Malaysia

Village Health Promoters bringing care to rural communities in Malaysia

© UNICEF Malaysia/2005/Jothiratnam

A Village Health Promoter checking a woman’s blood sugar level in Sarawak, Malaysia.

By Lydia Lubon

SARAWAK, Malaysia, 26 May 2006 – Rudy anak Dugu, 9, experiences life as most boys his age do: He goes to school, enjoys sports and does his chores. But unlike most other young boys in Malaysia, if Rudy gets sick, he may have to travel an hour or more for help.

Together with his mother Umba, father Dugu and elder brother Harry, Rudy lives in a longhouse deep in the heart of Sarawak’s primary rainforests, along the banks of the great Rejang River. Their nearest health facility is in the bustling town of Kapit, at least an hour away by speedboat.

While 90 per cent of people in Malaysia today live within easy reach of a health facility, Rudy and his family fall into the remaining 10 per cent who – until recently – have been excluded from many of the material benefits of the modern world, simply because of the remoteness of their homes.

Access to medical care

But efforts such as the Village Health Promoters (VHP) programme, launched by the Malaysian Government in 1981, has helped bring basic medical services to Rudy and others living in remote parts of the country.

© UNICEF Malaysia/2005/Jothiratnam

Laila Chamam, 21, gets a check-up with the Village Health Promoter while her daughter Karisa, 2, looks on.

Using the principle of community participation, this Ministry of Health initiative engages qualified instructors to train volunteers – who are appointed by their own longhouse community members – in general health knowledge, first aid and simple care and treatment. 

Fletcher Siner anak Sipeng, one of the very first VHP trainers, recalls the beginning of the programme. “It was tough going, especially in the early days,” he says, “but somehow we managed to recruit and train some VHPs. Slowly, word about it spread, and soon the scheme really took off and became a success.”

Rudy’s mother Mba anak Kujat, 27, is a strong advocate of the VHP project. “When I was a child, my parents had a lot of difficulty obtaining medicines for me and my brothers and sisters,” she notes. “Often, they didn’t know what medicines to buy or use. In fact, a few people I know lost family members because they had no proper health care. Sadly, most of them were women and young children.”

Remarkable progress on health

At the Ministry of Health, the Director of the Family Health Division, Dr. Narimah Awin, adds that “the VHPs, in effect, are internal agents for change, serving to motivate, organize and mobilize their own communities. Since they come from within the communities themselves, they serve as ideal, trusted entry points to build partnerships and to encourage the communities to take responsibility for their own health and well-being.”

Today, there are more than 2,500 trained and dedicated VHPs currently in service to their communities. According to the Ministry of Health, the VHP programme reaches nearly 2,000 villages in the state of Sarawak, benefiting over 300,000 people.

“Malaysia has made remarkable progress for its women and children,” says UNICEF Representative in Malaysia Gaye Phillips. “It’s under-five child mortality rate and maternal mortality rate are among the lowest in the world. It has reached out to its women and children, whether in urban areas or remote rural areas. The Village Health Promoters scheme has been part of that success story.”

Often beyond the sight and reach of laws, budgets and government programmes, remote communities are among the most difficult to reach. But effective interventions, such as the VHP programme, make it possible for health services to stretch far beyond clinics and hospital wards, reaching women and children deep in the interior of Sarawak.