tag:blogger.com,1999:blog-81680783203762128482024-03-13T05:55:18.200-07:00District Health Office PostingK.A.Narayanhttp://www.blogger.com/profile/03307511160149404141noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-8168078320376212848.post-4590338871689060072008-11-18T05:31:00.000-08:002008-11-18T05:31:00.309-08:00Family Medicine Posting in Klinik Kesihatan Merbok (Group A3) Part 2 [09/11/2008-12/11/2008]<strong><span style="font-size:180%;">Hello back....</span></strong><br /><br />So sorry for me to take some time to continue writing in this blog regarding our 2nd week experience in Klinik Kesihatan Merbok. We had a wonderful and fabulous time there.<br /><br /><br /><br /><span style="color:#6600cc;"><strong>Day 6 (09/11/2008)</strong></span><br /><span style="color:#ff0000;">We had a very short day wherewe just clerked elderly patient and did some assessment on them such as Elderly Cognitive Assessment Questionnaire (ECAQ), Mini Mental State Examination (MMSE), Psychiatry Depression Scale, Symptoms of Dementia Screener (SDS) and Modified Barthel Index. Those test are actually compulsory to be tested on every elderly patients. We then presented our patients to <span style="color:#000000;">Dr. Jamilah</span>. We were also told that there is something called as "Geriatric Giants" which includes Instability, Immobility and Incontinence.</span><br /><br /><br /><br /><strong><span style="color:#6600cc;">Day 7 (10/11/2008)</span></strong><br /><span style="color:#ff0000;">First of all, we were being briefed on children with special needs programme. We were told that it is the most important to prevent handicap children here in Malaysia and that the MOH (Ministry of Health) had launch a pre-pregnancy clinic in year 2004 where these clinics are located in both Klinik Kesihatan and in the Hospital to have a pre-pregnancy care. In the pre-pregnancy care, a couple of things have been looked into such as:-</span><br /><span style="color:#ff0000;">1) Early diagnosis of Diabetes Mellitus, Hypertension, and Thyrotoxicosis<br />2) Counselling for all patients <50><br />3) Advise to pregnant mothers that:-</span><br /><div><span style="color:#ff0000;"> (a) If mother is diagnosis to have thyrotoxicosis, they can be pregnant after the treatment</span></div><div><span style="color:#ff0000;"> (b) Thyrotoxicosis can cause abortion</span></div><div><span style="color:#ff0000;"> (c) Mothers who are pregnant are advise to take folic acid to prevent teratogenicity</span></div><div><span style="color:#ff0000;"> (d) Mothers who are pregnant with diabetes mellitus have to be taken good care of to prevent </span></div><div><span style="color:#ff0000;"> anencephaly, spina bifida, etc</span></div><div><span style="color:#ff0000;"> (e) Mothers who are pregnant with heart problem will eventually face more medical problems </span></div><div><span style="color:#ff0000;"> compare to their child</span></div><div><span style="color:#ff0000;"> (f) Mothers who are pregnant with diagnosis of epilepsy can have teratogenicity effects to the </span></div><div><span style="color:#ff0000;"> child if the mother is on anti-epileptic drugs</span></div><div><span style="color:#ff0000;"> (g) If the mother is pregnant and is diagnose to have rubella infection, 99% the fetus will get </span></div><div><span style="color:#ff0000;"> teratogenisity effects and therefore abortion have to take place. In the first trimester if </span></div><div><span style="color:#ff0000;"> the mother comes with fever and rash, must ask whether the mother concern has been </span></div><div><span style="color:#ff0000;"> given immunisation towards rubella or not. Then a titer test must be done and if the test </span></div><div><span style="color:#ff0000;"> turns out to be positive, then pregnancy must be terminated.</span></div><br /><div><span style="color:#ff0000;"></span></div><div><span style="color:#ff0000;">Normally after delivery, agross examination will be done during the follow-up. Any developmental milestone delay will be detected and a early stimulation programme or exercise is done during the infant period (in this category, different exercises are given based on the age of the patient). After the age of one, if there is still a gross delay, then the patient is referred to the Paediatric Department to confirm the diagnosis. Once the diagnosis is confirmed in the Hospital, the patients will then be follow-up in any Klinik Kesihatan nearby. The diagnosis is categorised into mild, moderate or severe and then the patient undergo the multidisciplinary approach (including Paediatricians, Health team, Teachers, Physiotherapists, Social welfare and Parents) in order to get optimal care.</span></div><br /><div><span style="color:#ff0000;">For the mild disability, they are sent to the TASKA. The moderate disability children will still be trained by the occupational therapist on simple tasks like toilet train skills, self-care and basic occupational therapy. As for the sever disability, they will be sent to the Children Rehabilitation Centre (PDK) and will be taught basic living there.</span></div><br /><div><span style="color:#ff0000;">For severe mental retardation (eg. imperforated anus, etc), it involves two care units which are:-</span></div><div><span style="color:#ff0000;">1) Health Care </span></div><div><span style="color:#ff0000;"> (a) Nursing for nursing care</span></div><div><span style="color:#ff0000;"> (b) Physiotherapist for physiotherapy care</span></div><div><span style="color:#ff0000;"> (c) Specialist for medication treatment</span></div><div><span style="color:#ff0000;"> (d) Medical Officer for medication treatment</span></div><div><span style="color:#ff0000;"> (e) Paediatricians for further care</span></div><div><span style="color:#ff0000;"> (f) Occupational therapy - refer to Hospital</span></div><div><span style="color:#ff0000;"> (g) Speech therapy - refer to Hospital</span></div><div><span style="color:#ff0000;">2) Community Care</span></div><div><span style="color:#ff0000;"> (a) Jabatan Kesihatan (Health Department)</span></div><div><span style="color:#ff0000;"> (b) Jabatan Pelajaran (Education Department)</span></div><div><span style="color:#ff0000;"> (c) Jabatan Kebajikan Masyarakat (Social Welfare Department)</span></div><div><span style="color:#ff0000;"> (d) Jabatan NGOs (Non-Governement Organisation)</span></div><br /><div><span style="color:#ff0000;">In the district of Kuala Muda, Kedah, there are some Child Rehabilitation Centre (PDK). They can be found in:-</span></div><div><span style="color:#ff0000;">1) Merbok</span></div><div><span style="color:#ff0000;">2) Bedong</span></div><div><span style="color:#ff0000;">3) Bukit Selambau</span></div><div><span style="color:#ff0000;">4) Kota Kuala Muda</span></div><br /><div><span style="color:#ff0000;">We then follow <span style="color:#000000;">Dr. Jamilah</span> to a Child Rehabilitation Centre (PDK) in Merbok. Over there, they are taught according to the ages. For the young ones, they are given some toys to play with. For those schooling-aged, they will be taught simple words and pronouncation. For adolescents, they will be given some tasks to do like sewing, bakery, etc and the things that they had done will be sold off so that the disabled children can received some money in the end. The parents of each children will be paid some money to encourage them to send their child to the centre. Currently they are paid RM 150 per month.</span></div><br /><div><span style="color:#ff0000;">We were then being left in the Muzium Arkeology Bujang when the day ends.</span></div><br /><div></div><br /><div><strong><span style="color:#6600cc;">Day 8 (11/11/2008)<br /></span></strong><span style="color:#ff0000;">We were being briefed by <span style="color:#000000;">Staff Nurse Meriam</span> on nutrition control on antenatal mothers. A normal diet containing carbohydrate, protein and vitamins were being advised to those pregnant mothers.</span></div><br /><div></div><br /><div><strong><span style="color:#6600cc;">Day 9 (12/11/2008)</span></strong></div><div><span style="color:#ff0000;">Today is our last day in Klinik Kesihatan Merbok. In the morning, we were assigned a few patients to be clerked and then we headed to the Physiotherapy Department to follow-up a patient. Over there in the department, a short briefing were being told to us by a new physiotherapist. Besides observing her teaching a stroke patient on how to move her right upper limbs, she also brief us on regarding the physiotherapy unit. In the whole of Malaysia, there are more than 200 Klinik Kesihatan but only 18 Klinik Kesihatan has a Physiotherapy unit with equipments by its own. In Kedah, there are 3 Klinik Kesihatan which has the facilities. They are:-</span></div><div><span style="color:#ff0000;">1) KK Merbok</span></div><div><span style="color:#ff0000;">2) KK Bandar Alor Setar</span></div><div><span style="color:#ff0000;">3) KK Pendang</span></div><br /><div><span style="color:#ff0000;">However, in Sungai Petani, there are 5 Klinik Kesihatan which has physiotherapy unit of which only one had equipments. The 5 are:-</span></div><div><span style="color:#ff0000;">1) KK Merbok</span></div><div><span style="color:#ff0000;">2) KK Bedong</span></div><div><span style="color:#ff0000;">3) KK Selambau</span></div><div><span style="color:#ff0000;">4) KK Bandar Sungai Petani</span></div><div><span style="color:#ff0000;">5) KK Kuala Muda</span></div><br /><div><span style="color:#ff0000;">Out of the 5 mentioned above, the physiotherapist from KK Merbok will visit the rest of the Klinik Kesihatan once in a month with portable equipments.<br /></span></div><div><span style="color:#ff0000;">We then have a brief closing up session with <span style="color:#000000;">Dr. Jamilah</span> discussing about the whole entire programme of ours in the 2 weeks. </span></div><br /><div><span style="color:#ff0000;">In the afternoon, we had a briefing on Tuberculosis and Adolescent by <span style="color:#000000;">Staff Nurse Norizah</span>. In the tuberculosis briefing, we learnt that there is 2 types of treatment given which are known as PR1 (Pusat Rawatan 1) and PR 2 (Pusat Rawatan 2). In PR1, they can start with anti-tuberculous medcations. The places are such as chest clinic (seen in any KK with Family Medicine Specialist (FMS) - KK Merbok and KK Bandar). For PR2, they are not allowed to start any medications but can only give DOTS to the patients. Screening for tuberculosis is open to:-</span></div><div><span style="color:#ff0000;">1) Walk-in patient with symptoms</span></div><div><span style="color:#ff0000;">2) Any diabetes patient with symptoms </span></div><div><span style="color:#ff0000;">3) Any HIV patients</span></div><div><span style="color:#ff0000;"></span> </div><div><span style="color:#ff0000;">The screening for tuberculosis regardless of any type of the patients will have to fill up the TBIS form and sent to the District Health Office Kuala Muda within 1 week. The 'Pegawai Persekitaran' will go to the patient's house to get any family members who may be in contact with the patient. A notification form is also been filled up. The patient's contact will be ask to take sputum and chest X-ray (for child, Mantoux test is taken and no CXR is taken). Patient is clerked by the doctor (an envelope and a file will be given to the patient). Baseline investigations (eg. LFT, AST, Sputum C&S, HIV status, RBS, etc) were done. Then, treatment (dosage) is given to the patient depending upon the body weight of the patient. A small book will be given to the patient; either yellow (for PTB +ve) or white (PTB -ve). For PTB negative, sputum culture is not require.</span></div><div><span style="color:#ff0000;"></span> </div><div><span style="color:#ff0000;">There are 2 different phase for treatment. In Phase 1, 52 doses are given. Then, the chest X-ray and sputum culture is being repeated before proceeding to Phase 2 where 32 doses are given (every fortnightly). After that, follow-up will be the first 3 months, follow by 6 months, 9 months and 2 years respectively. If patient's contact or family members were to be found positive, treat them accordingly too. If there is a defaulter, the 'Pegawai Persekitaran' will be informed and they will track the patients down and treatment is tobe started all over again. Then, they will be given a red card.</span></div><div><span style="color:#ff0000;"></span> </div><div><span style="color:#ff0000;">A template or brochure is given to patients to let them realise the importance of DOTS, the food and diet and also to educate the patient on tuberculosis. If a patient were to be transferred, a 'Borang 10K' must be filled up and the receiving place must make sure that the patient turn up for regular follow-ups. If the patient has passed away, a 'Borang 10J' have to be filled up. All together, there are about 25 forms just for tuberculosis. </span></div><div><span style="color:#ff0000;"></span> </div><div><span style="color:#ff0000;">In KK Merbok which covers areas like Bedong, Selambau and Merbok, there are about 10 new patients of tuberculosis yearly.