Ambil langkah-langkah tambahan untuk mengawal coronavirus (Malay/English)

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Image by CDC/Alissa Eckert, MS; Dan Higgins, MAM - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #23312 - Wikimedia Commons

[ENGLISH VERSION BELOW] Kami, kumpulan dan individu yang menandatangani surat ini (daripada People’s Health Forum kepada Perdana Menteri Muhyiddin Yassin) ingin merakamkan penghargaan kami setinggi-tingginya terhadap usaha yang telah dan sedang diambil oleh kakitangan Kementerian Kesihatan untuk menangani wabak coronavirus.

Langkah-langkah kementerian untuk mengecam dan merawat kes, mengenalpasti dan mengasingkan kontak telah memainkan peranan besar dalam menyekat penularan penyakit ini di kalangan rakyat Malaysia.

Kami, kumpulan sivil, ahli akademik, aktivis kesihatan dan pengamal perubatan sedang mengikuti perkembangan wabak coronavirus di Malaysia dan juga di arena antarabangsa.

Kami ingin mengemukakan beberapa langkah tambahan yang kami rasa harus dilaksanakan untuk memantapkan lagi respons negara kita untuk mengawal ancaman kesihatan serius ini. Antaranya adalah:

Berkaitan pengasingan kontak kes-kes coronavirus

Kami mengalu-alukan pengumuman perdana menteri pada 11 March 2020 berkaitan penubuhan Tabung Covid 19 dibawah seliaan Agensi Pengurusan Bencana Negara untuk membantu pesakit dan kontak coronavirus.

Kami ingin mengesyorkan usaha ini diperkukuhkan dengan:

  • penubuhan jawatankuasa bersama di peringkat tiap bandar/daerah yang melibatkan Jabatan Kesihatan, majlis kerajaan tempatan, Agensi Pengurusan Bencana Negara dan Jabatan Kebajikan Masyarakat untuk menghubungi kontak-kontak (melalui telefon), mengenalpasti keperluan mereka dan menghantar ke rumah-rumah mereka bekalan makanan, ubat-ubatan yang mereka biasa ambil, dan barangan keperluan lain bagi mereka yang tidak mempunyai ahli keluarga yang boleh menjalankan tugas ini
  • pembukaan asrama sementara untuk menempatkan para kontak yang duduk di suasana yang sesak seperti rumah pangsa kos rendah di mana pengasingan yang berkesan tidak dapat diamalkan (kerana rumah kecil dan tandas harus dikongsi). Asrama pusat sukan ataupun asrama kolej tempatan harus diambil alih buat sementara untuk tujuan menempatkan kontak-kontak yang tidak mampu mengasingkan dirinya di rumahnya supaya rebakan coronavirus dapat dihentikan

Perintah kawalan pergerakan

Kami terima baik keputusan kerajaan untuk mengumumkan perintah kawalan pergerakan yang berkuatkuasa 18 Mac hingga 31 Mac 2020. Ini merupakan langkah yang amat perlu pada takat ini untuk menyekat dan berhentikan penularan jangkitan coronavirus di kalangan masyarakat.

Jika tindakan tegas ini tidak diamalkan, rebakan Covid akan membebankan perkhidmatan rawatan kerajaan ke takat ianya menjejaskan rawatan kepada pesakit barah, pesakit HIV dan pesakit kronik lain yang sedang dirawati di hospital-hospital kita.

