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Set off from Pejabat Kesihatan Daerah (though we reached there earlier…)

More than 6 of staff members of the Vector unit departed in their vans, while we pursued them in cars.


Reached site at Kg Nelayan, Kuala Kedah.

Here we were split into two groups ,one of 5 and the other of 4 members respectively.

The two groups took samples from different houses in Kuala Kedah.

One of the staff sprayed Abate (liquid) in drains. Within housing area where water samples were taken for larvae, packets with Abate were dissolved. Abate is a liquid based insecticide(composition-1ml Abate in 8L water).

Permission is first obtained from the house owner before sample is taken. There were some houses without people in which case a notice is stuck in front of their house, informing them that their house will be surveyed the following day.

A sample may be taken from a house just for indexing purposes, in the event the larvae turn out to be Aedes larvae.

Water samples are taken from a house with stagnant water collections from the outside of house-flower pots and other places.

Water is sampled by a pipette to obtain a sample of at least 5 larvae.

The sample can be concentrated by draining off excess liquid in order to collect more larvae.

Sampling either done in areas where Aedes is endemic or from where dengue cases have been reported in the past or where there has been a report of a case of dengue. Even a single case of dengue reported warrants a sampling from that site.

Fogging is done later in the evening.

We came to know how to differentiate Culex larvae from Aedes larvae -Culex larvae swim at the top while Aedes swim at the bottom in the water sample taken.(it was interesting to peer at the water sample seeing a majority of them swimming at the top).

Also, only houses, stalls, other premise owners with Aedes larvae alone are fined, those found with culex larvae aren’t subject to it.

Also sampled was a nearby lake area which had sacks of cans left for disposal and lots of larvae were found swimming on top of sample.

Hence our morning passed by…


Our day resumed after staff and we had lunch. We assembled in the vector unit which had fascinating models of the different mosquito vectors and their distinct features such as the stripes on their body.

We were briefed by a busy female member of Vector unit about Vekpro.

Each case’s particulars were entered in detail in this data base including:

Details of time –year, week and what time, Person who registered it-Medical assistant, doctor or nurse.

Details of person-Patient details-address, IC

Details of place- the registration no. of district are taken

Also present are details of the hospital where the patient registered- hosp. registration no., ward name. There are three hospital codes-

HK-Hosp. Kerajaaan-govt. hosp

HS-Hospital Swasta- private hosp

KS-Klinik Swasta- private clinic

The lab result of patient’s blood profile such as PC, Prothrombin time, Platelet count bleeding and Clotting time present

Each patient is assigned to be treated by his district. Investigation is done about the recent movements of the patient- if he traveled to an Aedes endemic area and acquired the case there then he is treated as an imported case-kes import while if he caught dengue from his own place of stay where dengue is /is not prevalent-he is classified as a local case-kes tempatan.

Dengue cases are classified into three- dengue fever, dengue hemorrhagic fever, death due to dengue.

Based on patient details 3 places in Kedah were identified to have dengue outbreaks-data for which is being compiled.

We were given information leaflets on dengue.

Next we were briefed by a member of fogging unit.

He told us about the water based and oil base mixtures used for fogging

Aqua Resijen=0.16 L Aqua + 8L water

Acettellic= 0.32LAcetellic + 8L diesel

Abate500E = 0.001L Abate + 8L water

Acetellic= 0.16L in 1 case

Aqua res=0.08L in 1 case.

These are in 1 case used for foggers who fog manually. This is practiced usually and covers a perimeter of 200m.

If the workers aren’t enough then ULV is used this mans that the vehicle does the fogging. This spans a perimeter of 400m. This has a composition of 10L acetellic+15 L diesel.


We set off for fogging and reached College cum hostel of trainee medical assistants (female), Alor setar- Kolej Asrama Penolong Pegawai perubatan at 6.20pm.

A female candidate was reported to have dengue here hence the fogging.

The officers garbed themselves with the protective equipment- orange overalls, yellow caps, face masks, ear muffs and protective boots

The fogging tanks are known as Agrofogs. These agrofogs had gone through several startup trials at the PKD itself. They were unloaded from the trucks and some of them were filed with water base formulae while others were filled with oil based formulae after filtering the formulae. The former were for spray within the hostel premises while the latter for the area surrounding it. 4 areas were targeted for fogging.