</span></div><div><span style="color:#ff0000;"></span> </div><div><span style="color:#ff0000;">As for the adolescent briefing, we got to know that the range for adolescent is 10-18 years old. Any walk-in patient for screening or any refer cases (normally from the school) will then be given a form to be filled up. Then, any problems will be detected (eg drug abusers, smoking, depression, molest, etc) and they will be counselled. In KK Merbok, all female adolescent are counsel by <span style="color:#000000;">S/N Norizah</span>. Even for any male adolescent who smokes will be counsel by her too. For other male adolescent, they will be counsel by medical assisstant. Unless there is cases which are very severe, then those adolescent will be refer to the medical officer or the family medicine specialist.</span></div><div> </div><div>And this ends our 2 weeks of posting in KK Merbok. We did had a splendid time there...</div><div>i hope you did enjoy reading the article...</div><div>Thank you...</div><br /><div></div>Cheah Boon Euhttp://www.blogger.com/profile/09451820363944180614noreply@blogger.com1tag:blogger.com,1999:blog-8168078320376212848.post-82286913188714865302008-11-06T16:51:00.000-08:002008-11-06T16:51:01.060-08:00Family Medicine Posting in Klinik Kesihatan Merbok (Group A3) Part 1 [02/11/2008-06/11/2008]<strong><span style="font-size:130%;">Welcome back to this blog...</span></strong><br />But i would like to apologize that we do not have any photographs to show this time.<br /><br />Currently my friends and i from Group A3 are in our final year of MBBS and we are posted in Klinik Kesihatan Merbok for 2 weeks for Family Medicine.<br /><br />We consists of:-<br />1) Charlotte Marie d/o Ambrose Alexander (ID No: 0400387)<br />2) Chai Zsi Yuan (ID No: 0400414)<br />3) Chan Hui Ling (ID No: 0400420)<br />4) E'rlene Low Li Ern (ID No: 0400429)<br />5) Gan Yuen Keat (ID No: 0400435)<br />6) Cheah Boon Eu (ID No: 0400405)<br /><br />Our posting in KK Merbok started on the 2nd of November 2008 and will end on the 13th of November 2008.<br /><br />Hereby, what we have learnt it mostly a repetition of what we had done when we were in Year 4 (where we were posted in Baling and Sik for our District Health Office Posting). However, there are some activities and knowledges that we failed to collect during our previous postings in Year 4. Thus, i shall share it here with you.<br /><br /><br /><strong><span style="color:#6600cc;">Day 1 (02/11/2008)</span></strong><br /><span style="color:#ff0000;">A briefing about Family Medicine by <span style="color:#000000;">Dr. Jamilah Abdullah</span> and </span><span style="color:#000000;">Staff Nurse Hasnah</span><br /><br /><br /><strong><span style="color:#6600cc;">Day 2 (03/11/2008)</span></strong><br /><span style="color:#ff0000;">We were being briefed on how Pap Smear is being done in KK Merbok. According to <span style="color:#000000;">Staff Nurse Zakiah</span>, every year, they have a target of 550 patients for Pap Smear examination. Sometimes, they will do health campaign to make the community aware about Pap Smear. Previously they used to send the Pap Smear samples to Hospital Sultan Abdul Halim, Sungai Petani for further investigations but since November 2008, the Pathlab representatives will come and collect the sample. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">Besides Pap Smear, we were also told about Breast Self Examination (BSE).</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">After the two sessions mentioned, we were being briefed by <span style="color:#000000;">Staff Nurse Meriam</span> about Immunisation. Even though again this time we did not get a chance to go to the school to give the immunisation, we did learn some new things. First of all, all vaccines are being stored in the fridge at 2-8 degree Celcius. If at all there is no electricity, they will be inform early. However, most of the time, the fridge can maintain the temperature if left unopened for 48-72 hours depending on the different fridges used. The position of the fridge and the surrounding (eg. the wall) should be at least 30cm apart. And the fridge is normally placed in a room which is not exposed to the sunlight so that the temperature canbe maintained. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">The temperature is maintain by cold chain which a minimec termometer is used to measure the temperature. The temperature is being taken twice a day (once in the morning at 8am and once in the evening at 4pm) and it is then being recorded in a book. Every time when the temperature is taken, a button is to be pressed on the minimec termometer to get the current temperature (suhu semasa). 3 colours will be used to draw the graph in the book to record the temperature. The red colour indicates the maximum temperature, the blue indicates the minimum temperature and the green indicates the current temperature. On weekends and public holidays (when the KK is not opened), there will still be someone resposible to come and check the temperature. If at all the fridge is not working or the vaccines has been exposed to a higher temperature, all the vaccines will be sent to the lab to be tested for its potency.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">In the fridge, the vaccines are arranged in such a way that the live vaccines are placed at the most top. Live vaccines such as BCG, PV, Measles, etc; when given, it must not be cleaned with a spirit swab. BCG vaccination is given at birth and if there is no scar at the age of 3 months, it is given again and to be check again at the age of 7 years old, 12 years old and in secondary school. BCG is use to protect tuberculosis and the vaccination can only protect a person for 15 years.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">A type of vaccination which is called as Triantrix is currently given. It contains of DPT, Influenza or HiB and Hep B. Baby who are HIV positive or those who are under chemotherapy, OPV is not given to them due to low immune system. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">Complication for mumps in a male is impotence and complications for measles are meningitis, pneumonia and etc.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">For a pregnant lady, vaccinations such as Tetanus and Rubella are those commonly asked to them. If an antenatal lady is Gravida 1, then she will be given 2 doses of Tetanus and if the mother is more than Gravida 1, then she will only be given 1 dose of Tetanus. In Gravida 1, the first dose is normally given at the 18/52 POG. And the second dose is given after 1 month of the first dose. If mothers who are more than Gravida 1, the dose is given one month after quickening. Rubella on the other hand is given to mothers after one week of postnatal to those mothers who had never had Rubella vaccination before.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">For ATT, Hep B, DPT and DA (Double Antigen), they are usually whitish grey in colour. If it get spoiled, the colour will changed to yellowish brown. Another way of knowing whether the vaccination is still potent is by looking at the sediment. If there is sediment present, try to shake the bottle. If the sediment is still there, this means that the vaccine is no longer potent. As for MMR, the normal colour is light pink.</span><br /><br /><br /><strong><span style="color:#6600cc;">Day 3 (04/11/2008)</span></strong><br /><span style="color:#ff0000;">We had a more concise discussion about Cardiovascular Diseases and Diabetes Mellitus with <span style="color:#000000;">Dr. Jamilah</span> in Klinik Kesihatan Bedong. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">For Cardiovascular Diseases, the cut-off point for a screening is 45 years old for males and 55 years old for females. For hypertension, the most important investigations done is urine analysis. For lipid profile, the most important ones that they will look into are LDL follow by HDL and TGL.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">As for the Diabetes Mellitus, the current prevalence in Malaysia is 12%.</span><br /><span style="color:#ff0000;"></span><br /><br /><strong><span style="color:#6600cc;">Day 4 (05/11/2008)</span></strong><br /><span style="color:#ff0000;">For the morning sessions, we follow the clinic on NCDC (eg DM and HPT, mostly). We each clerk a case from the OPD in KK Merbok and presented them to <span style="color:#000000;">Dr. Jamilah Abdullah</span>.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">In the afternoon, we had a briefing on CDC (eg. HIV). We were told that the prevalence of HIV in the world is about 80,000 and the incidence for HIV daily is 16 patients worldwide. In Kuala Muda, there are about 50 patients with HIV and in the whole of Kedah, there are about 500 patients diagnosed with HIV. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">All tuberculosis and high-risk patients are subjected to HIV test. In a high-risk patients, ELISA is done and the samples are sent to the Hospital and it takes about 3-4 days for the results to be returned. If a low-risk patients (eg, pregnant mothers, marriage couples, etc) a rapid test is to be done in the KK.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">HIV virus will die once expose to the air. HIV can be transmitted through a lot of ways. As for needle-prick injury, the chances of getting HIV is 0.14% and HIV can be spread through sexual intercourse by 0.9%. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">In a pregnant lady with HIV positive, she will be started on STAT (short-term antiretroviral therapy). With the treatment, there is only 8% chances of the fetus developing HIV, but without the therapy the fetus is at a 30% rate of getting HIV. The therapy will be stopped after delivery. The objective of this therapy is to prevent the fetus from getting HIV from the mother. For all the HIV positive pregnant lady, the mode of delivery will be Caesarean Section as baby will have a higher chance (which is 60%) of getting HIV is the mother deliver through spontaneous vaginal delivery.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">All the treatment for infectious diseases are free of charge in Malaysia. As for HIV, a 6 monthly CD4+ check-up is done to see whether the patient needs the treatment for HIV (HAART). HAART is also known as highly active antiretroviral therapy which is given to those HIV patients with CD4+ count less than 250. The first dose is normally given to the patients but the subsequent doses is not free of charge. Currently, Malaysia is importing the HAART medications (Cipla) from India.</span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">If a HIV positive patient were to be diagnose with tuberculosis, the HAART therapy will be stopped for one month when they start with their anti-tuberculosis medications. In HIV positive patients, IV streptomycin will not be given as they are trying to reduce the risk of getting needle-prick injury. Unless the HIV positive patient has been on HAART therapy for a long time, then it is not stop as by stopping it can cause resistance.</span><br /><br /><br /><strong><span style="color:#6600cc;">Day 5 (06/11/2008)</span></strong><br /><span style="color:#ff0000;">We follow <span style="color:#000000;">Sister Che Bunga</span> and a <span style="color:#000000;">Community Nurse</span> for Home Visit programme. Before a home visit is done, the nurses in-charge must have a worksheet on the objectives of the "Rumah Lawat" programme and they must submit a report after that. A home visit is normally done to those who are postnatal, antenatal, child follow-up and HOSPICE follow-up. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">For the postnatal, a home visit is done on day 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 and 20. The first 10 days is important to detect for any Jaundice. The infant is then being measured for his or her weight at the 10th and 20th day. For antenatal home visit, it is done in a routine schedule which is once in first trimester, once in second trimester and once in third trimester. Unless, the mother has other complications, then the home visit would be more frequent. In a antenatal follow-up, first a urine dipstick is used to detect any abnormalities like sugar or protein in the urine. Then, a thorough medical check-up will be done (eg. measuring the blood pressure, checking for the fundal height and other general examinations). For child follow-up, it is meant for disable child or child with inadequate nutrition. </span><br /><span style="color:#ff0000;"></span><br /><span style="color:#ff0000;">The things which are being brought during a home visit are:-</span><br /><span style="color:#ff0000;">1) Delivery set</span><br /><span style="color:#ff0000;">2) Swabbing set</span><br /><span style="color:#ff0000;">3) Sterile gloves</span><br /><span style="color:#ff0000;">4) Swabs and swabs</span><br /><span style="color:#ff0000;">5) Top and Tail set</span><br /><span style="color:#ff0000;">6) Urine dipstick</span><br /><span style="color:#ff0000;">7) IV line</span><br /><span style="color:#ff0000;">8) Catheters</span><br /><span style="color:#ff0000;">9) Hibitane cream</span><br /><span style="color:#ff0000;">10) Hibitane spirit</span><br /><span style="color:#ff0000;">11) Fetal scope</span><br /><span style="color:#ff0000;">12) Needles and Syringe</span><br /><span style="color:#ff0000;">13) IV saline</span><br /><span style="color:#ff0000;">14) Disposable sucker</span><br /><span style="color:#ff0000;">15) Chinese paper</span><br /><span style="color:#ff0000;">16) Mask and drape</span><br /><span style="color:#ff0000;">17) Filter paper (to detect for G6PD)</span><br /><span style="color:#ff0000;">18) Blood pressure set (Sphingomanometer)</span><br /><span style="color:#ff0000;">19) Termometer</span><br /><span style="color:#ff0000;">20) Measuring tape</span><br /><span style="color:#ff0000;">21) etc......