Namun, ada beberapa isu penting yang tidak diperjelaskan dalam pengumuman perdana menteri pada 16 Mac. Antaranya:

a) Situasi pekerja harian, terutama pekerja wanita di sektor perkhidmatan di bandar umpamanya, pembantu di restoran dan kedai kopi. Gaji mereka dikira setiap hari dan jika kedai makan itu tutup, mereka tidak akan dibayar sebarang pampasan. Ramai antara mereka akan menghadapi masalah menanggung keperluan anak-anak mereka dalam dua minggu yang akan datang.

b) Kita harus mempertimbangkan juga situasi pekerja dengan gaji bulanan di kilang-kilang, kedai-kedai jualan barang dan premis lain yang akan diberi cuti oleh majikan mereka oleh kerana perintah kawalan gerakan ini. Situasi mereka harus diperjelaskan. Adakah cuti yang mereka diberi ini cuti tanpa gaji ataupun cuti bergaji. Bagaimana pula dengan majikan yang sedang menghadapi masalah kekekangan wang (cash flow) – tiada perniagaan tetapi kena membayar sewa dan gaji?

c) Ada ramai pembeli rumah yang akan menghadapi masalah melaksanakan bayaran ansuran terhadap pinjaman rumah mereka ataupun pinjaman perniagaan bagi bulan ini dan bulan hadapan kerana pendapatan mereka mengecut. Situasi mereka juga harus diambil berat dan ditangani.

Syor-syor kami terhadap isu-isu ini adalah:

  • Pemberian ration makanan untuk semua keluarga yang menghadapi masalah memperolehi bahan makanan kerana tiada wang. Jawatankuasa di peringkat daerah harus ditubuhkan dengan penglibatan Jabatan Kebajikan Masyarakat dan NGO-NGO kebajikan di daerah tersebut untuk mengenalpasti keluarga-keluarga yang sedang menghadapi masalah ini. Peruntukan yang mencukupi harus disalurkan kepada Jabatan Kebajikan Masyarakat untuk melaksanakan program ini
  • Majikan dengan jualan yang melebihi RM300,000 setahun harus dikehendaki membayar gaji basic penuh untuk tempoh masa “lockdown” ini. Manakala majikan yang lebih kecil boleh diberi kelonggaran untuk membayar gaji separuh untuk tempoh lockdown. Bank SME ataupun sebuah institusi serupa harus menyediakan satu dana khas untuk dipinjam kepada majikan-majikan yang menghadapi masalah cashflow supaya mereka dapat membayar gaji pekerja mereka. Pinjaman ini harus dikenakan kadar bunga yang serendah mungkin
  • Semua bank mesti diberi arahan untuk tidak mengenakan sebarang penalti terhadap sesiapa peminjam yang tidak dapat mematuhi bayaran ansuran untuk dua bulan ini (selain daripada langkah melanjutkan tempoh membayar balik pinjaman selama dua bulan lagi)

Langkah-langkah yang disyorkan di atas bukan sahaja menghulur bantuan kritikal kepada pihak-pihak yang sangat memerlukannya, tetapi juga akan menjana permintaan kasar di ekonomi tempatan dan membendung tendensi ke arah kegawatan ekonomi.

Pengendalian pekerja asing

Adanya dua juta pekerja asing dengan dokumen perjalanan dan mungkin empat juta lagi yang tidak mempunyai dokumen. Mereka sekarang dikenakan caj tinggi bila disiasat dan dirawat di hospital dan klinik kerajaan, dan oleh itu ramai antara mereka segan datang ke klinik dan hospital Kementerian Kesihatan.

Surat setiausaha bahagian kewangan kementerian bertarikh 29 January 2020 menyatakan pesakit yang disyaki mengidap coronavirus akan disiasat dan dirawat secara percuma. Tetapi surat tersebut tidak menjelaskan samada siasatan/rawatan yang dilakukan selepas pesakit itu didiagnosakan sebagai bukan pengidap coronavirus juga dilakukan secara percuma.

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Surat kementerian itu juga menyebut “pesakit yang tidak menunjuk sebarang symptom akan dikenakan fi pesakit luar sebanyak RM40 dan caj-caj lain yang berkenaan.”

Jika pekerja asing masih dikenakan caj tinggi untuk rawatan masalah perubatan lain, keengganan pekerja asing untuk datang ke hospital kerajaan akan berterusan dan ini akan mengganggu usaha kita mengawal rebakan coronavirus di masyarakat kita.

