Community Medicine Batch 9

Our Last Day in Sik

2009-02-26T23:31:00.000-08:00

Hi everybody! As all of us know, today is our last day of DHO posting in Sik. Although we are here just for two weeks, we can feel the “farewell day feeling” on our last day..

Actually, today our programme is outdoor activity. According to our schedule, we will be having short briefing on Bekalan Air dan Keselamatan Alam Sekitar(BAKAS). First we went to Pejabat Kesihatan Daerah Sik. The PPKP unit was in charge to guide us to Kampung Sungai Senam.

Then, to proceed further to top of the hill, we get into one jeep. This is definitely a different experience for all of us. We travel through the jeep along the way to hill. The jeep stopped halfway, and we experienced hiking to continue our journey to the place where water is stored.

The place is called Gravity Feed System (GFT). The GFT is built in 1987, but just functioned for 2 years and has not been used after that until now. Currently, the village people are planning to reconstruct the GFT. The source is from the hill water and supplying to village people.

Together with us and the PPKP, many village men followed us to the hill. After reached the hill, the Tok Imam of the village gave us a short briefing on the GFT, how it is managed and the reconstruction planning. Then, the PPKP showed us the method of checking water conductivity, oxygen content, pH and turbidity. The range of normal values for conductivity is <100, for oxygen content (by oxygen meter) is 1-1000, for pH is 5-7 and for turbidity is 1-1000. This is to ensure that the water is safe to drink by the village people.

After that, we had breakfast and drink prepared by the village people, which is not new thing for us in Sik. The village people are very friendly and humble as well.

This is our beloved captain, Mr.Nitiyanantham.

All of a sudden, one guy jumped into the water to open the pipe, and to allow the flow of the water. Photos below showing the chain of reaction of that incident.

After that, we came down the hill by the same jeep, and then by car back to Kampung Sungai Senam. Then, we went to Pejabat Kesihatan Daerah (PKD) Sik. We said goodbye to the people in PKD and left to Sungai Petani.

At the end of the day, we planned a get-together, so that we can share our memories in this past two weeks in Sik. So, we went for dinner together in Wandly Siang. Eventhough we were tired, we spent a lot of time tonight chit-chating with each other. We were very happy that we could work together. Through this posting, we learnt a lot about team work and hope we will get a chance to team up again in future. Goodbye and meet again next time!

Group A:Day 10 Kuala Muda

2009-02-26T19:43:00.001-08:00

The day started with a lecture on the scope of services provided by the Primary Healthcare unit by Encik Yusof, who is a long- serving Medical Asisstant with 27 years of experience. He was very passionate about the significance of Primary Healthcare and emphasized much on the definition and impact of Primary healthcare on the community.

Primary Healthcare is essential health care which is based on practical, scientifically sound and socially acceptable methods and technology and should be made universally accessible to individuals and families in the community. It forms an integral part of the country’s health system and has a central function in the social and economic development of the community.

Primary health care becomes the first level of contact for individuals, the family and the community with the national health system, bringing health care as close as possible to where people live and work and constitutes the first element of a continuing health care process.

Another unexpected incident that happen that day was Encik Yusof became the 1^st person in the district to give us a treat in the hospital canteen. Everyone had some light moment after the lecture.

Thus, in Kuala Muda District alone, there are 6 Klinik Kesihatan, 1 Klinik Kesihatan Bandar in Sungai Petani. Specific clinics such as Chronic Diseases Clinic which cater for patients with diabetes mellitus, hypertension etc. and Mental Health Clinic are also available within the Klinik Kesihatan. Another branch in Primary Healthcare which is rising in importance is the “Expanded Scope of Healthcare”, which includes Adolescent health, Geriatric health and a Quit Smoking Clinic.

Later in the day, we visited a secondary school (SM Sg. Layar). A group of staff nurses and Jururawat Masyarakat were already there to organize an Tetanus immunization session for Form 3 students. When we went there, we were asked to help out in physical examination of the students. It was quite overwhelming to see never- ending batches of students streaming into the room. Nevertheless, we were able to start organizing ourselves to perform physical examination and giving the ATT injections in an orderly manner.

In the afternoon, after a very late lunch at 3pm, we went to the out- patient department at Klinik Kesihatan Bandar Sg. Petani to collect some health clinic cards, forms and to observe the running of the OPD.

DAY 9 IN SIK

2009-02-26T07:37:00.000-08:00

Today morning at 7.30,we start our journey again to Sik.Thick mist along the way make us as tough we are entering Genting Highland.We reach PKD at 8.30am.At 9AM,PPKP Mohd.Dzullkifli Che Mit and PPKP Mohd.AsriHarun,from the food quality control unit,gave us briefing about food quality control and sampling of food.During the 2 hour talk,we learnt in detail about the process of food quality control and also about the Food Act 1983.

HACCP-Hazard Analysis Critical Control Point is identification of critical point(cp) or critical control point(ccp)in the process of making food which begin from the process raw food until to the end product.Identification of CP and CCP help in preventing occurance of food poisoning and besides that we can take preventive measurements at the point of the food production.

Then,we had a visit to Sek.Men.Kebangsaan Agama Sik to observe the management of canteen (DAPUR ASRAMA)in the context of cleanliness,preparation of food and also about the anti-thyphoid vaccination status among the food handlers.

First we visited the cold storage where raw foods such as chicken,fish,prawns are stored for daily uses.

There was another store room to keep dry foods such as rice,eggs,oil and other cooking things.

En.Ridzuan,the head of the "dapur asrama" ,gave us briefing about food handling safety and also the cleanliness of the canteen.

En.Ridzuan showed us the immunization cards of his workers.Each vaccination is RM20 for Malaysian citizen and RM40 for immigrants.

He also showed us the list of daily menu of the food to be prepared for the students.

This is the dining hall of the school.Wah,big,clean,filled with antique and attractive items.
And again the hospitality of people of Sik is truly touching.We were served with mee goreng,nutritious fruits and tea.

At night,8.30pm we had a golden opportunity to follow the officers fromthe FQC unit to three food premises in Sik.

At each premises,the officers invigilate about the cleanliness of the premises,the antityphoid vaccination status among food handlers and also the safety of the preparation of foods.

The is a specific scoring system used to evaluate the safety of the premises.If the scoring is less than 70%,the premise will be closed.We visited 3 premises and the second premise was closed due to two main reasons:none of the food handlers have been vaccinated against typhoid and raw foods were not kept properly which can lead to cross contamination.

Padang Terap D10: FINALE

2009-02-25T19:51:00.001-08:00

‘Wei... cun we are going back! Getting up early not as usual would be a scene to be cherished. The finale… had come. Lured into the excitement of heading back to a place where we esteem.’ That was the entire discussion the night before.

But the scene varied the day next. Getting up late and quite interestingly a slight dullness was painted on everyone’s face. DHO had Typhoid vaccination that morning and had invited us to join the program. The nurse guided us on methods of vaccination and even gave an opportunity for us to vaccinate some locals. They were mainly food handlers and our experience with needles earlier proved to be helpful.