</span><br /><br />This conclude our first week of our Family Medicine posting in Klinik Kesihatan Merbok.<br />Hope you enjoy reading our experience.<br />i will be posting our second week soon.<br />Till then, thank you very much.Cheah Boon Euhttp://www.blogger.com/profile/09451820363944180614noreply@blogger.com3tag:blogger.com,1999:blog-8168078320376212848.post-35027952044115885832008-04-18T21:24:00.000-07:002008-04-18T06:25:56.002-07:00Role of Medical Assisstants<strong><span style="color:#6600cc;">Some background information regarding medical assistants (MA)</span></strong><br />1) Multi skilled, multifunctional healthcare providers for more than 100 years.<br />2) Initially known as ‘dressers’.<br />3) Often called the ‘backbone’ of rural health services and ‘jack of all trades’ in hospitals.<br />4) Male nurse profession introduced in mid-50s<br />5) In 1977, Hospital Assistants (Registration) Board established under ‘Act 180’.<br />6) In 1992, nomenclature of ‘hospital assistants’ changed to ‘medical assistants’. Training upgraded to diploma level.<br />7) The Board functions under Medical Practices Division. DG of Health is the Chairman. Chief Medical Assistant is the Secretary of the Board.<br /><br /><span style="color:#ff0000;"><strong>Role of PPP (Medical Assistants):</strong></span><br />• Responsible in the promotion, prevention, curative and rehabilitation of community under the inspection of medical officer in the primary health care set-up.<br />• Assisting family medicine specialist and medical officer in term of clinical settings, documentation, medical training, management of health care and research.<br />• Head a primary health care clinic during the absence of medical officer.<br /><br />Their works includes:<br /><br /><span style="color:#3333ff;">A.) Screening of patient<br /></span>• History-taking.<br />• Vital signs examination.<br />• Physical examination.<br />• Lab investigation or X-ray ( whenever necessary)<br /><br /><span style="color:#3333ff;">B.) Examination, diagnosis and treatment<br /></span>• Carrying out certain diagnostic and therapeutic procedures, such as ECG, nebulization, IV infusion.<br />• Carrying out certain minor procedure, namely application of POP, I&D and so on.<br />• Giving injection.<br />• Taking IV blood sample.<br /><br /><span style="color:#3333ff;">C.) Emergency treatment</span><br />• Involve in preliminary management during emergency.<br />• Conduct First Aids and CPR.<br />• Referral of cases to medical officer / nearest health centre.<br /><br /><span style="color:#3333ff;">D.) Referral</span><br />o Refer cases which are not within their limit to hospital.<br />o Handling referral cases from paramedics.<br />o Receiving follow-up of stable cases from the hospital.<br />o In time of emergency, a medical assistant is allowed to drive the ambulance, provided that there was a written order from medical officer.<br /><br /><span style="color:#3333ff;">E.) Ambulance service<br /></span>• Head the ambulance team.<br />• Responsible to ensure that all the equipments in the ambulance are in good condition.<br /><br /><span style="color:#3333ff;">F.) Health education and counseling</span><br />Ø Responsible for counseling the patients and community.<br />Ø Involve in health campaign.<br /><br /><span style="color:#3333ff;">G.) Treatment of communicable diseases<br /></span>• Case tracing.<br />• Case notification.<br />• Contact tracing.<br />• Provide treatment.<br />• Give immunization injections when needed.<br />• Home visits to defaulters and to give health education.<br /><br /><span style="color:#3333ff;">H.) Treatment of non-communicable diseases</span><br />– Screening and detection.<br />– Initiate treatment.<br />– Follow-up for stable cases.<br />– Give counseling and health education.<br /><br /><span style="color:#3333ff;">I.) Immunization<br /></span>• Examination and injection of Anti-Typhoid jab to food handler.<br />• ATT injection.<br />• Meningococcal injection to those going to perform Hajj.<br />• Japanese encephalitis vaccination<br />• Cholera injection.<br /><br /><span style="color:#3333ff;">J.) After working hours</span><br />• Attend to emergency cases after working hours.<br /><br /><span style="color:#3333ff;">K.) As assistant pharmacists<br /></span>• Medication dispensing.<br />• Packing medicine.<br />• Recording medicine usage.<br /><br /><br /><br /><br />By [Michelle] Huang Mooi Sia<br />0400474<br />FMHS Batch 5/6<br />p/s: any suggestion, please feel free to contact me at michellehms82@yahoo.comCheah Boon Euhttp://www.blogger.com/profile/09451820363944180614noreply@blogger.com2tag:blogger.com,1999:blog-8168078320376212848.post-61498585115745158742008-03-30T16:40:00.000-07:002008-06-13T06:43:05.530-07:00District Health Office Posting in Baling, Kedah Darul Aman [Part IV - Week 4 (09/12/2007-12/12/2007)]Hi everyone once again,<br /><br /><div></div><div>Hereby, i shall bring you to the final week of our DHO posting in Baling, Kedah.</div><div><br /><span style="color:#ff0000;"><strong><a href="http://bp1.blogger.com/__vmaN6lEpco/R-9KcQ9npgI/AAAAAAAAAMU/FK85rgKPcZM/s1600-h/P1010009.JPG"><img id="BLOGGER_PHOTO_ID_5183443545576941058" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 107px; CURSOR: hand; HEIGHT: 81px" height="84" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-9KcQ9npgI/AAAAAAAAAMU/FK85rgKPcZM/s200/P1010009.JPG" width="85" border="0" /></a>SUNDAY 9TH DECEMBER 2007</strong></span><br /><span style="color:#6666cc;">- The topic for the day was primary care. PPKP Danial met the team in Klinik Kesihatan Kupang. We were briefed regarding the various primary care services available. Among the services available include Diabetic clinic, Antismoking clinic, Geriatric clinic, Hypertension clinic, HIV screening clinic and many more.<br />- PPKP Danial also briefed us regarding the emergency set up and basic life support. We were also taught regarding the functions of each item on the emergency trolley. We were also briefed about how an emergency call is directed to the call centre in Hospital Sultanah Bahiyah, Alor Star from Telekom Malaysia.<br />- Later in the evening, we attended the antismoking clinic in hospital Baling. Encik Mohd Rusli briefed us on how the clinic is run according to protocols set up by the Health Ministry. Later, we observed him counseling a new patient.</span></div><div></div><div><br /><strong><span style="color:#ff0000;">MONDAY 10TH DECEMBER 2007</span></strong><br /><span style="color:#6666cc;">- We met PPKP Nizam who is in-charge of Kawalan Mutu Makanan. We were briefed regarding the various forms available, the procedure of collecting food samples and transporting it to Butterworth, and also procedures regarding the closure of food premises.<br />- Later, PPKP Mazran explained to us about KPAS, that is the abbreviation of Kesihatan Pekerja dan Alam Sekitar. He explained to us regarding the duties and programmes of KPAS.<br />Among the activities carried out are:<br />(a) surveillance of cases of injuries and skin diseases among factory workers<br />(b) investigation and management of needle stick injuries<br />(c) education of workers regarding safety equipments<br />(d) monitoring of the school environment<br />(e) monitoring the cleanliness and sanitation of the Pusat Latihan Khidmat Negara before and during the programme<br />(f) supporting ‘healthy setting’<br />(g) early detection of cardiovascular diseases among workers<br />(h) investigation of public complains such as complains of cleanliness of animal farms</span></div><span style="color:#3333ff;"><span style="color:#6633ff;">- Later at noon, one of our AIMST Community Medicine lecturer; Dr. Sawri Rajan met us in the District Health Office of Baling to discuss about the activities we are suppose to be carrying out during our posting here. He also discussed with us regarding the write-up of the log book of Community</span> <span style="color:#6633ff;">Medicine.</span> </span><br /><div><br /><span style="color:#ff0000;"><strong><a href="http://bp3.blogger.com/__vmaN6lEpco/R-9OMw9npnI/AAAAAAAAANM/dzhI-7zg2zQ/s1600-h/P1010010.JPG"><img id="BLOGGER_PHOTO_ID_5183447677335479922" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="115" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-9OMw9npnI/AAAAAAAAANM/dzhI-7zg2zQ/s200/P1010010.JPG" width="160" border="0" /></a>TUESDAY 11TH DECEMBER 2007</strong></span><br /><span style="color:#6666cc;">- The Department of Food Quality Control arranged to take us to observe the process of food sampling. We first gathered at Pejabat Kesihatan Baling at 8 am and then left for Petronas with the Food Quality Control team at 9am. Upon arrival, we observed the team collect 5 samples of food from the Petronas Mesra convenient store. The 5 samples collected were Dutch Lady Full Cream milk, Tiger brand milk cookies, Silverbird fruit cake, DRINHO soya bean and OOZI peanut butter. We then learned the methods of packaging the food items, labeling them and sealing it with the seal labeled ‘ LAK Rasmi”.<br />- Then, we followed the team to Butterworth where we observed how the items were received and registered for microbiology investigation by Makmal Keselamatan dan Kualiti Makanan, Negeri Pulau Pinang.</span> </div><div></div><div><a href="http://bp0.blogger.com/__vmaN6lEpco/R-9MEA9nphI/AAAAAAAAAMc/rFQffKz4nGY/s1600-h/P1010001.JPG"><img id="BLOGGER_PHOTO_ID_5183445327988368914" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-9MEA9nphI/AAAAAAAAAMc/rFQffKz4nGY/s200/P1010001.JPG" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R-9MEg9npiI/AAAAAAAAAMk/zc2X3Akc5hU/s1600-h/P1010003.JPG"><img id="BLOGGER_PHOTO_ID_5183445336578303522" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-9MEg9npiI/AAAAAAAAAMk/zc2X3Akc5hU/s200/P1010003.JPG" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R-9MFA9npjI/AAAAAAAAAMs/RB6qbq9OnKI/s1600-h/P1010005.JPG"><img id="BLOGGER_PHOTO_ID_5183445345168238130" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-9MFA9npjI/AAAAAAAAAMs/RB6qbq9OnKI/s200/P1010005.JPG" border="0" /></a><br /><br /></div><br /><div><br /><strong><span style="color:#ff0000;"></span></strong></div><br /><div><br /></div><br /><div><strong><span style="color:#ff0000;"></span></strong></div><br /><div><strong><span style="color:#ff0000;"><a href="http://bp2.blogger.com/__vmaN6lEpco/R-9MFg9npkI/AAAAAAAAAM0/eor9y1iYWAE/s1600-h/P1010007.JPG"><img id="BLOGGER_PHOTO_ID_5183445353758172738" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-9MFg9npkI/AAAAAAAAAM0/eor9y1iYWAE/s200/P1010007.JPG" border="0" /></a></span></strong></div><div><strong><span style="color:#ff0000;"><a href="http://bp3.blogger.com/__vmaN6lEpco/R-9MFw9nplI/AAAAAAAAAM8/jdRjqAvrzIw/s1600-h/P1010008.JPG"><img id="BLOGGER_PHOTO_ID_5183445358053140050" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-9MFw9nplI/AAAAAAAAAM8/jdRjqAvrzIw/s200/P1010008.JPG" border="0" /></a></span></strong></div><a href="http://bp1.blogger.com/__vmaN6lEpco/R-9OMQ9npmI/AAAAAAAAANE/Xk147N_dAk4/s1600-h/P1010009.JPG"><img id="BLOGGER_PHOTO_ID_5183447668745545314" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-9OMQ9npmI/AAAAAAAAANE/Xk147N_dAk4/s200/P1010009.JPG" border="0" /></a><br /><div><strong><span style="color:#ff0000;"><a href="http://bp3.blogger.com/__vmaN6lEpco/R-9MFw9nplI/AAAAAAAAAM8/jdRjqAvrzIw/s1600-h/P1010008.JPG"></a></span></strong></div><br /><div><br /></div><div></div><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><strong><span style="color:#ff0000;"><a href="http://bp0.blogger.com/__vmaN6lEpco/R-9QQA9nptI/AAAAAAAAAN8/DqqrGFT65J0/s1600-h/P1010018.JPG"><img id="BLOGGER_PHOTO_ID_5183449932193310418" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 134px; CURSOR: hand; HEIGHT: 109px" height="100" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-9QQA9nptI/AAAAAAAAAN8/DqqrGFT65J0/s200/P1010018.JPG" width="108" border="0" /></a>WEDNESDAY 12TH DECEMBER 2007</span></strong><br /><span style="color:#6666cc;">- We attended the Blindness Detection Programme or rather known as ‘Program Kebutaan’ in Klinik Kesihatan Tawar. This is an activity arranged under Non-communicable Diseases Control (NCDC) unit.<br />- We were briefed by Penolong Pegawai Perubatan Encik Amir regarding this programme. This Blindness Detection Programme is the pioneer programme in the country. Its center is based in Klinik Kesihatan Tawar. Therefore, all referrals from any health centers in the district of Baling would be sent here for evaluation before being referred to Sungai Petani for consultation by the opthalmologist.