya alike) whilst ethnic mixing is common, it does not necessarily reflect on the harmony of these ties. Inter-ethnic tensions are well known and intra-ethnic groups tend to gel together much more willingly. However, when comparing an individual (regardless of ethnicity) who mixes freely with other races against another who does not, do they both hold the same stereotypes against other races?

According to A. Rabushka, who researched stereotypes in Malaya they both should do. In his paper titled ‘Racial Stereotypes in Malaya’ in 1971, he concluded that stereotypes are invariant and independent of social interaction. Rabushka argues that ethnic mixing does not alter one’s perception of an ‘out-group’ and display distinct beliefs of members of other ethnic groups, whilst acknowledging that this may not necessarily affect social or political behaviour.

Here Rabushka defines the fine line between prejudice and actual discrimination which may be a difficult concept to grasp. Anthony Giddens a leading social theorist defines prejudice as:

“…opinions or attitudes held by members of one group towards another…preconceived views are often based on hearsay rather than on direct evidence, and are resistant to change even in the face of new information…”

Whereas discrimination is defined as:

“…the actual behaviour towards another group or individual by making a distinction in favour for or against based solely on the group in which one belongs to...”

But there is much reason to doubt Rabushka’s conclusions in view of more recent psycho-sociological research on stereotyping between ‘in-groups’ and ‘out-groups’. It is simply common sense that an individual who spends more time together with an ‘out-group’ will be able to experience by encounter and gauge accordingly if any of his/her preconceived stereotypes hold and discard any stereotype should they prove false.

But what if they are true? Are these stereotypes then retained?

To explore this, I scourged the internet, literature and even took the liberty to conduct a quick survey amongst friends on their views of the ‘typical’ Indian. I must admit that I was nowhere near elated with the pattern that began to emerge from my ‘research’. The internet and existing literature generated a long list of negative stereotypes. My quick survey drew an immediate almost apologetic opening from most respondents, as though to warn me of unpleasantness and to prep me for their opinions before generating the already familiar long list of negatives.

I list down some the negative stereotypes regarding the ‘typical’ Indian that I encountered to provide readers with what I believe is a true snapshot picture of what people think of the Malaysian Indian population in general, in no particular order:-

“…passive, non-competitive, smelly, hairy, snaky, uneducated, gangsters, drunks, class/caste based, just the type of guys who you would expect to disturbs/harass the girls, pitiful, lazy, involved in petty crimes, way behind the Chinese/Malays in economic terms…”

I also choose to quote a selected excerpt from Peter J. Wilson from, ‘A Malay village and Malaysia’, 1967:

“…In general, villagers seem to regard Indians as people to laugh about: the blackness of skin, hairiness, and skinny men and fat women seemed to amuse them most… Village men and women alike object to, and find most peculiar, the smells associated with Indians. Most Indian stores have an incense stick burning, and there is often blended in with this the smell of scent. The smell of Indian cooking seems characteristic to Malay villagers, to whom the body smell of Indians is also oppressive. A major reason given by villagers for not travelling on a bus at night is that the smell of Indians is so strong… But whereas the Chinese are ritually or mystically dirty, Indians are considered squalid…”

John Crawfurd, a former colonial administrator in Malaya also wrote:

“…with respect to their intellectual faculties, the Indian islanders may be pronounced slow of comprehension, but of sound, though narrow judgement… it must be confessed that an Indian islander of the best capacity is unequal, in most respects to an individual not above mediocrity in a civilized community…”

N.B John Crawfurd has often described the Malay Archipelago as the Indian Archipelago, and therefore the term ‘Indian Islanders’ in his writings may potentially be a misnomer and could possibly be a reference to the Malay race. Or perhaps he was actually referring to the Indian race? I make the assumption in my text, that the term ‘Indian Islanders’ was in reference to the Indian race (perhaps at my own folly).

(to be continued; Part II will be posted on the 28th January 2007)

A transition from glorious Hindu Malay Kingdoms to crumbling Hindu temples

A transition from glorious Hindu Malay Kingdoms to crumbling Hindu temples:
The past and present of Hinduism in Malaysia.