Syor kami adalah untuk:

  • menangguhkan perlaksanaan Caj Baru Perubatan bagi Warga Asing (2014) untuk enam bulan yang akan datang
  • mengurangkan caj mereka ke kadar caj rakyat Malaysia buat masa ini
  • menyebarkan makluman itu secara meluas di kalangan masyarakat pekerja asing

Suatu isu lagi yang harus dikendali untuk mendapatkan kerjasama masyarakat pekerja asing adalah isu penangkapan dan dakwaan terhadap mereka yang diklasifikasi sebagai pekerja asing tanpa izin (Pati). Kerisauan mereka terhadap kemungkinan ini akan menyebabkan mereka mengelak daripada datang ke institusi kerajaan. Pati yang dikesan positif tidak akan memberi nama dan alamat kontak-kontaknya kerana takut semua kawannya akan ditangkap dan dipenjarakan. Oleh kerana jumlah Pati di negara kita begitu besar, keengganan mereka berkerjasama akan menimbulkan masalah besar untuk program kita mengawal wabak coronavirus.

Syor kami:

  • Isytiharkan satu moratorium selama enam bulan terhadap Pati
  • Pihak kerajaan memberi jaminan bahawa Pati tidak akan ditangkap atau didakwa atau dihantar balik ke negara mereka atas kesalahan ketiadaan dokumen perjalanan yang sah untuk satu tempoh tertentu
  • Syor tambahan – Tubuhkan jawatankuasa bersama dengan komuniti-komuniti pekerja asing untuk membantu Kementerian Kesihatan dalam mengenalpasti dan mencari kontak kes-kes coronavirus di kalangan mereka dan juga dalam menyampaikan maklumat kesihatan kepada golongan pekerja asing. Kerajaan juga harus menyediakan asrama khas untuk menempatkan kontak-kontak yang dikesan

Keselamatan kakitangan Kementerian Kesihatan

Rakyat Malaysia amat berhutang budi kepada para doctor, jururawat, paramedik yang lain dan pekerja sokongan hospital yang mendedahkan diri terhadap pesakit-pesakit yang dikenalpasti ataupun disyaki mengidap penyakit coronavirus.

Syor-syor kami:

  • Pastikan mereka dibekalkan dengan alat keselamatan seperti mask dan pakaian perlindungan dalam kuantiti yang mencukupi
  • Adakan sesi perbincangan/kaunseling bersama mereka supaya isu-isu yang merisaukan mereka dapat dibincang dan cara-cara mengatasi isu-isu ini dapat dikenalpasti

Syor-syor kami seperti digariskan di atas memerlukan koordinasi antara beberapa jabatan dan kementerian. Oleh itu adalah amat perlu sebuah jawatankuasa nasional yang melibati Kementerian Kesihatan, Kementerian Dalam Negeri, Kementerian Kebajikan, Kementerian Komunikasi dan Multimedia, Agensi Pengurusan Bencana Negara, Kementerian Pelajaran Tinggi dan Kementerian Kerajaan Tempatan harus ditubuhkan.

Jawatankuasa nasional ini harus dipengerusikan oleh perdana menteri sendiri supaya keputusan segera dapat diambil berkaitan pengendalian wabak coronavirus. Kami juga harap peruntukan yang mencukupi diberi kepada Kementerian Kesihatan dan juga kementerian dan agensi yang lain untuk melaksanakan semua program untuk membanteras wabak coronavirus ini.

English version

Take more measures to curb coronavirus outbreak

We, the signatories of this letter (from the People’s Health Forum to Prime Minister Muhyiddin Yassin), would like to take this opportunity to express our appreciation for the ongoing efforts by the Ministry of Health personnel to combat the outbreak of coronavirus.

The ministry has played a pivotal role in the containment of coronavirus among Malaysians by identifying the cases, tracing and isolating the contacts of those who are infected with the virus, and then treating them.

We, civil society groups, academics, health activists and medical practitioners, have been closely following the development of the coronavirus outbreak in Malaysia and at the international level.