<br />- According to statistics, Perak is the state affected with the highest amount of blindness. Kedah currently ranks as the state with the sixth highest amount of blind cases in the country.<br />In 1950, it was recorded that 38 million people in the world were affected by blindness according to statistics prepared by WHO. Later on, a study was carried out in Malaysia from year 1996 to 1998. It was discovered that 2.71% (518680 people) out of 19 million people were affected with blindness.<br />- We learnt on how the screening process for blindness was done, the various methods of investigations and the different types of treatment provided.<br />- The Blindness Detection Programme unit is very active as they not only provide this service every Thursdays in Klinik Kesihatan Tawar, but also participate continuously in many of the health campaigns arranged by the district health office with the hope of creating awareness in the community pertaining the importance of healthy vision.</span><br /><br /><br /><br /><a href="http://bp0.blogger.com/__vmaN6lEpco/R-9ONA9npoI/AAAAAAAAANU/meRxgqDnkVM/s1600-h/P1010012.JPG"><img id="BLOGGER_PHOTO_ID_5183447681630447234" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-9ONA9npoI/AAAAAAAAANU/meRxgqDnkVM/s200/P1010012.JPG" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R-9ONg9nppI/AAAAAAAAANc/4P1Kpa2ObzE/s1600-h/P1010013.JPG"><img id="BLOGGER_PHOTO_ID_5183447690220381842" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-9ONg9nppI/AAAAAAAAANc/4P1Kpa2ObzE/s200/P1010013.JPG" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R-9ONw9npqI/AAAAAAAAANk/bNqhWSUS-0w/s1600-h/P1010014.JPG"><img id="BLOGGER_PHOTO_ID_5183447694515349154" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-9ONw9npqI/AAAAAAAAANk/bNqhWSUS-0w/s200/P1010014.JPG" border="0" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><a href="http://bp2.blogger.com/__vmaN6lEpco/R-9QPg9nprI/AAAAAAAAANs/sdTOaFGf0Gg/s1600-h/P1010016.JPG"><img id="BLOGGER_PHOTO_ID_5183449923603375794" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-9QPg9nprI/AAAAAAAAANs/sdTOaFGf0Gg/s200/P1010016.JPG" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R-9QPw9npsI/AAAAAAAAAN0/f-8kZmCA4GY/s1600-h/P1010017.JPG"><img id="BLOGGER_PHOTO_ID_5183449927898343106" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-9QPw9npsI/AAAAAAAAAN0/f-8kZmCA4GY/s200/P1010017.JPG" border="0" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;"></span><br /><span style="color:#009900;">This is a photo of some of us bidding 'goodbye' to some of the stuffs in the Pejabat Kesihatan Daerah Baling.</span><br /><br /><br /><a href="http://bp3.blogger.com/__vmaN6lEpco/R-9Kbw9npfI/AAAAAAAAAMM/datcFbXYcCE/s1600-h/P1010002.JPG"><img id="BLOGGER_PHOTO_ID_5183443536987006450" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-9Kbw9npfI/AAAAAAAAAMM/datcFbXYcCE/s200/P1010002.JPG" border="0" /></a>Cheah Boon Euhttp://www.blogger.com/profile/09451820363944180614noreply@blogger.com0tag:blogger.com,1999:blog-8168078320376212848.post-6680556561969165412008-03-23T17:02:00.000-07:002008-03-30T01:42:59.630-07:00District Health Office Posting in Baling, Kedah Darul Aman [Part III - Week 3 (02/12/2007-06/12/2007)]Hi,<br /><div><div><div><div><div><div>Sorry for the delay...</div><div>Let us continue...</div><div><div><br /><strong><span style="color:#ff0000;"><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YOtg9no-I/AAAAAAAAAIE/lQXw1G7PEd4/s1600-h/P1010031.JPG"><img id="BLOGGER_PHOTO_ID_5180844596441621474" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="96" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YOtg9no-I/AAAAAAAAAIE/lQXw1G7PEd4/s200/P1010031.JPG" width="137" border="0" /></a>SUNDAY 2ND DECEMBER 2007</span><br /></strong><span style="color:#6633ff;">- The topic of the day was outbreak investigation. The team reported to Pusat Pengawalan Vektor at 9 am. We then followed a team of health officers to Kampung Tanjung Luas to prepare slides for detection of malaria based on the recent reporting of new cases in the area.<br />- We visited 2 houses where each one of us were taught and given the opportunity to prepare slides under the supervision of the health officers. As the road leading to the houses were small and unsuitable for vehicles, we reached the houses on feet to collect the samples.</span></div><div><a href="http://bp3.blogger.com/__vmaN6lEpco/R-YKFA9no0I/AAAAAAAAAG0/APxJN8V_qcg/s1600-h/P1010004.JPG"><img id="BLOGGER_PHOTO_ID_5180839502610408258" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 212px; CURSOR: hand; HEIGHT: 145px" height="111" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-YKFA9no0I/AAAAAAAAAG0/APxJN8V_qcg/s200/P1010004.JPG" width="120" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YKFQ9no1I/AAAAAAAAAG8/zU0Hev-_t44/s1600-h/P1010005.JPG"><img id="BLOGGER_PHOTO_ID_5180839506905375570" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 207px; CURSOR: hand; HEIGHT: 150px" height="112" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YKFQ9no1I/AAAAAAAAAG8/zU0Hev-_t44/s200/P1010005.JPG" width="122" border="0" /></a>The pictures besides show how the malaria sample is being taken. First, the amount of people and their details were recorded in a piece of paper. From there, the numbering system is being used as the first person in the list will have their blood sample stored in the first column in the box (shown<br /><div><span style="color:#ff0000;"><strong><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YKFw9no2I/AAAAAAAAAHE/IBM2T_m4wfc/s1600-h/P1010012.JPG"><img id="BLOGGER_PHOTO_ID_5180839515495310178" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 205px; CURSOR: hand; HEIGHT: 151px" height="110" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YKFw9no2I/AAAAAAAAAHE/IBM2T_m4wfc/s200/P1010012.JPG" width="135" border="0" /></a></strong></span></div><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YQjw9npGI/AAAAAAAAAJE/-btSoHtZGhk/s1600-h/P1010014.JPG"><img id="BLOGGER_PHOTO_ID_5180846627961152610" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="150" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YQjw9npGI/AAAAAAAAAJE/-btSoHtZGhk/s200/P1010014.JPG" width="215" border="0" /></a>in the third photo). The person involved is to be pricked in the finger (after a alcohol swab-to prevent infection) and blood is taken. The blood is smeared into thick and thin film before storing into the box. Below are photos of us being given a chance to perform the procedure.</div><div> </div><div> </div></div><div><span style="color:#ff0000;"><strong><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YKGg9no4I/AAAAAAAAAHU/VRhSxOC-gCE/s1600-h/P1010016.JPG"><img id="BLOGGER_PHOTO_ID_5180839528380212098" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 96px; CURSOR: hand; HEIGHT: 88px" height="105" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YKGg9no4I/AAAAAAAAAHU/VRhSxOC-gCE/s200/P1010016.JPG" width="96" border="0" /></a></strong></span></div><div><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YLxw9no5I/AAAAAAAAAHc/tQubzW4UK2s/s1600-h/P1010018.JPG"><img id="BLOGGER_PHOTO_ID_5180841370921182098" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 83px; CURSOR: hand; HEIGHT: 89px" height="87" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YLxw9no5I/AAAAAAAAAHc/tQubzW4UK2s/s200/P1010018.JPG" width="113" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R-YLyA9no6I/AAAAAAAAAHk/IBNsXeismaY/s1600-h/P1010021.JPG"><img id="BLOGGER_PHOTO_ID_5180841375216149410" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 89px; CURSOR: hand; HEIGHT: 86px" height="100" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-YLyA9no6I/AAAAAAAAAHk/IBNsXeismaY/s200/P1010021.JPG" width="120" border="0" /></a><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YLyg9no7I/AAAAAAAAAHs/ZX36-b4lG48/s1600-h/P1010026.JPG"><img id="BLOGGER_PHOTO_ID_5180841383806084018" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 85px; CURSOR: hand; HEIGHT: 84px" height="84" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YLyg9no7I/AAAAAAAAAHs/ZX36-b4lG48/s200/P1010026.JPG" width="106" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YLyw9no8I/AAAAAAAAAH0/hAcH3ixzQWw/s1600-h/P1010029.JPG"><img id="BLOGGER_PHOTO_ID_5180841388101051330" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 89px; CURSOR: hand; HEIGHT: 83px" height="90" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YLyw9no8I/AAAAAAAAAH0/hAcH3ixzQWw/s200/P1010029.JPG" width="86" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YLzQ9no9I/AAAAAAAAAH8/1lzktkQ5jck/s1600-h/P1010030.JPG"><img id="BLOGGER_PHOTO_ID_5180841396690985938" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 85px; CURSOR: hand; HEIGHT: 84px" height="102" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YLzQ9no9I/AAAAAAAAAH8/1lzktkQ5jck/s200/P1010030.JPG" width="111" border="0" /></a><br /><br /><br /></div><div></div><div><br /></div><div><span style="color:#6633ff;"></span> </div><div><span style="color:#6633ff;"></span> </div><div><span style="color:#6633ff;">- The next programme planned for the day was fogging. We gathered in front of Pejabat Kesihatan Daerah Baling at 6pm.<br />- We were separated into 2 groups whereby 3 students followed one health officer who conducted the fogging. We were then given a chance each to fog a certain area ourselves. Fogging began around 6.15pm and ended around 7pm. The health officer explained to us that fogging is usually done during dusk and dawn. This is because it is the nature of the Aedes mosquitoes to come out during that time.</span><br /></div><div><div><span style="color:#6633ff;"><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YOtw9no_I/AAAAAAAAAIM/kHBjKTK_ZHg/s1600-h/P1010003.JPG"><img id="BLOGGER_PHOTO_ID_5180844600736588786" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YOtw9no_I/AAAAAAAAAIM/kHBjKTK_ZHg/s200/P1010003.JPG" border="0" /></a></span></div><div><span style="color:#6633ff;"><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YOuQ9npAI/AAAAAAAAAIU/txld0mtg-4E/s1600-h/P1010004.JPG"><img id="BLOGGER_PHOTO_ID_5180844609326523394" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YOuQ9npAI/AAAAAAAAAIU/txld0mtg-4E/s200/P1010004.JPG" border="0" /></a></span></div><div><span style="color:#ff0000;"><strong><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YOuw9npBI/AAAAAAAAAIc/8KAEdc-edu4/s1600-h/P1010008.JPG"><img id="BLOGGER_PHOTO_ID_5180844617916458002" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YOuw9npBI/AAAAAAAAAIc/8KAEdc-edu4/s200/P1010008.JPG" border="0" /></a></strong></span></div><br /></div><div><span style="color:#6633ff;"><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YOtw9no_I/AAAAAAAAAIM/kHBjKTK_ZHg/s1600-h/P1010003.JPG"></a></span></div><div><br /></div><div><span style="color:#6633ff;"><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YOuQ9npAI/AAAAAAAAAIU/txld0mtg-4E/s1600-h/P1010004.JPG"></a></span></div><div><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YOuw9npBI/AAAAAAAAAIc/8KAEdc-edu4/s1600-h/P1010008.JPG"></a></strong></span></div><div><br /><br /></div><div><span style="color:#6633ff;"><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YOtw9no_I/AAAAAAAAAIM/kHBjKTK_ZHg/s1600-h/P1010003.JPG"></a></span></div><div><br /><div><span style="color:#ff0000;"><strong></strong></span> </div><div><strong><span style="color:#ff0000;"></span></strong> </div><div><strong><span style="color:#ff0000;"></span></strong> </div><div><strong><span style="color:#ff0000;"></span></strong> </div><div><span style="color:#ff0000;"><strong><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YOvQ9npCI/AAAAAAAAAIk/2YlrxCIWSLE/s1600-h/P1010010.JPG"><img id="BLOGGER_PHOTO_ID_5180844626506392610" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 200px; CURSOR: hand; HEIGHT: 154px" height="100" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YOvQ9npCI/AAAAAAAAAIk/2YlrxCIWSLE/s200/P1010010.JPG" width="97" border="0" /></a></strong></span></div></div><div>The first photo showing the 'agrofog' which was used during the fogging session done on that day. After being shown the way of fogging, we were each being given a chance to fog a particular area.</div><div> </div><div><br /><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YQjg9npFI/AAAAAAAAAI8/0x780MJPe3w/s1600-h/P1010026.JPG"><img id="BLOGGER_PHOTO_ID_5180846623666185298" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="80" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YQjg9npFI/AAAAAAAAAI8/0x780MJPe3w/s200/P1010026.JPG" width="90" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YQiw9npDI/AAAAAAAAAIs/cHDB5IZUpSc/s1600-h/P1010018.JPG"><img id="BLOGGER_PHOTO_ID_5180846610781283378" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="81" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YQiw9npDI/AAAAAAAAAIs/cHDB5IZUpSc/s200/P1010018.JPG" width="90" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R-YQjA9npEI/AAAAAAAAAI0/5k2QH20InEA/s1600-h/P1010023.JPG"><img id="BLOGGER_PHOTO_ID_5180846615076250690" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 90px; CURSOR: hand; HEIGHT: 83px" height="76" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-YQjA9npEI/AAAAAAAAAI0/5k2QH20InEA/s200/P1010023.JPG" width="82" border="0" /></a><br /></div><div><br /><br /><br /></div><div></div><div><br /></div><div><span style="color:#ff0000;"><strong>MONDAY 3RD DECEMBER 2007</strong></span><br /><span style="color:#6633ff;">- We reported to PPKP Rozaidi Shamsudin in the morning. He taught us on data entry and analysis regarding the outbreak investigations such as dengue, malaria, filariasis and Japanese Encephalitis.