Klinik Kesihatan Lanang, Sibu. 

Selamat Tahun Baru 2006

Tiba saja akhir tahun saya sibuk menyusun perancangan untuk tahun depan. Antaranya membuat justifikasi bagi memohon jawatan baru. Kebanyakan kakitangan di Klinik Lanang adalah dari Klinik lama Low King How yang kini telah di robohkan untuk memberi laluan kepada projek Sibu City Centre. Antara jawatan baru yang diminta termasuklah jawatan physiotherapy dan telefonis/operator. Ini memandangkan jumlah bilangan pesakit yang terus meningkat. Kedatangan pesakit sekarang telah mencecah hampir 400 orang sehari dan dijangka terus meningkat lebih-lebih lagi apabila siapnya jambatan baru yang menghubungkan Bandar Sibu dan Sarekei.

Sarawak...the largest state in Malaysia 

Telehealth in Sarawak 

TPC Hardware 

TPC facilities in Sarawak 

Teleprimary Care is coming

Finally, the Ministry of Health has approved KK Lanang to be included in the Teleprimary Care (TPC) Network. It is simply because the family physician is one of the major key players in the game. They have allocated 250 thousand for the clinic and the hardware installation is under progress. TPC which is under Telehealth project is one of the flagships of Multimedia Super Corridor. As we move forward to become a developed nation, the government is committed to provide a comprehensive health system which is equitable, affordable, efficient, technologically appropriate and customer friendly.

One of the major problems of health services in Malaysia is the availability of comprehensiveness and quality of health care in remote health centres. When patients are transferred from the health centres to the hospitals for further treatment, this not only incurs inconvenience to the patients and their family but also increases the cost to the health care system. Teleprimary care is one of the tools to overcome this problem. The doctors in the remote clinics are able to discuss the problem cases through teleconsultation with the doctors and specialist in the hospitals using an audiovisual system to provide better care in the health centers without transferring the patients to the hospitals. Only the essential and needy patients are referred to the hospitals. This has not only reduced the number of patients referred to the hospitals but it has reduced the cost to the health care system. It has also provided a more comprehensive care to the patients in the health centres. The doctors in the health centers are also provided training and are also updated on the latest in medicine. This method of training has made doctors in the health centers more efficient and satisfied.

TPC is still under a pilot project. Besides Johor, Sibu and all the health centres along the Rajang basin has been selected as the pilot area. With it mountainous and hilly topography which is only accessible either by river or air, Sarawak especially Sibu and the Rajang Basin will benefited the most from this project. I remember seeing patient who departed as early as 2 am with the express boat from Kapit and reach Sibu only 4 hours later. After receiving treatment from the clinic or hospital they have to spend a night in Sibu before they can cruise back the next day because there is no express boat service after 12 pm.

Pertandingan menulis khat 

Pemandangan di rumah panjang 

Makan tengahari beramai-ramai di ruai 

Kumpulan nasyid 2 in 1 

Kena naik feri menyeberangi Sg. Rajang 

Sehari di Rumah Panjang

Tanggal 26 November lalu saya bersama sebuah badan NGO telah berkunjung ke sebuah rumah panjang di kawasan Bintangor lebih kurang 40 minit dari Sibu. Tujuan kunjungan tersebut adalah bagi menjayakan program Berhari Raya (orang Sarawak panggil program ramah tamah / berambeh). Rumah panjang Iban tersebut telah memeluk Islam sekitar tahun 1997. Sebagai seorang yang menggemari kerja-kerja sukarelawan kunjungan ini adalah saat yang ditunggu-tunggu. Ianya bukan hanya untuk merapatkan hubungan silaturahim tetapi yang lebih penting ialah mengenali masyarakat pribumi Sarawak dengan lebih dekat dan mendalam. Rumah panjang yang menempatkan hampir 40 keluarga diketuai oleh seorang ketua yang dipanggil ‘Tuai Rumah’.

