Saturday, August 2, 2008
DAY 3 of DHO posting
today's programme was on geriatrics health, adolescent health, as well as malnutrients. To this we have to go to Klinik Kesihatan Kuala Kedah, to meet Mr. Romli(medical assistant). he brought us around the health clinic to give us insight of health care services available in the clinic. then the person incharge of each department brief us on activities conducted in their respective departments. at noon one of our aimst lecturer, Dr. saurirajan join us for the discussion, and gave us more information regarding the activities conducted by the departments. thats all.....good bye
DAY 4 and DAY 5 from SIK District Clinic
Day 4 (31.07.2008) - we had a talk by the PPKP Mr Asri regarding Food Quality and Safety
details regarding day 4 will be added as soon as possible as we attended a field work with the PPKP to a restaurant for an assessment of the food quality and safety.
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Day 5 (3.08.2008) - at 9am, we had a talk by the
KMAM- Kawalan Mutu Air Minuman (PPKP Noor Hazimah)
Functions to increase QOL thru safe drinking water … free of E.Coli in general
(indicator) . They include:
- programme for safe drinking water
- budgeting the programme in the district level
- interpret results of sample tested by Jabatan Kimia Pg … if not available, then sample will be sent to Jabatan Kimia Ipoh.
(clarity of water must be NTU<5)..>
- sample collected once a week for one year in a Thio bag which contains thiosulfate.
5.check on the chlorine level in the treatment plant and give suggestions to the water
supplier (>0.2)
- investigate based on the reports given by the community regarding dirty drinking water.
- samples taken from sampling point of a blue box which is labelled as JBA
- other than the Thio bag, samples are also taken in universal bottles
- hache meter is used which tests for turbidity,ph,total dissolved solids,chlorine.
- maintenance of water quality system
- water also assessed for temperature in a reference bottle where the temperature
should be between 4 to 10 C.
PPKP NOOR showing how the sample collection is done..
at 11 am .. we had a talk by the KPAS or Occupational HEalth and Environmental Health PPKP Mr.Zaki on the functions and activities they do.
Functions of the KPAS unit:
1. inspection of hospitals
2. farm and garbage disposal area inspection
3.licensing of kindergarten, poultry and rubber industries
4. harzard analysis
5. inspection of quaries
6. healthy setting of a workplace and so forth
other than that, they also participate in the enforcement of tobacco production control and from time to time, they do check on the NAtional Service Camp site to keep track of the facilities provided for the National Service candidates.
we called it a day at 1pm ... more to come tomorrow..
Friday, August 1, 2008
d' Padang Terap Team reporting...
Day 8(05/08/08)
Today we had briefing on Occupational and Environmental Health unit or KPAS (Kesihatan Pekerjaan dan Alam Sekitar) by Mr. Muhammad Fadzil(PPKP). We had short briefing on how the unit is works and as a field work, we followed him for an auditing work in a “Klinik Desa” nearby.
On his briefing, he explained to us that this unit only responsible for the occupational health of individuals working under the health ministry. The unit is responsible in providing all the safety equipments needed by other units and also health care providers. For example they provide safety vest for JM’s in “Klinik Desa” used when they go for house visit.
Then he explained to us about the forms that used to record the cases in health care units. The diseases are noise induced hearing loss, skin diseases, poisoning and lung diseases. Accident and sharps injury also will be notified and investigated.
Besides that, KPAS also responsible in making sure that certain group of health care providers get their Hepatis B vaccination. They are doctors, pharmacists, nurses and laboratory workers. Everyone who falls into this category will require having their vaccination and a card will be given to them stating the date of injection, anti-HBs test and HBsAg test result for further reference.
End of the session, he explained to us about the auditing process required to access the safety of workplace and also the safety precautions taken by the workers. This requires us to fill up two forms and there will be a calculation to get their demerit point. The demerit point will be reference when they should have the next auditing. If the point is more than 75%, the next auditing will 3years once, followed by 2 years once if the point is 50-75% and less than 50% indicates auditing of 6 months once. The form that used is OHU/Audit H&S-1 and Sheet 1.
Then we visited “Klinik Desa” Nako Nambua for auditing. Upon reaching and greeted by the JM, we start our auditing with the help of PPKP and his assistant. It takes about 1 hour to finish our auditing. Our attachment with KPAS unit is over with the field work in “Klinik Desa”.
d" Padang Terap Team Reporting....
Day 5 (1/8/08)
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...
Padang Terap Team Reporting....
Sorry for late update of daily report of my group. It is due to some technical problem that cannot be avoided.
Day 3 report:
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:
1. screening
2. diagnosis
3. 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.
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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.
more info to come as special report.
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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