The staff kindly demonstrated how to carry these heavy Agrofogs upon seeing our interest. Some of our heroes and heroines posed for pics with the machines as you may see(pictures to be uploaded later).

The strong (Ahem…) boys were selected to help the foggers with their equipment while we girls stood aside to watch. Unfortunately the staff didn’t have any spare protective equipment for us so even the boys found themselves running off the smoke…

So ended a tiring, informative but fun day

Day 8

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Morning 8.00am
After we had a WARM welcome by Mr.Tengku Yusuf yesterday, finally we reached Kota Setar DHO by 8am today. However, we were then told that our activity will only start at 9am. So all of us had our SECOND breakfast in a mamak shop.

We had a short introduction about BAKAS and their job responsibilities given by Mr. Haji Rami from Unit Kebersihan Alam Sekitar. Then our field trip started.

We reached our destination which is “Sungai Mati Langat”. This place is named so because the sungai (river) here is really dead, water was dried out and it became a garbage dump.

We were shown about the piping system which was still under construction. It was started just about 2 days ago. The villagers worked together to build on it. This area looks quite modern since most of the houses are brick houses and now they have proper flush toilets.

The people here are very nice and they welcomed us with coffee and some kuih-muih. The coffee is processed by themselves. It tastes sweet although they added only a bit of sugar. FANTASTIC!! Oh, we also had some free rambutan.

We headed to another place to see the completed piping system. It was completed in 2008. Without our knowledge, we crossed the “Sempadan of Pokok Sena”. Here, we saw the manual water pump

We also bought lots of rambutan here. Yummy, our field trip today is very fruitful.

Afternoon 2.30pm
After having our lunch, we were briefed by Mr. Izudin from unit KMAM about water sampling. He showed us the tools needed for water sampling such as water container, whirl pack, pH meter, NTU meter... Then we were shown about the procedures in water sampling at a sampling point nearby.

Each of us gets the chance to try to get the water sample. Make sure your hands are clean so that the water will not be contaminated.

by Lauren


day 7 : Food Quality Control...

Posted in By Meera 1 comments

Morning 8.30am

we had a WARM welcome by Mr.Tengku Yusuf, Mr.Willam’s boss, head of Enforcement Unit and Food Quality Control Unit. We wee rthen introduced to Mr.Wan Qaiyim who is in-charge of food sampling and food premise inspection.


We had a short introduction about food sampling method and food premise inspection. Our group was then split into two:

Group A: Went to a stall and a grocery store for food inspection

Coordinator: Mr.Lai

Group B: Was sent to Tesco for food sampling (to check for pesticide concentration level) in green vegetables, local and imported fruits, nuts and tubers.

Coordinator: Mr Wan


Field trip to Tesco by 6 of our group members and 5 of their team members.

Procedures include:

1) Samples obtained (potato, short beans, senkuang) [minimum 1 kg for sampling]

2) Sealed in a special paper bag with pores for ventilation purposes

3) Cover sealed using a sticker provided with the KKM logo

10 am:

Went to a ice cream stall and checked for the level of cleanliness, and license for the shop keeper including their anti typhoid vaccination (kad pelalian pengendali makanan). They follow a list of guidelines to be followed by every shop with an overall scoring system. Every shop should obtain a score of above 70% for their continuity of their shop. Those shop that has obtained a score less than 70% according to the law, the shop will be closed for a maximum of 2weeks.


Went to KFC outlet and learned something special about that change the oil which is done once in every 10 days.


We had a short lecture topic about food acts, methods of food sampling, confiscation of food products, reporting of complains received about the particular food, and food poisoning control program.


Mr.Lim, in-charge of the Unit Penyiasatan dan Pendakwaan showed us a few case files of which he was the officer in-charge. He also said that the Food Act 1983 includes Food Regulation, Peraturan Kawalan Hasil Tembakau and Peraturan Kebersihan Makanan 2009 which is to be enforced in 2014.



day 6: CDC, NCDC, KPAS...