Part II of II

Down the years following independence, the days of the British divide et impera, are long gone, but the waves of its repercussions still shake the wreaking foundations of our multiracial society. The demographics of Malaysia have changed remarkably, and there are much less single ethnic based local populations who remain confined within a certain geographic distribution. With the window of opportunity to break their confines, many Malaysian Indians have managed to migrate into larger towns. But remnants of their previous settlement still exist with a small proportion of Malaysian Indians who are unable to break into the larger mould, mostly because of the lack of opportunities but also due to complacency; with all their needs fulfilled within the small local population, I hypothesize that many Malaysian Indians chose to remain faithful to their existing state to avoid the hassle and pure convenience. Therefore, regardless of how small a Hindu population, their religious needs for a temple within the local population will never cease to exist.

But not all temples experience the same fate. Numerous small temples have been abandoned or poorly maintained and do not serve their intended purpose as a place of worship. Also with the increasing migration of Malaysian Indians from rural to urban areas, many temples have lost a significant amount of their worshipers or those that have been abandoned remain situated in inconvenient (or impractical) locations. Furthermore, the numbers and scatter of some of these temples do not reflect on the demographics of Hindus in Malaysia. Whilst Malaysian Indians only make up approximately 8% (2 million) of the general population, most whom are Hindu devotees, the number of Hindu temples in certain areas are disproportionately high.

The Selangor Chief Minister, Datuk Seri Dr Mohamad Khir Toyo said that a study conducted through its local authorities estimated that there are over 5000 Hindu temples in Selangor and certain areas within the state had too many temples located too closely together. He also said that it is the state’s policy that a place of worship can only be built in an area where there are between 2500 and 5000 followers, and the ratio applies to all religions. In October 2006, he released a statement to the press, which implied that 95% of the temples in Selangor will be demolished for numerous reasons, including others that have not been cited above.

Whilst I thoroughly recognize the problems that beset many of the Hindu temples in Malaysia, is this mass demolishment of Hindu temples justified, albeit its’ numerous shortcomings and inadequacies?

HINDRAF (Hindu Rights Action Force) have filed a civil suit at the high court against Datuk Seri Dr Mohamad Khir Toyo and several other Chief Ministers for the unlawful ‘Hindu temple cleansing’ in Malaysia, but I regret to say that is the extent of my knowledge on the legal proceedings. Currently, statistics by HINDRAF estimates that at least 1 temple is being demolished every 3 weeks in Malaysia. Between 22^nd February and 30^th November 2006, at least 15 temples have been demolished; 3 temples were at least 100 years old. During this period, at least 48 other temples have been issued notices and threatened with demolitions; at least 9 beyond the century mark and one temple even having allegedly received recognition from UNESCO.

Subang Jaya Muncipal Council President, Ahmad Fuad Ismail claimed that most Hindu temples in Subang Jaya were illegally built, as they occupied state land and failed to apply for permission to use the land for temples. Here I deem it necessary to educate readers that occupancy of land prior to Merdeka, does not grant any form immunity to the occupants against state or government land acquisition as stated under the constitution and the Land Acquisition Act 1960. This thereby requires temples to applying for permits to allow them to continue to occupy these sites. In a huge number of cases, many of the temples were built on privately owned plantations prior to Merdeka, but were transferred to government ownership afterwards.

However, on the other side of the argument, numerous temple officials have claimed that fault was not on their side for the failure to apply for permits, instead they have rigorously applied for permits, only to repeatedly receive rejections for their applications. This inconsistency between the government administrators’ and temple officials’ account of the event has not only contributed to a major communication breakdown but has the potential to escalate racial tensions. What bemuses me most is that under government ownership, these temples should be valued as national monuments and symbolic of our diverse culture and tolerance within our multiracial society, instead the decision to demolish these places of worship over petty paperwork implies that there may be a more sinister motive hidden underneath the red tape.

