- 5 months ago
What does a country’s health system say about its deepest values? In this powerful episode of Life Confessions, we sit down with Dr Rabindra Abeyasinghe, WHO Representative to Malaysia, Brunei, and Singapore, to explore the human side of global health leadership.
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00:00is the choice between life and death.
00:02The shortage of resources, we are not looking for publicity.
00:06Our priority is how many lives did we save by circumventing or preventing a situation.
00:13Fundamentally, I'm a doctor.
00:15I work from the perspective that life is precious.
00:19Malaysia has been the poster child for health in the region.
00:23I'm saying has been previously.
00:26Okay.
00:26It means that you have to make choices.
00:30Those choices result in some people losing their lives.
00:34And that is a terrible dilemma that you have to face as a doctor.
00:46Welcome back to another episode of Life Confessions.
00:49Amazing guests join us.
00:50We find out more about what they do as well as who they are.
00:54And today with us is a representative of World Health Organization for Brunei, Malaysia and Singapore.
01:00We have with us Dr. Rabindra Abiasinger.
01:03And thank you for joining us today, Dr. Rabi.
01:06Thank you, Terry.
01:07This is really appreciated.
01:08Thank you for making time and thank you for inviting me.
01:10Absolutely.
01:11There's so much to find out about what you do.
01:13And also you as a person as well.
01:16Now, let's start with the man.
01:18Do you remember the first time you stepped into a community as a young doctor or health officer?
01:25What struck you most in that moment?
01:27And how did it maybe shape your purpose in those early days?
01:32Well, the point is that I am still young.
01:34But if I go back, I started a while ago when I was struck by fresh out of school, finished my internship.
01:48And I'm talking going into service.
01:51And I was struck by the suffering that people undergo, whether it's in hospital initially and when later on when I went into public health and started visiting poor communities.
02:10It just drove home the fact that you've got to do something to help these people alleviate their suffering.
02:19What initially drove you to be a doctor?
02:21Oh, it just fell into place, I guess.
02:27It came easy when I was in school.
02:30I mean, I liked biology.
02:32I liked chemistry, which is not very popular, I know, these days.
02:37But somehow that's what I liked.
02:40That's what I did well.
02:43And so the path sort of fitted in.
02:46But yeah, I didn't sort of visualize myself being a doctor when I was a student in school.
02:56But when I went into university, then I, yeah, it fitted in.
03:01You found your way there.
03:03Yeah.
03:03It's almost like it picked you as well, because you just found yourself being a doctor somewhere along the way and enjoying it as well.
03:11Yeah.
03:11I mean, the enjoyment came a little later.
03:14Hmm.
03:15Right.
03:15Initially, you are dealing with the challenges.
03:19You're dealing with coming to grips with the realities.
03:24Admitting that there's just so much that you can or you should do.
03:30Right.
03:30Right.
03:31Right.
03:31And that sometimes is very overwhelming.
03:33Right.
03:34But recognizing that, yes, even you as an individual, you as a single clinician or as a public health person can make a difference for people.
03:46And that probably is what drove me to public health.
03:50Because as a clinician, I always saw that I can impact one person, make a difference.
03:56But when you go into public health, you're helping communities, you're helping many more people.
04:04Right.
04:04And that was the attraction for public health.
04:06When did you realize you wanted to be in public health?
04:10Very early in my career.
04:12I'm not going to say dates because that could reveal how young I am.
04:16But very early in my career as a doctor.
04:19Right.
04:20So just like 25 years old, like last year.
04:24Yeah.
04:26Now, what was the hardest lesson you had to learn when you first began working on the ground in disease control?
04:34Did it change your approach to medicine and helping people?
04:39Yeah.
04:40So like I said, I thought I am there to make a difference.
04:44I want to make a difference.
04:46But the hardest lesson was everybody doesn't share the same concern.
04:51So sometimes it becomes very challenging to convince other people to acknowledge that there is a difference that we can make together.
05:06Right.
