KUCHING – It is 10.43pm on February 25 as I sit down to type this story. I had just finished a lengthy phone-interview with Dr Nur Izatti Zaidin, whose last words to me were: “Yes, we have a dry run tomorrow in Klinik Kesihatan Belaga and Klinik Kesihatan Sg Asap.”
Dr Nur Izzati is a medical officer at the latter medical centre, located in Bakun within the Belaga district. Following the development of the Bakun Dam, the displaced local population was resettled in Sg Asap, which is sometimes referred to in jest as “Kampung Smoke on The Water”.
Earlier in the day, the medical practitioner had a rather eventful day. “It’s an honour for me and my clinical team to talk about our Covid-19 immunisation programme,” she said when approached for an interview with The Vibes. “But I’m so sorry, we’re busy making arrangements at our operations centre as the clinic will be inspected by health department officials tomorrow. Can we arrange for the interview to be done in the evening?”
Sure enough, Dr Nur Izzati called back in the evening – but past 8pm. “Sorry I am late, we still had a lot to do at the clinic!”
When asked if she was nervous, the young medical practitioner – who hails from Ampang, Selangor – simply said: “When first told of this ‘special mission’ in January, I would have said ‘Yes’ – but not anymore. I have trained my mind to believe that I can do it, and I now find that I can do it after all.”
Even through the phone, it was clear that the young lady was very fatigued – so much so that Dr Nur Izzati sounded likely to collapse into bed like a sack of potatoes. However, the dedicated doctor, who graduated from medical school in 2016, doesn’t seem to be the least bit fazed. After all, the job of getting close to 30,000 rural people vaccinated – some of whom are living in very remote regions of the district – has squarely fallen on her shoulders, and she sounds determined to get it done.
“After completing my housemanship programme at the Tengku Ampuan Rahimah Hospital in Klang, I was immediately posted here about three-and-a-half years ago,” she said. “To be honest, I had requested for a transfer back to Semenanjung in January in order to take up specialist studies in family medicine. But instead, they offered me this ‘special vaccine mission’ – and here I am still!” the young lady said with a giggle.
When I mentioned that the field of family medicine was worlds apart from preventive medicine, Dr Nur Izzati said: “Well, I perceive this mission as a ‘once-in-a-lifetime’ opportunity for me to be involved in a large-scale vaccination programme as part of efforts to tackle a historic global pandemic. That’s definitely special,” she said stoically.
“Besides, I have a fantastic back-up team of colleagues to help me – in addition to the immense assist extended to us by Murum assemblyman Kennedy Chukpai Ugon. The YB and his team have been a key liaison between the medical side and the people, campaigning to the people on his own – especially to the tuai rumah (longhouse chieftains) on ‘vaccine hesitancy’ and the importance of getting the population vaccinated,” said the young medic, adding that the assemblyman also was working hand-in-glove with the district office.
Proper planning is key
In addition to her normal duties as a medical healer, it is Dr Nur Izzati’s job to plan out everything for the clinic – and for now, she is preoccupied with the first phase of vaccine day, which is set for March 7.
As such, she is constantly updating herself by reading up on vaccines, acquiring additional knowledge of specific vaccine-types from manuals, as well as attending video-conference training from the experts in Kapit Hospital.
Although Bintulu Hospital is closer and larger in stature, Dr Nur Izzati feels a special kinship with Kapit Hospital. “The vaccines will be secured from Bintulu Hospital – but Kapit Hospital is ‘mission control’ for administrative aspects of the vaccine such as consultation on logistics, storage, expert advice, and transportation.
“In consultation with mission control, we have set our first phase vaccination day, which involves frontliners, for March 7. There are a lot of nitty-gritty details which I have worked out, and timing is very, very crucial.”
For the petite practitioner, all systems go must operate like clockwork. Just one break in the link, and things can go drastically wrong – so she is viewing the whole scenario as a precise military operation, where her role is that of a ground operation general.
The actual venue for the vaccination programme will be the Dewan Masyarakat Sg Asap where both the Sungai Asap and the Belaga clinics will be operating jointly, with Dr Nur Izzati as the major domo.
“I will not be involved in the actual jabbing; the nurses and other clinical staff will be taking care of that. I will act as the ‘floor manager’, getting things in order and troubleshooting when things go kaput. Not only will I be on my toes, but I will have to also think quickly on my feet,” the doctor quipped.
Getting down to the brass tacks
Dr Nur Izzati has already worked out the plan for securing the vaccine for the first phase. “I have worked out every minute detail, taking into consideration the vaccine’s fragility when not stored and handled according to the manufacturer’s instructions,” she said. “The Pfizer vaccine must be stored at an ultracold -94°F. However, it can be stored at a temperature of between 2°C to 8°C on short transits in special cold boxes.”
There is a catch, however. “When stored at this temperature, the vaccine must be used up within five days – so I have to order the right number of doses based on the total number of people to be vaccinated and the number of days needed for each phase of the inoculation programme. The math simply needs to add up – otherwise, major glitches can happen.”
Besides this, Dr Nur Izzati explained that she had to work out the timings – taking into consideration the distance travelled; the amount of time taken for her pharmaceutical team to arrive at Bintulu Hospital; the waiting time, as there will be other teams there to pick up their portions; and the time taken to return to Sg Asap.
“And of course, there is also the need to consider road conditions. The trip from Sg Asap to Bintulu takes about two-and-a-half hours one-way – and thankfully, there is a good road between these two destinations,” she said, adding that the Pfizer vaccine is unaffected by rough transport conditions, which means that there will be no issues when bringing it across uneven terrain into remote settlements.
The doctor worked out the schedule to secure the vaccine as follows: “Leave Sg Asap at 9am on March 6; pick up the vaccine and return immediately. The team will be escorted by police outriders to and fro to prevent any road mishaps that could cause delays during transit. The vaccine stock will then be kept at this clinic, and policemen will remain present overnight to make sure nobody meddles with it.”
To the roads less travelled
Dr Nur Izzati says that a mobile unit will also be made available to extend the vaccine programme to certain remote places, including Long Urun (which takes three hours by road); Metalun (five hours by road); Tegulang (five hours by road); and Punan Bah (three hours by boat).
The doctor and her team may also have to fly by helicopter if the Kapit team is not deployed to areas including Long Unai; Sang Anau; Batu Keling; Long Jawek, Kebuho; Lusong Laku; Long Kajang, Long Abit, Long Tanyit; and Long Ledem.
At a glance, the medical practitioner seems to have a never-ending workload, as the first phase of inoculation has not even started. After the first phase is done, there will be phases two and three – then the second dose has to be administered after 21 days for each phase. The entire vaccine mobilisation process – and the actual inoculation at the sites – keeps repeating itself multiple times.
Clearly, Dr Nur Izzati has her job cut out for her. Asked if her work will ever end, she laughed and remarked that that would be like wishing for the moon. However, the “Angel from Ampang” is resilient, even though she has to put her plans to take up family medicine on hold.
“For now, I have an urgent mission in my hands. The truth is, the Covid-19 virus remains hidden as a silent enemy. We cannot be complacent. It will be at our own peril.”
The mission that Dr Nur Izzati is referring to is to achieve that clinical matrix called “herd immunity” in the rustic corners of Belaga. Will the good doctor succeed? Going by the tagline displayed in her Whatsapp profile – “What your mind believes in, your body can achieve.” – it seems likely that she can.
May the Force be with you, Dr Nur Izzati! – The Vibes, February 27, 2021