A short Q&A session with En. Ali to fill up the missing bits on our assignments was the day’s start off. Soon after, we marched to the vaccination place. Some left halfway to get forms that were not available earlier on.
After the session, we were guided downstairs for a farewell party. And as expected, we had a treat that put a smile on our lips. A short photography session concluded our posting.

We were grateful to all members of Padang Terap District Health Office. They've guided us with ease and the entire posting was a fete to our hearts. We’ve learned a lot. Having said so, we do admit that there’s more to go however, our stay in padang Terap perhaps had fruited with experiences of a lifetime. We learned that despite the extensive roles of hospital is indisputable; the community approach of public health has its undeterred function and reputation.

Padang Terap D9: Day Before Finale

2009-02-25T19:50:00.000-08:00

Our second last day in Padang Terap was all about sampling. We began our day in a market where food inspectors from KKM bought two extra large chickens not for meal but for testing. Our officer in charge Mr. Pergas was kind enough to explain us all about food sampling and their role in monitoring. Our morning session ends in the office where we were briefed about food safety and control.

The evening was devoted to KMAM or the water team as we call them. These people took us to a pump station in Kuala Nerang to teach us on water sampling and testing. Again (now not by car but by van) we set out on that 5 minutes journey to a well maintained station. The oficer taught us on all procedures and tests that are routinely performed. It was a great to see sampling and testing being done in that small van.

Well, the day was supposed to end there but our doctor (which is us actually) had their chance to write their first referral letter to the hospital on the kids that we diagnosed during our visit with the school team. That would surely be ‘a dream come’ true for them.

That night we had a special time with our ‘favorite’ Vector Unit’ in seafood shop. Except for the vegans, we enjoyed our food. But the whole lot of us had a great time. We can’t believe that tomorrow would be our last day. Well, every beginning has an end.

Group A: Day 9 Kuala Muda

2009-02-25T07:37:00.000-08:00

On the 9th day, we gathered early to complete our task of gathering additional information from the hospital staff. Then, we marched towards the TB Unit for another essential briefing session by MR Rosli about his core duty in investigating the contact person of TB patient by visiting their respective houses after notification. According to him, it is vital to fill in various forms such as BORANG 10A-1 ( Maklumat Penukaran Rawatan Pesakit TB ), BORANG 10C-2 ( Pemeriksaan Saringan TB ) , BORANG 10C-1 ( NOtis Menjalani pemeriksaan pengesahan ), 'Slip no. daftar TB' and 'maklumat penyiasatan kes TB'.

In addition, the recent format they are practicing now is the ‘e-notis’ system that started in 2008, which it is updated daily by reporting TB cases. As such, any TB cases will be notified in a very short period of time.

There are 3 main treatment centre in Kuala Muda, namely HSAH, KK SP, KK Merbok also known as PR1 while 5 others are in KK Bukit Selambau, Bedong, Bandar Baru Sungai Lalang,, Kota Kuala Muda, and Bakar Arang. These 5 centres are named PR2, where only drug therapy (DOTS) is available. While in PR1, the centre provides extra services such as diagnosing or detecting and treating TB patient in addition to the DOTS programme. These many centres provided by our beloved government are for the conveniences of the public to continue their daily treatment nearby their residence.

The DOTS programme is usually under the supervision of the staff nurses in the TB control unit room. The usual regimes for TB drugs are rifampicin, isoniazide, pyrizinamide, ethambutol, streptomycin. These drugs are packed according to the patients' daily dosage and kept in a white container with the patient;s name written. We also managed to observe, a walk-in patient receiving his daily treatment at the centre.

The evening session started with a breezy rain. MR ZAMANI (PPKP) from the CDC Unit took another two hours of briefing. This unit usually deals with diseases such as TB (MR. Rosli), HIV infection (MR. Hasani) , and communicable diseases which are divided into water and food borne diseases under the management of Pn. Ros and non-water and food borne diseases by Mr. Zamani himself. Being an experienced health officer, he explained about how the notifications of the notifiable diseases were done, common cases that were usually reported such as measles, hand,food and mouth disease, dengue fever, TB, Chikugunya and food poisoning. He showed us various types of forms that must be filled. He also taught us on how to carry out an investigations if an outbreak should occur like, food poisoning. We then learnt about CDC surveillance system such as measles using ‘e-notis’ (SM2) by reporting the cases to the federal health office from the district. Mr. Zamani also shared with us about his job responsibilities in handling HIV patients in which all of us found very interesting. Last but not least, we went to his work place to have an overview idea about notification via ‘e-notis’ using his computer.

Group A:Day 8 Kuala Muda

2009-02-24T08:34:00.000-08:00

FOOD!!

Since most of us are dieting currently it became a sensitive words among us. Lol. Anyway, today the food quality control unit was in charged. As usual, we had a briefing and bombarded lots of questions to them, in particular how they monitor the quality of food and what parameters they used. Since we were so enthusiastic and “aggressive”, Mr. Suhaime and his colleague quickly took some folder with different colors that look like this…

Notice the tagging with different colors in the front page of the folder? It’s for the grading of the food premises. Of course, grade A is the best while grade C is considered as fail.

Grade A------- >=75%

Grade B------- 51-74%

Grade C------- <=50 (the premises will be closed down)

The green color is for restaurant, the orange folder is for makeshift stall, while the red one is for canteen and hawker. In fact, not only the color that differentiate them apart, the food quality control form or checklists they used were also different. As an example, for restaurant, they have a special column for toilet while others don’t have. The health officer will give marks according to the form and act accordingly. The forms are shown below..

Notice the tagging with different colors in the front page of the folder? It’s for the grading of the food premises. Of course, grade A is the best while grade C is considered as fail.

Grade A------- >=75%

Grade B------- 51-74%

Grade C------- <=50 (the premises will be closed down but during this period, they can apply for reopening, which will guarantee a second checking)

As for what they will bring along, they have a “kit” as shown below,

- Checklist

- Infrared Thermometer

- Tag and identification card

There are 7 officers in food quality control unit, of which one of them will do the paper work, 6 officers will divided into 3 teams, 2 officer each, and they will either inspect the premises or take food sampling.

We followed 2 teams, one is to TESCO and the other one is to VILLAGE MALL.

A trip to TESCO

Here, we took samples of wet food at random and sealed it, before transporting to laboratory in Bukit Kayu Hitam via cold box. When asked about quantity they need to take, they give some practical examples.

Chicken- at least 1kg

Fish- at least 1kg

Eggs- at least 10eggs

Prawn- at least 1kg

The lab will test for CHLORAMPHENICOL, FORMALDEHYDE, etc.. surprise right!

As for the dry food, they usually takes 3 samples, of which one will send to lab, one will keep it in their office, one will be seal at the place where they took. Their target is to collect 900 samples in a year. Any violation of food act, the manufacturer but not the seller will be responsible for it.

A trip to VILLAGE MALL

We split into 3 teams, of which they will inspect the food premises in village mall, Secret Recipe, Pizza Hut, Starbuck and Chicken Rice Shop. Usually they will ask for TY2—to prove that for all the food handlers there took the typhoid vaccine, and the city council license. The TY2 is compulsory for all food handlers to take it to provide 3 years immunity against Salmonella typhi.