05:06And that continues to be a challenge at whatever level you are in, whether it's national public health, global public health.
05:18Right.
05:19Do you find you have to take a lot of time managing people on top of having to deal with whatever crisis that you're dealing with?
05:29Always.
05:30Always.
05:31And when I say managing people, it starts with your own team.
05:36Just making everybody understand that we have a common mission.
05:43We work together.
05:44What's your approach then?
05:45We should be in the same.
05:46Yeah.
05:46It's all about teamwork.
05:50I'm just the oil that oils the machinery and the team does the work.
05:55But having the machine functioning smoothly in one direction, that is important because that way we can achieve impact.
06:05But then beyond that, it's not just limited to the team.
06:08It's also about engaging with other stakeholders, convincing them of what's best.
06:15But the role that you play is so pivotal and time consuming.
06:21It could take away, for many people, it would take away from their personal lives, the ability to lead a more family-oriented life.
06:30How do you find that balance for yourself?
06:32That's the price you pay.
06:34Just accept it.
06:36I mean, it sort of comes easy in my family because my wife is also a doctor.
06:43Right.
06:43And we are both quite busy, but we both understand that there is a calling and that we are serving a purpose.
06:51So, I guess there is an advantage in that and a disadvantage.
06:56Right.
06:57Because there's the understanding that we understand each other.
07:01Right.
07:02That we both have our own calling and we need to do things, which if your partner is not a doctor, probably it's more difficult.
07:11That's what I've seen.
07:12So, both understand that there is a greater good to be served.
07:17Yeah.
07:17But then, of course, there is a price to pay.
07:20Right.
07:21Like, my kids have complained through the years that you don't have time.
07:27You're busy.
07:28It's an acknowledgement, but it's also a recognition that there is a price we are paying.
07:34Right.
07:34And do you have to explain to them so that they understand the sacrifices that are being made?
07:40Now they're big, so they understand.
07:42Right.
07:43And some of them are following in your footsteps as medical professionals as well?
07:47My daughter is, yes.
07:48Right.
07:49So, even more so, she understands then.
07:51Yeah.
07:51She's beginning to understand the burdens of working as a doctor.
07:55And they must be equally as proud of you.
07:57I guess so.
08:01What's, you know, one memory you can share with us from your time in the field?
08:05Maybe during a malaria campaign or outbreak response that has stayed with you, like, even after the job was done.
08:12Sometimes in the quiet moments of your day or your life, you think back and it still comes back to you or even haunts you.
08:19So, well, I couldn't single out one event, but one thing that's always stayed with me is I am deeply touched when I see the suffering of people.
08:31And I continue to dwell on what can we do better?
08:36How should we work around these challenges that people face?
08:40Right.
08:41And it comes probably because I started my career in public health in a remote rural area in Sri Lanka, where there was very high levels of poverty and a lot of challenges that people faced.
08:58But that hasn't actually changed over the years, even after my stint with the Ministry of Health in Sri Lanka when I went global.
09:09Right.
09:09And I've worked in so many countries and the challenges that people face are practically the same across many, many countries at an individual level, at a family level.
09:24Right.
09:25There are huge challenges that families face.
09:27And when we look at it at a country level, we probably don't recognize it.
09:32But as a public health person, when you go into the field, you do see it.
09:37Do you find that because you were exposed to the medical needs of people who lived with less in rural settings, that it has pushed you even further to achieve more in the role that you're in now?
09:57Yeah.
09:58Yeah.
09:59Yeah.
09:59I mean, fundamentally, I'm a doctor and I work from the perspective that life is precious.
10:09And we take the hypocritical oath, we want to ensure that we save as many lives as possible, but we also give people the best possible living conditions to stay healthy.
10:24Right.
10:25Now, we're already talking about not just being disease-free, but about well-being, being able to enjoy life to its fullest.
10:34Yeah.
10:34And that is what the vision of WHO is.
10:39And therein is the challenge, right?