Majlis diadakan di ruang tamu yang dipanggil ‘Ruai’. Hampir separuh yang hadir adalah wanita kerana kaum lelaki ada yang pergi bekerja. Upacara dimulai dengan ucapan aluan oleh wakil NGO diikuti oleh tuai rumah. Kemudian kami didendangkan dengan persembahan nasyid oleh anak-anak rumah panjang. Subhanallah ingatkan cuma satu kumpulan rupanya ada 3 kumpulan termasuk yang veteran. Yang menariknya satu kumpulan nasyid remaja yang menggelarkan diri mereka kumpulan 2 in 1 mendendangkan sebuah nasyid kontemporari. Acara seterusnya adalah peraduan mewarna untuk kanak-kanak dan peraduan menulis khat untuk dewasa. Alhamdulillah semuanya berlumba-lumba mengambil bahagian.

Majlis berhenti rehat untuk solat zohor dan disambung semula selepas makan tengahari. Tersentuh hati bila mendengar anak-anak kecil membaca doa makan beramai-ramai. Acara sebelah petang adalah pertandingan membaca fatihah dan azan serta diakhiri dengan acara sukanika. Sebelum penyampaian hadiah satu ceramah agama dalam bahasa Iban telah disampaikan oleh Ustaz Yaakob dari Sibu.

Program hari tu memang cukup bermakna kepada kami dan juga penghuni rumah panjang tersebut. Mudah-mudah Allah menguatkan iman mereka dan melimpahkan kesejahteraan kepada seluruh penghuni rumah panjang tersebut. Amin.

UKM Convocation Day 

UKM Convocation 2005

Having a chance of going back to KL was indeed a happy moment. For me and family it was not just to meet friends and relatives but to settle a lot of unfinished works. We took Air Asia from Sibu 8.30pm and reached KL 2 Hours later. Air Asia services was not bad, despite their low cost fair the others essential services were quite good. But of course there were no food served and it limits the cargo for only 15kg per person. So for me and my family we got 75kg and we only used ¾ of it. First time coming back from Sibu we brought the famous ikan terubuk masin 50 pieces with 2kg udang harimau.

After the rehearsal on the 15 Sept I took an opportunity to visit Dr Salmiah in KK Batu 9 and get some advises. That night I hang around with Dr Tong at the Mamak stall. We talked about various topics; family stuff, clinical and politics. A lot of ideas were generated within those 2 hours. I suggested to Tong to have his own weblog as many of the family physician around the world did.

I believed that all of those who attended the convocations have had a great time. The only words from the Chancellor Tuanku Jaafar that stick in mind was: “ Jadilah insan yang berguna, dicampak ke laut menjadi pulau, dicampak ke darat menjadi gunung, dicampak ke angkasa menjadi bintang kejora”.

Program Keceriaan

Pagi tadi berlangsung program keceriaan bagi seluruh warga Klinik Kesihatan Jalan Lanang. Proram yang julung kali diadakan itu adalah bertujuan untuk merapatkan hubungan silaturrahim diantara staf serta memupuk semangat berpasukan disamping mencergaskan tubuh badan. Seramai 70 orang kakitangan dari semua unit hadir. Program bermula seawal jam 8 pagi dengan acara senamrobik diketuai oleh fasilitator dari Jabatan Belia dan Sukan cawangan Sibu. Ianya disusuli kemudian dengan acara sukanika. Antaranya ialah membawa telur dalam sudu, meminum air cola serta membuat barisan terpanjang dengan alatan yang ada pada tubuh. Selesai acara sukanika, upacara penyampaian hadiah dan ucapan berlangsung di lobi klinik. Ia diikuti dengan jamuan tengahari dan bersurai. Semua kakitangan kelihatan gembira dan ingin program seperti ini diadakan setiap tahun. Saya juga berasa gembira dan berharap program ini dapat meningkatkan produktiviti dan komitmen semua kakitangan dalam kerja mereka seharian.

