11th January 2012, Day 6 of DHO posting
Today we were attached to the Water Supply and Environmental Sanitation Unit or Unit BAKAS (Bekalan Air dan Kebersihan Alam Sekitar in Malay language). We were placed under the supervision of Puan Dian binti Mohd Isa, Assistant Environmental Health Officer and her assistant, Encik Saidin Mat, Assistant Health Officer. The following are the main areas of concern to the Unit BAKAS:
i) Methods of safe water supply to rural areas
ii) Disposal of wastes
iii) Waste Management
iv) Job responsibilities of health officers
v) Water quality monitoring
Methods of safe water supply
There are various methods by which safe water can be delivered to households including the Gravity feed systems, well systems, rainwater harvesting and so forth
There are various methods by which safe water can be delivered to households including the Gravity feed systems, well systems, rainwater harvesting and so forth
Disposal and Management of wastes
Solid wastes: Wastes are burnt in a cement container outside the house. Ashes will be used as fertilizers
Water wastes: Water is collected in a small drainage basin made of cement outside the house.
Job responsibilities
There are approximately 21 mukim or sub-districts in English. Each sub-district has about 13- 14 villages. 1 health officer is in charge of 2-3 sub-districts.
Each Health officer has the task of carrying out monthly inspections on toilets and waste water drainange systems. He must also report if there are newly built houses or increase in number of people in a given area which falls under his purview. This is so that the Districit Health Office can evaluate the adequacy of water supply in the area and forms the platform for further action.
The health officer will also carry out water sampling 6 months once to ensure good water quality.
The stipulation is that each health officer must complete his survey on at least 2 villages by the end of each month.
As usual, we gathered in the meeting room and awaited further instructions. Puan Dian, who was accompanied by Encik Saidin, came in not long after we had settled down and talked to us briefly about the plan for the day. We got into our vehicles and quickly set out on our trip. After a quick drive, we arrived at our first destination: Kampung Gelung, Mukim gelung. Here, we saw Sistem Pelupusan Air Limbah (waste water diposal system)
Next, we were also shown the method in which solid wastes are disposed. (sistem pelupusan sisa pepejal). A huge cement container is used for this purpose. The solid wastes are burnt. The ashes from the burned wastes will find their way through the multiple openings at the bottom of the cement to the ground below. These ashes will then be used as fertilizers. To prevent pollution, a cover is used.
Above images are of the cement container used for burning solid wastes. The latter shows the bottom of the cement container. Ashes from the burned wastes will exit the container here.
After that, we all set out for Kampung Hutan terabak. Here, the officers showed us the tube well system (Sistem Telaga Tiub) . It is only built if there is no tap water supply in a given area. This method of water supply is not preferred as ground water may be contaminated by fecal matter. The well sytem extends approximately 120 feet beneath gorund level.
the tube well system
Our next destination was Kampung Pahana. The officers explained to us about the Flush toilet (tandas curah) system used here. Coincidentally, there was a household which is still using the well. And we also saw the waste water drainage system which was similar to the one we saw earlier.
Water obtained from the well
Flush toilet (Tandas Curah) connected to a septic tank (far right of picture)
Our last destination of the day was Kampung Buluh Nipis. Here, we were shown a modern motor-driven well system.
After visiting the final site, we returned to the District Health Office for briefing on Communicable Disease Control. We had a great time with Puan Dian, Encik Saidin and Dr Kyaw Min.
Prepared by Nicholas Cheong
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DEPARTMENT OF DISEASE CONTROL
1. Vector Control
2. Centre of disease control (CDC)
3. Tuberculosis4. HIV/AIDS
CENTRE OF DISEASE CONTROL
Venue: DHO Kubang Pasu
Time: 11am
Speaker: PPKP Nur Diana bt Nanyan
Organization chart
To be updates as the PPKP was unable to produce her department's organization chart. Planning to retrieve from the management office. Sorry for the inconvenience caused.Main Responsibilities
A. Notification- This is to be done by doctors (medical practioners) from clinis of both government and private, doctors from hospitals of both government and clinic.
