Questions/Answers
Question 1
Please provide a brief summary of the initiative including the problems/challenges it addressed and the solutions that the initiative introduced (300 words maximum)
Ulu Baram (Upriver Baram), a remote area of northern Sarawak, is residence of the Orang Ulu (Upriver People), a collective name that includes the Penan , Kayan, Kenyah, Saban, Punan and Kelabit. Covered by rugged and lush forest, the major economic activities in Ulu Baram include loggings and plantation estates.
Provision of healthcare has been challenging due to difficult terrain and scattered population. Accessibility to that area is served by ungazetted logging roads. Primary healthcare is provided by nearby government clinics and flying doctor service under the public health programme.
A free healthcare service was initiated in 2009 by a private company which has its operational site within the area in Ulu Baram. It is started with the aim to complement the existing healthcare services. It started as small scale project, including the participation of several government agencies and other interested parties. The campaign has managed to attract more than 1,000 nearby villagers to seek free healthcare every year.
Miri hospital has been involved in this project since 2011. Staff from various specialties of the hospital had volunteered to participate in this outreach programme which provide extended healthcare services which were not accessible to the villagers. This collaboration between Miri Hospital and various agencies had managed to provide rare specialized healthcare services to the indigenous people.
It is one of the most well coordinated medical outreach campaign jointly organized and participated by multiple interested parties in the region.
a. What are the overall objectives of the initiative?
Please describe the overall objectives of the initiative (200 words maximum)
1. To provide free healthcare services to the rural community with limited access to medical care due to distance and cost incurred.
2. To complement the existing healthcare service.
3. To provide more specialized healthcare service to the rural population.
4. To allow hospital staff to contribute Corporate Social Responsibility to the community
5. To provide opportunity for hospital doctors, especially the junior doctors, to experience healthcare provision at rural setting and to appreciate the logistics challenge of rural people to access to healthcare.
b. How does the initiative fit within the selected category?
Please describe how the initiative is linked to the criteria of the category (200 words maximum)
Sustainable Development Goal No 3 aims to provide Good Health and Well Being to the people. Through partnership and collaboration with various government agencies and private sectors, various healthcare services were made available to the Ulu Baram community. The programme had managed to target various diseases plaguing the rural people spanning from infectious to non infectious diseases. During each campaign, many preventive, curative and rehabilitative activities were carried out by the hospital volunteers from different disciplines.
The provision of these healthcare services had its objective in tandem with SDG goal which will directly improve the health and well being of various indigenous community residing within this area.
Question 2
The initiative should improve people’s lives, notably by enhancing the contribution of public services to the implementation of the 2030 Agenda for Sustainable Development and the realization of the SDGs
a. Please explain how the initiative improves the delivery of public services (200 words maximum)
Miri Hospital, a public hospital is the only referral hospital for northern Sarawak. However, the specialised services could hardly reach the indigenous population due to distance and logistic challenges.The journey from Ulu Baram to Hospital Miri will take approximately 4 to 6 hours by road. This outreach programme brings the hospital services closer to the local community. The outreach project is also participated by public health teams and dental team from Miri division. These services include medical and general health screening, opthalmology and otorhinolaryngology screening, psychological assessment , gynaecology screening , infectious disease and vector screening, maternal and child health service, orthopaedic assessment, dental care, minor surgical service, physiotherapy and pharmacological service. Delivered through a focal One-Stop concept, the free healthcare services will provide the rural communities with higher standard of healthcare.
In addition, there are other government agencies involvement in addressing the social welfare issues affecting the rural villagers.
Question 3
The initiative must impact positively a group or groups of the population (i.e. children, women, elderly, people with disability, etc) and address a significant issue of public service delivery within the context of a given country or region.
a. Please explain how the initiative has addressed a significant issue related to the delivery of public services (200 words maximum)
The outreach project aims to provide healthcare services which cater the whole spectrum of age groups in a family. .Due to the extensive involvement of various specialized medical services in this outreach program, the project will cater for preventive aspect of communicable and non communicable disease and the treatment. Oral health assessment were also being offered during the 3 days programme.
Such extensive arrangement of diverse health services have allowed the carnival to attract over 1000 participants each year.
b. Please explain how the initiative has impacted positively a group or groups of the population within the context of your country or region (200 words maximum)
In Malaysia, essential health services is provided by a comprehensive public health network and is available to all who need them. However, the specialized healthcare services are normally available in the urban setting and may not be readily accessible to the rural population. In order to ensure a justified universal health coverage for all, the health system needs to address the accessibility and affordability issues affecting especially to the rural and indigenous community.
This medical outreach program has set to to overcome some of the challenges by bringing more specialized medical services to the groups where of community residing around the Ulu Baram region.