This however, is merely the tip of the iceberg revolving around the ‘Hindu temple cleansing’ saga. Demolishment notices have even been issued to temples for failing to gain approval for buildings, when these buildings have existed years prior to the governmental organizations. Some temples have been issued notices for demolishment to make way for housing projects, which can so easily be manipulated to accommodate both the temples and the housing projects. Let me be quick to remind you that these were only the cases that were reported to, and discovered by HINDAF, and there is much reason to suspect that many more such cases exists throughout the country, falling onto deaf ears.

The legalities surrounding these issues are grey. The constitution states, that under Section 295 of the Malaysian Penal Code that it is a criminal offence to violate or defile places of worship. It is mystifying how the demolishment of Hindu temples can proceed even with the Land Acquisition Act when such an implicit contraindication in the constitution exists. The Land Acquisition Act 1960, also states that those affected by land acquisition will receive adequate compensation based on the value of the premises as evaluated by Jabatan Penilaian dan Perkhidmatan Harta. How ‘adequate’ translates into moving a place of worship adjacent to sewerage tanks or into a 10x10 feet allotment, I fail to understand.

However, it would be folly to blindly accuse the government administrators and place all blame on them. It is undeniable that there exist numerous temples scattered too closely together that have been poorly maintained and provided inadequate service to meet the religious needs of a small number of Hindus. From the government administrators’ perspectives, it is important to identify these temples located in prime areas that are redundant in purpose and adopt strategies that will allow the state government to ensure the necessary development in these areas. Some of these poorly maintained temples which fail to fulfil their purpose certainly need to give way and warrant demolishment or relocation.

While the state governments’ hopes that these numerous smaller poorly temples should cleared in place of a single well maintained temple has its impracticalities, which demonstrates further evidence of a lack of sensitivity of the government towards Hinduism and essentially a communication breakdown between community leaders and administrators. The nature of Hinduism’s “many forms of Gods” (within its monotheist concept) makes it difficult for a single temple to cater for the needs any given Hindu population in a similar manner there exists numerous sects within any given religion.

This is exemplified by a statement by Muniandy (Section 11, Shah Alam Temple Chairman) who said, “It seems that they want us to build all the temples under a single roof in a complex-like manner or even a pasar malam. All we’re asking for is a room for prayers. Just as much as their need for a room for their prayers, we’re simply conducting our prayers in our room…. If this continues, how can we pray?”

Nevertheless, what angered the Hindu devotees most above all was the manner in which the temples were demolished. Ahmad Fuad Ismail stated that although notices were issued well in advance, the temple authorities despite having more than ample time to carry out the necessary arrangements to vacate the premises in a respectable manner failed to do so. He also stated that the failure of the temple authorities was the reason behind the fracas of the demolishment of temples, and even so the enforcement team on one occasion gave the temple authorities an hour to relocate the deities, and even helped them do so. This however is contrary to experience of the majority of the Hindu devotees during the many temple demolishments.

A witness of a temple demolishment in Seksyen 7, Shah Alam on June 12^th, claimed that during the demolishment, the municipal council officers all had sticks in their hands, accompanied with police and the Federal Reserve Unit (FRU). He deemed that all this effort was unnecessary to demolish such a small temple and questioned the need for the presence of about 100 law enforcers at the temple’s premises. He also added that he perceived this action by the authorities as a mockery towards the inability of Tamils (Hindus) to respond or retaliate.

Nevertheless, before I am accused of bias, I wish to clarify, that there also have been accounts on which the local authorities had made attempts to be sensitive to the Hindus. There is evidence to Fuad’s claims that the authorities did attempt to preserve the deities and religious symbols whilst only demolishing the building structures of the temple. There were instances where the local authorities allowed the temple authorities and the temple’s worshipers to remove the deities respectably immediately prior to the demolishment, even despite the fact that this should have been settled by the temple authorities at a more convenient time after the clearance notice had been issued.

