Decided to stagger my blog posts with an English prose. SO!!!! As I have been discreetly keeping a rather low profile, you might be unaware of my recent whereabouts. Now here's an antidote for your tenacious curiosity. ;P
So, I had been volunteering at Tzu Chi's free clinic (Pudu) for 2 weeks. For some context, Tzu Chi(慈济, meaning mercy and aid respectively) is a Buddhist organization originated from Taiwan. As the organization's christened, it aims at rendering help to the needy and less fortunate. Such compassion is incarnated through a spectrum of community services, varying from recycling to free education and health services(which I'm involved!).
The reason as to why I'm involved would demand a 50,000-word essay to detail. So to keep things sweet and succinct: I wanted to do something meaningful and rewarding during summer break, and coincidentally, my lovely neighbor could bridge the opportunity. Did that in 20 words, Hell ya! Jokes. Delving deeper into the former point--"meaningful and rewarding", I had personally approved the organization's benevolent motifs after some background research. Atop that, my familial background had sculptured my lack of exposure to local clinics and community services. Ergo, I viewed it as a positive-sum experience as good services are delivered to the needy, while I could broaden my horizon.
Sorry for veering off course, back to more context! The clinic offers a good range of health services, entailing Western medicine, Traditional Chinese Medicine (TCM), psychological counselling, physiotherapy and dental care. The main target group of the services is the refugees, followed by the poor and needy locals. As much as I dislike being captain obvious, "free" implies that the services do not incur any fee, and that include consultation, investigation(eg. USS, ECG) and medication. Essentially, all expenditure is absorbed by the organization.
Before some insight, the last (and essential) piece of the puzzle is my role of involvement. So, I have been facilitating (or I thought so) the doctor-patient encounter by recording the consultation history (including presenting complaint, assessment, prescription etc) into their computer program. You may be snickering derisively, "That sounds like a pretty mundane and rather redundant position". I certainly agree that my role is not of utmost vitality as many doctors are capable of operating the computer themselves. However, imagine you're working in this clinic, and you have to consult 80-100 patients a day, sometimes all crammed in a morning. Every second counts. You need to multitask, you have to key in the consultation details, while communicating with the patient through an interpreter in the midst of contemplating your next move, having in mind that the previous patient is waiting for an investigation(dipstix or UPT) that needs to be translated into the computer. So, wouldn't it be nice to have someone guarding this barrage of the vast battlefield? In fact, such relief morphs to reprieve when some senior doctors are less apt with electronic gadgets.
When doctors see their past, they teach
Firstly, I need to convey my deepest gratitude to all the doctors who had patiently guided my volunteering regime and bestowed me such an integrative experience. Amongst them, there are a few whose teachings were etched deep in my head and had definitely shaped the mould of my future practice.
Doctor C made me feel more prepared for the clinical years. In terms of hands-on-experience, I was allowed to use a glucometer, perform DEPO injections and remove sutures (almost removed an ingrown toenail T_T). All experiences are accompanied with selfless tips and guidance that a second year medical student would have asked for. Also, it was a timely exposure to the jargons and abbreviations for a medical student who has been divested of clinical exposure.
Doctor N taught me the importance of knowledge and empowerment for a doctor. Knowledge affects one's clinical judgment, granted. Aside that, empowerment is a doctor's capability of doing the right thing at the right time, without losing his objectivity due to tantalizing enticement. Empowerment embodies the referee of clinical judgment - an unbiased judgment ensures the best game. On a side note, why be an uptight doctor when you can be charming?
Doctor T's patient-centered approach reminded me of its importance. More often that not, doctor patient interaction slants asymmetrically as time loses their guard, or wielding patriarchy seems more befitting on dependent and vulnerable patients. It is always easier to blame patients than to educate them, to treat their symptoms than their mentality.This reminder serves as an awakening slap- a mark to be borne for life, a talisman that protects both the patients and doctors.