10:41Right.
10:42It's not just about providing services to the sick.
10:47Right.
10:47But it's also about helping people stay healthy for longer, free of disease.
10:52One of the biggest battles that seems to be waged in terms of health is malaria, right?
11:04How is WHO supporting Malaysia's efforts to eliminate residual malaria, especially in East Malaysia?
11:12And what regional collaboration models have proven effective in this fight and this battle?
11:18So, just to clarify, I know you're asking a question on malaria because I spent the first 25 years of my life dealing with malaria.
11:27We actually succeeded in eliminating malaria from Sri Lanka.
11:30Right.
11:32And then we've sort of duplicated that now, I think, globally in about 45 countries that have been certified malaria-free.
11:45I'm very happy that, I just noted, three days ago, we just certified East Timo as malaria-free.
11:53Amazing.
11:54That was the last country.
11:56Right.
11:56But Malaysia, you know, Malaysia achieved malaria-free status almost five or six years ago.
12:03Right.
12:03And we were very happy about it.
12:05But that's human malarias.
12:07The problem is that malaria, in Malaysia, you have this problem of zoonotic malaria, or what we call monkey malaria.
12:18And that seems to be a huge challenge, especially in East Malaysia.
12:22So, while you've got rid of the human malarias, this zoonotic malaria continues to spill over and affect individuals.
12:30Right.
12:30Tell us more about why it's such a challenge.
12:32Because, in the first place, you don't get these zoonotic malarias all over the world.
12:38They're in very few countries which have a lot of forest coverage.
12:42It's a spillover from, that's why they're called zoonotic malarias.
12:47Right.
12:47The parasites are usually in apes and monkeys.
12:53Right.
12:53But they do spill over to humans, and that's the challenge.
12:56So, we are working with the Malaysian government to address this challenge.
13:00Malaysia has done amazing work with zoonotic malaria, so much so that we are now in the process of discussing the potential for malaria, for Malaysia to set up a center of excellence, what we call a WHO collaborating center.
13:16Right.
13:17To address the global challenge of zoonotic malarias, not just here in Malaysia, but also to use the expertise you have to work around solutions for other countries also.
13:29Right.
13:30So, that's the process we've just discussed with the Ministry of Health.
13:34Right.
13:35And we are hopeful that we can move to the next stage of designating that center.
13:41It's going to be in Sabah.
13:42Right.
13:43In the University of Sabah.
13:46Right.
13:46So, we will work with them to set up this global center, and hopefully we'll find solutions.
13:52Right.
13:53Not only to address the challenge of zoonotic malarias in East Malaysia and Malaysia, but also in other countries faced with similar challenges.
14:02Right.
14:02Do you find that, which is the bigger challenge, or are they equally ranked in your mind when it comes to infrastructure versus knowledge, when it comes to letting people know what to look out for and how to be, take better care of themselves?
14:20Well, I think we are beyond the stage of knowledge.
14:25Hmm.
14:26Right.
14:27We have generally acceptable high levels of literacy.
14:32Hmm.
14:32At least most people know what's good for them.
14:38Mm-hmm.
14:38Right.
14:40But knowing what is good doesn't always translate to the correct behaviors.
14:48To practicing what we know.
14:49Yeah.
14:50I use the common examples.
14:53Everybody knows that tobacco is harmful, but people tend to smoke, right?
14:58Yeah.
14:59Everybody knows that alcohol is bad.
15:01Yeah.
15:01People tend to drink.
15:04And closer to home, everybody knows that sugar is bad, but we continue to take a lot of sugar and sweet stuff.
15:11So, but what actually is important is not just the knowledge.
15:16The knowledge is important, but largely it's there.
15:20But how do we touch that nerve which tells people, I need to make a change.
15:26Right.
15:27My behavior needs to change.
15:29I need to exercise.
15:31That is important.
15:33Hmm.
15:33And that's what we are working with the government, this behavior change, understanding what will actually help people adopt a healthy behavior.
