A two-year-old child passed away in Miri Hospital, Sarawak, from diphtheria in March 2018. An investigation by the Ministry of Health (MOH) Malaysia revealed that the parents chose to not have her immunised against diphtheria due to concerns about the halal nature of vaccine.
According to the MOH, there were 32 cases of diphtheria – including seven deaths – reported throughout the country last year. Out of those cases, 75% were unvaccinated, most of them children.
Health Director-General Datuk Dr Noor Hisham Abdullah advised that children should be administered with the ‘five-in-one’ injection at two, three and five months, including a booster at 18 months.
Vaccines are Halal
The technical committee chairman of vaccine advocacy programme Immunise4Life, Datuk Dr Zulkifli Ismail, said the anti-vaccine sentiment has created confusion and distrust towards vaccination. “There is nothing in Islam or any other religion that says you cannot give vaccinations to children. The only reason we are seeing diphtheria cases is not because vaccine has failed, but because parents do not want their children to take the vaccine.”
The MOH urged Muslim parents to not doubt the halal status of vaccines.
The National Fatwa Council has also issued a statement that vaccines provided by the government are all halal. Health Deputy Minister Datuk Seri Dr Hilmi Yahaya advised Muslim parents to trust the data provided by experts instead of false information circulated on social media.
“In Malaysia, there is only one vaccine which contains porcine DNA – the rotavirus vaccine. The government does not buy this vaccine. It is only available in private clinics to treat severe diarrhoea,” he added.
Dr Zulkifli encouraged the use of reliable resources to retrieve information on immunisation, such as Immunise4Life website (www.ifl.my) and MYVaksinBaby app.
A study by the World Health Organization (WHO) in 2013 revealed that almost 40% of all murdered women were killed by their intimate partners, and 42% of women who have experienced physical or sexual violence at the hands of a partner had suffered some form of visible injuries. MIMS Today met with Tan Heang-Lee, the Communications Officer of Women’s Aid Organization (WAO), to talk about the organization and how healthcare professionals (HCPs) play an important role in identifying domestic violence
1. Could you share with us the type of services provided by WAO?
We are a local organization that has been operating for about 35 years. We provide services related to gender-based violence, which includes domestic violence, sexual assault, rape, abuse of migrant domestic worker, trafficking, etc. We are the largest service provider for domestic violence survivors in Malaysia.
Domestic violence covers the entire spectrum of violence, comprising physical, emotional, psychological, sexual and even financial abuse. There’s social isolation and our clients usually have been forced to sever ties with family and friends, and they are completely alone. Our social workers assist clients to access the services provided by various government agencies, such as the police, hospitals, welfare department, the courts, etc. Apart from that, our social workers provide emotional and psychosocial support and educate our clients about their rights.
In terms of advocacy, we strive to improve law and policies, and their implementation and enforcement. We also work to shift the public’s mindset and behaviour towards recognizing women’s rights.
2. How do you liaise with government agencies?
We work very closely with the police,hospitals and welfare department. The One Stop Crisis Centre (OSCC) is located at the emergency departments of government hospitals, and it is where survivors of gender-based violence can obtain comprehensive services. When facing difficulties, survivors of domestic violence can lodge a police report there and get the necessary medical attention and support.
Hospitals are actually the first place that many women go to following domestic violence. It makes sense because hospitals feel like a safe place. Doctors and nurses are generally very friendly, they genuinely care and patients trust them.
3. What would be a typical scenario that you deal with?
I don’t think there really is a typical scenario. However, when survivors interact with a healthcare professional, it’s common for survivors to not disclose that they are being abused. If they are injured, they may say that they had fallen, but their injury does not match that of a fall and the perpetrator is usually reluctant to be separated from the victim.
If an injured woman comes in with a potential perpetrator, there’s a dynamic there and doctors need to be attentive. If doctors suspect something amiss behind an injury, they should try to ask if the woman would like to talk to them in private, or they could ask the suspected perpetrator to leave the room for a while.
4. Where do these survivors of domestic violence go after they are discharged from the hospital?
We do have a safe-house, a temporary shelter at a secure location for survivors of gender-based violence. Apart from providing the much-needed necessities, we also have empowerment programmes such as creative writing classes to help our clients express and process their emotions by having them write about their feelings. We also try to conduct programmes to enhance their skills so that they will slowly become more confident and independent as time goes by. These programmes include workshops on job interview skills, financial literacy, economic empowerment, and so on.
Generally, our clients can stay up to 3 months but it really depends on the case. A majority of our clients stay for a few weeks to clear their minds and calm themselves after their initial traumatic experience. We also have a Child Care Centre, so domestic violence survivors can obtain child care as they begin to rebuild their lives and get back on their feet.
5. What is the most important thing that healthcare professionals should know about domestic violence?
Firstly, it’s recognizing the dynamics of domestic violence. As mentioned earlier, domestic violence covers the whole spectrum of abuse. As such, when a doctor suspects that something is not right, try to talk to the patient in private or note down their concern in a medical report for proper documentation. Domestic violence is usually a cycle, so being attentive is important. A study by WHO in 2013 revealed that almost 40% of all murdered women were killed by their intimate partners.
Even when there is no physical abuse, survivors of domestic violence could be facing other forms of abuse, such as being stalked, receiving threats, or being isolated socially. Healthcare professionals thus need to be alert. If a patient is experiencing domestic violence, healthcare professionals can share with patients the WAO Hotline number: 03 7956 3488 and the WAO SMS/WhatsApp line: 018 988 8058.
The One Stop Crisis Centre also has guidelines on how to handle domestic violence cases. The OSCC guidelines are readily available online and in hospitals.
Tan Heang-Lee, 27 Jun 2018 Communications Officer Women’s Aid Organization (WAO)