<br />- We were introduced to the data system used by the Baling district vector control department ( Pusat Pengawalan Vektor daerah Baling). It is a unique and sophisticated system called VEKPRO, which is in short for Vector Programme.<br />- The system consists of data registration of new cases and statistics management of all cases according to the respective years.<br />- We also learn how cases are prioritized. For example, one reparted malaria case is considered an outbreak whereas for dengue, it is considered an outbreak only when at least 2 dengue cases have been reported within the same area within 14 days.</span><br /></div><div><br /><br /><br /></div><div><span style="color:#ff0000;"><strong>TUESDAY 4TH DECEMBER 2007</strong></span><br /><span style="color:#6633ff;">- The programme for the day was environmental health and sanitation. However, as there was a leprosy patient that was going to be transported to Hospital Kulim from Baling district, we were allowed to follow this team. We learnt the procedure of referring a defaulted patient from Klinik Kesihatan to a nearby hospital.<br />- We followed a health department vehicle into Kampung Seratus to pick the patient and then transport the patient to Hospital Kulim. We had the opportunity to elicit history from the patient and to conduct a short physical examination on him.<br />- Later in the afternoon, we proceeded with the programme for the day under the guidance of PPKP Hamzah Ahmad. We were briefed regarding environmental health and sanitation for this district, their activities, contributions and achievements throughout the recent years.<br />- We were then brought by the health officers to Kampung Rebong where we were introduced and exposed to the house connection system. We saw water sysem of each house which communicated with other surrounding houses. This system then drained into two water tanks which finally released the water into a nearby river. This ensures the cleanliness and sanitation of the area is maintained. It also helps prevent the spread of diseases among villagers.<br />- We also had an opportunity to watch several villagers “gotong royong” to build a squatting toilet or rather known as ‘tandas curah’. This project is subsidized by the government.</span> </div><div><a href="http://bp3.blogger.com/__vmaN6lEpco/R-YTHA9npHI/AAAAAAAAAJM/JHqkkU2Ushs/s1600-h/P1010008.JPG"><img id="BLOGGER_PHOTO_ID_5180849432574796914" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-YTHA9npHI/AAAAAAAAAJM/JHqkkU2Ushs/s200/P1010008.JPG" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTHQ9npII/AAAAAAAAAJU/l3zaO_Gszuc/s1600-h/P1010010.JPG"><img id="BLOGGER_PHOTO_ID_5180849436869764226" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YTHQ9npII/AAAAAAAAAJU/l3zaO_Gszuc/s200/P1010010.JPG" border="0" /></a><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YTHg9npJI/AAAAAAAAAJc/lSXY-Q2CFYc/s1600-h/P1010011.JPG"><img id="BLOGGER_PHOTO_ID_5180849441164731538" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YTHg9npJI/AAAAAAAAAJc/lSXY-Q2CFYc/s200/P1010011.JPG" border="0" /></a><br /><br /><br /></div><div><br /><br /><br /></div><div><br /><br /></div><div><div><span style="color:#ff0000;"><strong><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YTIw9npLI/AAAAAAAAAJs/Q8Mvf-0TaWg/s1600-h/P1010017.JPG"><img id="BLOGGER_PHOTO_ID_5180849462639568050" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YTIw9npLI/AAAAAAAAAJs/Q8Mvf-0TaWg/s200/P1010017.JPG" border="0" /></a></strong></span></div><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YUdg9npMI/AAAAAAAAAJ0/fqWyUckZSNc/s1600-h/P1010020.JPG"><img id="BLOGGER_PHOTO_ID_5180850918633481410" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YUdg9npMI/AAAAAAAAAJ0/fqWyUckZSNc/s200/P1010020.JPG" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R-YUeA9npNI/AAAAAAAAAJ8/3tIApoYrd3w/s1600-h/P1010021.JPG"><img id="BLOGGER_PHOTO_ID_5180850927223416018" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-YUeA9npNI/AAAAAAAAAJ8/3tIApoYrd3w/s200/P1010021.JPG" border="0" /></a><br /><br /></div><div><br /><br /><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YTIw9npLI/AAAAAAAAAJs/Q8Mvf-0TaWg/s1600-h/P1010017.JPG"></a></strong></span></div><div><br /><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YUeQ9npOI/AAAAAAAAAKE/Jk1iI2T-9do/s1600-h/P1010031.JPG"><img id="BLOGGER_PHOTO_ID_5180850931518383330" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YUeQ9npOI/AAAAAAAAAKE/Jk1iI2T-9do/s200/P1010031.JPG" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s1600-h/P1010014.JPG"></a></strong></span></div><div><div><span style="color:#ff0000;"><strong><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YUeg9npPI/AAAAAAAAAKM/PmG4-VG_0bI/s1600-h/P1010036.JPG"><img id="BLOGGER_PHOTO_ID_5180850935813350642" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YUeg9npPI/AAAAAAAAAKM/PmG4-VG_0bI/s200/P1010036.JPG" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s1600-h/P1010014.JPG"></a></strong></span></div><div><span style="color:#ff0000;"><strong><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s1600-h/P1010014.JPG"><img id="BLOGGER_PHOTO_ID_5180849454049633442" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s200/P1010014.JPG" border="0" /></a></strong></span></div><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s1600-h/P1010014.JPG"></a></strong></span></div><div><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s1600-h/P1010014.JPG"></a></strong></span></div><div><br /></div><div></div><div><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s1600-h/P1010014.JPG"></a></strong></span></div><div><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YTIQ9npKI/AAAAAAAAAJk/0lo71WIWPKU/s1600-h/P1010014.JPG"></a></strong></span></div><div></div><div></div><div>The pictures above show how the drainage system of the 'kampung' works. From the sink of the house, it is drained into a a pipe with a filter at the end of it. Then this pipe drains from every houses to a particular tank. From the first tank it is drain into the second tank where the water is filtered again to prevent the oily water from entering the river later on.<br /></div><div>The 7th picture above shows the villagers doing 'gotong-royong' in order to build a 'tandas curah' for themselves. The boys will spent their time helping out during the school holiday.<br /></div><div><br /></div><div>The last picture shows how the villagers store their equipments.<br /></div><div><br /></div><div><span style="color:#ff0000;"><strong><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YWpw9npRI/AAAAAAAAAKc/h1MtL9TzmaI/s1600-h/P1010004.JPG"><img id="BLOGGER_PHOTO_ID_5180853328110134546" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 107px; CURSOR: hand; HEIGHT: 79px" height="90" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YWpw9npRI/AAAAAAAAAKc/h1MtL9TzmaI/s200/P1010004.JPG" width="113" border="0" /></a>WEDNESDAY 5TH DECEMBER 2007</strong></span><br /><span style="color:#6633ff;">- The topic for the day was environmental health and sanitation or rather known as BAKAS. We were first taken to Lata Sungai Sedim where we were able to appreciate the gravity feet system.<br />- We then proceeded to Kuala Cahaya where we were shown the village water system that consists of a large well that supplies water to 111 people in a total of 26 houses. We spent some time with the villagers before we proceeded back to Baling.</span> </div><div><br /></div><div><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YWpQ9npQI/AAAAAAAAAKU/hR4_WeVN6SQ/s1600-h/P1010003.JPG"><img id="BLOGGER_PHOTO_ID_5180853319520199938" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YWpQ9npQI/AAAAAAAAAKU/hR4_WeVN6SQ/s200/P1010003.JPG" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YWqQ9npSI/AAAAAAAAAKk/YpZC6LWQjrQ/s1600-h/P1010042.JPG"><img id="BLOGGER_PHOTO_ID_5180853336700069154" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YWqQ9npSI/AAAAAAAAAKk/YpZC6LWQjrQ/s200/P1010042.JPG" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YWqw9npTI/AAAAAAAAAKs/xoma-sXP9Y8/s1600-h/P1010043.JPG"><img id="BLOGGER_PHOTO_ID_5180853345290003762" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YWqw9npTI/AAAAAAAAAKs/xoma-sXP9Y8/s200/P1010043.JPG" border="0" /></a><br /><br /><br /></div><div><br /><br /><br /></div><div><br /></div><div> </div><div> </div><div><br /> </div><div> </div><div><a href="http://bp0.blogger.com/__vmaN6lEpco/R-YWrQ9npUI/AAAAAAAAAK0/Mc24YD2fxRA/s1600-h/P1010045.JPG"><img id="BLOGGER_PHOTO_ID_5180853353879938370" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YWrQ9npUI/AAAAAAAAAK0/Mc24YD2fxRA/s200/P1010045.JPG" border="0" /></a>The pictures show the 'Gravity-Feet System' which use to supply water to 111 villagers in the total of 26 houses. Over here, the water is being filtered before supplying to the villagers.<br /><br /><br /></div><div><br /><br /><br /></div><div><br /><strong><span style="color:#ff0000;"></span></strong></div><div><br /><br /></div><div><strong><span style="color:#ff0000;"></span></strong></div></div><div><div><br /></div><div><strong><span style="color:#ff0000;">THURSDAY 6TH DECEMBER 2007</span></strong><br /><span style="color:#6633ff;">- The topic for the day was health promotion and health quality control. The nutritionist or rather known as Pegawai Zat Makanan, Puan Juliani Faridza Alias briefed us on the health promotion and quality control programmes run by the Pejabat Kesihatan Daerah Baling.<br />- She mentioned that the department’s duty is divided into three main parts which consists of monitoring, rehabilitation and promotion. Monitoring includes ethics regarding breast feeding whereby factories are given restrictions regarding promoting and encouraging the sales of their milk formulas to mothers. Among the examples of restrictions drawn up by this ethics include the restriction of promotion of such formulas in hospitals that are baby friendly and the restriction of giving out samples of milk formulas in clinics that promote breastfeeding. Rehabilitation and promotion include providing financial aid to families according to their income margin, arranging cooking demonstrations to mothers with under nourished children, promoting breast feeding, counselling for individuals with diabetes and hypertension, providing iodine salt to individuals with iodine deficiency disorder ( IDD ) and iodinators to schools, providing food baskets ( bakul makanan ) which consists of rice for carbohydrate, eggs and sardine for protein, Scott’s emulsion or Champs supplements for vitamins and milk for calcium to undernourished children from families of the lower income group, providing hematinics and softgel for individuals with anemia and many other activites such as breast feeding campaigns.<br />- After the briefing, we were brought to Klinik Kesihatan Kampung Lalang where we observed how the nurses conducted cooking demonstrations to mothers with under nourished children. We were then taught how to enquire thoroughly regarding a child’s diet from the mother and were each given a chance to elicit history and counsel these mothers under the supervision and guidance of the nutritionist.<br />- After that, we were brought to Klinik Desa Tanjung Pari where we were shown the breast feeding room of the clinic that won the best room among all other clinics in the district of Baling.<a href="http://bp0.blogger.com/__vmaN6lEpco/R-YaRQ9npaI/AAAAAAAAALk/6qRjGXvwT9E/s1600-h/P1010002.JPG"><img id="BLOGGER_PHOTO_ID_5180857305249850786" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R-YaRQ9npaI/AAAAAAAAALk/6qRjGXvwT9E/s200/P1010002.JPG" border="0" /></a><a href="http://bp1.blogger.com/__vmaN6lEpco/R-YaRg9npbI/AAAAAAAAALs/8mm_cZF-WCI/s1600-h/P1010004.JPG"><img id="BLOGGER_PHOTO_ID_5180857309544818098" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R-YaRg9npbI/AAAAAAAAALs/8mm_cZF-WCI/s200/P1010004.JPG" border="0" /></a></span></div><div><span style="color:#6633ff;"><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YaRw9npcI/AAAAAAAAAL0/BYnBFZ_IDEU/s1600-h/P1010005.JPG"><img id="BLOGGER_PHOTO_ID_5180857313839785410" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YaRw9npcI/AAAAAAAAAL0/BYnBFZ_IDEU/s200/P1010005.JPG" border="0" /></a></span></div><div><span style="color:#6633ff;"><a href="http://bp2.blogger.com/__vmaN6lEpco/R-YaSw9npeI/AAAAAAAAAME/eTgwgoMBRw4/s1600-h/P1010008.JPG"><img id="BLOGGER_PHOTO_ID_5180857331019654626" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R-YaSw9npeI/AAAAAAAAAME/eTgwgoMBRw4/s200/P1010008.JPG" border="0" /></a></span></div><div><span style="color:#6633ff;"><a href="http://bp3.blogger.com/__vmaN6lEpco/R-YaSA9npdI/AAAAAAAAAL8/CZKRQa4zQ6I/s1600-h/P1010007.JPG"><img id="BLOGGER_PHOTO_ID_5180857318134752722" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R-YaSA9npdI/AAAAAAAAAL8/CZKRQa4zQ6I/s200/P1010007.JPG" border="0" /></a></span></div><div><span style="color:#6633ff;"></span></div><div><span style="color:#6633ff;"></span></div><div><span style="color:#6633ff;"></span></div><div><span style="color:#6633ff;"></span></div><div><span style="color:#6633ff;"></span></div><div><span style="color:#6633ff;"></span></div><div><span style="color:#6633ff;"></span></div></div></div></div></div></div>Cheah Boon Euhttp://www.blogger.com/profile/09451820363944180614noreply@blogger.com2tag:blogger.com,1999:blog-8168078320376212848.post-4694085008125943932008-02-17T17:10:00.000-08:002008-03-04T18:34:01.173-08:00District Health Office Posting in Baling, Kedah Darul Aman [Part II - Week 2 (25/11/2007-29/11/2007)]Hi again,<br /><div></div><div>Let me once again bring you to our posting in Baling in the second week.