Thus, we would like to suggest a few additional measures which have to be implemented to further strengthen our country’s response in controlling this serious public health threat.

Some of the additional measures are:

Isolation of coronavirus contact cases

We welcome the prime minister’s announcement on 11 March 2020 pertaining to the establishment of the Covid-19 Fund managed by the country’s National Disaster Management Agency to help coronavirus patients and those who have had close contact with these patients.

We hope that these efforts could be further strengthened by:

  • establishing a joint committee with the Health Department, local councils, the National Disaster Management Agency and the Welfare Department in every town and at district level to trace those who have had been in contact with coronavirus patients (through phone calls), identify their needs and send essentials such as food, their regular medication and other essentials for those families who may have not been able to carry out these tasks because their family members are infected with the virus
  • opening temporary boarding facilities to accommodate the contacts of coronavirus patients who may live in a crowded environment such as low-cost flats, where effective isolation could not be done because of limited space and where toilets and bathrooms have to be shared. Sports centres and local college hostels could be temporarily used to accommodate these contacts who may not be able to isolate themselves in their houses. This is important because it can prevent the transmission of the coronavirus
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Movement control order

We support the government’s announcement of a movement control order, which takes effect from 18 March to 31 March 2020. At this stage, this is a very important measure to curb the outbreak of coronavirus among people from all walks of life.

If this measure is not implemented strictly, the transmission of coronavirus will burden the public health system. More resources and personnel will have to be channelled to combat the outbreak, and this will disrupt the ongoing treatment of patients with cancer, HIV and other chronic illnesses.

In conjunction with the prime minister’s announcement of the movement control order dated 16 March 2020, we would like to highlight some grey areas that need to be addressed for the welfare of the people:

a) Daily wage earners, especially women workers working in the service sector such as restaurants and coffee shops, are paid daily and if work are closed, they will not be paid any compensation. Many of them earn a meager incomes and will face difficulties in providing the necessities for their children in the coming two weeks.

b) We also need to consider the situation of factory workers who are paid monthly, those who are working in goods and retails shops and other premises. These groups will be given leave by their employers due to this order and their state of income is very unclear and therefore needs to be clarified. Are they given paid leave or uppaid leave? How about the employers who are facing cash flow issues with no business activity but they will have to pay fixed costs such as rentals and salaries?

c) Many debtors who have mortgages and loans will face difficulty in paying their monthly instalments for March and the coming month due to their losses and decrease in incomes. Their situation will need to be considered, and measures should be taken to alleviate their concerns.

Our suggestions for the above issues:

  • Rationed food for families who are unable to buy their monthly house provisions due to loss of income. A committee at the district level should be established, with the involvement of the Social Welfare Department and NGOs working on welfare issues in the district, to identify families who are facing these problems. An adequate allocation has to be channelled to the Social Welfare Department to carry out this programme
  • Employers with businesses making annual net revenue of RM300, 000 and above should be ordered to pay full salaries for the period of the restriction control order. On the other hand, business owners with smaller net profits should be given some flexibility to pay a half month’s salary for this period. Small and medium-sized banks or other similar monetary institutions should provide a special fund, which could be lent to those business owners facing cashflow problems so that they are able to pay their employees’ salaries. This loan should have low interest rates
  • All the banks should be ordered not to impose any penalties to those who are unable to pay their monthly instalments for these two months. (The loan/mortgage repayment period should be extended for the next two months.)

The above recommendations would represent a critical alleviation for those who are in pressing or dire situations. Besides that, they would also boost aggregate demand in the domestic market, which will eventually lower the probability of a recession or economy crisis.

Managing foreign workers

There are about two million foreign workers and another four million or more undocumented workers.

Currently, many of them have to fork out a hefty sums of money for their diagnosis and treatment in public hospitals and clinics. Therefore, many are reluctant to visit government clinics and hospitals.

A letter from the Ministy of Health’s treasury department secretary dated 29 January 2020 stated that investigative diagnosis and treatment would be free for patients suspected of having coronavirus.