Doctor S taught me the eclectic approach to medicine. As a TCM practitioner, he sees reason and importance behind Western medicine. Ergo, he amalgamates relevant theories into his practice. For instance, he discourages Chinese massage (铁打) right after a sprain/strain for fear of exacerbating the edema. As a matter of enlightenment, I will endeavour to understand theories behind different streams of medicine and reconcile theories that I see fit into practice.
A beautiful encounter of a Western medical student and Traditional Chinese Medicine(TCM)
Herbs contain phytochemicals that can potentially initiate a cascade of physiological response. In collaboration with lifestyle changes, placebo, time and other essential ingredients, no doubt that TCM may have certain efficacy on certain conditions.
In the realm of modern medicine, evidence-based approach should prevail. Yes, as much as I would attempt to understand some elusive theories and to absorb the preponderant endorsement by users and TCM practitioners, statistics and trials are much needed to testify their efficacy. In fact, I personally reckon the lack of objective measures is one of the biggest issues they are facing. For instance, it's ludicrous to believe that a herb improves liver function, when liver function test isn't performed on the consumers as a means of monitoring. As long as pioneers from TCM are willing to breakthrough the shackled mentality and start applying objective measures, I'm sure TCM will sprout and blossom in near future. And to my great relief, my friend from this field told me that TCM is veering towards this trend as more research is being initiated.
However, even though objective measures are still lacking currently, I don't negate the potential health benefits of TCM. In fact, I personally loud the stronger emphasis they place on lifestyle changes. It is definitely an upstream approach to certain conditions, especially diabetes, hypertension etc first world diseases. However, when it comes to conditions that are either severe or/and symptomatic, it's still more recommendable for TCM to serve as an adjunct rather than the main intervention.
A glimpse of the refugee issue
From my limited interaction with the doctors, staff and patients, I managed to get a cursory glance at the refugee issue. So, many refugees used Malaysia as a transit to migrate to countries such as the US, Australia etc, mainly through UN and other NGOs. Apparently many of them used around RM3000 to trespass the custom (from north for the Myanmar people and by sea for the Indonesians and Africans) through underground agencies. As they laid feet on Malaysia, apart from the more affordable human labour that they offer, they also inflicted surges of socio-economic impact that ripples all over. Some of them spread PTB (pulmonary tuberculosis) as many of them work as kitchen staff while good hygienic practices are lacking, some forged medical documents in hopes of migrating to the aforementioned countries, some became pregnant without proper family planning and spread STIs unintentionally, some committed crimes and got involved in fights after boozing went wild. As per one of my doctors described, “they’ll eventually get to the US, but leaving all the [disasters] (censored) in Malaysia”.
I felt very sorry for the refugees, I suppose they suffered from poverty and political crisis from their home country and now ended up in a foreign country with despicable status and substandard treatment. Although I can understand why some doctors and staff are frustrated and eventually turned apathetic towards them, I feel that they still deserve decent treatment and attitude. As much as I appreciate what the clinic is doing - providing free medication, preventing spread of infectious disease, providing them health advise (eg. family planning etc), sadly, the spine of the problem remains unaddressed. The problem lies in the fact that immigration policies aren't tightened. How could so many refugees trespass the custom should the authority retains their self-righteousness and integrity? Also, it’s inexorable that this situation will persist on a primordial level, should the Third World Countries' socioeconomic problems remain unresolved. To dig out the root of the problem will certainly take time and effort. Small steps should be taken systemically and thankfully, Tzu Chi has been sweeping the tripling stones out of the way in the mean time.
In future, if I’m capable, I would like to serve at the clinic as a doctor (part-time of course) and try to affect a change, even if it's small.
Thank you everyone for the wonderful experience! Without your kind patience and willingness to teach, I wouldn't have gained as much as I did. Two weeks had fallen short for me to interact with everyone on a deeper level. However, memories blossomed here will be embedded in the cockles of my heart. I'm certainly blessed! =)
When you believe in everything,
you believe in nothing.
There is no room for doubt.
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