Thursday, July 30, 2009

Kubang Pasu District

First session


Location: Kubang Pasu District Health Office

Topic: primary health care

Person in charge: PPPK Mohd. Amin b. Saad

The fine morning started off with a briefing about the various divisions and functions of the primary health care, activities for the geriatrics age group which included morning workouts and establishments of various clubs which played an active role in geriatrics health. The function of the Primary Health care are:
• Outpatient department
• Maternal and child clinic
• Special programmes ( geriatrics care)
• Rehabilitation
• Library
This is followed by an excursion to the klinik kesihatan Tunjang at around 10.30 a.m. There we were briefed about the green book which is used to record information and track the health record of diabetic patients. This book allows the proper documentation of the health progress of diabetic patients. There are two copies of the green book which are exactly the same in contents, where the larger one is kept as a record by the clinic and the smaller version kept by the patients themselves.
The other book was the blue book for recording information of hypertensive patients

Kubang Pasu District

Time: 2pm

Venue: Meeting room

Activity: Health promotion En Amir Faruq

Around 230pm Dr Sapna and her team came to visit us and ask us about the progress in our DHO posting. They asked what we have done the past few days and asked us different questions that we later found out from the respective units.

Later, after the meeting, we had a talk on Health Promotion which was given by Encik Amir Faruq. He told us the functions and objectives of health promotion. There are only 3 persons handling the unit. This unit is operational all year round and they have certain targets to be accomplished by the end of the year.

He also explained to us about ‘Program Doktor Muda’ and PROSTAR.

-‘Program Doktor Muda’: This program is for the primary school students (standard 4-6). However, only the selected few which are the grade A students, are chosen for this program. This program was introduced in 1998 and fully functionally in year 2000. This program is conducted up to the national level. The main objective of this program is to expose the young minds to general health.

-‘PROSTAR’: This program is for secondary school students, where the main objective is to nurture and cultivate good morale among the teenagers.

The main objective of PROSTAR is ,To increase awareness and knowledge of the dangers of HIV infection, prevention and control measures, To instill a positive attitude amongst teenagers about the problems of HIV which is also connected to teenage social issues, To encourage teenagers to practice healthy lifestyle and to stay away from high risk behaviors’ that may put them at risk for HIV infection, To form a group of Pembimbing Rakan Sebaya (PRS) who can influence teenagers towards healthy living and also to encourage them to fight AIDS, and finally To create a group of PRS who would take the role as social service volunteers to give support service to other teenagers.

Although others such as NCD and CDC department also doing health promotion, this department will give the ideas and encourage some activities that are suitable during their health promotion. They will help each other’s among their department

Among the other activities that they do are under health promotion are:


-Health Campaign

-Carnival; which is usually conducted for 3 days.


Kubang Pasu District

First session

Date: 12th July 2009

Time: 9.00am

Location: Kubang Pasu District Health Office, Jitra

Topic: Tagging System,Immunisation,Pap Smear, Maternal & Child Health, Geriatrics (Family Health and Development Department)

Person in charge: Sister Zurida bt Abd Hamid

We assembled in the DHO meeting room to attend a talk by Sister Zurida bt Abd Hamid. There are 8 klinik kesihatan (Klinik Ibu &Anak) and 21 Klinik Desa in Kubang Pasu district. This unit provides services such as antenatal care, postnatal care, child care (for child age between 0-6 years old), School Health, Geriatrics care, Public Health, Prostar, Mental Health, Food and Diabetic care, Home Care Nursing (for geriatrics and chronic case only), Rehabilitation clinic, and also Dental care. We were briefly explained about the operation policy of Klinik Kesihatan (which includes all types of clinic available) in Kubang Pasu according to BUKU B.

The objective of Klinik Kesihatan is to provide comprehensive and quality service to the community to enhance the status of public health and to improve the accessibility to the health services. The organization chart of Kubang Pasu DHO and the function of various departments under this unit such as pharmacy, laboratory, clinical, imaging and administrative function was explained.
Klinik kesihatan provides its services:
• to walk-in patients,
• patient referred from various types of health care center
• they handles minor surgeries
• Non CD cases such as diabetes, high BP, Asthmatic, psychiatric patient, heart patient, and occupation related diseases.
• Ambulatory Medical Emergency treatment
• Simple fractures, minor orthopedic cases
• Besides that, this unit also responsible to prepare medical report, reten HMIS and carry out health promotion to their patient who visits their clinic.
• Screening test
• Last but not least, the aim in this clinic in this district is to give importance to antenatal care, including from beginning until the end of this period (more focus in this area).

