Aimst University M.B.B.S Community Medicine and District Health Office Posting
MBBS Batch 7 District Health Office Posting in Padang Terap, Kedah Darul Aman
Week 1 (27/07/2008-01/08/2008)
Day 1(27 July 2008)
Reported at the district health office at 9am and we were welcomed by Mr. Musarrahad the Assistant Health and Environment Officer of the Food Safety and Quality Control Unit and subsequently briefed us on the general workings of the district health office. We had a general overview of the demographic details of the locality and the structural unit of the office and their respective responsibilities.
Padang Terap is the one of the biggest district in state of Kedah with total size of 1300 km2 with total population of about 68,768 peoples. The health office of the district situated at Kuala Nerang approximately 35km from North Alor Setar toll exit.
There is 1070 staffs of various ranks working in the District Health Office, headed by its respectable district health officer Dr.Latifah. There is
- HOSPITAL KUALA NERANG
- 4 health clinic
- KLINIK KESIHATAN LUBUK MERBAU
- KLINIK KESIHATAN KUALA NERANG
- KLINIK KESIHATAN NAKA
- KINIK KESIHATAN BANDAR KUALA NERANG aka. HOSP K.NERANG,
- 16 "KLINIK DESA" under the administrative umbrella of Padang Terap District health office.
The ratio of health clinic to the population is, 1:22,922 while the ratio of "KLINIK DESA" to the population is 1:4298.
Soon after the general briefing, Mr.Pregas Rathnam the Assistant Health and Environment Officer of the Food Safety and Quality Control Unit (Unit Keselamatan & Kualiti Makanan) commenced briefing on the workings and organization of the unit. He explained to us the responsibilities and protocols undertaken by the unit to control the safety and quality of food in this district.
Their responsibilities governed are:
- Food safety and toxicology control
- food contamination control program, eradication and control of Aflatoxin in food
- Food sampling
- Food premises inspection
- Closure of food premises
- Food seizing and to destroy if necessary
- Food poisoning investigation and control
- Issuance of license to bottled water manufacturer
- Imported food control
- Exported food control
- issuance of "Health Certificate"
- Prosecutions and legal proceedings
- Industry and consumer education
- Laboratory services support
We were assured that we will be called to join a field work soon………. We thank them a lot for their kind and considerate cooperation.
Day 2 (28 July 2008)
Today at 8.45am, we met with Mr.Azlan Hussain the PKA of HIV/AIDS division of CDC unit. He talk to us about the unit workings and also the AIDS/HIV eradication and education program especially to teens from 13-30 years old. He told us real time stories and the challenges they face in preventing and educating the people on AIDS/HIV.
He also told about the programs and the counselling sessions which they conduct at district level.
Then after the short tea break, we met Mr.Faizul, one of the PPKP of CDC unit about notification of diseases, the procedure involved and also the process of dealing diseases like dengue, thypoid, HMFD and food poisoning. He also chat with us some realtime experiences.
Tomorrow we're joining the CDC unit again and expecting a fulfilled field work.
Till then, chiow.....
Day 3 (29 July 2008)
Padang Terap Team Reporting....
hi! everyone,
As normal we arrived at the health office at 8am awaiting for some field work. As scheduled, today we had be given briefing by Tuan Haji Yaakob regarding HIV/AIDS cases and tuberculosis cases managed.
He started his briefing with some statistic about the HIV/AIDS cases. There is 3 identified HIV -positive case in Padang Terap this year. And he is not able to reveal the total cases that already identified and being treated in Padang Terap District.
His briefing mainly focused on:
- screening
- diagnosis
- what is the role of district health office when HIV/AIDS patient passed away.
Screening
- before marriage, it is compulsory for the Islam couples to get their HIV/AIDS screening done before they proceed with their marriage
- voluntary with details, whereby such person gives their full consent to get their blood tested for HIV/AIDS
- voluntary without name, gives full consent for report but there will be only identification number and the person just can call the office to know their result.
Diagnosis
According to Tn Haji Yaakob, the diagnosis of HIV/AIDS only confirmed after the person who is positive of screening test undergone two ELISA test and both shows positive.
After the confirmation of the diagnosis, the details of patient is will be inserted into CDCIS or E-NOTICE which will act as database for Health Ministry to monitor the cases with the help of DHO.
when the HIV/AIDS patient passed away..Close monitoring by the CDC unit
The patient will be wrapped into few layers of clothes and plastics before given to the their family. The patient will be cleaned with hypochloride solution then a layer of white cloth will be used followed by the plastic cover. Then will be wrapped again with the cloth. This procedure is mainly done in hospitals.
In case where the patient passed away in house and he/she not brought to hospital, the DHO will be providing the family with necessary things such as apron, mask and clothes.