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We were welcomed by Mr.Cheang, Health Inspectorate, at 9.30pm. He gave a brief talk on the enforcement of tobacco usage, He further explained on the smoking issue among the community of Kota Setar. He also provided us with a list of prohibited areas to smoking and shared some personal experiences of his own while he was carrying out his duties. The job sounded cool..:)...but dangerous!.....He then reffered us to Mr.Yong who is currently incharge of the non-CDC department......

Mr.Nazri, another Health Inspectorate then took over where he spoke on Tuberculosis and Leprosy. He provided us with a copy of the epidemiology and the statistical data for the prevalence of tuberculosis in the district of Kota Setar. The referral system for a patient with sputum positive results is as follows:

Some of the criteria in this TBIS system are:

a. DHO will become the centre for data collection, and the reports are given to the district

b. Main reports are from the DHO which start from the treatment centre

c. State level report is sent to the ministry 3 months once

d. All cases even from the private sector are registered at DHO according to residence address

e. Patients data and the lab results are important according to DOTS

The main 5 components of DOTS:

a. Leadership commitments

b. Case detection through sputum evaluation

c. Standardized regime treatment usage and DOTS

d. Continuous medical supply

e. Uniform Information Management System

Mr.Nazri then continued on a briefing about leprosy. He told us that there was only 2 reported cases in Kota Setar. There are 2 types of mycobacterium leprae namely multibacillary( contagious) and paucibacillary (non-contagious). This desease is spread by bodily contact.

The day was further prolonged by another talk by Mr.Hasrul who is incharge of the HIV unit of the Kota Setar district. He showed us slide presentations on the disease prevalence in this district. He was happy that the prevalence rate has dropped over these years due to the effectiveness of programs conducted by various levels of the community such as PROSTAR, NSEP, and Health Carnivals.

Nurse Rozaini and Mr. Fitri of the KPAS unit had a discussion with us shortly after Mr.Nazri's. They briefed us on occupational hazards such as accidents at work place, acquired skin and lung diseases, and noise induced hearing loss. There are separate forms that are filled up according to each hazard eg: WEHU A1, WEHU S1 S2, and WEHU L1....:)

Finally we left for lunch and returned for the last session of the day at 2.30pm with Mr. Yong. We had a discussion on non-CDC such as Diabetic Programme, Hypertension Programme, Asthma, Obesity Programme and Quit Smoking Clinic. He told us that in future the Mental Programme will be included as one of the non-CDC aswell. In Kota Setar district there is a 25% of successfull rate of the counselling session for the Quit Smoking Clinic and there are about 19000 reported of diabetes till this year at the Diabetic Clinic.

Our day finally ended with Mr.Yong showing us around the Diabetic Health Clinic and also to the record storage room.......

It was a hectic day, but however we enjoyed ourselves!



Posted in By ~Meenu~ 0 comments

Today our topic was on communicable diseases. We were welcomed by Mr Hasan Abidin the person in charge of CDC & NCDC. He briefed us on this topic, basically CDC have 2 PPKPK but when there is outbreak other units join to assist. He then introduced us to Mr.Ooi Teak Look, the person in charge of CDC (except TB and HIV). Mr Ooi explained to us about the notifiable cases within 24 hours, and notifiable cases with or without specimen. He also said that if the doctor fail to notify a case, they will be compound a maximum of RM1000 but only 1 doctor has been compound  RM10 so far.  He then told us the most prevalence disease in kota star is HFMD (hand foot and mouth disease) which hit a total of 800 cases in 2009 and 659 cases in 2008. 

At about 9.45am our group facilitator Dr.Kay came to review about our topics for the past days. She guided us on how to probe questions to get more info and emphasized on the importance of each and every topics.
After 20mins of meeting with Dr.Kay, we continued our session with Mr.Ooi. He further explained to us on outbreak investigations and notification chart. He also showed us the e-notification system for kota star district.

Mr Ooi concluded at about 11.40am by giving us a soft copy of the charts and statistics. We were supposed to collect the info regarding TB from Mr Nazri and Zaidi  but they were out for field work so our next session with them will be on sunday.