Next, they will assess the kitchen, food storage, dustbin, and sewage system based on the forms and criteria provided by the ministry of health. All the restaurant in Village Mall achieve an A list score and only will be reviewed once a year unless there are any complaints by the public.

Padang Terap D8: Kids here we come

2009-02-24T00:19:00.001-08:00

Today, our journey begins in Klinik Kesihatan Kuala Nerang. Here, we were lucky enough to meet the School Health Team, a team dedicated for the purpose of school child health. As usual the morning starts with a small briefing by the nurses’ in-charge. The school team comprises of two nurses and their two assistants. We did enquire if a doctor would be more appropriate for the team. But again, the lack of staff in the health sector proved to be a strong challenge against perfection. Nevertheless, the team was good enough having sufficient knowledge, equipment and most of all dedication to this noble profession.

The start of our interesting day took us to SRJK(C) Kou Hua, a small Chinese based school in Kuala Nerang. There were not many younglings who greeted us, but the minute pack proved to have the cutest faces and expressions that could make you smile and laugh for hours. Here, we were to screen the health status of these kids (weight, height, general examination and eye test) and also giving them a shot of immunization which is of course what they feared.

The first batch (Standard 1 students) walked in looking very much lost. For a moment we searched them, for those were the shortest but cutest of the people we have met throughout our posting. They complied with all our instructions and the girls in our group were best with the motherly instincts reflected when they pampered and cared for a crying little one who had so much fear for the needle. Some of us even got our chance (first time) to have a firsthand experience in giving the immunization shots. The nurses personally requested from us a detailed examination for the kids since we were almost doctors. Well, it paid off when we detected few respiratory problems (thanks to Alia’s auscultation skill) and referred them to the clinic. The nurses were more than content to have a better screening session with us around.

A visit around the school brought back our memories of our schooling age. The excitement and laughter was so innocent. Friends were always friends. Enemies were always temporary. The kids had so much fun posing in front of the camera hoping to somehow fit in each snaps taken. We believe these individuals deserve the best and this health program offered is indeed a wise option.

Our day ends with a 30 minute visit to a small exhibition by the ever active vector unit in Kuala Nerang taxi terminal. It was tiring, but the fun was just too good to forget.

Padang Terap D7: Neverending

2009-02-23T06:59:00.001-08:00

It was like every other morning, chillness of the air that dampened our spirits and will. But as always, we’ve got housemates to wake each other along with surprises that excites. Getting used to our environment, the house was filled with grown kids fighting for the limited number of bathrooms, well, what to say… quite a sight nevertheless.

Upon reaching our destined place as usual and like always, the internet in the air-conditioned meeting room started our day proper. At about 9 a.m., a middle aged lady in dark blue outfit entered the meeting room with a sweet smile on her face. She addressed herself as Matron Sabariah who had the duty to enlighten us about MCH which consists of maternal health, child health and family planning this morning.

Before we departed to Klinik Kesihatan Kuala Nerang, Matron Sabariah briefed us about the objectives and responsibilities of the MCH unit. She also stressed on the importance of preventing maternal and child mortality as it has a significant impact on the nation’s development. We also had a question and answer session with her and through her answers we realized that she is very knowledgeable and has had a lot of experience in the public health.

The clinic is just a mere 5 minutes drive from the District Health Office. Guided by the health office van, we reached with little effort. Upon reaching, we were welcomed by the staff nurses. We informed our purpose there and in no time, we trailed the nurse to look around. After a short wait, the nutritionist was ready to meet us. She was indeed sweet and welcoming. As nutrition shares many topics in common, we bulleted her with diverse questions but calmly she replied with a smile. Common nutrition problems encountered here such as anemia and diabetes in ante-natal women, underweight and overweight children were amongst the issues discussed. Consequently, the food basket programme was conversed in greater details. Overall, nutrition was covered extensively.

After that, staff nurse Sopiah,spoke to us about family planning. According to her, family planning unit is a branch of family medicine which also includes antenatal and child health. In KK Kuala Nerang the staff nurse is in charge of this unit. They have a specific room for their unit where counseling and treatment takes place. Usually patients start with family planning after 42 postnatal days. The most common method of contraception used here is contraceptive pills (OCP). This method is usually preferred by the patients themselves. Doctors also do give suggestions to them when any complication arises. For the insertion of IUCDs, they are referred to private clinic or to the O&G specialist. The follow up is usually once in 2 months or depending on the supply of medication. PKD supplies each KK with OCPs once in a year. LPPKN also provides family planning services.

Today, many of us split to acquire passable information on variable topics. Like hyenas, we grouped the nurse to source our information. The scene was hectic and as always was beneficial. It was a short session in the morning and we left early for lunch.

After lunch, about 3.00p.m, all of us gathered to attend the afternoon session lead by the Kesihatan Pekerjaan dan Alam Sekitar (KPAS) official, Encik Mohd Azran bin Ahmad. The division functions to take care the welfare of health workers in the district. This includes staffs working in Klinik Desa (KD) and Klinik Kesihatan (KK). Each of them are required to take Hepatitis B vaccination. Influenza vaccination is given once yearly. They also supply Personal Protective Equipment (PPE) like mask, goggles and respirator for the fogging team. To avoid needle stick injury, the health care workers at KD and KK are monitored by this unit and cases will be reported for further action to be taken. They also make sure that schools are equipped with fire extinguisher in case of emergencies like fire. They are also responsible to release license for public events such as “menorah”, “tajjai” and “wayang kulit”.

For maternal health services, it consists of pre-conceptional, antenatal, natal, postnatal and family planning. For pre-conceptional services, health education is done by the school team for secondary school students. In antenatal care, the patient comes to register and to confirm pregnancy. Treatments are also done if they suffer any medical conditions. There is also tag system which indicates the risk category of the mothers. Natal services are done mainly by the staff nurse and community nurse. If complication arises then the patient is referred to Alor Setar Hospital. After delivery, postnatal visits are done within 24 hours at the mother’s house. The follow up continues up to 20 days after deliver at home. On the 30th day, the mothers will go to clinic for further follow up.

Child health proved to be an established service in Padang Terap. Child health was very much a successful program here. A visit to KKK Nerang taught us exotic knowledge on child health care. From child protection, anti-HIV kids, child with special need, nutrition program to immunisation were well performed in perfect balance. According to a staff nurse in KKK Nerang, the statistics for child health is satisfactory and compliance towards this program is almost perfect. It reflects the quality of PKD administration is Padang Terap.

Day 2 of the new week ended at 5.00p.m and Mr. Rezwan from vector department joined us for a short chilly ABC session. We headed back right after.

Group A: Day 7 Kuala Muda

2009-02-23T06:49:00.000-08:00

Today was kinda special for all of us in group A..nothing special enough to brag about..just that we got to a little late as the posting will only start at 9.30am. We were attached to the district matron Sister Sariana, who was supposed to brief us through the family and adolescent health. We were kind of disappointed as we did not get the chance to visit schools children for their general physical examination as well as vaccination programme as the hospital staffs today were too busy to attend to us students from AIMST.

