REGARDING DATO' SERI ANWAR IBRAHIM'S MEDICAL TREATMENT

 
1.  On the night of his arrest on 20th September 1998, Dato' Seri Anwar Ibrahim was viciously assaulted by the-then-Inspector Police General of Police, Tan Sri Rahim Noor.   During the course of this assault, Anwar fell backwards onto the cement floor with his handcuffed hands directly beneath his spine.  He was denied treatment for this and other serious injuries for several days.  In the months that followed, Anwar complained intermittently of back pain, but it was not enough to warrant a request for special treatment. 

However, in October 1998, he began to experience continuous and increasingly back pain, and repeatedly asked to be given a proper examination at a hospital.  The authorities finally agreed to send him to Selayang Hospital for examination and treatment.  He was not allowed to be warded and thus had to be transported back and forth between prison and hospital.  These frequent journeys further aggravated the problem.  It   was only in late November that Anwar was admitted in Hospital Kuala Lumpur (HKL), where he remained ever since.

2.  Dato' Seri Anwar has been examined by a team of Malaysian specialists as as a specialist from Germany, Dr Thomas Hoogland.  Dr Hoogland's report dated 13th March 2001 (attached) , and which has the agreement of the Malaysian doctors attending Anwar, clearly states that Anwar's condition is both serious and complex.  He is suffering from a big lumbar disc herniation coupled with a tight spinal canal, which has already caused neural damage, especially to the cyatic nerve on the left side.  it is also significantly limits his movement, and causes him continuous severe pain.  The problem is furthermore, growing progressively worse.

3.  It has been the consensus of the doctors that Anwar requires surgery to correct his condition.  Failure to operate will result in irreversible paralysis of the lower limbs and some other functions.  Anwar's condition is an unusual one, and is further complicated by an older injury suffered to his neck.  The doctors have concurred that endoscopic microsurgery is clearly the preferred option in Anwar's case, offering several siginificant advantages over conventional surgery :-

    a)    It is minimally invasive and is performed under local anaesthetic; the patient can thus expect a speedier              recovery

    b)    The approach to the damaged disc is from the side of the spine, thus avoiding the risky procedure (as in              conventional surgery of pushing aside the spinal cord, damage to which could cause permanet paralysis

    c)    The operation is carried out under local anaesthetic so that, during the course of the operation, he patient              can cooperate with the surgeon by informing him when a nerve is touched  This helps to minimize the risk             of neural damage

    d)    Due to Anwar's earlier neck injury, conducting a spinal operation under general anaesthetic would be              inadvisable, as it would introduce an additional risk of causing further damage

    e)    The chance for full recovery after the operation is significantly higher than that for conventional surgery.               Dr Hoogland's technique, if performed in his own clinic in Germany, offers a 90% chance of complete               recovery.

To summarise, endoscopic microsurgery offers greater safety during the operation, and better promise in terms of the outcome of the operation.

4.  Endoscopic spinal microsurgery is a highly specialised field and there are few practitioners anywhere in the world.  Dr Hoogland is a renowned expert in this field, specialising entirely in treating spinal problems.  His experience is probably unrivalled, with 9,000 spinal operations performed.  He has set up his own clinic in Munich, Germany which is fully equipped with the necessary state-of-the-art facilities and also a team and also a team of specially trained medical support staff.

On being informed that the Malaysian authorities would most likely insist that the operation be conducted at HKL, during his visit to examine Anwar, Dr Hoogland also assessed facilities available there.  His report (attached) outlines several major shortcomings which could seriously jeopardise both the safety of the operation and its outcome, namely :-

    a)    The entire main operating theathre complex is under renovation.  Only the smaller neurosurgical                  operation suite and emergency operating theathres are available

    b)    The operating table is too small, being designed for conventional surgery.  For endoscopic microsurgery,              the patient lies on his side, requiring a wider table.

    c)    During endoscopic microsurgery, the surgeon 'sees' what he is doing via an imaging machine.  The              image needs to be large and very sharp (clear).  Although the relevant machine could in theory be brought             to HKL (at great expense), the power source available is not strong enough to produce the required              sharpness

    d)    Medical support staff with the required expertise are unavailable.  In particular, Dr Hoogland's operating              technique requires a very specific method of administering anaesthetic, which can only be performed by             someone with the relevant training and experience. 

In the latest development, a statement by Dr Hoogland released on 9th April 2001 said that he declines to perform operation at HKL due to the government's attitude and inadequate facilities.

5.  Since Anwar's arrest, the Malaysian authorities have several times taken action which seriously endangered his health and safety.  They have also on occassion deliberately hidden from his family his true state of health and safety of his person.   For this reason, Anwar and his family are understandably now very appehensive about entrusting his life and health to any government facility.  This apprehension is intensified by the condition imposed by the government, that Anwar must bear full responsibility for the safety and outcome of the operation. even if it is performed at HKL.

6.  We are sure that Tan Sri is aware of the UN principles for the Treatment of Prisoners (14th December 1990), which document sets out clearly the right of prisoners to have access to any medical treatment they need, wherever it is available.  It would be shameful for Malaysia, as a member of the UN, to act in contravention of these principles.

7.  The doctors attending Anwar are unanimous in their opinion that the assault by Rahim Noor represents a major contributory factor in Anwar's present condition.  The government should thus be held morally and legally liable and should ensure that he receives the best treatment available.

8.  It should be noted that Anwar's family has offered to bear the entire cost of his operation should he be allowed to undergo it at Dr hoogland's clinic.

9.  Anwar and his family have given their proposal assurance that he will return to Malaysia when the treatment is completed.

Tan Sri, after Dr Hoogland examined Anwar, he recommended that the operation should take place between 4-6 weeks from the date of his examination.  5 weeks have already passed, and it is therefore imperative that permission should be given immediately for Anwar to proceed overseas for the operation.

It would be an enormous tragedy and to eternal shame of our country if this man, who has contributed so much to the nation and has, over the last two and a half years been subjected to unprecedented injustice and cruelty should be allowed to suffer paralysis when it could be avoided.

Anwar is the chosen leader of the ALternative Front and a majority of Malaysians still want him to take his rightful place as the future Prime Minister.  This, too, is their democratic right.

We would like to thank you for all the initiatives and interventions that you have taken, and will, we are confident, continue to take as a Commission taht upholds the rights of all Malaysians.  We know you can make a difference.



Hjh Fuziah Salleh
Head,
Women's Wing
Parti Keadilan Nasional