</div><div><br /><strong><span style="color:#ff0000;">SUNDAY 25TH NOVEMBER 2007</span></strong><br /><span style="color:#6633ff;">- We reported to Pejabat Kesihatan Daerah Baling to KJK Maznah Hussin. We were informed to help the other nurses to run a health campaign in Kampung Masjid Sera.<br />- We helped the 4-hour-long campaign.<br />- We assigned each other to various counters whereby we measured the height, weight, calculated the body mass index (BMI) , took blood pressure, checked blood glucose level and we counsel the patients. </span><span style="color:#6633ff;"><br />- In return, the villagers happily invited us to join in their local luncheon called kenduri.</span><br /></div><div><a href="http://bp2.blogger.com/__vmaN6lEpco/R7fvYXrAbUI/AAAAAAAAAE0/wUyWidEklwE/s1600-h/P1010015.JPG"><img id="BLOGGER_PHOTO_ID_5167862299381230914" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="153" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R7fvYXrAbUI/AAAAAAAAAE0/wUyWidEklwE/s200/P1010015.JPG" width="205" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R7fvY3rAbVI/AAAAAAAAAE8/zuDQBq5RklE/s1600-h/P1010016.JPG"><img id="BLOGGER_PHOTO_ID_5167862307971165522" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R7fvY3rAbVI/AAAAAAAAAE8/zuDQBq5RklE/s200/P1010016.JPG" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R7fvZXrAbWI/AAAAAAAAAFE/xt6dmDXbLtI/s1600-h/P1010019.JPG"><img id="BLOGGER_PHOTO_ID_5167862316561100130" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="157" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R7fvZXrAbWI/AAAAAAAAAFE/xt6dmDXbLtI/s200/P1010019.JPG" width="212" border="0" /></a><br /></div><div><br /><br /></div><div><br /></div><div><br /><br /></div><p><br /><strong><span style="color:#ff0000;"></span></strong></p><div><br /><br /></div><div><p><strong><span style="color:#ff0000;"><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fvaHrAbYI/AAAAAAAAAFU/hKVqAm5D4HY/s1600-h/P1010021.JPG"><img id="BLOGGER_PHOTO_ID_5167862329446002050" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="154" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R7fvaHrAbYI/AAAAAAAAAFU/hKVqAm5D4HY/s200/P1010021.JPG" width="207" border="0" /></a></span></strong></p><p><a href="http://bp0.blogger.com/__vmaN6lEpco/R7fvZ3rAbXI/AAAAAAAAAFM/6d-U5aukQ-A/s1600-h/P1010020.JPG"><img id="BLOGGER_PHOTO_ID_5167862325151034738" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R7fvZ3rAbXI/AAAAAAAAAFM/6d-U5aukQ-A/s200/P1010020.JPG" border="0" /></a></p><a href="http://bp2.blogger.com/__vmaN6lEpco/R7fw0XrAbZI/AAAAAAAAAFc/8cnF4omQlcU/s1600-h/P1010023.JPG"><img id="BLOGGER_PHOTO_ID_5167863879929195922" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R7fw0XrAbZI/AAAAAAAAAFc/8cnF4omQlcU/s200/P1010023.JPG" border="0" /></a><br /></div><div><br /><br /></div><p><strong><span style="color:#ff0000;"></span></strong></p><div><br /></div><div><strong><span style="color:#ff0000;"><br /><br /><p><strong><span style="color:#ff0000;"><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fvaHrAbYI/AAAAAAAAAFU/hKVqAm5D4HY/s1600-h/P1010021.JPG"></a></span></strong></p></div></span></strong><strong><span style="color:#ff0000;"><p></span></strong></p><span style="color:#000000;"></span><p><span style="color:#000000;">The above are some photos taken during the health campaign where we had participated in taking the blood pressure, measure the height and weight, calculating the BMI, getting the glucose results from a glucometer and advising the villagers on their diet control and how to lead a healthy lifestyle.</span><br /><br /><strong><span style="color:#ff0000;"></span></strong></p><p><strong><span style="color:#ff0000;">MONDAY 26TH NOVEMBER 2007</span></strong><br /><span style="color:#6633ff;">- We began our day with a short introduction to communicable diseases of control (CDC) from PPKP Rosli Mansor and PPKP Lem Kiah Kwong.<br />- We were then introduced to the Communicable Diseases Control Infection System (CDCIS) via an online system and were allowed to help the officer in charge register the new cases of communicable disease online.<br />- In the afternoon, we proceeded to the Baling Hospital accompanied by PPKP Rosli Mansor to investigate a newly reported case of typhoid.<br />- Next, we were brought to Kampung Muda where we observed the health officers collect samples of water and stools of family members. The members were also counseled regarding sanitation.<br />- We then observed how the health officers sprayed sodium hypoclorite 10 % around infected areas.</span><br /><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fw1HrAbaI/AAAAAAAAAFk/_j3KSpNcSTs/s1600-h/P1010006.JPG"><img id="BLOGGER_PHOTO_ID_5167863892814097826" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R7fw1HrAbaI/AAAAAAAAAFk/_j3KSpNcSTs/s200/P1010006.JPG" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R7fw2nrAbbI/AAAAAAAAAFs/o1KiyRdqX0w/s1600-h/P1010007.JPG"><img id="BLOGGER_PHOTO_ID_5167863918583901618" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R7fw2nrAbbI/AAAAAAAAAFs/o1KiyRdqX0w/s200/P1010007.JPG" border="0" /></a>A brief introduction of Communicable Diseases of Control (CDC) were given by both PPKP En. Rosli and PPKP Mr. Lem. We were later being introduced the programme CDCIS (Communicable Diseases of Control Information System) by PPKP En. Rosli.</p><div><strong>CDCIS</strong></div><div><br /></div><div>CDCIS is a online programme for the officers in charge to register the new cases of communicable diseases. Once the cases are registered, the cases can be reviewed by the higher health centres. By this, the number of cases in the whole of Malaysia which has been reported can be traced and pre-cautions can be taken before the communicable diseases spreads. CDCIS is also useful in the sense of keeping the records. </div><div></div><div>The cases will be notified by the doctors either in the Hospital or in the private sector. The doctors will called up the Health Office to notify them and povide them with necessary information. </div><div></div><div>There are 9 communicable cases which need to be notify within 24 hours. They are:-</div><div>1) Dengue fever and Dengue Haemorrhagic fever</div><div>2) Yellow fever</div><div>3) Ebola</div><div>4) Cholera</div><div>5) Food Poisoning</div><div>6) Plaque</div><div>7) Rabies</div><div>8) Polio</div><div>9) Diphteria</div><div></div><div>The other communicable diseases can be notify within 1 week.</div><p><strong><span style="color:#ff0000;"><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fw3HrAbcI/AAAAAAAAAF0/IvwrNNw_Rzo/s1600-h/P1010008.JPG"><img id="BLOGGER_PHOTO_ID_5167863927173836226" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R7fw3HrAbcI/AAAAAAAAAF0/IvwrNNw_Rzo/s200/P1010008.JPG" border="0" /></a></span></strong></p><div><strong><span style="color:#ff0000;"><p><strong><span style="color:#ff0000;"><a href="http://bp3.blogger.com/__vmaN6lEpco/R7fw4nrAbdI/AAAAAAAAAF8/DjngaG7dROM/s1600-h/P1010012.JPG"><img id="BLOGGER_PHOTO_ID_5167863952943640018" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R7fw4nrAbdI/AAAAAAAAAF8/DjngaG7dROM/s200/P1010012.JPG" border="0" /></a></span></strong></p><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fw3HrAbcI/AAAAAAAAAF0/IvwrNNw_Rzo/s1600-h/P1010008.JPG"></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R7fyPnrAbeI/AAAAAAAAAGE/G75GeySkxVY/s1600-h/P1010014.JPG"><img id="BLOGGER_PHOTO_ID_5167865447592259042" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R7fyPnrAbeI/AAAAAAAAAGE/G75GeySkxVY/s200/P1010014.JPG" border="0" /></a></span></strong><br /><br /></div><p><strong><span style="color:#ff0000;"><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fw3HrAbcI/AAAAAAAAAF0/IvwrNNw_Rzo/s1600-h/P1010008.JPG"></a></span></strong></p><div><br /></div><p><strong><span style="color:#ff0000;"><a href="http://bp3.blogger.com/__vmaN6lEpco/R7fw4nrAbdI/AAAAAAAAAF8/DjngaG7dROM/s1600-h/P1010012.JPG"></a></span></strong></p><div><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fyQHrAbfI/AAAAAAAAAGM/efYeCrf1lAU/s1600-h/P1010015.JPG"><img id="BLOGGER_PHOTO_ID_5167865456182193650" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R7fyQHrAbfI/AAAAAAAAAGM/efYeCrf1lAU/s200/P1010015.JPG" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R7fyQnrAbgI/AAAAAAAAAGU/_4WBJ8oGdEs/s1600-h/P1010022.JPG"><img id="BLOGGER_PHOTO_ID_5167865464772128258" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R7fyQnrAbgI/AAAAAAAAAGU/_4WBJ8oGdEs/s200/P1010022.JPG" border="0" /></a> The above photos showed initially we went to the Baling Hospital as there was a typhoid case been reported.</div><div></div><div>In the afternoon, we went to the resident of the patient who was suspected of typhoid. The third photo showed PPKP En. Rosli spraying sodium hypochlorite 10% around the breeding grounds. This is done to prevent the spread of the flies as the flies are the main vector for causing typhoid. The fourth photo showing him again taking the sample of the water which will be sent to Penang Hospital for further investigations. It is learnt that the patient's resident uses 2 types of water (the JBA and the water from the hillside). Thus, samples of water were taken from the 2 water sources. The last photo showed a large dug-up place where the villagers throw their rubbish. </div><div></div><div>At the end of the spraying and the samples collecting, each villager who is related to the patient were given a swab to culture their stools the next day. Sampes are taken from the family members as to detect probable carrier states. The villagers involved were taught the correct way of collecting the culture. The following day, the samples of stools were collected and then immediately sent to the Sungai Petani Hospital for further tests.<br /></div><div><br /><strong><span style="color:#ff0000;">TUESDAY 27TH NOVEMBER 2007</span></strong><br /><span style="color:#6633ff;">- We arrived at Pusat Pengawalan Vektor daerah Baling in the morning and reported to PPKP Rozaidi Shamsudin and PPKP Abdullah Yusof.<br />- Both the health officers gave a concise briefing regarding outbreak investigation.<br />- We learned that Baling has the fourth highest dengue cases in Kedah recording 211 cases up till November 2007 following Kota Star, Kuala Muda and Kulim respectively.<br />- We also learned how fogging for dengue infected areas, were carried out. Under normal circumstances, fogging would be done in a radius of 200m around the affected area.<br />- The health officers also mentioned about other common outbreaks such as filariasis, malaria and Japanese Encephalitis.</span></div><span style="color:#6633ff;"></span><div><a href="http://bp1.blogger.com/__vmaN6lEpco/R7fyRHrAbhI/AAAAAAAAAGc/UOXdBscYByU/s1600-h/P1010001.JPG"><img id="BLOGGER_PHOTO_ID_5167865473362062866" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R7fyRHrAbhI/AAAAAAAAAGc/UOXdBscYByU/s200/P1010001.JPG" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R7fyRXrAbiI/AAAAAAAAAGk/54RxIdq4iHc/s1600-h/P1010003.JPG"><img id="BLOGGER_PHOTO_ID_5167865477657030178" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R7fyRXrAbiI/AAAAAAAAAGk/54RxIdq4iHc/s200/P1010003.JPG" border="0" /></a> The photos showed the vector department where we were being given a brief idea of what the department do. Later we were told that there was a fogging session in the following week and we urged to follow and observed what they do. </div><div></div><div>Over here, in this department, there is also a programme where they key in every cases noted. For example, if there is a case of dengue noted, they will sent out teams to do fogging. At the same time, they have the right to 'saman' those houses where the breeding of mosquito is found. In the programme showed to us, each person who is been 'saman' will be noted until they have pay the compound.<br /></div><div>If there is a case of suspected dengue noted, fogging will be done once. However, if there is a positive dengue case noted, the second time of fogging is taken place.<br /></div><p><strong><span style="color:#ff0000;">WEDNESDAY 28TH NOVEMBER 2007</span></strong><br /><span style="color:#6633ff;">- A short briefing regarding non-communicable diseases was given by PPKP Cik Haslinda.<br />- She explained that the non-communicable diseases covered by Pejabat Kesihatan Daerah Baling included diabetes, hypertension, cardiovascular diseases, family violence and others.