In separate events however, there have been other reports of wrongdoings by the authorities at several other unrelated temple demolishments. In Setiawan, the Manjung local council in Perak had allegedly thrown the smashed deities into drains after the demolishment. At another temple demolishment in Ipoh, an estimated RM17, 000 worth of jewellery and donation money was reported stolen after the demolishment in the presence of Ipoh City Hall Enforcement Officers and the police force. Whereas, in Setapak, a mentally challenged Hindu devotee was allegedly beaten up by enforcement officers after being held for false accusations of robbery in a series of events that followed a temple demolishment.

In view of the potential damage the mass Hindu temple demolishment could cause to ethnic ties, there is no doubt that this should have been approached with greater sensitivity and a greater effort by dialogue between government administrators, leading political parties with MIC as a frontrunner, community leaders and a the general public. The failure to do will lead to devastating consequences and for some cause irreparable damage.

On the 20^th October 2006, about 200 Hindu devotees, Hindu Servai Sangam officials and NGOs protested against the demolishment of Hindu temples at the parliament house and hoped to submit a memorandum regarding this issue to UMNO ministers. However, the Chief Security Officer of the parliament stated that there were no UMNO ministers present to receive the memorandum. A video presentation by Malaysiakini truly captured the emotions and sufferings of the Hindu devotees during the protest, and presented the rest of Malaysia with much reason to lament our flailing multiethnic society.

An interviewee in the 10 minute video presentation said, “We cannot be expected to go to Batu Caves every time we want to pray. Other religions in Malaysia have their places of worship, so why can’t we? Why are Hindu temples being demolished?”…the expression on his face said it all; his brows furrowed in frustration, his voice trembled with anger as he demanded an answer to this atrocity towards Hindus in Malaysia.

For argument sake, even if the temple demolishment proved to be lawful, we must acknowledge that legislation has its limitations, and reason can sometimes elude us when it involves matters close to our hearts such as religion and God. The actions of Malaysia as a moderate Muslim country can be perceived as a denial of its deep Hindu heritage which has played an immense role and a significant influence on its society, culture, traditions and language. The glorious days of the Hindu Malay kingdoms are long gone and it appears that history is repeating itself as the future of Hinduism in Malaysia is looking increasingly bleak. This is simply a testament of Malaysia’s blatant intolerance towards other Hinduism, despite priding itself as a democratic multiracial country which allows the freedom of religion.

…Unfortunately, I still am only human. My thoughts, judgements and rationale, are not impervious to my emotions.”

A transition from glorious Hindu Malay Kingdoms to crumbling Hindu temples

A transition from glorious Hindu Malay Kingdoms to crumbling Hindu temples:
The past and present of Hinduism in Malaysia.

Part I of II

“Emotions can often so easily cloud judgement and deprive even the highest intellect of his rationale. But emotion makes us human, and we can never wholly separate emotion from our thoughts…

The demolishment of numerous Hindu temples in Malaysia has provoked both emotion and thought, and it is a struggle to approach this issue with rationale. I attempt this arduous task in hope to explore the various perspectives of the people involved in this issue, whilst trying to maintain an unbiased opinion on the matter, with a view of the historical roots of Hinduism in Malaysia.

The origin of Hinduism itself in Malaysia (or rather Malaya) is deep stemmed in our rich history, but like many other things in the past, the exact details remain elusive to us due to missing links in historical evidence of civilizations in the Malay peninsula, between the pre-historic periods and the Malacca Sultanate. Numerous texts attempt to fill in these missing pieces, but have failed to provide reliable citations which make this task not only difficult, but lacking credibility.

Nevertheless, The Malay Annals (Sejarah Melayu), Kedah Annals (Hikayat Merong Mahawangsa), Chinese chronicles and King Rajendren Chola’s historical writings have all described ancient Hindu Malay kingdoms that predate the Malacca Sultanate.