Tuberculosis
Tuan Haji Yaakob explained very briefly about the procedures and the forms that used in process of treating tuberulosis and eradicating the contacts
There is 12 forms that used in case of Tubeculosis.
- Form 10A1- case monitoring
- Form 10A2- confirmation
- Form 10A3- investigation (hospital and field)
- Form 10A4- record purpose
- Form 10B1- hospital record
- Form 10B2-hospital record summary
- Form 10C1 and Form 10C2 - Contact form
- Form 10E - defaulters
- Form 10F - contuination of treatment
- Form 10G- MDRT
- Form 10J- Tuberculosis patient dies (*used only when the patient is still under medication)
He explained the procedures that to be followed when filling up the forms and also investigating the case.
In addition, he talled to us about DOTT (direct observation of tuberculosis treatment). It is normally done in chest clinic in hospital and the patient will be required to come there everyday to take anti-tuberculosis drugs under the observation of the nurses. It is normally done for at least 2 months and more for those who frequently defaulting the treatment course.
Then Tuan Haji Yaakob brought us to Pondok Inabah 1 which located approximately 7km from district health office. Pondok Inabah 1 is the private centre to treat the drug abusers and it is recognised by the Anti-Dadah Kebangsaan (ADH).
There we briefed by the Tok Guru about the drug-free method to treat the drug abusers. It is mainly through holistic methods whereby the principle that they're using is follows Quran.
It was new experience to us whereby until now we thought that only government centers are providing such services.
In afternoon we had pleasant visit by Dr.Sawrirajan.We explained to him the activities had been done so far and he gave some suggestions and instructions that should be done before the end of this posting.
We would like to thank him for his suggestions.
Then we had short discussion with Distric Health Officer, Dr.Latifah. She talked to us about the services that available in Health Clinics in this distric and also states more about the organization chart of the Padang Terap Distric Health Office.
We also would like to thank you her for the guidance and advise given
Pondok Remaja Inabah 1,Malaysia- d' Padang Terap team
On day three of our posting in Padang Terap Health Office. We were briefed on the workings of the communicable disease control unit PPKP Tn.Haji Yaakob who is in charge of the HIV & TB unit. After a comprehensive briefing we were brought to visit a drug rehabilitation centre called Pondok Inabah 1 Malaysia. It is located in a remote place deep in the rubber estate in Pokok Sena district. It is a drug rehabilitation centre especially for Islam’s.
The centre focuses on religious upbringing and enhances the religious beliefs in the drug abuse victims and thus able to eradicate the addiction on the substance. It was said to originate from East Jawa, Indonesia in 1905, pioneered by a religious teacher named Tok Guru Abah Anom. Who set up a religious based drug rehabilitation centre there after concerning for many youngsters who were drawn into the social degradation. The methods of rehabilitation was then was learned by the Tok Guru from Malaysia who thus set up the Pondok Remaja Inabah 1 in Malaysia 28 years ago in Kedah.
Now there are 3 such centers in Malaysia and various counselors through out the country to help the Islamic youngsters to cope and free from such substance abuse behaviors. The methodology or "method" as they call it is fundamentally based on constant religious teaching and prayers. Its concept is to control and cleanse ones thoughts, lust and the heart or emotions. With that they are able to control their desires and thus refrain from such addictive behaviors able to channel their thoughts and desire in a positive channel.
Their main method of therapy is to bath in fresh water at 3am in the morning called "mandi taubat", and then they pray and constantly chant religious scriptures. Despite that they also do various activities such as reading and group based discussions. They also undergo various vocational training in order to self sustain them in the future. The methodology used here is of a holistic approach as to refrain oneself from indulging in socially ill behaviors through inner self control and to be able to accept the community in a new perspective. Thus far their track record incredibly excellent with more than 4000 victims or "anak bina" have been successfully rehabilitated and have attained a very successful life.
Day 4-holiday
Day 5 (1 August 2008)
As normal we reached the office at 8am and we scheduled to have briefing about the non-communicable disease and also the about the enforcement unit.
The officer, Mr.Zuraidi greet us with warm welcome to the meeting with him. He is responsible for two units and he is the only PPKP for that two units which comes under the PPKPK, Mr.Ali.
The two unit that under him is non-communicable disease unit and also enforcement unit. First of all, he started with the details of enforcement unit which responsible in charging those people who caught for health related offense.
He explained to us the flow of the process involved from the point of someone is get caught until the point his/her case goes to the court. He used the example of smoking in area which labeled as non-smoking area.
Unfortunately we can't join him on the enforcement activity even we're just 4 in number because he wanted to avoid the consequences that we will be facing if someone is get caught. We are quite disappointed for not able to join him on his activity.
Before leaving, he briefly told us about the non-communicable diseases and will be telling us in detail next week.
That's all for week 1 of DHO posting...