Sister Sariana brought up a lot of discussion amongst us where she highlighted the problems youth in this country faces, be it physical, mental and sexual health. We were enlighten on how the ministry of health have taken part in helping these youth. Family health were mostly on how the primary health care set up helps in family planning which we had been brief through before in day 1 in the maternal and child health clinic. Throughout the session, most of us keep pastering Sister Sariana to bring us for the school visitation and our relentless effort was fruitful at last when she finally found a slot in our timetable to schedule us for the visit later this week.

After Sister Sariana left about 10.45am, Tuan Haji Samad gave us the briefing about the enforcement unit in Kuala Muda district. His talk was supposed to be on the first day in our posting but was postponed till today due to his tight schedule. It was a short but info filled session with him and as usual we end our day with photo sessions.

Dr Sapna came "investigating" with a pre warning and all of us have to stay back in hospital although there was nothing else this afternoon. Dr Sapna ask for our feedback and commented on our posting. It was really nice of her to bring out topics that haven been discussed by us as well as to remind us of what we should find our in all the respective units so that we will be well prepared during our seminars and exams. An hour long discussion ended with a photo shoot as well and all of us were looking forward for tomorrows activity which is visitation to the food premises...time to get some food with discount!

Day 7 at Sik

2009-02-23T05:51:00.000-08:00

Today, according to the schedule, we are supposed to have a talk on Law Enforcement in Public Health. As a part of the programme, we are brought to the Sik Magistrate Court which is situated very near to Sik DHO. The idea of this activity today is for us to have an exposure and experience about the court environment and some of the law acts related to public health.

So, here we are in front of Sik Magistrate Court. It was a sizzling hot day...

This is the front view of the Magistrate Court building...

This is the interior of the court room where the case discussion is held. The long compartment in the middle of the court is called the "kandang saksi" where the witnesses are called upon for further case discussion. Those people sitting in the court are the Public Prosecutors. Mr.Chin, one of the Health Officer of Sik DHO was one of the Prosecuting Officer in the court today. He was in charge of a case prosecuted under the Food Act 1983. Briefly, it was a food poisoning case where after food sampling, it was found that the food contains pathogenic microorganism called Salmonella spp.

All of us with our respected Mr.Chin.

So, more info about the Magistrate Court... The Interpretor plays an important role in the court. He does most of the talking.... Generally, he translates and reads out the charge sheet to the judge and the accused. There are very limited seats available inside the court room. Thus, it took quite some time for all of us to enter the court room one by one as people get out of the court room. Before the case discussion starts, Mr.Chin gave us a short briefing about the rules that everyone should follow. As we enter the court room, we must always bow before the judge to show our respect. The same rule applies as we exit. Besides that, we are strictly prohibited from taking any photographs inside the court room.

The environment inside the court room is completely different from what we actually have in our imagination of a court. It is definitely not like what we see in movies... it was very silent inside there...we could hardly hear what are they talking.... most of the case discussed in the court today was on some kind of addiction to "daun Ketum".

Chitchatting with Mr.Chin about some of the cases discussed in the court

Then, for the evening session we had briefing with one of Sik DHO Health Officer. He explained to us about law enforcement more in detail with examples. Here is a picture taken with him...

Well, that's all for today's entry...however we would like to continue with some of the pictures which we could not post earlier in the blog....

This is the waterfall located near Baling district... We seriously had a *mind blowing* time together...

Having a blast!!!

Our newly found friend there... who is posing proudly with the nature....lolz!

This is "Swami Nithiyanantham" and "Swami Momo" showering their blessings to the visitors of the waterfall....

We ended the day by having dinner together in Ananda Bhavan... we were promoting our delicious Indian cuisine to our colleagues and we were very glad that they enjoyed the food...

It was another great day which should be remembered forever....so, that's all for today's update, dear friends... cya!

DAY 6: FRESH START TO A NEW WEEK IN PADANG TERAP

2009-02-22T08:42:00.000-08:00

Fresh faces, happy contented smiles, excitement was evident on everyone today morning as it was a start of a new week after a good though short weekend back home or for some after a good vacation. So, after a hearty breakfast, at about 8.45am, we met En Roshdi, the PKPP , who briefly shared his knowledge of the primary healthcare system with us.

At about 9.30am, we drove down to Klinik Kesihatan (KK) Naka, which was 25km away From Kuala Nerang….a sleepy ride. Upon reaching, we took a walk around to see the settings of the clinic and must be commended because it was a very well kept place. We were told that the KK had three divisions which are the Out Patient Dept., ante natal and special clinics.

After having a look around, at 10.15am, we met Dr. Azliza who was the medical officer in charge of KK Naka. The initial few moments were awkward as she asked us what was the reason we came there but after a minute or so we found our voices and explained that each of us have queries pertaining to the specific subjects in public health. Thus, started our question and answer session where we each inquired on the various subjects such as primary care, maternal and child health services, special clinics, referral system, adolescent health etc. and the doctor diligently cleared our doubts. She made us see the important role played by the KK as the first liner in the healthcare system and the difference in the setting of a hospital from the KK.

The session extended until 11.45am and at the end of it the doctor commented that she was happy with all the questions that we brought up as she did not expect us to ask that many questions. We were allowed to leave early today as they had nothing else planned for us today. All in all it was really on eye opening day on the duties of a medical officer in the KK setting.

DAY 5 +1: Padang Terap's special report on saturday night activity. (Screening for Malaria and Filariasis)

2009-02-22T08:04:00.000-08:00

Cruising along with the health officers at 8.30p.m surely tremble the light hearts. Filariasis and malaria are common brought over by foreigners. Thus, screening for these diseases is commonly done at night. And today, we were on the verge of visiting a place beyond our imagination for a similar purpose.

Driving about 20km further into the already daunting routes and creepy silhouettes, anxiety companied us all the way. We were brought to a place that we’d last imagine or perhaps never had. Dark as ever with accelerated fear, none of us were ready for such a sight. The place was called Naka and is in the midst of well how to say… not to be rude… JUNGLE undeniably. A construction site was obvious at first sight, the thoroughfare fuddled with normal driving and all eyes surrounding were on us.
Upon reaching, we realized they are all foreigners, mainly from Bangladesh and many others. At reach, many ran away from us and invariably shocked us, but it was later that we’ve learnt that they were the illegal immigrants.

They set the gears to begin the procedure. Swiftly, the person in charge did the work. Making a thin smear and a thick smear on two slides was the entire task. As easy as it sounds, it was daunting when we got our turn. Somehow, some of us who’ve got the chance to do the smear used every opportunity. Our concern on infectious diseases did not broke the spirit on taking some blood. Our precision might have been compromised but I guess we did it functionally able.

The foreigners were cooperative and eased us as time goes on. However, a slight fright was inevitable. Somehow, we manage to get the glimpse of their living condition and apprehended our gift to able to end and begin our day in a very much better place.

The entire session ended about 11.20p.m. We stopped for small refreshment before continuing our journey back home that took not very long as always. The day was satisfactory and we were truly grateful to Jashithra’s parents for inviting us for dinner earlier. That gave us the energy not only to be physically able to survive the place but as well to be not vexed by the eerie place.