We were then briefed by a assisting nurse Sister Salma Roshida from the HIV division at 12.15pm. She showed us the notification form and the rapid test kit. The routine HIV screening test is compulsory for donated blood, inmates of drug rehabilitation and correctional institution, high risk prisoners and antenatal mothers attending government antenatal clinic. One of our group member ranjeetha volunteered to try the rapid test kit for HIV to experience how it is being performed.

Our day ended at 3pm after waiting for other CDC person in charge but the session were postponed on Sunday. 

Day 4- School Health Programme and Nutritional Talk

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Today unlike most other days, we received a call from Sister Salmah notifying us that the school health programme is on. We were not expecting it since she told us that we might not be able to follow the programme because the particular school was further away from our district. Fortunately there was a change in the venue. We were told to meet them at the Sekolah Rendah Islam Darul Aman for a vaccination programme which includes OPV (oral polio vaccine, DPT and MMR) for the standard one students. They had to conduct this programme for 5 classes, but however they managed to cover 2 of them by today, the remaining classes will be conducted tomorrow.

The Unit Sekolah from the DHO Kota Setar was led by Mr. Azrul (MA in-charge) with a few other nurses and MA students doing their practical under Mr. Azrul's guidance. The day started with the whole team teaching the students using diagrams about the importance of clealiness. There were mainly 4 stations which are the recording station where they had to check the parents' approval of their child's vaccination and calculating the BMI of each student (if underweight or over-weight they will notify the student and parent for a dietary counselling), another station was using the Snellen's chart (for the eyesight), physical and general examination (from head-to-toe) and lastly after the students have completed all these stations they will proceed to the vaccination station. They are given 2 drops of OPV and both i.m. injections for DPT (on the left arm) and MMR (on the right arm).

During the whole session, there were certain new cases that were diagnosed such as bronchial asthma, head lyses and rashes (the students were given appropriate lotion for the head lyse and rash).

We then took leave once it was almost lunch, after completing a class of 35 students. We went back to DHO Kota Setar around 2.30pm where we had a talk on nutrition by the Pegawai Zat Makanan, Ms. Wahiddah Azmi. She gave us a brief overview about the Program Pemulihan Kanak-kanak Kekurangan Zat Makanan, dietary recommendations for those who are obese, diagnosed of having hypertension and any cardiovascular risk. She also enlightened us on the importance of breast-feeding and the essential nutrients required for pregnant mothers.

Well that was basically what we had done for the day. Everyday we had a new take-home message.! Till then toodles.!!

Day 3- Care for Children with Special Needs and Spastic Center

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Today we had an adventorous and very memorable journey. We went to KK Simpang Kuala, which is about 15 minutes drive from our KK Kota Setar. There we met Sister Muzleefah who was in-charge of bringing us to the special home @ Pusat Pemulihan Dalam Komuniti Putrajaya (PDK).
*PDK is under the umbrella of Jabatan Kebajikan Masyarakat (JKM). It is a project that complements, supplements and has partnership with JKM. Special children who are not able to cope with studies in regukar schools are enrolled in PDK to receive appropriate education.*

We were warmly received by the caretakers, Cikgu Wan and her helpers. This home fosters children who needs special attention like down syndrome, spastic, autistic, dyslexic, hyperactive, blind and mute children. There are about 30 children on an average who attends the sessions conducted here which comprises of all the 3 races. The age ranges from 2-20 years old. This sessions are conducted daily (except on public holidays) lasting from 8am till 2 pm.

This is the schedule for the home.
This is Dik Nah who is a Down's child. Though appeared very reserved at first she slowly opened up n started playing with the rest of us.
These are Muaz and Ashraf. Muaz is a spastic child where both his lower limbs are weak and thus he uses his hands to move around. Ashraf on the other hand is a slow learner and dyslexic.

This is Ah Boy who is mentally challenged and a hyperactive child. He is not able to communicate with us but he never failed to amaze us.!

We spent almost half a day there. We played games and sat together with them for colouring activity. Since most of the children are a big fan of football, they were overjoyed with the mini-FIFA that we played together.!
Finally it was lunch hour, we joined them for lunch and bit a very sad farewell. :(

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