Quality of life, the Sejahtera option

THE inaugural Borneo Quality of Life Conference took place last week in Kota Kinabalu co-organised by the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah together with the State Department of Health.

It is an important initiative which is timely given the long-term view of where Malaysia wants to be in the future. Let alone as a developed nation in fewer than 700 days from today.

Quality of Life (QoL) is a significant concept that is rarely spoken about in many major forums nationally compared to the so-called "standard of living" that is more "materialistic" (economic) in nature. Even then, of late it has taken a beating with the rising cost of living especially in places like Sabah and Sarawak where the base cost of living is higher than the rest of the country.

The impact on QoL therefore cannot be underestimated. While it is closely linked to the status of health, it goes beyond the mere medical aspects of absence of disease and infirmity.

In other words the notion of QoL captures among others the issues of inequality, injustice and indignities that arise from disparities in bringing about "progress" and "development" to the rakyat. As is often the case, they are linked to a number of unintended consequences that further reduced the apparent impact of QoL.

More frequently these manifest as stress factors and "pressures" on life especially in relation to mental health that are already emerging. Reportedly, a third of Malaysians are said to be affected with young adults being most vulnerable. Twelve per cent of those under 18 years allegedly have mental health problems.

For Sabah the situation is even more alarming based on the 2015 National Health and Morbidity survey that shows the state has "the highest rate of mental health problems in Malaysia".

Could it be a short-term problem of inability to cope or has it longer term implications that need urgent attention?

Either way many claimed to be struggling to look for appropriate and adequate care despite the fact most of the problems are treatable.

The conference was informed that current mental health systems are "inadequate for the scale of the problems that young people face".

Many have to drop out of school or work when faced with difficulties in accessing quality mental health care. Especially for the poor and marginalised where mental health issues carry a huge social stigma. Meaning they will be condemned to a bleak future making a mockery of the much touted slogan: no one is left behind.

Moreover Sabah has more than 50 ethnic groups with varying standards of living, never mind QoL. Each facing its own socio-cultural barriers, other than economics, in trying to attain higher QoL without having to sacrifice their own communal values and context which are no less critical in (re)defining QoL.

At this juncture the keen observation made by the state tourism, culture and environment minister with respect to the Kingdom of Bhutan and the concept of gross national happiness as a measure of development without marginalising its local relevance is highly pertinent.

He aptly said: "If we can find similar measures in Malaysia that will be a real step forward."

In other words, Sabah hence Malaysia, has a larger role and responsibility to safeguard its indigenous wisdom and knowledge in enriching QoL to be shared globally just like what the Bhutanese did. It takes courage and confidence to uphold this based on centuries of experience. What is sure is that it has demonstrated to be viable in stabilising long-term multicultural, multiethnic and multireligious living that is harmonious and balanced – rarely seen in other parts of the world.

Significantly it relates to one common word "sejahtera" – not translatable to other languages because of its multi-layered concept.

"Sejahtera" is very familiar to Malaysia and Malaysians as a form of greeting (salam sejahtera), and all manner of taglines and name of organisations, even ministries and departments.

It also appears in a song Sejahtera Malaysia and a public toilet, "tandas sejahtera" near Pasar Khadijah in Kelantan. You cannot get more Malaysian than this particularly when the concept is rooted in the Falsafah Pendidikan Kebangsaan since 1988. Yet unfortunately it is dismally understood and applied to bring out the very essence of QoL that it purveys.

Thus it is timely to revisit it since the relevance of GDP as an indicator has long been questioned, the latest at the 2018 World Economic Forum.

"There's emerging agreement that the kind of statistics we've used in the past just aren't working any more," to quote an economist, Diane Coyle of University of Manchester.

There is now more room to argue for the "intangibles" to be taken into account as indicators with some level of recognition. Despite big data we have a myopic focus that is blur about mental health which is often out of sight. Yet research indicates that more than 34 million people globally suffer from mental health problems like depression, predicted to be a major burden in a new age of loneliness.

In this sense Sabah has taken the first critical step in admitting that there are potential mental health problems in the air.

The next move is to gallantly challenge what QoL is all about from the Malaysian and the indigenous perspectives in the way GDP and its brute measures have been placed under scrutiny, in preference to more nuanced "indicators".

This presents tremendous opportunities to take "sejahtera" to the next level internationally, as in the case of South Korea today. For this we wish you Selamat Sejahtera.

The writer presented a keynote address entitled "QoL: The Sejahtera perspective and approaches" at the conference. Comments: letters@thesundaily.com