Day 5 Pdg Terap: CARNIVAL!!!

2009-02-22T07:53:00.000-08:00

It was the earliest start of our week in Padang Terap today when the alarm went off around 6am. Dressed in our sports attire, we journeyed 10 km away from the DHO office to FELDA Bkt Tembaga, the same village our Dengue Survey was conducted. Today was a day to party and have fun. That was at least what we thought when we saw the banner ‘Karnival Kesihatan 2009’. Nevertheless, a health campaign can never be better even in a small village like Bkt Tembaga.

After waiting for almost one hour, we were greeted by three active ladies who announced for the start of the campaign, an aerobic session. The first impression was ‘Who’s conducting?’ and ‘Not another boring exercise!’. However, those threesome gave us quite a shock with a superb aerobic performance which was more like a dance sequence. We danced and enjoyed the 30 min workout more at the end for a duck-hip shake dance step. It really reflected the healthy lifestyle of villagers in Bkt Tembaga.

Around 10am, the story hikes to its climax. There were several booths, the dental booth, BMI, BP and blood sugar testing, vector booth and some NGOs promoting health products. Even the Jabatan Bomba and Jabatan Penjara took the opportunity to shine the campaign. As usual we took turns to take BP and BMIs for the villagers. Some even had the chance to prick few fingers for a blood test. It was a sight of delight to see so many people from all age group, giving their support and getting their health assessed. One of the best experience was to convince an old grandma, who BP was 200/180, to start treatment in the hospital. She actually lived her whole life with this. Again, the campaign reflects the quality of public health in Malaysia.

Lunch time signaled the end of the carnival and food for vegetarians was again a trouble. But we have to say this, the humble villagers were so adamant of providing us with any vegetarian food though we insisted. This caught our hearts with no words to express our appreciation and gratitude to these friendly individuals.

As to end our report for the day, we should say, we were actually posted to the Health Promotion Unit today to learn on Health Promotion. But, a firsthand experience in this carnival has in every way to instill the message we were looking for ‘education and providing health services through health promotion’. This is where Malaysian Primary Health Care stands, and we are proud of it.

PS : We even had a small UNO game session with the Vector guys of Padang Terap. It seems we have successfully spread the UNO fever here.

KUBANG PASU DAY 6...:(

2009-02-22T07:02:00.000-08:00

We are back from Sungai Petani and frankly speaking are thrilled with the new week that we have ahead in Kubang Pasu. We arrived at the KKKP at 830 thinking that we will be visiting the water treatment center as promised. However due to a confusion of dates, we were stranded in the office not knowing what to do. But later, we were visited by a stern lady with more than 20 years of experience. Her name is Sister Yati aand she is in charge of the MCH program of the district. Her first question to us was “What do you understand with public health”. Embarrassingly, we found ourselves lost in thoughts as to what public health is really about. She gave us a 10 minute break to learn about public health and after the time limit; we manage to impress her with our answers. Sister Yati educated us A to Z on the maternal and child health system of the KP district.

After noon, we followed Sister Radzoah to Klinik Desa Kota Naga, a tiny Health care center surrounded by beautiful paddy fields. There, she enlightened us on how the clinic works, their activities done, their roles, their budget, their limitations etc. She also showed us the booking book, immunization chart, and a colour coding scheme for expecting mothers. We were later taken around a tour of the clinic, which was not very significant except for the fact we saw the cold chain for the vaccines.

tRYING TO GET THE DEFINITION OF PUBLIC HEALTH RITE...

Thats it for now, hope to hear from yall soon.

Good Night and Good Luck!

Shtshrj

Prema, Janaki, Venilla, NagaPriya, Uthayan, Ganesan, Cassandra, Jasmine Anthony and Jasmine D’Cruz

day 6 water sampling station & water treatment plant

2009-02-22T06:46:00.000-08:00

Basically, what we have seen is what kuala muda’s group has seen today. So, just to add a bit what is not mentioned, there is a gadget called sensION 5, looks the same as sensION1 used to test for PH is used to test for conductivity (free ion) of the sample. It has to be less than 1000micro⁵/cm of unit only considered to be normal.

turbidimeter:- less than 5ntu is safe to drink

sensION5( Ph indicator):-6.5- 9.5 is normal

sensION5(conductivity indicator):- less than 1000 is normal

colorimeter: at least >0.2

Some pictures of the water treatment plant in batu 5 SIK:-

intake of river water into SINGLE DROP AERATOR as seen in the pic above, followed by lime dosing at the upper level before flowing down to a lower level as seen in the pic below.
water seen in the pic above will flow into a compartment in which aluminium, chlorine& fluorine dosing is done. (aluminium has been replaced by pac18 in this water plant, alum is no more used; chlorine& fluorine is added alternately.)

pic above: fluorine chamber leading to water treatment system

pic above:- chlorine chamber channeling into water treatment system

pic above:- alum mixing tank which is no more operating.

pic above:- hydrated lyme mixing machine

pic above:- pac18 which has taken over the role of aluminium sulphate. (according to the infoman la)

pic above:- baffle flocculators/ Lovo sedimentation tanks( in a zig zag manner), pile of dirt is seen trapped in one of the channel, due to the effect of pac18.
filter tanks(4 of them) which recieve water from the lovo sedimentation tanks. underneath this water is a 4 layer sand filter which filter the water. after the water is done with chlorine dosing and lime dosing again, the water is either stored in 1. backwash tank 2. p'glas G.L storage tank for distribution(4 of them) or 3. directed to chemical dosing.

what to do with the dirt trapped in the 4 layer sand filter? it is done by backwash pump which pump the water back to the 4 layer sand filter from the backwash tank in an opposite direction. see the bubble in the pic above? the effect of backwash at a rate of 620metercube/hr for 8 minutes. but before this, the sand filter is shakened by the effect of the "penghembus udara" in order to loosen the dirt trapped in the filter.

pic above:- the backwash valve is closed to let the dirt flow into a passage channeling the waste back to the river again. itu dia Si niti closing the valve. Macho....

the dirt is cleared bit by bit.....

wait....

wait,wait.....

okay, now the dirt is cleared. after the filter is dried up, make sure there isnt any mud ball, otherwise it has to be MANUALLY dug out upon the commencement of the next filtration.

PICTURES OF THE DAY

i know!.... but according to puan PPKP, somebody suddenly disappear after washing his sampan near this place . so we still dun know if it's a safe place to go...

Group A: Day 6 Kuala Muda

2009-02-22T01:20:00.000-08:00

The day started at 8.30 am. We followed Mr. Selva from the KMAM unit (water quality control unit) to his work stations. Due to some technical problem, it took us some time to find the first water sampling station. We werre suprise to find that the station was by the road side, a small setting that we usually omit about its existence. It was a little blue hub, with a taip water,pressure metre, and sink inside. Well, then, here started the work of Mr. Selva and his staff.

First of all, its the chlorine test.

Water sample is taken in 2 bottles (10ml each)-bottle A and bottle B.
Bottle A is for standard and bottle B is for sample reading.
Reading taken for bottle A without adding chlorine by using colorimeter (used only for chlorine reading) and it set zero.
Reading taken for bottle B by adding chlorine by using colorimeter .(Normal reading = >0.2)

SECOND,for turbidity test
Turbidity is measured by using10ml of water sample, using turbid meter.
Normal reading = < 5NTU

THIRDLY,for pH test
pH is taken by measuring 100ml water.

