SOCIOECONOMIC CHANGES, HEALTH AND ILLNESS IN MALAYSIA

by Dr PHUA Kai Lit
School of Medicine and Health Sciences
Monash University Sunway Campus
Bandar Sunway, Malaysia

LECTURE: SOCIOECONOMIC CHANGES, HEALTH AND ILLNESS IN MALAYSIA

Recent social and economic changes in Malaysia:

(1) Economic changes

Industralisation and appearance of new industries

(2) Social changes

Migration and urbanisation of Malaysians
Female participation in labour force
Marginalisation of Orang Asli and estate workers
Foreign workers (legal and illegal)

Industralisation

Through encouragement of foreign investment
Has transformed Malaysian economy from an agricultural/mining economy to an industrial economy
Has increased GNP per capita (Gross National Product)

Has also created new health problems:
Occupational injuries
Occupational diseases
Environmental pollution - air, water, solid waste, hazardous waste etc

QUESTION: What are the environmental health and occupational health impacts of new industries such as petroleum/petrochemicals, electronics, textiles, automobile manufacturing and of old industries such as oil palm?

Environmental and occupational health laws may be:
Inadequate
Not properly enforced
Violated because of ignorance
Deliberately violated by factory owners and managers to save money

Remember that workers in SMIs (Small and medium-sized industries are most at risk

Social Changes

Migration and urbanisation of Malaysians - people move from the rural areas and small towns to urban areas for education and (primarily) for jobs
Rapid urbanisation can lead to problems such as overcrowding and appearance of slums and squatter areas

Female participation in the labour force - what are the possible health consequences? For example, exposure to radiation from VDTs (video display terminals) and miscarriages, electronics assembly work using microscopes and eyesight deterioration, etc.

Marginalisation of Orang Asli and estate workers - conversion of jungle and agricultural land to industrial land, housing projects etc can lead to loss of livelihood and homes for Orang Asli and estate workers (rubber, oil palm estates).
When the displaced people migrate to the cities, they can end up in poverty and live in slum areas. Resulting social problems - unemployment and underemployment, alcoholism, drug abuse, crime and violence

Foreign workers (legal and illegal) - rapid economic growth has attracted foreign workers into Malaysia. Foreign workers (especially the illegal ones) are often poorly paid, live in slum housing and are exposed to dangerous working conditions. Maids can be overworked and be physically abused. Foreign workers may bring in diseases which are under control in Malaysia such as filariasis.

Why slum housing (called "squatter areas" in Malaysia) affects health adversely:
Lack of clean water, poor sanitation (disposal of human wastes, rubbish), built in undesirable areas such as steep hillslopes & flood-prone areas, poor drainage of stormwater, blocked sewers and drains.
Health risks from:
Neglect by authorities (Government may view squatters as a "nuisance" and deliberately ignore them. It may be difficult to provide squatter areas built on steep hillslopes with services.
Accumulation of rubbish
Contamination of environment by human waste
Vector breeding
Dangers from flashfloods, landslides etc
Inadequate water supply - quality and quantity are lacking. People may have to queue up for water at wells and standpipes. May have to carry the water for long distances to get home. People may even have to buy water at high prices from water vendors.