Recently, I read an article titled “We need smarter ways to keep people out of hospitals”, which highlights a reality many already know: hospitals are overcrowded, and healthcare workers face immense pressure because illnesses are often addressed only when they have become severe.

The article is right – if we truly want to reduce hospital visits, the solution is not just to build more facilities. We need to rethink how we approach health itself.

One Health surveillance

One of the most effective ways to do this is through One Health surveillance. One Health is a simple idea: human health is closely linked to animal health and the environment we live in.

Many diseases do not begin in hospitals; they start in our homes, workplaces, farms, forests, rivers, and neighbourhoods. When these early warning signs are missed, infections spread silently until people become seriously ill and require hospital care.

Take tuberculosis (TB), for example. TB remains common in Malaysia, especially among people living in crowded conditions, migrant workers, and those with weakened immune systems.

TB spreads through the air and often develops slowly. Without early screening and good information sharing between clinics and public health teams, many patients only seek help when their lungs are already badly damaged.

By then, long and costly hospital treatment is unavoidable, even though early detection could have prevented this.

Another example is leptospirosis, a disease many Malaysians associate with floods, rivers, and outdoor activities.

It spreads through water contaminated with urine from infected animals, especially rats. After floods, cases often increase.

Unfortunately, many patients only reach hospitals when they are already suffering from kidney failure or severe infections.

Better coordination between environmental monitoring, animal surveillance, and public warnings could prevent many of these cases before exposure happens.

Scrub typhus is another disease that often goes unnoticed, particularly in rural areas, plantations, and forested environments. It is spread by mites living in bushes and tall grass. Farmers, soldiers, and outdoor workers are most at risk. Early symptoms such as fever, headache, and body aches are frequently mistaken for common flu.

Without early diagnosis, complications can develop and hospitalisation becomes necessary, even though early treatment is simple and effective.

We also cannot ignore dengue, which continues to place a heavy burden on Malaysia’s healthcare system.

Dengue is not just about mosquitoes; it is strongly influenced by environmental conditions, human behaviour, waste management, and urban planning.

When data from local councils, clinics, and laboratories are not shared quickly, outbreaks grow unchecked.

Hospitals then become overwhelmed with severe dengue cases that could have been prevented through early mosquito control and community action.

Other diseases closely tied to Malaysia’s environment include melioidosis, a serious infection found in soil and water that affects people with diabetes, and hand, foot and mouth disease, which spreads rapidly among young children in childcare settings.

These diseases all send the same message: waiting until patients are sick enough to be admitted to hospital is simply too late.

Analysing health information

To change this, data sharing across sectors must improve. Health information should not remain locked within hospitals alone.

Clinics, laboratories, veterinary services, environmental agencies, and local councils all collect valuable data. When this information is connected and analysed early, authorities can identify risks sooner and respond faster, before illnesses spiral into outbreaks.

Equally important is community education. Prevention is effective only when people understand why it matters.

Malaysians should know when a long-lasting cough could signal TB, why a fever after floods may not be “just flu”, how outdoor activities can expose them to scrub typhus, and why early treatment is safer, cheaper, and far less stressful than hospital admission.

Health messages must be simple, practical, and delivered in languages people understand. Telling people to “stay healthy” is not enough.

They need clear guidance: When should I see a nurse? What symptoms should I watch for at home? What environmental conditions increase the risk? Community leaders, schools, workplaces, and local clinics all play an important role in spreading this knowledge.

Building trust and encouraging community participation also help ease pressure on hospitals.

Keeping people informed, empowered

When people feel informed and empowered, they make better health decisions, avoid unnecessary hospital visits, and seek help earlier.

This allows healthcare workers to focus on patients who truly need critical care and improves overall outbreak control.

In short, smarter healthcare means detecting disease earlier in people, animals, and the environment, sharing information quickly so it leads to action, and educating communities in ways they can understand and use.

By embracing One Health, strengthening data sharing, and investing in meaningful public education, Malaysia can shift from responding to illness in hospitals to preventing it in the first place.

This approach reduces healthcare costs, protects families, eases the burden on hospitals, and strengthens our ability to face future health threats.

-- BERNAMA

Dr Zubaidah Ya’cob is an Associate Professor and Researcher at the Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya and may be reached at zyacob@um.edu.my .