KUALA LUMPUR, May 31 ― With foreigners contributing about 20 per cent of tuberculosis (TB) cases reported in the country, concerns are mounting over the breeding of the disease among refugees here.
Institute of Respiratory Medicine senior respiratory consultant Prof Datuk Dr Abdul Razak Mutallif said many refugees live in cramped conditions in small houses.
“Myanmar, for example, has a high number of TB cases, one of the highest in Asia. The chances of their nationals here already having TB in their lungs are great,” he said.
He said the pressure and stress of leading tough lives here also made them vulnerable to contracting the disease, and spreading it.
Dr Abdul Razak said there are no proper medical checks done when refugees enter the country, thus the absence of statistics to show the number of TB patients.
However, cases of TB appear rampant among the community.
He also pointed out the increase in the number of multidrug-resistant TB (MDR-TB) cases over the past decade.
“In the past, less than one per cent of the total cases were MDR-TB. That amounted to about 20 cases a year. Today, we have about 100 cases a year,” he said.
Patients fail to take their medicines properly, allowing the bacteria to become resistant to drugs.
Dr Abdul Razak said many refugees from Myanmar and Indonesia are TB patients as the number of MDR-TB patients is high in those nations.
“The number of MDR-TB cases will continue to increase, especially among drug addicts and the homeless,” he said.
There are 160,000 refugees in Malaysia, with the majority being Rohingya from Myanmar, according to the Home Ministry. The number is based on those registered with the United Nations High Commissioner for Refugess (UNHCR).
Observers, however, think the figure is much higher.
The ministry has also announced that 300 UNHCR registered refugees will work in the agriculture and manufacturing sectors here under a pilot project. They will be allowed to work if they pass security and health screenings.
Dr Abdul Razak said some of the refugees contracted TB in Myanmar but showed no symptoms.
“But when they come here, with the stress, shortage of food and poor living conditions, it (the disease) gets activated. They also have limited access to healthcare,” he said.
Active screening of refugees is only done before they are resettled to another country.
“They will have to be fully cured before they leave Malaysia and that could be close to a year. That is the only active screening we have,” he said.
“The hundreds of thousands who are waiting to be resettled stand a high risk of passing on TB or contracting it.”
Refugees are not allowed to work here. Many end up doing odd-jobs with a large number selling vegetables, fruits, seafood and meat at wet markets or night markets. A large number of the Rohingya community can be seen trading at the Selayang wholesale market.
Malaysia is not a signatory to the 1951 Refugee Convention and is not bound by international law to provide refuge, asylum, jobs and education to refugees. It has done so out of goodwill and on humanitarian grounds.
UNHCR health officer Dr Susheela Balasundaram said TB infection among the refugee community in Malaysia is significantly fewer than “the two to four million undocumented migrants in the country”.
“There are currently five cases of MDR-TB among refugees and their treatment is being managed by the Institute of Respiratory Medicine with drugs being funded by UNHCR,” she said.
She said that in the proper management of TB, it is important to ensure there is early identification of the disease and access to treatment.
“UNHCR has procedures in place to detect and deal with TB cases among refugees, including with referral pathways in place to allow for cases to be informed to us for immediate treatment,” she said.
She said UNHCR actively works in the prevention of TB among the population through extensive community-based information dissemination and awareness raising efforts.
“Prices of fertilisers and pesticides have increased. This could make the pomelo more expensive.”