FOURTH, for microbiology testing
Sample water is taken in the 100ml fill line bag containing tablet (sodium thiosulphate) to clear chlorine from water for microbiology testing.

Thats a little bit about how the water sample was collected for investigation.

We followed Mr.Selva for 2 sampling collection stations before he took us to the Loji pembersihan air Sungai Petani & Pinang Tunggal (water treatment plant).

Mr Selva left the loji after handed us to the person in charge of the loji. Mr. Selva had to carry on with his 12-more-stations-water- sampling- collection- mission.

The person in charge of the loji showed us the process of the water treatment plant. It was confusing at the beginning, but we managed to sort out the process clearly( well, at least we got the basic concept about how it works). Emm, to prove that we know it clearly, let me explain the superficial info about the steps. The processes of treating the water before it reaches AIMST cafetaria are as below :

1. TREATING RAW WATER
2. OXYGENATION
3. ADDING OF CHEMICAL
4. COAGULATION
5. SEDIMENTATION
6. FILTRATION
7. SOFTENATION
8. FLORINATION
9. DISINFECTION
10. TREATED WATER STORAGE
11. LABORATORARY
12.WATER TUNNEL UNDERGROUND THAT WILL REACH AIMST CAFE, EVENTUALLY.

:-) Relax, Dr. Sapna, we definately know more than that. The above is just the SUPERFICIAL INFO, will impress you when we come back!

About 12.30 pm, all of us left the loji in a hypoglycemic and dehydration state .After an under-the-hot-sun routine group photo session with the staff of the water treatment plant, food hunting!!

3.00pm, we gathered back in the DHO kuala muda. Mr. Selva waiting..... We had a serious in-dept Q&A session with Mr. Selva. (well, Mr. Selva has 2 sons,a daughter, AND a wife). Hmm.. apart from that, he explained to us about , the organization structure of the unit, the water monitoring & control, recovery treatment, data analysis, etc...

Then, Photo session! It took sometimes for Mr.Selva to comb his hair. (refer photo)

Well, thats the end of the day!

By: Chee Ming

DAY 4 PADANG TERAP : Hawker Hunt

2009-02-20T18:02:00.000-08:00

A somber start on day 4. We were still recovering from yesterday's tiring day. Nevertheless, as every other day surprised us with lots of fun, we were thrilled for more. Mr. Azlan who is PKPP from the CDC branch got us some information on various communicable diseases. Though the whole session was done in the meeting room, the information was fruitful as ever. We discussed on various diseases on Cholera, Typhoid, HFMD, Dysentery, Food poisoning and Tuberculosis. However, there were no specificity seen in here as most questions asked were said to be standardised. Also, the incidence and prevalence here was not alarming despite recording higher cases as mentioned by Mr. Azlan. The morning session ended at noon, and as usual we went out eagerly for the one thing that unites us in common... FOOD.

Later in the day, as promised we were taken for food premise’s inspection. Feeling authorised for the very first time, we have to admit, we felt good. But again, we were not physically promising in that job. The hawkers were no threatened by our presence. Anyway, we were introduced as medical students, so what to say…hmmm.

It was not long before our day came to an utter end. After a short post-mortem of our inspection result, we headed back home to continue our extra-curricular activities.

Day 3 Evening: Padang Terapians had gone for fogging

2009-02-20T07:56:00.000-08:00

'40KM and you'll need to bring your own transport'!!!, said En.Ali barely within few seconds after we were told there's a fogging session later in the evening. We were excited and simultaneously feared the driving that has to be done. At about 5.00p.m, we gathered in front of DHO to set ourselves for the anticipated journey. 2 cars and 1 will, we followed the 4 wheel drives with logging spirit. Briefing was done earlier in the day after our BAKAS trip. We were told about various type of fogging machines and methods carried out. They also told us about the place that we'll soon discover to our excitement.

I have to say, they cruised at a scary pace. keeping up with them at one point seemed the most difficult task in our posting :) Lubok Merbau the place is and the serenity triumphed Kuala Nerang.

They started with the announcement of the fogging session and within minutes we were given a treat to actually witness the entire session. Focusing mainly in the potential breeding areas, I could say, well, they actually do not miss any place. Drains, pots, back lawn leftovers... you name it.. they've fogged. It looks like a gun and and what comes out is pure white smoke. They even fogged the interior of houses suspected with dengue case. Some had the chance to even use them. (THE GIRLS GOT THE CHANCE)

As the fogging was goin on.... KABOOM... sound that reminded of hmmm... ACCIDENT!! Every souls in the vicinity rushed to origin of the sound and found a guy and a bike on the ground.. OUCH... One of the guy in the Kementerain Kesihatan jeep accidentally opened the door and the guy in the bike hit the door and thus fell. But not to worry, the paramedic team were there to help ( it was us...hehehe). Almost to the end, the girls were all given a treat at the roof top of one of the jeep to hitch a hike around the area. Fun was shining in the girls eyes.

The day ended pretty much about 7.30p.m and the journey back was dreadful to think but was not as bad as it seemed. We all reached home safe and were craving for food. Had our dinner and headed to hit the bed. We were all tired but entirely satisfied.

Kubang Pasu Day 5 Report

2009-02-20T03:10:00.000-08:00

We had an early start to the day and arrived at the health office much earlier than previous times. There we met healthy settings and occupational health officer, Mr Yadzid. He decided to teach us out in the outdoors about his job scope such as making sure schools and clinic are safe for the public, doing health surveys once a year, health checkups, beautiful clinic competitions and campaigns for needle stick injury.

Does Not Hurt For Her at all....

Later, the food department were busy with the Typhoid vaccination of food handlers so we were there inspecting the whole process.

After Noon, we met with a youthful man named En. Ahmad Mahmud, PKA Unit Promosi Kesihatan dan Prostar. The MOH usually gives him health promotion topics and he is given the resources to conduct them. These campaigns are for example ‘Kempen Cara Hidup Sihat’, ‘Kempen Menangani Stres’, ‘Cintailah Jantung Kita’, and ‘Kempen Pemakanan Sihat’. But he is more active in the PROSTAR program usually targeting youths between 13 to 25 although there are no age limits. He usually gives youth talks in many schools and works on getting more schools involved deeply in the Prostar program. He ended his briefing by kindly giving us a lot of his health promotion pamphlets and also PROSTAR badges.

Later in the evening, Dr Sawri Rajan, Dr Kay and Dr Lely visited us and had a review session of the past week. We left back to Sungai Petani around 6.We can’t wait for next week.

That’s it for now, hope to hear from y’all soon. Good Night and Good Luck!

Shtshrj

Prema, Janaki, Venilla, NagaPriya, Uthayan, Ganesan, Cassandra, Jasmine Anthony and Jasmine D’Cruz

5th Day in Sik..