15:44Yeah, that's a big question.
15:47Yes.
15:48Are we getting closer to an answer for that?
15:50Yeah, we are.
15:51I mean, and I am quite proud because Malaysia led a resolution at the World Health Assembly in 2022 on incorporation of behavioral insights for better health.
16:05Well, we have supported the government.
16:06We have supported the government in establishing a behavioral sciences unit.
16:13We have just now completed, together with the MOH, developing a national blueprint of behavioral science, which we believe will be launched in September by the government.
16:24So, yes, a lot of work is happening on using and integrating behavioral science into health promotion and communications.
16:32Right.
16:32Let's hope we see some of the fruits of your labor soon as well.
16:37I'm speaking for myself.
16:38Well, you have to be realistic.
16:41It's not going to happen overnight.
16:42It will require a five to ten year period.
16:46Okay.
16:47I look forward to that down the road then.
16:50Yeah.
16:50Now, in your April 2024 statement on the right to health, you highlighted telemedicine and mobile clinics, which is something definitely that is necessary, right?
17:03How has WHO supported scaling these initiatives, especially in remote or underserved Malaysian communities?
17:10How has that been progressed with reaching out?
17:14So, if I ask you a cross question, what's the biggest challenge face in the Malaysian health system, you'd say it's the shortage of health workers.
17:25True.
17:25Right?
17:26Yeah.
17:26So, it's going to take time for us to address that.
17:31But at the same time, we are in that stage of development where we could look at innovative approaches to provide services.
17:40Right.
17:41And that's where the digital health comes in.
17:44That's where the telemedicine comes in, right?
17:48Yes.
17:49You need to find innovative solutions that we can provide services to people.
17:55And it doesn't need to be face to face.
17:57Yeah.
17:58Right.
17:58It can be done remotely.
17:59In many cases, and I'm talking about not first time consultations, but repeat consultations.
18:07If you have and you can provide virtual consultations for many people who are having chronic diseases, if you have digital health platforms that their reports can be uploaded.
18:23Actually, you don't need a face to face consultation with a doctor, right?
18:29It can be done virtually.
18:31Right.
18:31Can you imagine how much of decongestion will happen in the clinics if a lot of those second, third, fourth, tenth time patients are not actually coming to the clinic?
18:42Yeah.
18:42But are getting their treatments through virtual consultations.
18:46Yeah.
18:46It's going to make a huge change in the clinics, right?
18:52Yeah.
18:52So it's going to decongest the clinics.
18:56On the other hand, the same, if you can provide those kinds of services to areas where you have absolute shortages of doctors.
19:07Yeah.
19:08Or it's difficult to access places to get to hospitals for remote populations.
19:16Yeah.
19:16So it's going to be a game changer because you can provide the service without physically going there, without addressing the doctor shortages in some remote areas.
19:33Yeah.
19:34And on the other hand, you're also reducing the cost for patients who have to travel to clinics that are quite far away.
19:43Yeah.
19:44Right.
19:44So it's a win-win.
19:46And if you're an environmentalist, you'll say, okay, and you don't have to travel, that means you're reducing the carbon footprint.
19:54Right.
19:54Yeah.
19:55Another benefit.
19:56Yeah.
19:56So there's many, many advantages.
19:59Of course, there's challenges also because data security, establishing the platforms, all of that is important.
20:06So we are working with the government.
20:08We have set up the guidelines.
20:10We are sharing them.
20:12And it's up to governments to adopt them to their national situations.
20:16Right.
20:17But this is the way forward, right?
20:19And that's definitely one of the factors, the accessibility factor when it comes to the health inequities that even were outlined in the health white paper in June 2023.
20:31The other issues that seem to be a factor would include quality of medical services as well as equity.
20:41How do we go about, like, addressing these issues?
20:45I mean, Malaysia has been the poster child for health in the region.
20:52I'm saying has been previously.
20:55Okay.