Kubang Pasu District

Second session (Evening Session)

Date: 12th July 2009

Time 2:00pm

Location: School Unit, District Health Office Kubang Pasu, Jitra

Topic: Excursion to KKIA Jitra, School Unit, briefing on School Health Programme

Person in charge: JK Zulfadzilah bt. Ahmad

In the afternoon, we were briefed on the function of School health unit which is responsible on vaccination of the school children, personal hygiene, food and nutrition monitoring, Programme Doktor Muda and PROSTAR. There are 55 primary school, 25 secondary and 44 preschools in Kubang Pasu district. A School Team is comprised of 2 nurses, 1 attendant, 1 driver and MA (STUDENT)

Standard 1 students:

· OPV, MMR & DT is given

· Talk on personal hygiene, methods of brushing teeth and visual assessment.

Standard 6 students:

  • Rubella is given to female students ( will be stoped in year 2010)
  • Boys are checked for colour blind.

Form 3 students:

  • ATT is given and physical examination is carried out

After the briefing, we went to the School Health Unit to observe the method of vaccine storage, 2 types of thermometer which are MINMAX THERMOMETER AND DIAL THERMOMETER used to monitor the temperature of the vaccine, temperature chart. Cold chain and the method and the importance of maintaining the required temperature of the vaccine was explained by KJ Zulfadzilah bt. Ahmad.

Wednesday, July 22, 2009


Unit Kawalan Mutu Air Minum (KMAM) is headed by Mr. Saiful. The objective of KMAM is to monitor the quality of drinking water. There are five treatment plants in Padang Terap. They are situated in Kuala Nerang, Padang Senai, Lubuk Merbau, and Nami.

The water quality monitoring activity is a four network system and involves all five water treatment plants. They are:
Network 1 = Kuala Nerang A and B
Kuala Nerang Water Treatment Plant
Network 2 = Lubuk Merbau Water Treatment Plant
Network 3 = Nami Water Treatment Plant
Network 4 = Padang Sanai Water Treatment Plant
Water is sampled from 27 sampling stations. 4 from Intake, 5 from Treatment Plant Outlets, 5 from Service Reservoir Outlet, and 13 from the distribution centre.
The water sampled is analyzed under 3 different components. They are physical, chemical and microbiological. Under the physical component, water is tested for the turbidity, colour, pH and temperature.
Chemical analysis is further subdivided into short and long analysis. The short analysis involves test such as fluoride and chloride level while the long analysis involves testing for heavy metals such as argentum and zinc.
Microbiologically, the water sample is tested for E. coli and fecal coliform. Ideally these organisms should not be present.

Procedure for Water Sampling
1. The tap is fully opened and water is let to run for 2-5 minutes.
2. Then the tap is shut.
3. After that the pipe is heated up by direct flame for 3 minutes to remove any contamination.
4. The water is then collected.

Procedure for Water Treatment in Kuala Nerang Treatment Plant
1. The raw water undergoes a process of aeration. The purpose of aeration is to oxidize the water, thus increasing content of oxygen.
2. Next, it undergoes a process of flocculation in which Polyaluminium Chloride (PAC) is added to the water. PAC is a coagulant and it will form floc.
3. After that, the water will be directed to the sedimentation tank. Here, the floc sinks down the tank leaving cleaner water on top. This tank is washed fortnightly.
4. The fourth step involves filtration of the water. Here, the filter used is the rapid sand filter. It consists of two layers which are of rough sand and fine sand. There are 6 filters in total in this plant.
a. Cleaning of the filter is done every 3 days. First water is drained then the blower is used to get rid of mud balls.
5. The water is then directed to the contact tank, where fluorine and chlorine is added to it. Water is left there for 4 hours so that the chemicals dissolve evenly.
6. Then water enters into the clear water tank where lime is added to raise the pH of the water. The ideal pH is from 6.5-9.0.
7. This treated water is then pumped to the Service Reservoir Outlet for distribution.

