APRIL 11 — Upon approaching the four-week mark of the movement control order (MCO), most Malaysians were unsurprised that this necessary public health measure was extended by two weeks.
While the Ministry of Health has been outstanding in its efforts to contain the spread of infection by contact tracing and active case detection, we are not out of the woods yet.
As of 10th of April 2020, 118 new Covid-19 cases were reported in Malaysia, with a cumulative total of 4,346 cases and 70 deaths.
Coronavirus has gained a foothold in our community and continues to spread despite our best efforts.
It is time for us to look to our neighbours in Singapore and learn from their example.
Singapore had early success in containing the first cases of Covid-19 but recently had a resurgence. A rigorous form of physical distancing is now enforced to act as a "circuit breaker" in disrupting viral transmission.
A recent spike of cases, with 287 cases reported on the 9th of April, was linked to foreign workers' dormitories.
Some 200,000 low-wage migrant workers from the construction and other sectors are housed in overcrowded dormitories with common sleeping, cooking and lavatory areas, making physical distancing impossible.
Since then, the Singapore government has proactively implemented measures to screen, isolate and separate those migrant workers testing positive from others.
Alternative housing has been arranged, as well as measures to ensure the well-being of workers by providing cooked food and payment of wages by employers.
In Malaysia, a similar situation is unfolding in Kuala Lumpur. Two densely populated flats occupied predominantly by migrant workers were placed under enhanced movement control order (EMCO) since the 7th of April.
The EMCO is a more rigorous form of lockdown which prohibits residents from leaving or non-residents from entering the area.
These measures involve some 6,000 residents in 365 residential units.
Initially, the Malaysian government refused to provide food for these residents, mostly non-citizens from India, Pakistan and Bangladesh, calling upon their embassies to look after their citizens' welfare.
Thankfully, this decision was quickly rescinded, and common sense prevailed in providing free food to all involved.
Here Malaysians must be very clear, the next frontier of infections does not lie only with the threat of imported cases coming from overseas, from returning Malaysians or from undocumented migrants crossing our porous borders.
Our next frontier is within the country, among our most vulnerable groups, the non-citizens, who consist of approximately 10 per cent of our population.
Most non-citizens in Malaysia are labour migrants, with 2 million documented migrant workers estimated by the ministry of home affairs in 2019.
The number of undocumented migrants in Malaysia is less certain, with estimates for all migrant workers ranging from 4 to 6 million, including documented and undocumented workers.
Also, approximately 180,000 refugees and asylum seekers were registered by the UNHCR in 2019. As of 9th April, the ministry of health reported 416 cases of Covid-19 and two deaths among non-citizens in Malaysia.
Non-citizens are especially vulnerable, as they are employed in low-wage jobs and face many hardships including poor housing and working conditions.
This pandemic and the subsequent lockdown has potentially left millions unemployed and destitute.
Long-standing government policies effectively exclude non-citizens from accessing public healthcare.
These include unaffordable user charges and the criminalisation of those without legal identity documents, like valid passports and work permits.
The lack of trust towards authority figures does not engender co-operation with public health activities.
While the ministry of health lifted the non-citizen fees for the management of Covid-19, these measures alone may not be enough to bring non-citizens forward.
Currently, the ministry of health is working in partnership with the UNHCR and various NGOs to ease contact tracing and active case detection among these vulnerable communities.
Civil society organisations have stepped up in preparing and distributing health promotion materials to educate non-citizens on the coronavirus and providing food to the destitute.
Health is greater than just access to healthcare services. Health is determined by multiple inter-related social, cultural and economic determinants.
Lockdown measures are idealistic and have no meaning to the poor. How does one practise physical distancing when living in a crowded migrant kongsi?
How does one practise hand hygiene without access to clean water and soap? Hunger is a known enemy, yet the coronavirus is an unknown threat.
How do we move forward with this?
Firstly, employers should step up and take responsibility for the workers' welfare. To follow the example of Singapore, the government should ensure that wages are paid, despite the shutdown of all but the most essential businesses.
Secondly, the management of this pandemic should not become a national security issue. Having the police, army and immigration authorities involved will not engender trust or the co-operation of non-citizens.
Working with civil society organisations and community partners will prove to be a more effective strategy.
Thirdly, we need to properly frame Covid-19 related health promotion messaging for all non-citizens. Malaysia has at least 15 different nationalities living in the country, from various cultural backgrounds and levels of literacy.
Therefore, it is important that health promotion material is available in a variety of non-citizen languages and pictorial forms, also reflecting cultural contexts.
Innovative distribution channels for health promotion are necessary to ensure messaging reaches their target audience. For example, WhatsApp or SMS messaging may be more effective than the use of mainstream media channels.
Finally, this isn’t the time to separate people based on citizenship entitlements. Non-citizens should be given equal treatment in all aspects for health, employment and welfare benefits.
We must all realise that this virus does not recognise borders, nor does it respect man-made constructs such as race, religion, political affiliation or citizenship.
The only way to overcome these challenges is with compassion and inclusion, and not by building walls and securitising our borders.
* Dr Tharani Loganathan is a Public Health Medical Specialist and Medical Lecturer at the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
