MANY of us entered 2023 with a glimmer of hope, a feeling that the nation has turned a corner for the better. The hope comes from the election of a new government that we place our trust in to bring us back to a better place where every person in the country is respected and included.
Over the past few decades, our nation has sunk further in terms of human rights, particularly in regards to the care and support of children.
We cannot be considered a developed nation if we continue to deny all children the right to education as enshrined in the Convention on the Rights of the Child.
Malaysia acceded to the Convention on the Rights of the Child on Feb 17, 1995. We have had nearly 30 years to fix key issues on children’s rights.
It is critical for the government to reverse policies that are harmful to children. They need to implement institutional reforms now to protect the well-being of children.
The following are areas that need to be reformed.
No child should be denied education
We have many children who are being denied basic education. A child without access to education is imprisoned in a lifetime poverty trap, which is a shame for a developing nation.
All children, whether they are migrants, refugees, stateless, of a different nationality or disabled, must be given access to primary and secondary education. Yet, Malaysia’s “Zero Reject Policy” is only applicable to Malaysians.
Institutional and policy reforms required: We need to introduce and implement a mandatory universal education access policy for all children, regardless of their status.
Children should not be treated as adults
The Convention on the Rights of the Child defines a child as “every human being below the age of eighteen years”.
Yet, in the 30 years since Malaysia acceded to the convention, there remains many policies and laws that fail to acknowledge children’s rights. For example:
-> The Children and Young Persons (Employment) Act 1966 (Act 350) defines a child as a person under 14 years of age, permitting those aged 15 and above to work, with some conditions. This definition, which is not consistent with the Child Act 2001, deprives Malaysia of a key means of protecting children from being exploited as child labour.
-> Children aged 12 and above are admitted to adult wards and cared for by health professionals who are not trained to look after children. It is traumatic for children to be bedded next to ill adults. It is long overdue for the Health Ministry to recognise those aged 12 to 17 years as “children”, and provide age-appropriate patient services.
-> Older children and adolescents are sometimes incarcerated in adult prisons and brought to court handcuffed, along with adult inmates.
-> Migrant/refugee children are held in detention, often in sub-optimal conditions, with many separated from their parents.
And the list goes on.
Institutional and policy reforms required:
1. Harmonise all legislation and policies with the Convention on the Rights of the Child.
2. Take requisite actions to ensure that ministries and government entities at all levels recognise the Convention on the Rights of the Child and the Child Act 2001, and accord all children protection, support and services.
3. Remove all reservations on the Convention on the Rights of the Child.
4(a) Place sick adolescents in age-appropriate, child-friendly health facilities, and under the care of those trained to meet their needs.
(b) Establish adolescent wards in all hospitals and clinics, which are staffed by personnel trained in their care.
Routine healthcare for migrants, refugees and stateless children
There has been a longstanding neglect and lack of provision of routine, primary healthcare for migrants, refugees and stateless children. The basic rights to healthcare, as enshrined in the convention have yet to be upheld by Malaysia.
These children do not receive routine primary immunisation, growth and developmental monitoring, and health advice/education.
No family should have to pay for basic life-saving immunisation of a child. Provision of primary immunisation for migrants, refugees and stateless children protects not only them but Malaysian children as well via herd immunity.
Pregnant women from these groups do not receive routine antenatal care and are known to deliver in extremely unsafe conditions, with adverse mother-child outcomes.
The prospects are even worse for children in these groups who require hospitalisation or specialist attention. While admission is possible for life-threatening illnesses, guardians still have to pay high fees for hospitalisation, procedures and medication, putting specialised healthcare out of the reach of the majority.
Those who are admitted are denied discharge until their bills are settled. Others are reported to the Immigration Department and transferred to detention facilities.
How can we assert to have among the best health services in the world when we place so many barriers stopping vulnerable families from accessing basic healthcare for their children?
Mortality rates among migrants, refugees and stateless children aged under five in Malaysia are 15 to 25 times that of the national rate, and are comparable to those in third world countries.
Institutional and policy reforms required:
1. Enact legal provisions that guarantee all children living in Malaysia the right to healthcare, regardless of their legal status, in line with the Convention on the Rights of the Child (Article 24), and our Child Act 2001.
2. Remove prohibitive and expensive medical treatment fees/charges levied on children who are migrants, refugees or stateless.
3. Protect migrants, refugees and stateless children and their families from arrest and detention when they seek healthcare at hospitals and clinics.
4. Join as a signatory and ratify the Convention relating to the Status of Refugees and its Optional Protocol.
5. Join as a signatory and ratify the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families.
No child should be stateless and left in poverty
No child should be left without an identity. Many children, especially in Sabah and Sarawak, remain stateless with no access to healthcare, education or a meaningful future.
Some of these children are born into families that have lived in Malaysia for generations but have no official documents. These children are not supported by government services and their poverty is not addressed as they are not recognised as Malaysians.
Regardless of their origin, all children must be protected. Article 7 of the Convention on the Rights of the Child states: “The child shall be registered immediately after birth and shall have the right from birth to a name, the right to acquire a nationality and, as far as possible, the right to know and be cared for by his or her parents.”
Institutional and policy reform required: Make a concerted effort to end the statelessness of children in Malaysia and not allow it to persist.
This article is not exhaustive in its scope. There are other areas that need attention for us to regain our humanity as a nation. Some areas have been neglected for a long time and require more concerted efforts.
Taking a social determinants approach to supporting children’s well-being is an optimal way forward. It is important that Malaysia leaves no child behind. We need to give every child in our country the best possible start in life.
We look to and trust this government to urgently institute reforms to protect, support and nourish all children in Malaysia.
Datuk Dr Amar-Singh HSS, consultant paediatrician, child-disability activist, Advisor, National Early Childhood Intervention Council, Yuenwah San, activist, care partner, and Honorary Senior Advisor (Disability Inclusion), Social Development Division, United Nations Economic and Social Commission for Asia and the Pacific. Comments: letters@thesundaily.com