2009-02-19T07:25:00.000-08:00

The first thought I had when I woke up today was finally a week has passed since we were posted in Sik. Travelling to and fro everyday is taking a toll on our level of alertness but that does not stop our never-ending questions and fun. Our day started with a small session with Mr Jamil from disease control division as a continuance from our previous meeting yesterday. After that he introduced us to Mr Mohd Akhir from vector borne disease unit who proceeded to talk to us about the dengue situation in Sik. According to him, Sik is one of the critical district in dengue and chikungunya outbreak and both diseases are spread by the Aedes mosquitoes. Two new names wormed their way into our brain today as we were shown the model of Aedes aegypti, which acts as a vector for dengue virus and Aedes albopictus who carries the chikungunya virus.

Take a wild guess as to which is Aedes aegypti and Aedes albopictus. =)

We learned the miniscule difference between the two mosquitoes which is oni apparent when one were to observe the body clearly. Imagine when you see a mosquito with striped legs on your body and all you are trying to do is to observe the body and see if its one line or four lines and wonder which virus it might carry! As seen above aedes aegypti has 4 stripes while aedes albopictus has one. Mr Mohd Akhir also briefed us on their habitats and the symptoms seen in each disease. His wit, sense of humour and overall pleasant personality kept us glued to his every word for an hour or so.

We were very interested in the night trapping activity that went on the other day so he explained in detail how it was done. It seems that his team has to sit quietly in the jungle from 7 pm til 11 pm and expose their thighs, make no noise, no smoke and everything else that might scare the mosquitoes away. When mosquitoes bite them, they will trap them in bottles and send them to the laboratory for further investigations on the species and etc. However, this week's outing was not fruitful and they came back empty-handed. I guess this is a blessing in disguise as this shows that the control measures taken to reduce the population of mosquitoes in that particular area are working very well. His unit also performs Aedes survey whereby they go to houses of the people who are suspected or confirmed to have dengue fever and check the inside and surroundings of the house for mosquito larva. Compound would be issued to the house owner if such larva are found.

Sample of mosquito larvae found during Aedes survey

Poison for larva - to be put in places where there is collection of water

As usual, our group photo after a briefing. Well, with the addition of two mosquitoes as the temporary members of the group.

After the dengue briefing, Mr Mohd Akhir (not the previous health officer) and Mr Ramachandran came in to talk to us about malaria and filariasis. They are also kind enough to show us how to perform BFMP and our ever outgoing group leader decided to donate his blood again for the demonstration. They promised to allow us to try and perform BFMP next week in a secondary school and record all the data. Imagine our excitement when we heard that! Later, we were brought to the vector control unit store to take a look at the spraying device used to spray walls of houses. It sounds funny and outrageous at first to hear that mosquitoes will perch on walls of houses after sucking our blood because they are too full and heavy to fly far.

Materials needed in preparing the BFMP
In the process...

Right after the blood are "dotted" onto the slide..

Finally, a completed blood film.
The spraying device

Ramu demonstrating the way to hold the spraying device

The poison used

Mr Mohd Akhir and Mr Ramachandran in vector control unit store and the various equipments and poisons stored in it.

After that we had lunch at a Malay stall opposite the District Health Office and it was yummy!! We were all complimenting the various nasi goreng and maggi goreng served. With our full and satisfied stomach, we went to the vector control unit to learn a little about Vekpro, a surveillance method used for dengue and also learnt about mapping of an outbreak. Our official activities end for the day and thus begins the fun.

We explored Sik and found a waterfall after going the wrong way up until we reach the border of Baling, the neighbouring town under the lead of Ramu who insisted its a good adventure! Changing our formal clothes into tshirts and shorts, we had a great time splashing water and having "water massage" by the cascading waterfall. A few of us have some funny moments because of the slippery algae all over most of the rocks and overall, its a good way to unwind after a whole week of eye-opening learning experience in Sik. We then proceeded to have our dinner in SP and for this week we decided to go for Indian food and was introduced to some of the delicacies served there.

With a week of new experience and stronger bond of friendship between our group members, we are psyched and looking forward to the promises of new and exciting learning opportunities ahead!

Day 5 Kuala Muda

2009-02-19T07:24:00.001-08:00

We were told to come to the vector unit at 8am but due to unforeseen circumstances, were made to wait in another room while the guys at the vector unit carried out a meeting. We were placed in a room with many larger-than-life-sized miniature models (which by the way aren’t miniatures) of different types of moisquitoes such as the aedes, anopheles and the culex types. There was also a big and hideous giant model of an aedes aegypti the size of a dog! We also got to look at specimens of mosquitoes at different life cycles (i.e. egg, larvae, pupa aka. jentik-jentik, and finally an adult full-grown mosquito). Once the meeting was over we were given a briefing on what we were going to do for the day, and it’s Aedes Survey! After that we followed the team to nice place for breakfast at about 9.30 a.m.

Once we’ve all eaten and satisfied, we got all ready for our field assignment. We got broken into 2 groups, one was to go to Taman Arked and the other to Kampung Bakar Kabor, places we’ve never heard of having lived in SP for 3 years! We arrive at our respective sites at about 10am kicked off the Aedes Survey for the day. Basically we followed the officers around from house to house (or shop to shop) where they would first introduce themselves to the residents and then tell them the objective of the visit. Having gotten consent, they would then begin inspecting around for potential aedes breeding sites such as areas with stagnant waters (in vases, tyres, plastic bags etc) and toilets. If a risk is recognized then they would throw in some abat granules into the water tanks and etc to help get rid of the jentik jentik so that they would never have a chance to grow into blood-suck parasitic adults. Finally before leaving the place, they would give the residents a word of advice on how to battle the war on dengue. Once we have finished going through all the houses/shops we had a short Q&A session with the officers just before the van returns to pick us up. We then adjourned for lunch at about 12.30p.m.

At 3p.m. we met back at vector unit at Kuala Muda District Health Office where we were given a talk by Mr. Burke, head of the vector dept. This time we had a more intensive Q&A session regarding matters of CDC, investigation of outbreaks, functions of the vector unit, Dengue & Chikungunya (being the problems most faced by the vector unit), larvaciding, as well as the use Guppy fish as biological prevention (as well as many more things we would prefer to share with you all at the coming seminars). This went on until about 5.15p.m. after which we called it a day… Oh the weekends!

Jick

Day 4 Kubang Pasu

2009-02-18T08:09:00.001-08:00

With the dengue fogging team

Group leader Govinda Ram Prema Suhanya seem to be having fun

Oooh..

I found them cool

Visit to the paddy muzium in our spare time...

Hemodialysis patient were comfortable at the center after many years

We arrived at the office at 830 as usual but to our dismay most of the officers were in an important meeting so we found our privileges around the vicinity limited. However, the all so kind En. Hussain from Day 1 managed to hook us up with the hemodialysis team of the clinic.

There we were told to wear only their sterile slippers and enter. In it, we were greeted by En. Raman, a technician at the center. Mr. Raman educated us on how the dialysis machine works. It does not look as simple as it looks haha. The patients there receiving their newly cleaned blood were all cheerful and all new each other as they have routinely bumped into each other for many years. It’s wonderful how they appreciated these magical machines from Germany.