But the letter did not state if the investigative diagnosis and treatment is free of charge for patients suspected of having coronavirus who are then diagnosed as free of coronavirus. The letter stated that “patients who do not show any symptoms will be charged an outpatient rate amounting to RM40 and other incidental charges where applicable”.

Many foreign workers will continue to be reluctant to visit public hospitals if they have to incur high charges for treatment of other conditions (false coronavirus cases). This will undermine our country’s efforts to curb the transmission among Malaysians.

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We recommend a deferral of the implementation of the Treatment Fees for Foreign Workers (2014) for the next six months. It will helpful for now if the treatment fees for the foreign workers is reduced to the same amount as the treatment fees for Malaysia, and this information should be disseminated effectively among the foreign workers.

Besides that, the government will have look into the issue of detention, arrest and filing of charges against those who are classified as undocumented foreign workers and illegal immigrants. Many of them may fear deportation and thus avoid going to government institutions. Those who are coronavirus-positive will not reveal the names and their addresses of their close contacts who may be susceptible to the virus for fear of deportation, arrest and detention. Thus, due to the staggering number of undocumented workers and illegal immigrants (about four 4 million), their fear and reluctance to cooperate will undermine our efforts to curb this outbreak.

Our suggestions:

  • Declare or announce a six-month moratorium on undocumented workers and illegal immigrants. The government should be able to guarantee that they would not be arrested, charged or deported to their origin countries for not having legal or legitimate travel documents for a particular period of time
  • Establish a joint committee with foreign worker communities in order to facilitate the Ministry of Health’s efforts in identifying and tracing the contact cases of coronavirus among these communities. This joint committee should also be responsible for disseminating information pertaining to health services and the coronavirus among the foreign workers. The government should provide accommodation and hostels to place these identified coronavirus contacts

Safety of health personnel

Malaysians are very grateful to all the doctors, nurses, paramedics and hospital auxiliary workers who are in the front lines dealing with identified coronavirus patients or those who are suspected of having coronavirus.

Our recommendations:

  • Ensure they are provided with sufficient personnel protective equipment such as surgical masks, visors, protective clothes (surgical gowns) and gloves
  • Hold regular discussions or counseling sessions with medical workers so they have an avenue to channel their distress and together devise ways on how to overcome their distress and other identified work-related issues

Our recommendations in this letter will require coordinated efforts with other agencies and ministries. Thus, it is vital to establish a national committee that comprises the ministries of health, home affairs, social welfare, communications and multimedia, higher education, and housing and local government as well as the National Disaster Management Agency.

This national committee should be chaired by you (the prime minister) so that immediate responses to related to the management of the coronavirus outbreak can be taken.

We also hope that an adequate allocation is provided to the Ministry of Health and other relevant ministries involved in the implementation of all programmes aimed at curbing the coronavirus outbreak.

The People’s Health Forum

Kumpulan-kumpulan yang mengendorskan memorandum ini:

