Malaysians begin Code Black protests in support of contract doctors

Addressing a problem that has been growing since 2016.

July 1, 2021

Malaysians begin Code Black protests in support of contract doctors

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The Code Black online protests have officially begun in Malaysia, where dissatisfaction pertaining to the treatment of contract doctors has driven many in the country's medical industry to turn their social media display pictures monochrome.

The issue regarding the poor handling of contract doctors, or contract healthcare workers (HCWs), has become a hotly discussed topic as of late, and has culminated in people calling for the Malaysian government to resolve the many issues afflicting contract-based HCWs.

IMAGE: The Atlantic

For those unfamiliar with the situation, Malaysia's healthcare system requires that all fresh medical graduates undergo employment at government institutions for no less than five years after graduating.

But over the past decade, the country has faced an oversupply of medical professionals owing to a large number of graduates coming from the country's many medical schools.

In addressing this problem, the Malaysian government introduced a system in 2016 whereby new doctors would only be offered contractual positions at healthcare institutions rather than permanent roles.

Meant as a stop-gap measure, the system ensured that new medical care graduates were only offered contracts that excluded the many benefits enjoyed by doctors in permanent positions, such as access to specialist training, postgraduate opportunities, and progressive salary increments.

IMAGE: China Daily

These contracts were offered on a two-year basis, and saw many of Malaysia's newer doctors enter into working conditions with long working hours, non-existent benefits, and no clear opportunities for upward mobility in their careers – a far cry from the better conditions enjoyed by their peers with permanent positions.

Compounding the problem is the fact that only 789 of the 23,077 contract HCWs (three percent) have been offered full time positions since the implementation of the system in 2016. With the selection criteria not being made clear, the vast majority of contract medical professionals have been left with a sense of hopelessness and no long-term job security.

Right now, most of the contract HCWs face the expiration of their latest tenures at the end of 2021, with no small number still unsure about their futures following the end of their contracts – will they be offered renewal, a permanent position, and perhaps better benefits? Or could they possibly face extended periods without a steady source of income?

Enough is enough.

With no reassurances in sight, thousands of young doctors have now started to revolt, with the Code Black campaign one of the larger shows of displeasure among many others in Malaysian cyberspace.

IMAGE: MMA Schomos

The campaign was organized by the Malaysian Medical Association's (MMA) Section for House Officers, Medical Officers, and Specialists (Schomos), and has since encouraged both medical professionals and public supporters alike to swap their social media profile photos for a black or monochrome image from July 1, 2021 to July 12, 2021.

For the final day of the campaign (which has been dubbed "Black Monday"), contract HCWs have been urged to show solidarity with their peers by dressing in black for work (of course, this is only applicable for those needing to be physically present at their places of employment).

One other impending move is a large single-day strike called #HartalDoktorKontrak (which translates to "contract doctors' strike") that's set to happen on July 26, 2021, where a group of independent doctors have threatened to down tools and walk out should their concerns not be addressed by the government by then.

Although, the movement has attempted to rally more young contract doctors to the cause, the MMA has said that it does not condone such measures, and reminded Malaysian healthcare professionals of the guiding principle within the Hippocratic Oath that instructs them to do no harm.

Many have eagerly joined in the Code Black movement, with some also planning to join the upcoming walk-out. All of them have made the same demands for better benefits, opportunities for career progression, better working conditions, and of course, job security.

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One doctor anonymously told Free Malaysia Today (FMT) that the current conditions faced by contract professionals were akin to "modern-day slavery", while a number of others have lamented the physical and psychological strains being currently faced, especially with the ongoing pandemic making things all the more difficult.

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So far, many individuals and organizations have acted on the call to go black, with groups such as the student-led Malaysian Medics International (MMI) swapping all of its colored display pictures for monochrome images on its social media channels.

"We have again and again, called for the Ministry of Health to improve the welfare of contract medical officers," MMI said in a separate post on Facebook. "However, we have again and again, received minimal to no response from the government."

"This idleness has caused burnout and extreme feelings of dissatisfaction amongst junior doctors, unfortunately leading to the HARTAL (strike) movement that we are seeing today."

One female supporter of the movement posted up a monochrome photo of herself in solidarity with the cause, saying, "I have seen a lot of my fellow contract colleagues opting to quit the Ministry of Health, migrate to other countries, and even give up their childhood dream of becoming a specialist."