During our lunch break we took a quick tour to the Paddy Muzium which illustrated the long history of the Paddy industry in Kedah.

After lunch we met with En. Johari PKAK Bahagian Vektor. He endowed us with loads of useful information on vector borne diseases such as dengue, malaria, chikungunya and filariasis. Mr. Johari was really enthusiastic in his teaching which was proven by a scary session of questions to recall our memory on his lecture. Thankfully we managed to hold it together and answer most of them.

Later in the evening, we divided our group to 5 each to follow the vector disease team on a fogging journey at 2 separate locations. The first left for Jasmine Rice Factory and the second to a boarding school. Both of which had new case of dengue. There we were taught all on the fogging process, and some of us were lucky enough to fog around the places.

That’s it for now, hope to hear from y’all soon. Good Night and Good Luck!

Shtshrj

Prema, Janaki, Venilla, NagaPriya, Uthayan, Ganesan, Cassandra, Jasmine Anthony and Jasmine D’Cruz

SHTSHRJ..DOIN HIS STUFF HEHE....

Kubang Pasu a late day 3 report

2009-02-18T07:51:00.000-08:00

Lazing around

En Rahaimay teaching us

In his place

As it says

Attentively on water sampling

same thing

Report Day 3

First and foremost I would like to apologize for the late updates; we have been really busy with the curriculum and extracurricular activities that we just could not find a decent time to do a report in an internet café.

We began D3 a little late as we were expected to be there only at 9. We arrived at the health office 10 minutes earlier and for the first time, we were greeted on time by En Rahaimay, PPKP for the water sanitation department. En. Rahaimay quickly took us to a nearby water sampling station which is located within the compounds of the district health office. There he taught us on how a water sampling is done and gave a whole information on the system. However, we were not given permission to go with him to the privatized water treatment plants as there were 10 of us.

Our time with En. Rahaimay at the station was over in 20 minutes, so at 9.20am we have finished our session in the morning. We explored the KKKP for a few hours when we decided to leave for lunch.

Some of us spent our lunch break at the Jitra mall playing arcades and singing karaokes.

At 2 we came back to meet with En. Rahaimay again. Now, he brought us to his RM30, 000 worth of equipments office in a small corner of the Health office. There he gave us a presentation on the water sanitation system of Kubang Pasu. Mr. Rahaimay does know his stuff well as he answered all our bombardments of questions brightly. A

t evening we explored KP once again and found a beautiful huge recreational lake. Our boating session in the evening was tiresome but yet we found time for some night bowling and a traditional malay tom yam dinner.T

hank you, good night and good luck

Shtshrj

Prema, Janaki, Venilla, NagaPriya, Uthayan, Ganesan, Cassandra, Jasmine Anthony and Jasmine D’Cruz

Fourth Day in Sik

2009-02-18T07:08:00.000-08:00

Today is our 4th day in Sik. We departed before dawn and return after dusk. We have spent more than 12hours in Sik today.

Our 1st class started with PPKP Jamil who taught us on Communicable Disease Control (CDC). He was so friendly and thus, we were having a very great time with Mr.Jamil discussing on some communicable disease in Sik. He showed us a graph of food poisoning cases on year 2008. We found out that the number of food poisoning cases will be increased every time there were school holidays, after Fasting Month of Muslim, during celebration day or fruit season (July-August).

After having an interesting discussion with Mr.Jamil, we were told to have an activity of disinfecting dead body of Muslim with HIV in Masjid Sik Dalam at 2.30pm. As usual, “sick” (Sik) group will have our group photo with health officer on each day. The following picture are “sick” people and Mr.Jamil.

Then, we went for our lunch in coffee shop that is just opposite to DHO. From the picture below, you all can see we are happily waiting for our lunch to be ready.

After the lunch, we went to waterfall in Rimba Taqwa which is also Pusat Latihan Khidmat Negara (PLKN) as we still have 1 more hour to go to Masjid Sik Dalam.
According to our leader Niti, every group also showing their picture to waterfall, so we “sick” ppl also need to show that we have been to waterfall as well…..Haha… Sorry, leader…please don’t hit me tomorrow….

We can see that Niti is happily folding his pants. He was too excited when he saw the waterfall.

Group photo again!!~

To make our day more interesting, Momo has created a Photo Hunt for everyone!!~ Please look at the picture below and find out 4 items listed here:
(1) 2 shoes
(2) 1 sandals
(3) 1 sock
*New visual test for all of you* (enjoy it)

Another picture! Please guess who is this in the picture below:

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We left the waterfall at 2.15pm and we reached the masjid after 5 minutes. However, there was nobody in the Masjid at all. We cant find anyone from DHO, so we called back to DHO and asked Mr.Chin (PPKPK), he was then contact the person-in-charge(Mr.Sharunizam). We were soooo disappointed when we were being told that they have preponed the time of the activity and finished it following the morning session. According to Mr.Sharunizam, they were supposed to have a lunch break after a morning session and continue the activity at 2.30pm. However, due to some reasons, they were forced to finish the activity earlier. Mr.Chin felt so sorry to us, so he asked us to go back to DHO for a theory class on how they disinfect the dead body of a Muslim with HIV.

We reached the DHO at 3pm. Surprisingly, Mr.Sharunizam is a quite “funny” person who kept joking with us. He is from unit of HIV and PROSTAR programme. He started to introduc himself and talk about his wife and all his ex-girlfriend of 3 races!~ Then he told us about HIV cases in Sik and some stories of those interesting cases. As he was the one who conducting the Masjid event that we have missed just now, he asked us to go for tea-break as an apology to us.

Free meal again!~ We have had 3 free meals since the 1st day we came to Sik… So nice!
Niti,Momo and Ying ya were enjoying Curry Puff, kuih and tea/coffee.

Then we were back to Bilik Mesyuarat again to see the demonstration by Mr. Sharunizam on the disinfection process and how they wrap the dead body of Muslim with HIV. According to him, disinfection need to be done with 1 Litre of Clorox to 10 Litre of water which has to be pour all over the dead body including the unexposed part. Then the body will be wrapped with 3 layers of white clothes (with a plastic between the inner most and 2nd inner layer to prevent leakage of the Clorox).

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5.30pm : we see the preparation work of fogging. The fogging machine that is called as Agrofox.

There is a compartment that need to be filled with 1 Litre petrol (to generate the machine)

Another compartment that is filled with the fogging drug (4L Diesel with 200ml Malathion) in order to kill adult mosquitoes. For lava, we need to use Abate instead of Malathion.

We were divided into 2 teams for fogging activity. One team went to Kampung Charok Tuk Uban whereas my team went to Kampung Bendang Man.

6.00pm : we were on the way to Kampung Bendang Man.

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6.30pm : we reached Kampung Bendang Man.

Only within 10minutes, Yin Ying got a "kiss" from mosquitoes there. ^^

This is the case house of dengue.

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We were taking picture with one of the fogging team member who are fully equip with mask, goggles and ear protectors. They called themselves as "Teddy Bear" !~ So sweet~~

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Our "Teddy Bear" start fogging in the dengue victim's house that i have shown above.

We started to come back to Sungai Petani at 7.45pm.

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