  1. Agora Society
  2. Aliran
  3. All Women’s Action Society (Awam)
  4. Arts-ED Penang
  5. Bersih 2.0
  6. Beyond Borders Malaysia
  7. Centre for Independent Journalism (CIJ)
  8. Childline Foundation
  9. Citizens’ Health Initiative
  10. Consumers Association of Penang (CAP)
  11. Engage
  12. Federation of Reproductive Health Associations, Malaysia
  13. Foreign Spouses Support Group
  14. Galen Centre for Health and Social Policy
  15. Health Equity Initiatives
  16. Idris Association
  17. In Between Cultura
  18. Institute for Education Development, Social, Religious, and Cultural Studies (Infest)
  19. International Domestic Workers Federation (IDWF)
  20. International Women’s Rights Action Watch Asia Pacific (IWRAW-AP)
  21. Johor Yellow Flame (JYF)
  22. Justice For Sisters
  23. Kryss Network
  24. Labour Law Reform Coalition
  25. Local Unionist Networks (Malaysia)
  26. Majlis Tindakan Ekonomi Melayu
  27. Malaysian Campaign For Equal Citizenship
  28. MyPJ (Persatuan Penduduk Petaling Jaya)
  29. North South Initiative
  30. Our Journey
  31. Parti Sosialis Malaysia
  32. Penang Forum
  33. Penang Heritage Trust
  34. Penang Hills Watch
  35. Penang Stop Trafficking Campaign
  36. Peoples Like Us Support Ourselves (PLUsos)
  37. Persatuan Komuniti Prihatin Selangor dan KL
  38. Persatuan Penduduk Galing Besar Kuantan
  39. Persatuan Sahabat Wanita Selangor (PSWS)
  40. Persekutuan Persatuan-Persatuan Lembaga Pengurus Sekolah Cina Malaysia (Dong Zong)
  41. Pertubuhan Ikram Malaysia
  42. Pertubuhan Solidariti Hijau Kuantan
  43. Pertubuhan Wanita Malaysia untuk Kawalan Tembakau & Kesihatan (MyWatch)
  44. Positive Malaysian Treatment Access & Advocacy Group (MTAAG+)
  45. Pusat Komas
  46. Sahabat Alam Malaysia
  47. Save Malaysia Stop Lynas
  48. Saya Anak Bangsa Malaysia
  49. Suara Rakyat Malaysia (Suaram)
  50. Tanjung Bungah Residents Association (TBRA)
  51. Third World Network
  52. Toy Libraries Malaysia
  53. Women’s Aid Organisation (WAO)
  54. Women’s Centre for Change (WCC)

Individu-individu yang mengendorskan memorandum ini:

  1. Abel Benjamin Lim
  2. Andrew Filmer
  3. Assoc Prof Dr Aini Hamid
  4. Andrew Khoo
  5. S Arutchelvam
  6. Chee Yoke Ling
  7. Chan Yit Fei
  8. Charis Loke
  9. Dr Chee Heng Leng
  10. Chen Yoke Pin
  11. Chia Kien Eng
  12. Choong Tet Sieu
  13. Chow Chee Keong
  14. Chris Lowe
  15. Dr Chua Hang Kuen
  16. Foo Wei Meng
  17. Dr Jane Cardosa
  18. Janet Pillai
  19. Dr Jeyakumar Devaraj
  20. Dr Kam Suan Pheng
  21. Karen Lai
  22. Khoo Ai Wah
  23. Prof Khoo Boo Teik
  24. Dr Khoo Teng Jian
  25. Dr Khoo Teng Xiang
  26. Kuppamal Ramasamy
  27. Lee Chin Ark
  28. Lee Khek Mui
  29. Lee-Lim Ai Ping
  30. Lew Chee Leng
  31. Dr Lim Chee Han
  32. Lim Kah Cheng
  33. Lim Poh Im
  34. Loo Que Lin
  35. Low Swee Heong
  36. Dr Lynnie Lim
  37. Dr Mohd Nasir
  38. Mok Yim Paik
  39. Ng Fun Boon
  40. Norhidayah Nadila Maulad Daud
  41. Dr Peter Gan Kim Soon
  42. Prema Devaraj
  43. Dr Rajadorai Natarajah
  44. Radziah Othuman Sahib
  45. Roslin Ludiin
  46. Sathesh Raj
  47. Shanthi Dairam
  48. Sharon Khoo
  49. A Sivarajan
  50. Dr Sharuna Verghis
  51. Sherley Tan
  52. Soh Sook Hwa
  53. Stefan Dawson
  54. Syed Mohamed Shahruddin
  55. Tan Pek Leng
  56. Dr Toh Kin Woon
  57. Dr Vivian Lee
  58. Prof Wong Chin Huat
  59. Wong Hoy Cheong
  60. Wong Sau Ngan
  61. Yap Heng Lung
  62. Yatie Jonet
  63. Yeap Jin Soo
  64. Yee Pey Cheng
  65. Zi Qing Low
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