20:55When you had remarkable progress in bringing down the communicable disease burdens, addressing the challenge of infant child and maternal deaths.
21:09But that progress seems to have stagnated over the last 10 years.
21:13And at the same time, you're faced with an increasing burden of non-communicable diseases now.
21:22And so the white paper envisaged a shift in the system.
21:27So further advances in universal health coverage, which are doing pretty well, but which you could do better.
21:35Right.
21:35But also universal health coverage also means that the quality of care is good.
21:45It's equally accessible.
21:47And that's the equity aspect, irrespective of whether you live in East Malaysia or on the east coast of Peninsula, Malaysia or in Selangor.
21:57Yeah.
21:57And also the quality of the care.
22:00Right.
22:00So that's something that we can continue to strive to improve.
22:05And that's what I think the white paper is all about.
22:08Right.
22:09So we initially supported the development of the white paper.
22:14It also looks at strengthening primary health care.
22:19Because given the increasing burden of NCDs, the aging population, we need a much stronger primary health care system.
22:28Right.
22:28Which strong community outreach.
22:31Right.
22:32That would help significantly reduce the burden in hospitals, the crowding in hospitals.
22:40And so those are some of the efforts that we are partnering with the MOH.
22:44And I must say, the MOH is making its best to do what it can.
22:52Right.
22:52But you are dealing in very resource-constrained settings.
22:58And I'm not just talking about human resources.
23:00I'm also talking about financing.
23:03And so it's not easy because you can't give up something and expand the primary care services.
23:12Right.
23:13Because of the ask and the demand on the hospital curative services.
23:17Right.
23:19You need to continue to keep and continue to keep investing in that.
23:23Right.
23:23But at the same time, you need to find the resources to expand the primary preventative services.
23:30Because otherwise, the number of people falling ill is only just going to increase and it's going to crash the system.
23:39Right.
23:39So you have to find this balance, which is not easy.
23:42Do you see a future where our universal healthcare would be, the structure would be strong enough to support all of our needs, where private healthcare would be secondary and not seen as the preferred way to seek out treatment?
24:03Well, the achievement of universal healthcare in Malaysia and for Malaysia recognizes the dual system.
24:13So it's not without the private sector.
24:16It's in partnership with the private sector.
24:18That's how it works.
24:19That's how it works.
24:20And that's okay.
24:22But it should eventually reach a stage where the services provided by the government sector are equal, if not better.
24:34And that is the case already in some areas.
24:37Okay.
24:38Some specialties than the private sector.
24:42Right.
24:43But we need an expansion and development of both, because it's only through that, that we're actually going to achieve universal healthcare.
24:53So this is not about the government taking the full burden and trying to do it.
24:58But it's about a better partnership with the private sector.
25:02Right.
25:04Recognizing what drives the private sector.
25:06But that then means that the government also needs some sort of ability to regulate the services and the cost inflations that the private sector brings.
25:19Right.
25:20We need a population that is very comfortably enlarged in the middle income that can afford private healthcare.
25:31So that not everyone is seeking the government-aided healthcare.
25:37Right.
25:38So how much of this can we, does WHO actually involve themselves in when it comes to planning for this?
25:50Well, we, our core business is with the state public sector.
25:55Right.
25:56But we are also cognizant of the fact that expansion of the private sector will also help advance universal healthcare.
26:06Yeah.
26:06So having the correct policies.
26:09And when I say private sector, I'm not talking top-tier private sector hospitals.
26:13Right.
26:14The key issue for Malaysia is that we need smaller-scale private sector hospitals in the smaller cities.
26:21Right.
26:22Right.
26:22Which provide a lot of the basic services.
26:26That's actually going to be what will take the burden off the government.
26:32Right.
26:32So when you're talking about the M40, right, we are not saying that the private sector is there only for the T20.
26:43Right.
26:44Exactly.
26:44Yes.
26:45So we need to have a private sector, which is also probably two-tiered, not the ultra-expensive, but a more affordable private sector that can provide something in between to what the government is providing and what the top-tier private sector centers in CAIL and big cities are providing.