Question 4
The initiative must present an innovative idea, a distinctively new approach, or a unique policy or approach implemented in order to realize the SDGs in the context of a given country or region.
a. Please explain in which way the initiative is innovative in the context of your country or region (200 words maximum)
This Ulu Baram medical outreach campaign is a private sector, established locally, utilizing Blue Ocean Strategy to provide an extended and more efficient healthcare delivery to the Ulu Baram community. Through the participation of multiple government agencies especially the public health sectors and non governmental Organizations, the approach is exceptionally unique in its own way.
In order to ensure continuity of services without interruption, the operation site has also erected a permanent structure to serve as clinical operational area.
The organizer has also provided incentives for the villagers to mobilize the local transports.
The outreach programme is also supported by the participation of political leaders during the official ceremony.
Question 4b
b. Please describe if the innovation is original or if it is an adaptation from other contexts (If it is known)? (200 words maximum)
While there were many smaller scale medical outreach projects done previously in various part of the region, activities of such magnitude with the involvement of multiple government agencies and civil society is uncommon. As a private sector initiated medical campaign, assisted by various government agencies, addressing the healthcare needs of the indigenous people, this model is a relatively new approach.
Question 4c
c. What resources (i.e. financial, human , material or other resources, etc) were used to implement the initiative? (200 words maximum)
1. Logistics requirement
Vehicles such buses and 4WD vehicles are used to transfer villagers and staff from health agencies to Ulu Baram
Transportation of medical and dental equipment is done using military trucks.
2. Human resources
On average, 70 staffs from various medical and dental department participated in each event.
There are other non medical volunteers such as cooks, barbers.
3. Material
Medication, pap smear kits, dental equipment, health promotional material, screening devices, consumables e.g needles, branulas, cotton.
4. Food & accomodation
These are prepared by the private sector at the operational site.
5. Publicity
Radio announcement is the tool to disseminate the information to various nearby communities.
6. Financial
Private sector is the main funding contributor.
Question 5
The initiative should be adaptable to other contexts (e.g. other cities, countries or regions). There may already be evidence that it has inspired similar innovations in other public-sector institutions within a given country, region or at the global level.
a. Has the initiative been transferred to other contexts?
Yes
Smaller scale medical outreach programme through partnership with various private and public sectors are conducted in various places in the country.
Question 6
The initiative should be able to be sustained over a significant period of time.
a. Please describe whether and how the initiative is sustainable (covering the social, economic and environmental aspects) (300 words maximum)
This outreach programme has been carried out annually over the last 6 years. The main factor contributing to the success of this programme is the commitment and dedication from the private sector in providing the financial and logistic support which are the biggest challenges in providing such a big scale projects. . The strategic location of the campaign site enable the nearby communities to access the programme relatively easier.
Permanent makeover clinical rooms were also being set up to allow repeated campaigns being carried out.
b. Please describe whether and how the initiative is sustainable in terms of durability in time (300 words maximum)
The programme is sustaining largely due to establishment of economic activities of the private sector in that area. As most of the workforce were sourced locally, a healthy community will naturally translate to a healthy workforce. Therefore, this initiative will benefit different stakeholders which ensure long term sustainability.
Question 7
The initiative should have gone through a formal evaluation, showing some evidence of impact on improving people’s lives.
a. Has the initiative been formally evaluated?
No
Question 8
The initiative must demonstrate that it has engaged various actors such as from other institutions, civil society, or the private sector, when possible.
a. The 2030 Development Agenda puts emphasis on collaboration, engagement, coordination, partnerships, and inclusion. Please describe what stakeholders were engaged in designing, implementing and evaluating the initiative. Please also highlight their roles and contributions (300 words maximum)
Ulu Baram Outreach program is a project initiated by private sector and partnered with different stakeholders from public institutions and other civil societies. The roles which are contributed by various institutions are illustrated below:
1. Military department - handling the logistic needs of various agencies and to transport medical equipment to the outreach site.
2. Miri Hospital - offered specialized health care services to the Ulu Baram community.
3. Public Health Department -- provide various health screening programme covering both communicable and non communicable diseases.
4. Oral Health Department -- provide free dental care programme to the local community.
5. National Registry Department -- offer consultation and services on citizenship.
6. Labour Department - offer and promote social welfare programme to the local community
7. Civil Society such as Yaw Teck Seng foundation -- contributing the free reading glasses, surgery cost and transportation cost for those requiring further treatment in the hospital.
Question 9
a. Please describe the key lessons learned, and any view you have on how to further improve the initiative (200 words maximum)
Rural Medical Outreach Programme requires collaboration and commitment from various agencies and staeholders.
Initiation of such health programme led by the private sector is an alternative model of organizing health campaign compared to the traditional approach normally organized by public sector. Leadership and commitment from the private sector are critical success factors.
To strengthen such initiatives in the future, a formal evaluation of the initiative is required to gauge its effectiveness in addressing the Sustainable Development Goals. Involvement of academic institution in this aspect is desirable.
As the cost for organizing such a campaign is substantial, the involvement of more private sectors or civil societies may allow better cost sharing.
Finally, with the involvement of political leaders in each campaign, various health determining factors can be relayed more directly to the policy makers which will catalyze the development of that area in the future.