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Forging Ahead: Bridging Gaps in Global Surgery
9-11th July 2025,
Hilton Kota Kinabalu, Sabah
Rafaie bin Amin
Dr Rafaie is a Consultant Obstetrician and Gynaecologist, Maternal Fetal Medicine (MFM) Specialist, and Head of the Department of Obstetrics and Gynaecology at Sarawak General Hospital, Kuching. He also serves as the Sarawak State O&G Consultant.
He obtained his medical degree in 1996 and Master of Medicine (O&G) in 2003 from Universiti Sains Malaysia (USM). He completed his Maternal Fetal Medicine training in Malaysia and Singapore in 2009.
Dr Rafaie is an Adjunct Professor in Obstetrics and Gynaecology at Universiti Malaysia Sarawak (UNIMAS). At the national level, he chairs the MOH’s Research and Clinical Practice Guidelines Subcommittee under the Jawatankuasa Pengurusan dan Perkembangan O&G, and contributes to MFM subspecialty training and development.
He also holds leadership roles in the Malaysian Medical Council (MMC), including Chair of the MMC MFM Education Subcommittee and the MFM Subspecialty Selection Subcommittee. Internationally, he is a member of the Regional Advisory Group for the International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG), and serves on the MFM Subcommittee of the Obstetrics and Gynaecology Society of Malaysia (OGSM).
His main interests are fetal echocardiography and fetal therapy. He is deeply committed to advancing O&G care in Sarawak and across Malaysia.
Abstract
Global surgery is not new to O&G services in Sarawak and Sabah. For over two decades, district hospital medical officers have performed essential obstetric procedures, such as LSCS, ERPOC, MRP, BTL, laparotomy for ectopic pregnancy, and operative vaginal deliveries, due to limited specialist availability, geographic barriers, and access challenges.
To meet these needs, medical officers were trained and credentialed at major hospitals before deployment to remote areas. This practice saved countless lives and prevented severe maternal and neonatal complications, though specialists in referral hospitals still managed major surgical complications, including maternal deaths when they occurred.
Policies and guidelines were continuously refined to balance safety with the necessity of providing timely surgical care. As Sarawak’s healthcare system advanced, with more specialists, improved communication, and better accessibility, the reliance on medical officers to perform surgeries in district hospitals has declined over the past five years.
Importantly, Sarawak's maternal mortality rate has remained consistently below the national average over the past decade, thanks in part to careful evaluation and adaptation of global surgery practices. Moving forward, implementation should prioritize safety and local context over procedure counts as performance metrics