27:07Right.
27:07And that needs to be geographically dispersed so that more people can access those services.
27:12Do you see a growth in the more affordable private healthcare industry?
27:19I'm certainly hoping that that is the way the private sector will expand.
27:25You and me both.
27:26Yeah.
27:28Now, you know, if the public health system is a mirror of a nation's values, what do you think Malaysia's health landscape currently reflects about our social priorities, looking at the way it stands now?
27:42The way it looks like now.
27:45Is it a fair reflection of the people that we are?
27:48Given the success that your health system has achieved, I think it is quite a fair reflection.
27:56Given the discussions that are happening currently within the country on the need for further improvement and expansion of the healthcare services and access, it's a direct reflection of the compassionate position of the Malaysian mindset, right?
28:19About the need to provide services for everybody.
28:24Yeah.
28:24But it's also equally important to recognize the challenges faced by the medical community, how overstretched they are, and address those issues.
28:41And I mean, I'm really glad to hear that they want to accelerate the recruitment of doctors and other cadres.
28:52This is a step in the right direction.
28:54It addresses this core concern on the need to address the challenges faced by the health workers to improve their work conditions.
29:08Right.
29:10And at the same time, there's a lot that is being discussed and being proposed.
29:18That's good to know.
29:19Definitely.
29:19I feel it would seem like in the world that we live in now, one more issue that healthcare professionals have to deal with, even more so than before, is the dealing with misinformation that seems to spread so fast.
29:36While proper medical professionals such as yourself, WHO, are trying to help people with the information that you have that is legitimate information.
29:47But it's so quick for someone to jump online and spread something that contradicts what you say or what the medical community says.
29:54And then there's this game that happens of who can get the right information across because this misinformation can spread faster than a virus.
30:06What do you think health institutions possibly can do differently to regain or sustain public trust in this kind, in the world that we live in now?
30:16Well, there's multiple things that need to happen.
30:20We are clearly at the very early stages where our social media capacity is expanding.
30:29But as a medical community, I think we need to be trustworthy.
30:35We need to build that trust with the public.
30:40And we need to be able to communicate that and articulate that clearly to the public and be honest.
30:50I always tell my team, you need to be honest.
30:53If you don't know something, you say you don't know it.
30:56Right.
30:57If there's something bad, you need to admit to it.
31:00Right.
31:01Because that honesty is much appreciated by the public.
31:05If you're not honest, you open the door for misinformation.
31:08Right.
31:09But at the same time, it's not just only about what we as the medical community can do.
31:15As I mentioned, it's also about how can we better regulate what gets out there in the social media.
31:22And with the advent of AI, etc.
31:25I'm hoping that there will come a time when unsubstantiated claims that are not a reflection of reality will be weeded out from the social media platforms by their engines themselves.
31:42Right.
31:43Right.
31:43And so, there's hope for the future.
31:46What is AI but the monster that we created, right?
31:50So, it's either a monster that can help us or one that could cause more harm.
31:56So, like you said, it's important for us to regulate, which comes down to who is in charge and who is feeding the information to get involved.
32:05And I wouldn't call it a monster.
32:07I would call it a friend.
32:10I'll call it a friend.
32:11A big friend.
32:12A big friend.
32:13That sometimes you don't get along with.
32:15Now, in your career, you've witnessed both health triumphs and deep inequities as well.
32:22Because in the various different roles and different emergencies that you've actually been a part of, what is the maybe one ethical dilemma that has stayed with you throughout your career?
32:33Like a choice that was difficult to make or that you saw happen in a situation you were in?
32:41Well, the biggest dilemma is the choice between life and death.
32:49Right?
32:50The shortage of resources means that you have to make choices.
32:59And those choices result in some people losing their lives.
33:07And that is a terrible dilemma that you have to face as a doctor.
33:11Because we don't have all the resources we need.