Gangga Negara (meaning ‘a city on the Ganges’ in Sanskrit) is an example of one of the Hindu Malay kingdoms that was described in the Malay Annals (believed to be first compiled by Tun Seri Lanang, the bendahara of the Royal Court of Johor in 1612). It was believed to be founded by Hindu traders in the 2^nd century originating from Ganganagar. The Gangga Negara period also coincided with Langkasuka (another another Hindu Malay kingdom that had also adapted elements of Buddhism) and the Kedah Sultanate (where Sultan Mudzafar Shah is believed to be the first Islam convert in the Malay Peninsula). However, these civilizations were severely weakened or collapsed after a series of attacks by King Rajendra Chola I (a king from the great Cholan dynasty).

Here I believe that is worthy of note to mention that Kedah, was formerly known as Kadaram was founded too by a Hindu king, known as Merong Mahawangsa. The influence of Hindu-Buddhism in ancient Kedah is undeniable as numerous archielogical evidence (e.g. inscriptions from the Cholan Empire some dating as early as 1030 A.D.) have been recovered and extensively researched by Col. Low and Dr. Quaritch Wales. For the more enthusiastic historians, further evidence of Hindu Malay kingdoms in ancient Malaya can be found in a number of museums in Malaysia, such as the Beruas Museum and the Bujang Valley Archaeological Museum which displays artefacts recovered from ancient Hindu-Buddhist Malay kingdoms, some believed to be as early as 300 A.D.

It was following this period that kingdoms such as Srivijaya and Majapahit (both Hindu-Buddhist Malay kingdoms) rose to power in Southeast Asia, in the Malay Archipelago. Srivijaya, like the Hindu Malay kingdoms that preceded it suffered a similar fate as Srivijaya was subjected to a series of raids of King Rajendra Chola which although ultimately unsuccessful, left the kingdom severely weakened and eventually became a part of the Majapahit empire. It was shortly after this when Parameswara, a Hindu Srivijayan prince who was a descendent of Raden Vijaya (the first king of the Majapahit empire), founded the Malacca Sultanate in Malaya.

Parameswara later converted into Islam and assumed the title Sultan Iskandar Shah which sparked a remarkable turnaround in the fate of Hinduism in Southeast Asia. Upon his conversion, he encouraged his followers to also convert into Islam. However, it was under Sultan Mansur Shah that the Malacca Sultanate prospered as the centre of Islam in Southeast Asia. Using marriage alliances, he managed to convert the rulers of his conquered state into Islam and strengthen ties. He invited holy man (imams and ustazes) to discuss religion and often sent missionaries to spread Islam to Java, Borneo and the Philippines, at a time when most of Southeast Asia was predominantly Hindu. Whilst Hindus never proselytized, Islam swept over Southeast Asia by various means of active conversion (a topic which largely remains controversial till today in both scholarly and public opinion). Nevertheless Islam managed to grab a stronghold in Malaya, under which the influence of Hinduism in Southeast Asia gradually weaned.

The resurgence of Hinduism in Malaya began with the immigration of Indians (who were predominantly Tamil Hindus) as coolies under the British rule in the early 1900’s. The majority of the Malaysian Indians today can trace their ancestry to these immigrant families, and as dictated by evolutionary changes in the structures of our society, exists as the brand of Malaysian Indians that we recognize today.

N.B I remind readers that since the majority of Hindus in Malaysia are Malaysian Indians, and vice versa, from hereon I use these two terms interchangeably (and perhaps even wrongly so). Therefore I advice readers to explore the context in which these terms are used carefully to prevent any misunderstanding.

The second coming of Hinduism following the influx of Indians in Malaya never reached the heights achieved by the ancient Hindu Malay kingdoms, but was nevertheless significant.

Under the cleverly employed divide et impera (divide and rule), the British managed to isolate the various ethnic groups in Malaya to prevent any form of uprising, a similar tactic which was successfully employed in India (although the implementations itself were hugely dissimilar). Simply put the majority of immigrant Indians were employed as estate workers and therefore geographically concentrated in estates. Needless to say, that there were various factors which ensured this geographic distribution persisted, such as lack of social mobility and poor transportation system. However, this could only be achieved as long as the Indians were satisfied – meaning their needs including their religious ones were adequately addressed. Thus, many Hindu temples were constructed to meet the religious demands of the local Hindu population.

(to be continued)