Kesihatan Pekerjaan dan Alam Sekitar (KPAS)-PADANG TERAP

Kesihatan Pekerjaan dan Alam Sekitar (KPAS)
Towards creating a safe and healthy working environment for the staffs of Ministry of Health (MOH) in Padang Terap as well as for the customers through health promotion.

To create a conducive working environment by identifying hazards and taking actions to manage them, and to promote a quality level of health through prevention and control of disease, injury, and disability between men and work.

To raise and maintain the physical, social and mental well being of every staff of MOH in the district of Padang Terap at the optimum level.
1) To maintain a healthy and safe working environment, working process and daily practices as well as to prevent any health problem arising which may occur due to the occupation or environment.
2) To increase the level of knowledge and awareness about occupational health and safety among employers, employees and customers.
3) To increase the level of health, safety and well-being of individuals through prevention and disease control activities in a workplace.
4) To increase quality and productivity through increasing the level of health, safety and well-being of individual
1) By integrating primary health care and occupational health programme.
2) Provide training to the staffs in relation to occupational health.
3) To strengthen the surveillance network of the epidemiology of occupational diseases including chemical and pesticide poisoning.
4) To promote occupational health and safety.
5) To strengthen the cooperation and coordination of activities among various sectors, departments or agencies.
1) Notification and surveillance of occupational diseases.
2) “Quality Assurance” indicators, for example incidence rate of needlestick injuries.
3) Establishment of occupational health and safety committee.
4) Health and safety promotion at workplace by:
- Talks, courses and training.
- Providing necessary material for health education.
- Conducting ‘Workplace Risk Assessment.
5) Investigate complaints regarding occupational health and safety.
6) Conduct training/workshops/courses for staffs regarding occupational health and safety.
7) Conduct occupational health and safety assessment for health facilities.
8) Monitor health checks among healthcare workers
9) Monitor and conduct ‘Healthy Setting’ activities.
10) Conduct household safety assessment.
11) Conduct playground safety assessment.
12) PLKN assessment from time to time.
13) Assessment of building plan by local authority.
14) Assessment of license application for entertainment outlet.
15) Conduct sanitary assessment of schools/institutes

BAKAS – Bekalan Air dan Kebersihan Alam Sekeliling.-PADANG TERAP

BAKAS – Bekalan Air dan Kebersihan Alam Sekeliling.

To increase the standard of health and cleanliness of the villagers and reduce the incidence of communicable diseases through encouraging a clean environment, clean and safe water supply and usage of a complete sanitary toilet.
Provide complete flushing toilets, either by modification or supplying new ones.
Supply polypipe and fittings to enable a connection to JKR or KKM water supplies.
Building of “control wells”
Building of “control wells” with connections to houses
Building of Gravitational Feed System (GFS)
Building of rain water collection system (STAH – sistem tadahan air hujan)
Building of proper drainage system for used water (SPAL – Sistem pelupusan air limbah)
Building of solid waste disposal system ( SPSP – Sistem pelupasan sisa pepejal)
Surveillance and sampling of suburban water supply.
Health education, advice and monitoring environmental cleanliness.
Control and prevention of complications of iodine deficiency.
Tourist attractionsanitary examination program.

The wells built are all of no cost to the occupants of the villages.
There are two types of wells, one a manual pump, the other powered by electrical motor. The system is free of charge, but the villagers have to pay for the electrical bill. The electrical system is normally built in preference to the manual system, except in cases where no electricity is available.
Each well undergoes evaluation twice a year.
There is only one well drilling machine in the entire state of Kedah. (And it’s 30 years old)
There are a total of 32 wells currently servicing the district of Padang Terap.
Previously the toilets were built for the villagers by the unit, but since the increase in demand, they now build one as a model and ask the villagers to reproduce for themselves.
There are 2 GFS in Padang Terap; Perik and Puncak Janing.
Water from a river is collected into a man made reservoir where it builds up enough potential energy to provide a continuous water supply through a filter into thick PVC pipes which carries the water to the villagers.
SPAL works in the following way;
Water from the sink enters a filter box which separates it from most of the food waste.
The filter is cleaned every 3 to 4 days.
The water then enters an underground water collection tank.
When that is full, it pours out the water through freely laid out gravel which acts like a filter before passing into a second collection tank.
From there it is then carried away through the general drainage system.
We’d like to thank the villagers for giving us some of the best rambutans we’ve had and also for showing us a smoking monkey.