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.

JITRA :Antenatal COLOR Coding

An update of our earlier posting on maternal health....today was our Inspectorate general briefing.

MANAGING THE PREGNANT LADIES ACCORDING TO THE COLOUR CODING SYSTEM


RED COLOR –IMMEDIATE ADMITTANCE TO HOSPITAL

1. Eclampsia
Preeclampsia-high blood pressure with albumin content in the urine 1+ or having such symptom or BP >160/110 mmHg.
2. Chest pain during pregnancy with sign symptoms like shortness of breath and palpitation
3. Breathing difficulty during doing mild work like swiping the floor, washing dishes
4. Uncontrolled diabetes during pregnancy ( presence of ketone bodies)
5. Bleeding per vagina during pregnancy
6. Abnormal heart beat of the fetus
· FHR < 110/min at and after 26 weeks
· FHR > 160/min after 34 weeks( heart rate is raised in premature)
7. Presence of anemic symptoms regardless the gestation week
8. Premature contraction of the uterus
9. Leaking liquor without uterine contraction
10. Severe Asthmatic attack



YELLOW COLOR-REFERAL TO FAMILY MEDICINE SPECILIST /O& G CLINIC NEARBY

1. HIV positive mother

2. Hepatitis B positive mother

3. High blood pressure > 140/90 and <160/110>

4. Diabetic mother.

5. Reduced foetal movement at > 32 weeks of gestation.

6. Gestation is more than 7 days from the Estimation Date of Delivery

7. Multiple pregnancy


GREEN CODE-REFERRED TO MEDICAL OFFICER (M& HO)

1. Rhesus negative.
2. Body weight of mother before pregnancy or at booking weight is <>
3. Current health problem ( including psychiatry and handicapped) except Diabetes and Hypertension.
4. Past Gynecological operation.
5. Drug/cigarette/alcohol addiction.
6. Unsure Last Normal Menstrual Period ( LMNP).
7. Past History of continuous miscarriages ( > 3 times).
8. Past history of obstetrics.

· Caesarean

· History of Pregnancy Induced Hypertension / Eclampsia / Diabetes

· Premature Death

· History of Low birth weight of the new born -

· Third degree perineal tear.

· Sticked placenta.

· Post partum hemorrhage.

· Instrumental delivery.

· High blood pressure with urine albumin.

· Anemia.

· SFH difference of 4cm compared to gestation period.

· Head did not engage.

. Weight more than 80kg.

· Elongated labor.

· Abnormal lie.

WHITE CODE 1 – HOSPITAL DELIVERY

1.Primigravida.

2.Young or old mother.

3.Grand multi Para( 6 or more).

4.Height of less than 145cm.

5.Single mother.

6.Unsuitable home environment.

WHITE CODE 2 – ALLOWED FOR HOME DELIVERY/ ALTERNATIVE BIRTHING CENTRE

1. Gravida 2-5
   
2. No past obstetrics problem.
   
3. No medical problem.
   
4. No past antenatal complications.
   
5. Height of more than 145cm.
   
6. Child-bearing age.
   
7. Appropriate fetal size and weight.
   
8. POA is between 37 and 41 weeks.
   
9. Proper family and social support.