Improving Access to Health Services in Malaysia through Strong Partnerships

Kuala Lumpur, Malaysia – *Nilar was in good health when she first arrived in Malaysia in 2012, fleeing a military takeover in her hometown Dawei, Myanmar. After spending six months working at a factory in Southern Thailand with a friend, she took an overnight bus, with the help of smugglers, to reunite with her husband *Thet, who had arrived in Malaysia earlier in 2009.  

Like thousands of other refugees and asylum-seekers seeking safety in Malaysia, both tried to adjust to their new lives in a foreign country, working informally at a local restaurant while hoping they would be eligible for resettlement to a third country.  

Remaining hopeful for a better future despite living in uncertainty, both their lives took a drastic turn in 2019 when Nilar, aged 39 at that time, was hit with the startling news – she was diagnosed with stage 3 stomach cancer. 

“It started when I felt a sharp pain in my stomach, which I dismissed as a normal stomach-ache. But as the pain intensified, I sought treatment and underwent surgeries. The diagnosis was a shock; I was overwhelmed with sadness. I did not know how to handle the situation,” recalls Nilar, fighting back tears. 

Having sought treatment at a private hospital to skip the long waiting times, Nilar was unable to get discounted rates, which are only offered at public health facilities for UNHCR cardholders. To date, she and her husband had to work long hours and had used up all their savings to pay over RM5,000 (over USD 1,000) for treatments, check-ups and three operations without any financial support from anyone.  

“Even with 50% discounts at public health facilities for UNHCR cardholders, the fees are still too high for refugees and asylum-seekers who barely earn enough for a living,” explains Fawzia, a 34-year-old refugee from Maidan Wardak, Afghanistan.  

Fearing the dangers posed against her family and herself, they fled their hometown in 2017 and sought refuge in Malaysia. There, Fawzia secured a job as a teacher at a refugee learning centre. Unfortunately, her husband, who initially found employment at a rubber glove factory, lost his job during the start of the COVID-19 pandemic. Consequently, Fawzia has become the main breadwinner of the family. 

In the midst of these hardships, Farwzia has been accessing mental health services at Tzu Chi clinic since 2022 for anxiety and post-traumatic stress disorder (PTSD) resulting from her experience living in and then fleeing a conflict-ridden country.  

Tzu Chi, a Taiwanese international humanitarian and non-governmental organization, focuses on medical aid, disaster relief, and environmental conservation. The Malaysian branch is among the local health providers that IOM Malaysia has been collaborating closely for more effective case management of vulnerable migrants and refugees. 

Nilar and Fawzia are among the fortunate ones whose hardships in Malaysia will finally come to an end as they will be resettled with their families in the United States. The news came as a relief, especially to Nilar, who is looking forward to better cancer treatment abroad.  

Chronic diseases and mental illnesses are common among vulnerable refugees and migrants, often exacerbated by negative migration experiences, discrimination, poor living conditions, and limited access to healthcare. Furthermore, migrants in irregular, forced, or exploitative situations are also more prone to high morbidity and mortality. 

To ensure that refugees and migrants have proper access to quality medical services, the International Organization for Migration (IOM) has forged strong partnerships with multiple stakeholders in the health sector, including government ministries, public health facilities and other humanitarian organisations such as Tzu Chi. These alliances enable effective referral of patients to health providers for mental health support and monitoring chronic illnesses.  

Since 2005, IOM Malaysia’s Migration Health Assessment Centre (MHAC) has provided free health assessments, vaccinations, and fit-to-travel checks for over 130,000 refugees approved for resettlement to a third country. MHAC services include physical examinations that assess refugees’ health status and identify medical conditions needing attention before departure. Beyond these initial assessments, MHAC ensures medical follow-ups and specialised care for post-resettlement. 

As Fawzia and Nilar prepare for resettlement, they will need to continue their medical care in their new country, which they look forward to. So far, both have been satisfied with the quality of services they received from IOM and its partners. They are optimistic about their future plans, including better income opportunities and access to health services. 

Once her health improves, Nilar wishes to give back to her new community by helping others in similar situations. Fawzia, meanwhile, aims to pursue her studies – an opportunity she never had while living in Afghanistan – and to provide a good education for her three children while earning a sustainable income.  

“Despite our challenges as refugees, we have felt cared for and safe in Malaysia, thanks to the efficient services provided by Tzu Chi and IOM. I can happily say that I have found myself and feel like a human being again,” concludes Fawzia. 

*Names have been changed to protect the identity of the individuals.  

This story was written by Siti Munawirah Mustaffa, IOM Malaysia Communications Assistant, smustaffa@iom.int