<br />- The Baling district is the pioneer for Blindness Programme ( Program Kebutaan). Another clinic set up by this district is ‘Quit Smoking’ clinic.<br />- PROSTAR is another branch of service provided by the district health office. It encompasses ‘Program Sihat untuk Remaja’. In this programme, teenagers between ages 13 to 25 years are educated and exposed to various health hazards such as obesity and diabetes, and are also introduced to healthy diet.<br />- Finally, we were also informed of the yearly carnival that is held for 2 to 3 days long. This carnival includes a health campaign, blood screening, counseling and educational exhibitions. Its aim is to expose the public for primary prevention of diseases.</span> </p><div><a href="http://bp3.blogger.com/__vmaN6lEpco/R7fzInrAbjI/AAAAAAAAAGs/p5Wll51VAgs/s1600-h/P1010001.JPG"><img id="BLOGGER_PHOTO_ID_5167866426844802610" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R7fzInrAbjI/AAAAAAAAAGs/p5Wll51VAgs/s200/P1010001.JPG" border="0" /></a>This photo showed us being brief of Non-Communicable Disease of Control (NCDC) by PPKP Cik Haslinda. At the same time, PROSTAR is also been introduced to us.<br /><br /></div><div><br /></div><div><br /><br /></div><div><br /></div><div></div><div><br /><strong><span style="color:#ff0000;">THURSDAY 29TH NOVEMBER 2007</span></strong><br /><span style="color:#6633ff;">- The topic scheduled for the day was ‘Outbreak investigation ’. PPKP Rosli Mansor briefed us on how a certain outbreaks such as food poisoning and cholera were tackled in Baling.<br />- In terms of food poisoning, one episode is considered when one or more cases of similar symptoms develop in individuals. The definition of case in association with food poisoning includes an individual developing symptom or symptoms of food poisoning and receives treatment for these symptoms.<br />- Epi-Info is a statistical table that the district health office forms to calculate whether the food consumed is significant to that particular episode of food poisoning. This data helps the health officers identify the true cause of food poisoning.<br />- From the point of notification of case, the health officers would sent teams to clarify the cases with the affected individuals that include interviews to identify whether the symptoms suffered are due to food poisoning or a contribute of other factors. Once it has been clarified, then the patients and controls (those consumed the same food but are asymptomatic) are investigated. The final report concerning the outbreak of food poisoning is then sent to the health ministry at state level.<br />- In terms of cholera outbreak, one case in one locality during one incubation period is considered a cholera outbreak.<br />- Upon notification of case, and operation room (Bilik Gerakan) is formed. This unit consists of a health officer (Penolong Pegawai Kesihatan Perseketuan or PPKP), Control team, Investigation team, Case detection team and Health control unit.<br />- The health officer is the head of the operation team. The functions of the control team include isolating and secluding sites and premises identified to be the source of outbreak. Such actions are carried out according to Act 1988. The investigation team identifies the affected individuals in the hospital and interviews them. Among the functions of case detection team is to collect samples from the alleged source of infection. The health control unit plans talks and exhibitions to educate the public regarding such outbreaks.<br />- Upon the setting of the operation room, these teams are then sent to sites affected to carry out their respective responsibilities.<br />- For an outbreak of cholera, the activities of patients are tracked 5 days prior to the onset of symptoms. The case detection team goes to the site to collect samples of rectal swabs and disinfection of areas are done with disinfectants such as sodium hypochlorite 10% or Lysol 1:10.</span></div>Cheah Boon Euhttp://www.blogger.com/profile/09451820363944180614noreply@blogger.com2tag:blogger.com,1999:blog-8168078320376212848.post-57104876060209977592008-02-07T21:46:00.000-08:002008-02-17T00:05:49.738-08:00District Health Office Posting in Baling, Kedah Darul Aman [Part I - Week 1(19/11/2007-22/11/2007)]Hi everyone,<br /><br /><div><div><div><div><div><div><div><div><div><div><div><div><div>Let me first introduce my group members who were posted to Baling for our District Health Office posting from 19th November 2007 till 13th December 2007. Our group is headed by Chng Kay Ly and we had a fabulous and wonderful time there.<br /></div><div><a href="http://bp1.blogger.com/__vmaN6lEpco/R6qkjyMGSDI/AAAAAAAAAAs/S86qEWiHfJo/s1600-h/ckl.png"><img id="BLOGGER_PHOTO_ID_5164120857408587826" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 89px; CURSOR: hand; HEIGHT: 119px" height="118" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R6qkjyMGSDI/AAAAAAAAAAs/S86qEWiHfJo/s200/ckl.png" width="89" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R6qmsSMGSHI/AAAAAAAAABM/AEOKZiMFhU8/s1600-h/cma.png"><img id="BLOGGER_PHOTO_ID_5164123202460731506" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 84px; CURSOR: hand; HEIGHT: 117px" height="120" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R6qmsSMGSHI/AAAAAAAAABM/AEOKZiMFhU8/s200/cma.png" width="120" border="0" /></a> <a href="http://bp3.blogger.com/__vmaN6lEpco/R6qnaSMGSII/AAAAAAAAABU/JI58Gxn6HtY/s1600-h/cbe.jpg"><img id="BLOGGER_PHOTO_ID_5164123992734713986" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 87px; CURSOR: hand; HEIGHT: 118px" height="119" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R6qnaSMGSII/AAAAAAAAABU/JI58Gxn6HtY/s200/cbe.jpg" width="116" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R6qkkCMGSEI/AAAAAAAAAA0/b01s-Pe6owY/s1600-h/Jeevan.png"><img id="BLOGGER_PHOTO_ID_5164120861703555138" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 92px; CURSOR: hand; HEIGHT: 119px" height="130" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R6qkkCMGSEI/AAAAAAAAAA0/b01s-Pe6owY/s200/Jeevan.png" width="95" border="0" /></a> <a href="http://bp0.blogger.com/__vmaN6lEpco/R6qoCiMGSJI/AAAAAAAAABc/fC0oIk7e9CU/s1600-h/DV.png"><img id="BLOGGER_PHOTO_ID_5164124684224448658" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 86px; CURSOR: hand; HEIGHT: 119px" height="118" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R6qoCiMGSJI/AAAAAAAAABc/fC0oIk7e9CU/s200/DV.png" width="86" border="0" /></a><a href="http://bp1.blogger.com/__vmaN6lEpco/R6qoCyMGSKI/AAAAAAAAABk/8PXBuMkKKDw/s1600-h/SD.png"><img id="BLOGGER_PHOTO_ID_5164124688519415970" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 93px; CURSOR: hand; HEIGHT: 120px" height="116" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R6qoCyMGSKI/AAAAAAAAABk/8PXBuMkKKDw/s200/SD.png" width="110" border="0" /></a></div><br /><br /><br /><br /><br /><div><br /></div><div></div><div><strong><span style="font-size:85%;color:#3366ff;"></span></strong></div><div><strong><span style="font-size:85%;color:#3366ff;"></span></strong></div><div><strong><span style="font-size:85%;color:#3366ff;">From left to right: Chng Kay Ly (leader), Charlotte Marie, Cheah Boon Eu, Jeevan, Deva Vinod and S. Dinesh</span></strong><br /><br /></div><div>Hereby, I shall bring you to what we had done in our first week of our posting in Baling.</div></div><div><div><br /><strong><span style="color:#ff0000;">MONDAY 19TH NOVEMBER 2007</span></strong><br /><span style="color:#6600cc;">- Reported to Pejabat Kesihatan Daerah Baling(District Health Office) to KJK Maznah Hussin and FMS Dr. Delima Kalsom binti Abdul Wahab.<br />- We later left for Klinik Kesihatan Kupang and was introduced to FMS Dr Zamri Mansor and the medical officers.<br />- Dr Azira, one of the medical officers, later briefed us on the various departments that are available in the clinic. Among those available are the pathology laboratory, pharmacy, computer room, library, dental clinic, psychosocial rehabilitation (PSR), immunization room and many more.</span></div><div><br /><a href="http://bp3.blogger.com/__vmaN6lEpco/R6q1xSMGSMI/AAAAAAAAAB0/OdJzsg8InRs/s1600-h/P1010099.JPG"><img id="BLOGGER_PHOTO_ID_5164139781034494146" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R6q1xSMGSMI/AAAAAAAAAB0/OdJzsg8InRs/s200/P1010099.JPG" border="0" /></a><a href="http://bp1.blogger.com/__vmaN6lEpco/R6qy5yMGSLI/AAAAAAAAABs/OQ5be6lTIUY/s1600-h/P1010019.JPG"><img id="BLOGGER_PHOTO_ID_5164136628528498866" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R6qy5yMGSLI/AAAAAAAAABs/OQ5be6lTIUY/s200/P1010019.JPG" border="0" /></a><br /><br /><br /><br /><br /><br /><br /><br /></div><div><span style="color:#000000;"></span></div><div><span style="color:#000000;">The above photos are taken when we were posted at the District Health Office and Klinik Kesihatan Kupang; respectively.</span> </div><div></div><div></div><div></div><div><strong><span style="color:#ff0000;">TUESDAY 20TH NOVEMBER 2007</span></strong><br /><span style="color:#6600cc;">- We reported to Klinik Kesihatan Kupang. Our topic of study for the day was Maternal Child Health (MCH) and Family Planning.<br />- We were separated into 3 pairs and were assigned cases pertaining child heath, maternal health and family planning. The cases clerked were later discussed with the Family Medical Specialist (FMS) Dr Zamri.</span></div><div><span style="color:#6600cc;">- Jururawat Kesihatan Umum Haliza taught us the process of booking and we were allowed to perform booking for the patients under her close supervision.<br />- We also discussed with him the advantages and disadvantages of family planning, the criterias available and he diligently taught us about the history taking of family planning.</span><br /><span style="color:#6600cc;">- In the afternoon, we had a brief class on psychosocial rehabilitation(PSR); again by Dr. Zamri.</span> </div><div><br /><a href="http://bp2.blogger.com/__vmaN6lEpco/R6q7zCMGSNI/AAAAAAAAAB8/VAh4Ortdq9g/s1600-h/P1010015.JPG"><img id="BLOGGER_PHOTO_ID_5164146408169031890" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R6q7zCMGSNI/AAAAAAAAAB8/VAh4Ortdq9g/s200/P1010015.JPG" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R6q7ziMGSOI/AAAAAAAAACE/O20J4DYZ6s8/s1600-h/P1010018.JPG"><img id="BLOGGER_PHOTO_ID_5164146416758966498" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R6q7ziMGSOI/AAAAAAAAACE/O20J4DYZ6s8/s200/P1010018.JPG" border="0" /></a><br /><br /></div><strong><span style="color:#ff0000;"></span></strong><div><br /><br /><br /><br /></div><div></div><div>The photos are taken in Klinik Kesihatan Kupang during our MCH posting where antenatal check-ups, child healthcare and family planning were taken place. The first photo was taken when one of our group member were given an opportunity to book a pregnant lady with the gestation of 15 weeks. The photo on the right is taken during a child (at age 1 month) follow-up and the mother of the child also came for postnatal check-up and family planning dine by the staff nurse present.<br /></div><div></div><div><strong>MCH</strong></div><div><br /></div><div>MCH or better known as Maternal and Child Health has its own objectives as:-<br />1) To provide care and consultation to mothers during pregnancy<br />2) To screen women at potential risk of complications and difficulties throughout the three trimesters<br />3) To diagnose complications and plan treatment early<br />4) To reduce maternal apprehension regarding delivery<br />5) To reduce maternal and infant mortality and morbidity<br />6) To educate mothers regarding the available opportunities of family planning and the advantages and disadvantages to adhering to such programmes<br />7) To educate mothers about proper personal hygiene<br />8) To help mothers understand the need of proper care and proper environment for optimal health of infant </div><div></div><div><strong>Antenatal</strong></div><div>Regarding 'Booking' which is done for pregnant women who had their first check-up, it is normally done by the Community Nurse in Klinik Desa and Staff Nurse in Klinik Kesihatan. In Klinik Kesihatan, a red book and another card is being filled up simultaneously. The red book is later given for the pregnant lady to keep and they were informed to bring during their following follow-ups. There will also be another big record book which is meant to record all the patients who come for follow-up. From there, the nurses will be able to trace every patients for their compliance of follow-ups. As for the card, it will be kept as a copy in the Klinik Kesihatan. In both the books and the card, certain information are being recorded. The personal information, the height, weight and blood pressure were first taken as the vitals. Later, a blood test on Hb level, blood group and the Rhesus were taken. At the same time, a drop of blood will be use to test for the HIV status with the consent given by the patients. A urine test is also taken to confirm the pregnancy as well as to check for the albumin and sugar content in the urine. After that, the patients will be called into a room where a thorough medical examination is performed. During the thorough medical examination, the patient is also taught on how to do a "Breast Self Examination". After that, the patient is being advised on their food diet as well as some supplements (eg. iron tablets, etc) were given. A date is being given to the patient to come back for the next follow-up. If the patient defaulted the follow-up, the Staff Nurses will go to their house during their "Home Visit" period to follow-up the patients.