The story of the Sarawak General Hospital Heart Centre began in 2001, when the Malaysian government recognized the need to spread specialist healthcare and promote quality for a burgeoning and aging population. “One must have the courage to lead,” says Professor Sim Kui-Hian, a distinguished interventional cardiologist who was one of the founding doctors of the Sarawak Heart Centre and today serves as a senator in the Malaysian parliament. According to Professor Sim, building a specialist hospital – in his words, “in the middle of the jungle!” – was as much an uphill task as an opportunity.

Challenging Rainforest
Sarawak is the largest state in Malaysia and lies in the northwest of tropical Borneo. Its population is made up of multiple indigenous tribes and immigrant groups spread across swathes of rainforest, some reachable only by air. In the past, no specialist cardiac institutions existed in Borneo, the biggest of the Asian islands. However, once the idea for the heart center materialized, it grew at an amazing pace. Early on, its doctors recognized the benefits of embracing new technology and cutting-edge research.

A Cardiac Center Evolves
In 2004, the facility became the first cardiac center in the country to offer cardiac magnetic resonance imaging. Cardiac computed tomography began in 2005, another first among Malaysia’s government-funded hospitals. Soon after, a research study was carried out to determine the reliability of cardiac CT in assessing coronary disease in individuals with calcium deposition in their coronary vessels. The study included 134 of the heart center’s patients, and the results were published in the American Heart Journal in 2006.1

Affordable Healthcare
Initially a division within the Department of Medicine at Sarawak General Hospital, the center relocated to a new building complex in 2011. The sheer force of modernity is evident throughout the center’s corridors. It offers state-of-the-art cardiac care at a cost envied by most developed nations. Each patient pays RM5 (less than US$2) per visit. This includes a medical consultation, laboratory tests, and medications. A diagnostic coronary angiography costs RM50 (around US$13), and percutaneous coronary intervention would cost RM400 (US$105).

Equal Service for All
“Patients who come from isolated longhouses (a form of communal dwelling used by indigenous tribes and often lacking basic infrastructure), or vulnerable groups are all treated the same as the wealthy,” explains Dr. Ong. The center is unusual in that it makes no distinction between “first-class” and “second-class” rooms on its wards, unlike most Malaysian hospitals. This pledge to equality has certainly been a key to the center’s success.

Numerous Studies
Another key is its commitment to research, which has led to publications in prestigious medical journals that have broadcast local scientific talent to the rest of the world. For example, Professor Sim was a featured investigator in the multinational AVERROES study that involved a new anticoagulant for patients with atrial fibrillation. It comprised more than 5,000 patients across the world,2 and the results have helped to bring a new drug to the market. Similarly, the center recently participated in another landmark international collaboration designed to study the effects of a new medication for coronary artery disease.3

How to Boost Morale
Credit for all research projects is distributed equally among all investigators, regardless of their level of involvement. This has helped to boost morale, to create a sense of ownership, and to keep staff interested in research. “When we first started our clinical trials, it was difficult to motivate our colleagues to engage in research, as it is considered ‘extra-curricular’,” says Dr. Ong. “Then, after seeing the fruits of their work in publication, they couldn’t get enough of it!”

One Team – One Spirit
Today, the Sarawak Heart Centre regularly attracts cardiologists and technologists from as far away as Iran, hosting numerous workshops on cardiology and in particular cardiac CT. A large ornament in the shape of a heart greets all these visitors as they enter the reception hall. If they take a closer look, they will see that it is actually made up of many little hearts. “This has special meaning to us,” explains Professor Sim. “It symbolizes that this center is the result of everyone’s effort, and that it is for the benefit of everyone.”