The Lens: Malaysia’s nurse exodus is a wake-up call for healthcare reform

Malaysian nurses have been flocking to other countries for higher pay and better working conditions. Fewer nurses could worsen public health and lead to a decline in critical healthcare services such as maternal, senior and emergency care.

The loss of experienced nurses also reduces opportunities for mentorship and training new nurses, weakening the pipeline of future healthcare workers. Thanks to the influence of social media and the motto “you only live once”, more nurses in training will be tempted to move abroad.

A drop in Malaysia’s nurse-to-patient ratio will cause service quality to drop and increase the likelihood of errors.

Nevertheless, there are ways Malaysia can incentivise nurses to stay. The most obvious resolution is to increase salaries by aligning them with international standards. This could mean more government spending and taxes.

Another solution would be investing in modern equipment and improving working conditions so nurses could be well-rested.

As a long-term solution, the government can offer subsidies for furthering education and specialised training programmes to enhance job satisfaction. The last option would be the most appropriate, as Malaysia could keep nurses working locally and strengthen the field by having more educated workers.

I think this “exodus” can serve as a wake-up call for policymakers to understand the gravity of the situation and prioritise healthcare reform in the national agenda.

In addition, the growing dissatisfaction among nurses demands reform. Malaysia’s healthcare budget and economic constraints would limit immediate, substantial improvements in wages and working conditions. In this situation, the departure of nurses may continue, leading to further strain.

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The outlying island of Pulau Ubin, a rare rural spot in Singapore, is a treasure trove of biodiversity and home to wetlands.

“Life on the mainland doesn’t feel natural,” said 79-year-old Chu Yok Choon, one of 30 people living on the tiny island.

When he visited the city, Chu said he had to wait until the ferry filled up with 12 passengers paying S$4 (HK$23) each, which is comparable to Singapore’s efficient public transport. If he was in a hurry, he could pay S$48 (HK$277) for the entire boat.

Despite the lack of transport to the Singaporean mainland, residents are drawn to the island by a lifestyle that contrasts with the busy conditions in the city.

With the island’s youngest inhabitants in their 50s, conservation experts worry about its future, as no one can move there from the city. In 2001, the government said the island was safe from changes until they were required for development.

In its heyday, almost 4,000 people lived on the island, working in granite quarries and plantations. Many moved to the city after the largest quarry closed in 1970.

Singapore authorities have celebrated “Ubin Day” each June for the last nine years to foster appreciation for the island’s heritage, the National Parks Board said on its website.

The government shelved a 1991 plan to extend the subway there. Now, it talks about conserving the island, but there will come a day when it will have no residents.

Koh Bee Choo, 54, who lives in a wooden stilt house that juts over the waves, said she hoped authorities would allow more people to stay in guest houses on the island. “Not the high-end ones but the kampong-type,” she added, using the Malay term for a village.

“If this place becomes like Sentosa, then that’s the end,” said Lim Csye See, 69, referring to Singapore’s theme park island crowded with luxury hotels, condominiums and a marina.

Research and respond

• In what ways has the island of Pulau Ubin changed over the last 50 years? How will it continue to change?

• What measures do you think authorities in Singapore should take with the island? Should they focus on conservation or development?