</div><div></div><div>Besides that, there is a tagging system during booking. There are 4 different colour tagging - White, Green, Yellow and Red. </div><div></div><div>White: Patient has no complication during the follow-up of the pregnancy. </div><div>Green: Patient has minor complications (eg. Rhesus -ve, history of recurrent miscarriage, Anaemia, etc) and need to see a Consultant with a follow-up date given.</div><div>Yellow: Patient has complications (eg. GDM, HIV +ve, etc) and need to seek the Consultant within 48 hours</div><div>Red: Patient has complications (eg. Eclampsia, PIH, DKA, etc) and need to seek the Consultant immediately</div><div></div><div><strong>Postnatal</strong></div><div>Postnatal mothers also received follow-up in the Klinik Kesihatan or Klinik Desa respectively. However, those receiving follow-up in the two areas mentioned has to be confirmed by the doctors of any complications. This is also done by the Community Nurse in Klinik Desa and Staff Nurse in Klinik Kesihatan.</div><div></div><div><strong>Child Health</strong></div><div>After a delivery, the new infant is supposed to be follow-uped until the immunization status is completed. The mother of the child will be given a card with a growth chart and the immunization chart printed on it. She have to bring the child to either the Klinik Desa or Klinik Kesihatan for the follow-up. During the follow-up, the height, weight, and the head circumference were measured again either by the Community Nurse or Staff Nurse according to either Klinik Desa or Klinik Kesihatan respectively. Everytime a child is being measured, it is recorded in the card mentioned. Then, the growth chart is being plotted to see whether the child is growing well or not. If the child is coming for immunization, then the a thorough physical examination is done on the child to make sure that the child is healthy before the immunization is given.</div><div></div><div><br /></div><div><strong><span style="color:#000000;">PSR</span></strong><br /></div><div>PSR; Psychosocial Rehabilitation is a process to enable and to encourage those individuals with mental problems to achieve independency in the community, so that they are able to take care of their daily needs. In this programme in Klinik Kesihatan Kupang, the individuals are given chances to do sourvenirs, cooking, etc.</div><div><br /></div><div>Among the objectives for the PSR are:-<br />1) To enable the individual to adjust to attain his optimal level of independence, psychologically, socially, physically and economically.<br />2) To enable the mentally patients to understand and able to control their own illness, achieve their optimal functions and to obtain independency.</div><div><br /><a href="http://bp1.blogger.com/__vmaN6lEpco/R6r5YyMGSVI/AAAAAAAAAC8/bzspnVcp6EE/s1600-h/P1010002a.JPG"><img id="BLOGGER_PHOTO_ID_5164214126918388050" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R6r5YyMGSVI/AAAAAAAAAC8/bzspnVcp6EE/s200/P1010002a.JPG" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R6r5ZSMGSWI/AAAAAAAAADE/P2q3v9XHU10/s1600-h/P1010003.JPG"><img id="BLOGGER_PHOTO_ID_5164214135508322658" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R6r5ZSMGSWI/AAAAAAAAADE/P2q3v9XHU10/s200/P1010003.JPG" border="0" /></a> <a href="http://bp0.blogger.com/__vmaN6lEpco/R6r5-iMGSXI/AAAAAAAAADM/y1Ozytz7f3U/s1600-h/P1010005.JPG"><img id="BLOGGER_PHOTO_ID_5164214775458449778" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R6r5-iMGSXI/AAAAAAAAADM/y1Ozytz7f3U/s200/P1010005.JPG" border="0" /></a><br /><br /><br /><br /><br /><br /></div><div><strong><span style="color:#ff0000;"></span></strong></div><div><br /><br /><br /><br /><br /></div><div><span style="color:#000000;">The photos above are some of the sourvenirs done by the individuals when they spent their time in the psychosocial rehabilitation. They normally attend the rehabilitation on every Tuesday in the morning. Currently there are less than 10 patients as many of them has succeeded to be more independent and had found a better job.</span></div><div><br /><br /></div><div><strong><span style="color:#ff0000;">WEDNESDAY 21ST NOVEMBER 2007</span></strong><br /></div><div><span style="color:#000000;"><span style="color:#6600cc;">- We reported to Klinik Kesihatan Kupang. Jururawat Kesihatan Norolasikhin and Jururawat Kesihatan Hamzah divided us into 2 groups and took us for home visit for postnatal mothers and neonatal jaundice in various villages. Among the villages that we visited were Taman Sri Landak (postnatal 8 days with G6PD deficiency male neonate) and Kampung Seberang Ketil (postnatal 9 days with G6PD deficiency female neonate).<br />- Later, we visited Klinik Desa Kampung Pisang. We helped in the booking process.<br />- Our final visit for the morning session was to Kampung Bendang where we visited a mother in her 20th postnatal day<br />- In the afternoon, we were given a brief lecture on geriatrics by Dr Zamri.</span><br /></span></div><div><br /><br /></div><div><span style="color:#000000;"><strong>Home Visit</strong></span><br /><br /></div><div><span style="color:#000000;">Home visit is done normally for those patients who are unable to seek medical treatment because transportation is not available in their places. However, home visit normally is done for postnatal mothers and infants with medical illness such as Jaundice, G6PD (Glucose-6-Phosphate Deficiency).</span><br /></div></div></div><div><span style="color:#000000;"><a href="http://bp0.blogger.com/__vmaN6lEpco/R6r8IiMGSYI/AAAAAAAAADU/J88EQMno3-g/s1600-h/P1010030.JPG"><img id="BLOGGER_PHOTO_ID_5164217146280397186" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 190px; CURSOR: hand; HEIGHT: 151px" height="150" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R6r8IiMGSYI/AAAAAAAAADU/J88EQMno3-g/s200/P1010030.JPG" width="190" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R6r8JSMGSZI/AAAAAAAAADc/EHIlD-yLOZk/s1600-h/P1010042.JPG"><img id="BLOGGER_PHOTO_ID_5164217159165299090" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 189px; CURSOR: hand; HEIGHT: 152px" height="150" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R6r8JSMGSZI/AAAAAAAAADc/EHIlD-yLOZk/s200/P1010042.JPG" width="189" border="0" /></a><a href="http://bp3.blogger.com/__vmaN6lEpco/R6r8MSMGSaI/AAAAAAAAADk/qE4javz5BVU/s1600-h/P1010043.JPG"><img id="BLOGGER_PHOTO_ID_5164217210704906658" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 190px; CURSOR: hand; HEIGHT: 150px" height="150" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R6r8MSMGSaI/AAAAAAAAADk/qE4javz5BVU/s200/P1010043.JPG" width="190" border="0" /></a><br /><br /></div><br /><div></div><br /><div><br /><br /></div><br /></span><span style="color:#000000;"><div><span style="color:#000000;"><strong></strong></span></div><div><span style="color:#000000;"><strong></strong></span></div><div><span style="color:#000000;"><strong>1st photo:</strong> Taken in Taman Sri Landak with S/N Norolasikhin checking on a 8 days old neonate who had G6PD. A thorough medical check-up with vital signs was taken for the mother of the child with the help of one of our group member.</span></div></div><div><strong></strong></div><div><strong>2nd & 3rd photos:</strong> Taken in Kampung Seberand Ketil with S/N Norolasikhin weighing the baby followed by a thorough medical examination on the 9 days old neonate. The way of weighing the baby is done during Home Visit only as it is hard for them to carry around the weighing machine during the Home Visit.<br /></div><div><a href="http://bp2.blogger.com/__vmaN6lEpco/R6r-9CMGSbI/AAAAAAAAADs/Qo6jQ6eMUPo/s1600-h/P1010063.JPG"><img id="BLOGGER_PHOTO_ID_5164220247246784946" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="150" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R6r-9CMGSbI/AAAAAAAAADs/Qo6jQ6eMUPo/s200/P1010063.JPG" width="190" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R6r-9iMGScI/AAAAAAAAAD0/nsnRIp_jEQk/s1600-h/P1010066.JPG"><img id="BLOGGER_PHOTO_ID_5164220255836719554" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="150" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R6r-9iMGScI/AAAAAAAAAD0/nsnRIp_jEQk/s200/P1010066.JPG" width="187" border="0" /></a><a href="http://bp2.blogger.com/__vmaN6lEpco/R6r--CMGSdI/AAAAAAAAAD8/zt3a-Z06l0w/s1600-h/P1010067.JPG"><img id="BLOGGER_PHOTO_ID_5164220264426654162" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" height="150" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R6r--CMGSdI/AAAAAAAAAD8/zt3a-Z06l0w/s200/P1010067.JPG" width="188" border="0" /></a><br /></div><div><br /></div><div><strong><span style="color:#ff0000;"></span></strong></div><div><br /></div><div><span style="color:#000000;"></span></div><div><br /></div><div></div><div><br /></div><div></div><div><br /></div><div></div><div><br /></div><div></div><div><br /></div><div></div><div></div><div><strong>4th photo:</strong> Taken in Klinik Desa (Community clinic) Kampung Pisang where one of our group member is seen taking blood pressure for a lady who came for follow-up of her pregnancy.<br /></div><div><strong>5th & 6th photos:</strong> Taken during a home visit in Kampung Bendang where S/N Norolasikhin and S/N Hamzah is seen doing a follow-up for both mother and 20 days old neonate.</div><div><br /></div><div><strong><span style="color:#ff0000;">THURSDAY 22ND NOVEMBER 2007<br /></span></strong></span><span style="color:#6600cc;">- We introduced ourselves to a group of elderly people above 50 years of various background who are members of a society called ‘Warga Emas’.<br />- We joined them in their morning activity of Tai Chi and Qi Gong. We later on joined them for a light refreshment prepared by the elderly folks themselves.<br /></div></span><div></div><div></div><div><strong>Warga Emas</strong></div><div></div><div>"Warga Emas" better known as the Old Folks has formed a group of their own. They usually gather in Klinik Kesihatan Kupang on every Thursday from 8am till 10am. They will meet up; share their experiences and do some light exercises like 'Tai Chi' and 'Qi Gong'. Below are some photographs taken with their consents during their exercise activities. They normally exercise for about 45 minutes and then they will be served with some refreshment prepared by themselves.</div><div></div><div></div><div><a href="http://bp3.blogger.com/__vmaN6lEpco/R6sBYCMGSeI/AAAAAAAAAEE/2tKAvNVMu7w/s1600-h/P1010086.JPG"><img id="BLOGGER_PHOTO_ID_5164222910126508514" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp3.blogger.com/__vmaN6lEpco/R6sBYCMGSeI/AAAAAAAAAEE/2tKAvNVMu7w/s200/P1010086.JPG" border="0" /></a></div><div><span style="color:#6600cc;"><a href="http://bp1.blogger.com/__vmaN6lEpco/R6sBYiMGSfI/AAAAAAAAAEM/hVv0Higy1lI/s1600-h/P1010077.JPG"><img id="BLOGGER_PHOTO_ID_5164222918716443122" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R6sBYiMGSfI/AAAAAAAAAEM/hVv0Higy1lI/s200/P1010077.JPG" border="0" /></a><a href="http://bp0.blogger.com/__vmaN6lEpco/R6sBZSMGSgI/AAAAAAAAAEU/f216mnSbeSY/s1600-h/P1010078.JPG"><img id="BLOGGER_PHOTO_ID_5164222931601345026" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp0.blogger.com/__vmaN6lEpco/R6sBZSMGSgI/AAAAAAAAAEU/f216mnSbeSY/s200/P1010078.JPG" border="0" /></a></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"><a href="http://bp1.blogger.com/__vmaN6lEpco/R6sBaiMGShI/AAAAAAAAAEc/rmipbGwHQy8/s1600-h/P1010079.JPG"><img id="BLOGGER_PHOTO_ID_5164222953076181522" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp1.blogger.com/__vmaN6lEpco/R6sBaiMGShI/AAAAAAAAAEc/rmipbGwHQy8/s200/P1010079.JPG" border="0" /></a></span></div><div><span style="color:#6600cc;"><a href="http://bp2.blogger.com/__vmaN6lEpco/R6sBayMGSiI/AAAAAAAAAEk/r8KhF9Q5IUI/s1600-h/P1010073.JPG"><img id="BLOGGER_PHOTO_ID_5164222957371148834" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://bp2.blogger.com/__vmaN6lEpco/R6sBayMGSiI/AAAAAAAAAEk/r8KhF9Q5IUI/s200/P1010073.JPG" border="0" /></a></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;"></span></span></div><div><span style="color:#6600cc;"><span style="color:#000000;">Our experiences during the 2nd, 3rd and 4th week of out posting in the District Health Office posting in Baling will be posted soon.</span></span></div></div></div></div></div></div></div></div></div></div>Cheah Boon Euhttp://www.blogger.com/profile/09451820363944180614noreply@blogger.com3tag:blogger.com,1999:blog-8168078320376212848.post-63904850484034775012008-01-24T06:07:00.000-08:002008-01-24T06:11:02.761-08:00Experiences during DHO Posting.Dear Students of Batch 5 & 6,<br />This blog has been created to share the experiences during the DHO posting. Post the information gathered on each activity of the DHO separately.K.A.Narayanhttp://www.blogger.com/profile/03307511160149404141noreply@blogger.com1