- There are forms (with under the Act of Prevention and Control of Communicable Disease 1988) where doctors or any health workers will report cases of NOTIFIABLE diseases within 24 hours or 7 days depending on the type of disease.
- These forms are not to be printed by anyone,only by government authorized printing companies as they are individually numbered.
- The forms include information like name, IC num, Address, Phone num, Age, DOB diagnosis, diagnose by who and when, onset of disease, signature of doctor who is reporting.
- The doctor which failed to report the case or wrongly reporting a case will be compounded with RM500 by the DHO.
- With the reporting, DH officers will procede with investigating the case. This is when the add and phone num comes in handy.
- First, to contact the patient, informing themabout a home visit.
- Home visit includes checking the house condition, patient's condition, CONTACT TRACING.(esp inportant in cases like HIV, leprosy, TB etc)
- Also, officers will collect samples for futher lab inx if needed - eg of specimen: stool, urine, blood, sputum.
- Not forgetting, HEALTH EDUCATION. it is very important part of home visiting however the prupose of this is for prevention and control with is the next subtopic.
- There are various methods of prevention and control. All differs from one disease to another. I will explain a few that was told to us.
- Typhoid/Paratyphoid - disinfection with sodium hypochlorite, lysol, dettol, promoting gotong-royong.
- HFMD - isolation of cases,preventing them to go to daycare, putting mattress under sunlight.
- Leptospirosis - informing the department of Forestry regarding contaminated water source, to close down recreational areas (waterfalls) and water sampling done. Only with 3 negative results that the recreational park can be reopen.
- Most of other disease- health education on methods of preventing, spreading methods.
Recording data (usage of ICT)
A. e-Notification
- Monitoring of communicable disease.
- Used in all DHO, state level and Ministry of Health. (only government)
- Future plans to expand to KK, hosp and private practioner level.
- Able to register case, delete case(repetition, wrong diagnosis) and transfer case (from one district to another).
- Filled with details of communicable diseases of the whole Malaysia.
- Can be said to be like a POT OF GOLD =)
C.my- TB
D. NAR (for AIDS/HIV)
E. e-siasatan measles (SM2)
- new system, introduced around 5 years ago. Collected data from 2006-2011.
YEAR | REPORTED AND CONFIRMED CASES |
2006* | - |
2007* | 2 |
2008* | 12 |
2009 | 34 |
2010 | 28 |
2011 | 13 |
*Suspect under reporting because system was very new.
Yearly Report
PPKP was very kind to share with us an excel sheet of the whole 2011 reports. I have summarize the num of cases that was reported throughout the whole year as below:
There are many more information and I will share this in the upcoming presentation =)
Num of cases reported in 2011 | 594 |
Types of disease | Num of cases |
Cholera | 1 |
Dengue | 10 |
Dysentry | 13 |
Food poisoning | 234 |
Gonorrhea | 3 |
HFMD | 38 |
HIV/AIDS | 38 |
Influenza | 5 |
Leprosy | 3(all was multibacilli) |
Leptospirosis | 93 |
Malaria | 3 (2 was P.Flaciparum, 1 P.vivax) |
Measles | 18 |
Pertussis | 9 |
Syphillis | 6 |
TB | 99 |
Thyphoid/Parathyphoid | 13 |
Viral Encephalitis | 1 (Japanese Encephalitis) |
Viral Hepatitis | 7 (4 Hep B, 3 Hep C) |
18 out of 24 Notifiable diseases were reported in the district of Kubang Pasu.
LIST OF NOTIFIABLE DISEASE:
- Chancroid
- Cholera
- Dengue Fever and Dengue Haemorrhagic Fever
- Diptheria
- Dysentry
- Food Poisoning
- Gonococcal infections
- HIV (all form)
- Leprosy
- Malaria
- Measles
- Plague
- Poliomyelitis
- Rabies
- Relapsing Fever
- Syphilis (all form)
- Tetanus (All form)
- Tuberculosis (all form)
- Typhoid and Paratyphoid Fever
- Typhus and other Rickettsioses
- Viral Encephalitis
- Viral Hepatitis
- Whooping cough
- Yellow Fever.
Prepared by,
Yee Thean Sim
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