A medical assistant testifying at the Human Rights Commission of Malaysia (Suhakam) public inquiry into alleged human rights violations at Taiping Prison on Jan 17 said there is a need to increase the number of medical staff serving at the facility, as the current numbers were insufficient.
Muhammad Fadhil Mohamad Yusoff said the existing medical staff – comprising one doctor, two medical assistants, three medical orderlies, and one assistant pharmacist – was inadequate to serve the approximately 1,200 detainees at the prison.
The 28-year-old, who has been attached to Taiping Prison for eight months, told inquiry panel chairman Datuk Seri Mohd Hishamudin Md Yunus that while one doctor could serve 1,200 detainees, it would be better to have more medical personnel.
Hishamudin: If the doctor is on leave or medical leave, who replaces the doctor?
Muhammad Fadhil: Medical assistants.
Hishamudin: There will not be a relief doctor from nearby hospitals sent to the facility?
Muhammad Fadhil: No.
Hishamudin: Is the current number of medical assistants at the prison enough?
Muhammad Fadhil: No, we need at least three medical assistants.
Hishamudin: What about pharmacists?
Muhammad Fadhil: We need at least two, as medication supplies have to be packed individually for prisoners. Medication must be given according to dosage. We do not want prisoners overdosing or being given containers (usually for larger doses) which could be used as weapons. The pharmacist’s table at Taiping Prison is filled with medication, and the pharmacist spends the whole day packing it.
Hishamudin: Isn’t medication given based on a prescription?
Muhammad Fadhil: Yes.
Hishamudin: So what happens when the doctor is on leave?
Muhammad Fadhil: Medical assistants administer what we can. If we cannot prescribe certain medication, we refer the matter to the hospital’s emergency department.
Muhammad Fadhil said the Health Ministry had conducted two or three visits to the prison during his eight months at the facility. Audits would be conducted at the prison’s clinic, including checking its equipment. However, if there were shortages, it fell under the purview of the Home Ministry and not the Health Ministry.
During the inquiry, Muhammad Fadhil confirmed that 62-year-old detainee Gan Chin Eng had died on Jan 17. He said Gan was involved in what he described as a “riot” at the prison. Twentytwo13 had previously reported that Gan allegedly died from an abdominal injury caused by blunt trauma.
“I received a call (on Jan 17) from Taiping Hospital doctor, Dr Navin (Esavik) after Asar prayers, informing me there was an emergency. When I arrived, two Chinese inmates at the main entrance said Gan had fallen down,” Muhammad Fadhil told Suhakam’s assisting inquiry officer, Simon Karunagaram.
Simon: You had just finished prayers outside prison grounds, correct?
Muhammad Fadhil: Yes. When I arrived, Gan was already at the main entrance.
Simon: Who else was with you, and what was Gan’s condition?
Muhammad Fadhil: The two Chinese inmates and Dr Navin were present. Gan was lying down.
Simon: Did Gan have any injuries?
Muhammad Fadhil: Nothing obvious, but there was a wound on his finger.
Simon: Did you administer any treatment?
Muhammad Fadhil: No. I checked his vital signs, including his blood pressure. His SPO2 (oxygen saturation) was normal.
Simon: Did the two other detainees say anything?
Muhammad Fadhil: They acted as translators. They said Gan felt chest pains. I heard them telling this to the doctor.
Simon: Did you ask Gan how he fell?
Muhammad Fadhil: No.
Simon: What did you do after checking Gan’s vital signs?
Muhammad Fadhil: I passed the results to the doctor.
Simon: There was no need to administer CPR?
Muhammad Fadhil: No.
Muhammad Fadhil said Dr Navin requested an ambulance for Gan, but since a van belonging to the prison department was available, it was used to send him to Taiping Hospital. The van left at 6.18pm, and as the hospital was nearby, Gan would have arrived before 6.30pm.
Simon: Is it normal for people with vital signs to die within half an hour?
Muhammad Fadhil: It depends if there are injuries.
Muhammad Fadhil said he was later made to understand that Gan had died from blunt force trauma, which to his knowledge meant extreme force had been used.
He also said Gan had two medical cards that stated a history of hypertension, diabetes, high cholesterol and heart-related issues. The details, however, were not written by him but by Dr Navin.
Simon: How would the doctor know such information?
Muhammad Fadhil: I am not sure, maybe the two detainees had informed him.
Simon: Is an SPO2 of 90 normal?
Muhammad Fadhil: Not normal.
Simon: So you are saying the doctor’s record is wrong?
Muhammad Fadhil: I do not know why the doctor recorded it as 90. When I checked earlier, it was above 95. I had conveyed this verbally to the doctor.
Simon: How would you act if given unethical instructions, for example, to change information on a detainee’s medical card?
Muhammad Fadhil: I would not do it.
Later, Muhammad Fadhil told lawyer T. Shashi Devan that detainees requiring treatment had to be brought to the prison clinic, as there were no SOPs allowing medical personnel to rush to the blocks to administer treatment. Shashi represents some 99 families of Taiping Prison detainees, including Gan.
Shashi: So if someone has a heart attack, he has to be brought to the clinic?
Muhammad Fadhil: Yes.
Shashi: Each prison block is supposed to have a stretcher?
Muhammad Fadhil: Yes, but I cannot remember which blocks had them.
Shashi: So what happens if there is no stretcher at a block?
Muhammad Fadhil: It will be brought from the nearest block.
Shashi: Who carries detainees on a stretcher to the clinic?
Muhammad Fadhil: I do not know.
Shashi: Is it normal, according to SOPs, for prisoners to bring fellow prisoners to the clinic on their own?
Muhammad Fadhil: No. Usually block wardens bring them.
Shashi: Is it normal for detainees to be taken directly to the main entrance?
Muhammad Fadhil: By right, they should first be brought to the prison clinic.
Shashi: Is it normal for Taiping Prison to use its van to send detainees to hospital?
Muhammad Fadhil: Yes.
Shashi: As medical personnel, what are your views on using the van?
Muhammad Fadhil: Since Taiping Hospital is not far, it is acceptable in some cases, as it saves time. Using the van also allows escorts, which are not permitted in an ambulance.
Shashi: If there were an emergency, should the prison’s van be used?
Muhammad Fadhil: No.
Shashi: There is no medical equipment in the van, correct?
Muhammad Fadhil: Correct.
Shashi: The last Health Ministry audit – did they check if the van was used for hospital transfers?
Muhammad Fadhil: No. They only checked drugs, equipment and the management of infectious diseases.
Muhammad Fadhil also said it was cumbersome to contact hospitals as medical assistants were not allowed to bring in mobile phones. He had to go through the prison operator, which was tedious, especially when hospital calls went unanswered. He suggested medical personnel be provided with mobile phones to contact hospitals directly during emergencies.
He added that Dr Navin had on Jan 17 contacted Taiping Hospital, informing them of a “mass casualty incident” at Taiping Prison to ensure readiness.
“The call was made before Gan reached the main entrance. The hospital had prepared a cubicle for detainees,” he said.
The Suhakam inquiry, at its headquarters in Kuala Lumpur, continues.
