In 1991, an average man in Malaysia lived for 69 years. In the next 25 years, Malaysia’s social and economic progress created more opportunities for healthcare, education, and jobs, pushing the national life expectancy to 72.7 years. Kelantan’s male populous, however, continued to live only for 69.2 years, throwing it a generation’s progress behind the rest.
For years, nobody understood why Kelantanese men died so young.
Journalist Aidila Razak made an investigation. Was it because Kelantanese eats more sugar? They are, after all, the only people in Malaysia who adds sugar to their roti canais. But the numbers didn’t add up. Kelantan is only ranked eighth when it comes to diabetes.
Was it because they have the lowest income? Maybe. At RM3,079, Kelantanese has the lowest median household income in Malaysia. But if we plot a graph of household income and life expectancy, it is not clear that low household income was the main cause.
In 2016, Dr Noran Hairi of Universiti Malaya came up with a reliable answer. She took the map of Malaysia and plotted different shades of brown based on the levels of deprivation. The browner the area, the more socioeconomically deprived. Then she drew circles on each area to represent how many years were lost; the larger the circle, the more likely the population is to die young. What she found was shocking.
Dark brown shades and large blue circles were heavily concentrated on the east coast of Kelantan and Terengganu. Some circles were so large they almost cover the entire area.
When you’re so deprived, you’ve lost all hope
Deprivation goes beyond just income. It asks about the quality of house (brick or plank, bedrooms), drinking water and toilet facilities, education, employment, cars, and variables like whether they own a washing machine and refrigerator. The reason this is more reliable is that it accounts for the surrounding infrastructure that the government creates.
If you are sick and there’s no bus or roads to the clinic that is 20 minutes away, you are more deprived than a person whose house is just 5 minutes from 3 clinics.
Today, the number of hospitals, health clinics, and schools in Kelantan, on a per 1,000 people basis, is still among the lowest in the country. But it is not just the number of facilities; it is also whether they are accessible to locals. A clinic may be only 5KM away, but the lack of roads and public transport means that the journey there is arduous. The queue and income cost meant that it is better to just try to heal at home.
Aidila argued that lack of access, rather than the fear of modern medicine, may be the reason behind why half of Kelantanese cancer patients trust alternative treatments instead.
If you see that the muddy road outside your house hasn’t been fixed for over two decades, you do not hope that one day a clinic will miraculously appear in your community. When you hear your relatives in Kuala Lumpur visited a new shopping mall in their area, you do not for once think that the same would be found in Kelantan.
When nearly 30% of the people in your state still do not have access to clean piped water, your perspective on hope is very different.
Therein lies the context we need to understand the Malaysia Happiness Index. Nobel Laureate Amartya Sen once said that people who live in great misfortune with little hope may get more happiness over the little things they have. But we must not confuse this happiness with an improvement in well-being. A person who has been deprived for decades may now “lack the courage to desire much”, because hope has disappointed them many times before.
Is Kelantan the model state we want?
Therefore, it was painfully hypocritical to hear the Deputy Chief Minister of Kelantan, Mohd Amar Abdullah, proudly proclaim that the Malaysia Happiness Index of Kelantan is a testament to the good work the PAS government has done. All this while Kelantan remains the state with the highest concentration of poor households, second-highest poverty incidence, third-lowest GDP contribution, and chart-toppingsocial ills. Due to the lack of jobs and opportunities in Kelantan, 250,000 youths have fled the state to other economically prosperous places like Selangor – a figure equivalent to nearly 15% of the Kelantan population.
Mohd Amar’s own constituency of Panchor has the lowestnumber of hospitals per 1,000 people in the entire Malaysia. Health clinics, piped water, schools, police and fire stations are all significantly lower than the national median. Is this truly a model state we want to emulate for Malaysia?
Five years ago, Mohd Amar offered an explanation for Kelantan’s lack of progress that is both comical and chilling. He said that while Kelantan lags behind other states, this was “deliberate”, almost like an economic philosophy. PAS could have developed Kelantan into a Selangor if it wanted to, he said, but it preferred the slow pace because they were afraid Kelantanese could not catch up.
In other words, deprivation is justified because it is beneficial to the people. Do it long enough the people will stop hoping, and soon, they will even be happy with what they have.
It doesn’t matter if 30% of the people still do not have clean piped water at home. They can wait a bit longer.
What’s the rush? They’re so happy, can’t you tell?