Malaysia

With its prosperous economy, Malaysia attracts high numbers of laborers from poorer countries in Southeast Asia. Many of them come from Indonesia and the Philippines and a large number stay in Malaysia without legal status. A specific group within this population is those who have fled violence and persecution in Aceh, Indonesia and Myanmar. They cannot be granted refugee status in the country, as Malaysia is not a signatory to the international refugee convention. This has major consequences for their acceptance in society and for obtaining essential services, including medical care. Accessing healthcare is problematic for all migrants, who find it difficult to pay the higher fees required of foreigners, even in the public health system. Refugees have even more difficulty, as health staff in public and private facilities have a legal obligation to report undocumented patients to the authorities.

MSF started working in Malaysia in 2004, supporting a Malaysian non-governmental organization (NGO) in providing mobile clinics for refugees in and around Kuala Lumpur, setting up a system for referral to hospitals, and introducing mental health activities for the often traumatised refugees. Depression, anxiety-related disorders, thoughts of suicide and post-traumatic stress disorder are widespread.

The work has expanded to support this NGO in its medical work in detention centers, where arrested undocumented migrants are held, and at improvised settlements in the forests near major construction sites. The main disorders seen are upper respiratory tract infections, skin infections and gastritis, related to poor living conditions and psychological stress. MSF has supported the national NGO in medical and mental health services, offered weekly in three locations, to migrants living among the general population of Kuala Lumpur. The number of daily consultations averages between 80 and 100 per location. MSF is also establishing a network of Malaysian doctors and psychologists who volunteer some of their time to provide care to undocumented migrants.

MSF has worked in Malaysia since 2004.

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