33:16And so sometimes you have to decide what do you do?
33:22How do you prioritize?
33:24Right?
33:24I mean, I could talk of so many examples, both from my own individual career or even from a global public health perspective.
33:33The access to COVID vaccines, for example.
33:36Right?
33:36So, this is an ongoing dilemma, right?
33:41How do we come to grips with knowing that if you do X, Y, and Z, you're going to improve people's life, save lives?
33:52Because you know it, but you don't have the resources.
33:56You can't prioritize it.
33:59And so your hands are tied behind your back.
34:02And you know it.
34:03So, that is a dilemma that you have to live with every day, right?
34:07And you have to accept the fact that in that moment, this is the best that you can do?
34:13Exactly.
34:14Right.
34:14All the time.
34:17How do you deal with making that choice?
34:20Do you think it takes a unique person to be able to deal with that?
34:24You do your best and you console yourself that you are doing your best.
34:29But that also means that you have to continually push.
34:34Right?
34:34You have to continually think, can I do something better by innovating?
34:40Right?
34:40That internal conversation that you have with yourself must be something that takes so much effort alongside the work that you do daily as well.
34:55I mean, when you say internal, it's all the time because it's not, yes, it is internally personal, but then it's also with your team, right?
35:06What can we do differently that will make a difference?
35:10Speaking of which, if you had the power, let's say, to radically redesign one aspect of the global health system overnight, you could do this, let's say.
35:22What would you change and why if you could make this happen?
35:26There's nothing like that.
35:27There's no silver bullet for the problems.
35:30There's many things that needs to happen.
35:32And none of it can be done overnight.
35:36Right.
35:36So you've resigned yourself to that.
35:38There's no point imagining what can't happen.
35:41No.
35:42Right?
35:42It's good enough to acknowledge that things can be better, that we need to come together as a global community, and that we need to work together towards it.
35:52That's very practical, which is exactly why I think that makes sense that you're in the position that you're in, to be that practical voice of reason when facing an issue.
36:02How do you emotionally reconcile working in a field where success often means preventing something invisible from happening, like a disease that never happens, a crisis that never comes because you stop it, right?
36:17So your success is sometimes seen when the thing is not seen by anyone else.
36:24How do you tell yourself you've done a good job?
36:29Well, you can tell yourself you've done a good job because we are not all the time successful in completely preventing things.
36:38Oftentimes, efforts end up in reducing the scale of a potential problem, right?
36:45And then you can take comfort saying this could have been much worse if we didn't do X, Y, and Z, right?
36:55But at the same time, there is also the thing that we are not looking for publicity.
37:04We are not looking for highlighting a major event or a success.
37:10As I said, our priority is how many lives did we save by circumventing or preventing a situation.
37:21And that, to us, is the biggest value, right?
37:24Right.
37:26That's success.
37:27As it should be because your success is so clear.
37:30It isn't something that the world needs to see.
37:33It's you knowing that you've made a difference.
37:36Exactly.
37:36Every year, there are new people joining the healthcare world, whether in whatever capacity that they may join, as doctors, as nurses, as medical aides.
37:48If you could pass on and teach them one lesson that they could learn from everything that you've been through for that next generation of global health leaders,
37:58if they could draw from your journey, what would that be that you'd like them to know to better prepare themselves?
38:06It's not easy.
38:08Keep working at it.
38:10Because it is a long, hard journey.
38:14And you need to keep working at it because if you're already there, you should try to make a difference and not give up.
38:23And you would know for sure because you've been doing this for a long time.
38:29And you, of course, are someone that I'm sure many people look up to and they've said it to you as well.
38:34I'm sure people have come up to you and said that, you know, they admire your work.
38:40Do you, when someone appreciates you directly, when they come up to you and say that, you know, they appreciate the work that you do, how do you feel?
38:50I feel humbled.
38:51And it's a good thing.
38:55Doesn't always happen.
38:58Okay.
38:58Right.
38:59So don't expect praises and taps on the back.
