Mohamad Ghani Abdullah was abruptly woken up by the insistent ringing of the telephone. He checked his watch. It was almost 4am.

The estate hospital assistant (EHA) knew it had to be bad news or an emergency. True enough, a Bangladeshi worker had attempted suicide.

Ghani rushed to the estate quarters to find a man bleeding from a cut in his neck. As he attended to the injuries, he learnt that the man had tried to slit his throat. The worker then tried to hang himself but the falling chair had alerted his housemates.

After treating the worker, Ghani took him to the Sabak Bernam government hospital. He was transferred to the Tengku Ampuan Rahimah Hospital in Klang, where he received surgery. The man recovered.

Ghani, 65, says the worker had attempted suicide because he had been depressed.

“Sometimes, the separation from their families gets to foreign estate workers. Sometimes they become depressed because of the debts they have accrued to pay for their passage to work in Malaysia,” says Ghani, who has been working in estates since 1974.

Throughout his career, Ghani has handled all sorts of medical emergencies and problems, from headaches and heart attacks to injuries and poisoning.

He has done minor surgeries and counselled workers suffering from depression to help them cope with personal problems.

He has also been involved in public health campaigns, including those on anti-malaria and anti-dengue.

Ghani is always on call, even on his days off and when he is on official leave. He is among thousands of EHAs and medical assistants who provide yeoman services to workers, but are unknown to most Malaysians outside the estate setting.

They are the first line of defence in estates. If they cannot handle a particular case, they refer the matter to the visiting doctor. But if it cannot wait, they send the patient to the nearest hospital.

In 1974, Ghani got to know of a scheme by the Kedah Health Board where one would be trained and then absorbed into the estate healthcare system. His application to join the Padang Serai-Baling Road Group Hospital in Kuala Ketil, more popularly known as the Kuala Ketil Group Hospital (KKGH), as a trainee hospital assistant was successful.

The former student of St George’s Institution in Taiping went to live with his sister in Bagan Serai, Perak, from where he would travel daily to Kuala Ketil, Kedah.

He would hitch a ride on a lorry that went daily to Parit Buntar carrying a crew of workers, cross the river separating Perak from Kedah by a rope ferry to Serdang, then board a bus to the KKGH.

It was difficult and tiresome but Ghani knew that nothing came easy. This went on for a few months until the KKGH provided him a place at its staff quarters. He was grateful to receive a monthly allowance of RM50 during his three-year training.

“I was trained by Dr S Subramaniam, who was the resident medical officer of the KKGH,” Ghani tells FMT. “He was a good man and taught me well. He later went into politics, becoming the Kedah MIC chairman and a state executive councillor with a datukship.”

Ghani’s training began in the wards before he moved to the casualty section and lastly to the operating theatre.

“At that time, the government was heavily promoting family planning, and the KKGH operating theatre was used for vasectomies and other surgeries. I would assist Dr Subramaniam in this. In fact, we had something called Family Planning Day for the whole district during those days.”

He recalls that trainees had to study on their own, with guidance from the medical officer and qualified EHAs. The training was hands-on, not book learning in a formal educational institution.

After three years, Ghani passed the Grade 3 EHA examination conducted by the Ministry of Health and was absorbed as a hospital assistant in the KKGH with a starting salary of RM285.

Four years later he passed the Grade 2 EHA examination, and three years after that he passed the Grade 1 examination to become a senior EHA.

A dying breed

The 1970s was a time when there were comparatively few government hospitals and clinics. People, especially in the rural areas, had to travel long distances to get treatment. It was a time when estate group hospitals played a crucial role in public healthcare in Selangor, Perak and Kedah.

Kedah’s estate group hospitals, for instance, would handle minor surgeries, deliver babies, and attend to those who came with ailments and injuries. They treated not only estate workers but also smallholders. Their doors were also open to residents of villages in their vicinity.

Close to 95% of EHAs in the early days were Indian as they were the only ones willing to work under the difficult estate living conditions.

Estate group hospitals, however, closed down in the late 1990s. One reason was the cost of maintaining them; another was the increase in government clinics and hospitals in rural areas. Also, more estates began to have their own clinics managed by at least one hospital assistant.

Consequently, EHAs like Ghani became a dying breed as there were no estate group hospitals to provide the type of practical training they had received from the 1960s to the early 1990s.

In the early 1980s, Ghani began working at the Bentong Estate in Pahang but about 10 years later moved to the Serdang Group Hospital. In 1999, he joined Guthrie Estates in Sabak Bernam, which later became part of Sime Darby Plantation.

“This is where I acquired knowledge about the Roundtable on Sustainable Palm Oil (RSPO) and learnt more about estate management,” he says.

One of the most unforgettable moments for Ghani was when he attended the EHA/medical assistants convention for Sime Darby Plantation in 2011.

Given an opportunity to speak, he voiced the feelings of EHAs, pointing out that medical assistants who were recruited into the plantation sector were getting higher salaries than EHAs who had more experience. Estates were then employing diploma holders trained in healthcare at private institutions as medical assistants.

Ghani told the top management that it was unfair for EHAs to be paid lower salaries, and that it was time to standardise the salaries and perks of EHAs and medical assistants as their workload was the same.

He received loud applause. Some of the EHAs even started shouting, “Hidup Ghani!”

“I was very happy when, within two months, Sime Darby headquarters sent a letter asking all EHAs to go for a refresher course at the Sime Darby Nursing School on weekends to be upgraded to the same level as medical assistants,” Ghani says.

“I was glad that the management listened to its staff and did the right thing.”

Even today, when Sime Darby EHAs see Ghani, they salute him for it.

‘Closed but quieter’

Ghani retired from Sime Darby in 2015 and was employed by Southern Perak Plantations as a senior hospital assistant, where he works until today.

“This is where my knowledge of RSPO helped in implementing Malaysian Sustainable Palm Oil certification measures in plantations owned by Oriental Holdings Sdn Bhd,” he says.

Asked whether he is bored after all these years in an estate environment, Ghani replies no. Life as an EHA is “closed but quieter”, he says, and he has no regrets.