39:03Well, then I will tell you to, right now, we appreciate the work that you do.
39:07No, but the reality is this world is easy, more ready to criticize than to acknowledge.
39:18Right.
39:18Right.
39:19So you have to be prepared for that.
39:21Right.
39:22But at the same time, yes, you're correct.
39:25And that humbles me when people acknowledge that we have made a difference.
39:30We've now come, Dr. Rabi, to the rapid fire question part of the interview where we ask you a question and whatever comes to mind is the answer that you give.
39:42What's the first thing you do when you land in a new country for work?
39:46Well, the first thing I would do is I get my passport stamped.
39:49But beyond that, I mean, before I come to a country also, I start trying to understand the context I am walking into.
39:58How can I make a difference?
40:01Right.
40:02Right.
40:02Because every little bit of information is helpful.
40:06Oh, so it's prep.
40:08Yeah.
40:08I mean, it takes a lot of prep.
40:11What's your most memorable field visit?
40:14Where was it and why is it memorable?
40:16I really can't single out a field visit that is memorable because there are memorable visits for good reasons.
40:26There are memorable visits for bad reasons.
40:29So I wouldn't single out anything.
40:30Too many.
40:30Too many.
40:31Okay.
40:32Who's the most inspiring leader you've met through WHO?
40:36Again, I'm going to have to tell you that I can't single out a single leader because I find people inspiring for what they say and they do.
40:48And that changes.
40:49So it's stumped.
40:50And it depends on the context.
40:52So in some situations, I find leaders who are very committed.
40:57Right.
40:58Right.
40:58Right.
40:59And say nice things.
41:01And that's inspiring.
41:02But then at the same time, there are leaders who don't say but also do nice things without talking.
41:09Right.
41:09Who are doers.
41:10Right.
41:11And that also inspires you.
41:13Right.
41:13So better not to highlight one when there are so many.
41:16Yeah.
41:17Okay.
41:18Tell us one thing you always carry in your bag on your WHO missions.
41:23There's not one thing that I carry in my bag.
41:27I would probably say it's my toothbrush.
41:30Oh, okay.
41:31I would be not honest if I say I don't carry coffee.
41:36I do carry coffee.
41:38In your bag?
41:39Yes.
41:40Like?
41:40Because I'm not quite sure that I'm going to get good coffee.
41:44Finally, what does health for all mean to you?
41:50If you had to summarize it in a word, what does health for all mean?
41:54You can summarize it in a word and then explain that word.
41:56Equity.
41:57Equity.
41:58Equity.
41:58Access to good quality, affordable health care.
42:04Right.
42:05Everywhere for everyone.
42:06Do you think it's achievable?
42:08We will strive for it.
42:10We are not going to achieve it by 2030.
42:12Right.
42:13But we will continue to strive to achieve it because I think that's what we need to do for humanity's sake.
42:21When you say you give me hope as well, finally, if you had the opportunity to make one change as Prime Minister of Malaysia for a day, big one, what would it be and why if you could make one change happen?
42:39Well, for me to be Prime Minister, there will need to be a constitutional change because I'm not a Malaysian.
42:48Okay.
42:48This fantasy world.
42:49In the fantasy world.
42:51It's hypothetical.
42:52I would certainly like to see more resources going into health.
42:58Well, that's a straight, one-line, direct answer.
43:03I would vote for you.
43:07Thank you so much, Dr. Rabi, for joining us today.
43:10It's been very insightful and hopeful at the same time.
43:13Everything that you say, I hope, comes to fruition because almost everything that you said would benefit not just Malaysians,
43:20but it would benefit the world as a whole to see a healthcare system that is more inclusive and also would solve the issue of equity when it comes to healthcare.
43:32We appreciate you.
43:33Thank you so much.
43:34Thank you very much.
43:35It's been a pleasure.
43:35And we will see you in the next episode of Life Confessions here on SHOCK.
43:40Thank you for joining us.
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