Aktiviti Klinik

Sejak Klinik Kesihatan Jalan Lanang mula beroperasi awal tahun ini, beberapa program dan kursus peringkat negeri Sarawak telah diadakan di sini. Awal Julai yang lalu satu kursus pendek ’Early Interventional Program for Children with Special Needs’ telah diadakan. Kursus tersebut telah dirasmikan oleh Pengarah Kesihatan Sarawak. Ianya mengumpulkan seluruh kakitangan kesihatan dan NGO yang terlibat di dalam penjagaan kanak-kanak berkeperluan khas di Sarawak.

Pada pertengahan Ogas pula diadakan ‘Screening Program for Special Olympics’. Ianya adalah program saringan bagi kanak-kanak keperluan khas yang akan telibat di dalam sukan Special Olympic. Berbeza dengan paralympic , sukan Special Olympic adalah khas untuk mereka yang mempunyai kecacatan mental seperti Down’s Syndrome dan Slow Learner.

Sibu Central Market 

Central Market 

A day consultation

Among the things that struck me in this clinic (Lanang Health Clinic, Sibu) is the number of STD cases which is relatively higher compared to a few health clinics I used to work in West Malaysia. Almost every week I got a referral of such cases either from my MOs or from the neighboring health clinic. The fact that these cases are not confined to the adult but also involving children is extremely alarming.

Recently I saw a 3 year old girl presented with yellowish vaginal discharge which later on confirmed to be N. Gonorrhea infection. I’ve seen a few cases of gonorrhea ophthalmia neonatrum which were diagnosed quite late. Maybe it is high time to have a common policy such as pre-pregnancy Gonorrhea screening and prophylactic eye drop for newborns. This one I’m yet to discuss with my boss and the hospital side.

Wassalam.

Sibu...a city in the making. 

Greetings From Sibu

Assalamualaikum and selamat sejahtera,

At last I managed to get the internet connection. This one is via a wireless phone. I'm quite upset for not be able to subscribe to the broadband connection that allowing me to use the cheaper VOIP phone call . Wireless broadband only been provided by Jaring and restricted for the Klang Valley at this moment.

Sibu is not as bad as what I was told. The people here are warm and friendly especially the bumiputras (Iban, melanau etc..). As for the Foo Chow I have not encountered any aggressive behaviour so far. In contrast some of them were so friendly. In fact one the taukeh here lend me his car while waiting mine to arrive from semenanjung.

The first remarked I got from one of my staff clinic was:
" Oh Doctor, you have created a history."
I asked him " What have I done?"
" You are the first family physician in Sibu. Actually we have another one from Taiwan before but he left after working for a few months."
" OK I hope I can serve Sibu longer."


As the first rule when you are posted to a new place is to develop a networking. So last Friday I made an introductory visit to the hospital. It seems that most of them welcoming me although some were skeptical; what kind of specialist I am. A senior pharmacy in the hospital told me:
" So you are the one that we awaiting for, the HQ has allocated 200K for your list A drugs."
I just nodded my head although I were not sure whether that was an adequate amount.

Back to the health side, my boss (Division Health Officer) asked me which post I wanted to "menanggung tugas" MO U48 or FMS U48. Taking MO U48 post means I will be in charge of the clinic and have to do administrative work in addition to the clinical work. While I am aware that we can be both clinician and manager, I just don’t want to be bothered by the nonsense and nitty gritty problems such as leaking pipes, uncut grass etc. On the other hand I don't want others (senior MO/MO in charge) to interrupt my planning (I learned this from the senior fms during our scientific meeting recently) . So I have to make a quick assessment; what are the chances that MOi/c will be an obstacle to me. At last I decided to "menanggung" FMS U48 post and lets MO U48 post taken by another MO (3 years junior from me).


As the first step I told the mo i/c that we need to have a meeting. They hardly have any meetings before and there are a lot of issues and problems that need to be addressed. So we have our first meeting last week. I presented a draft of two years Strategic Planning for the clinic focusing into three key result area; clinical services, human resource development and R&D. I told them that I wish I could turn this clinic into the best primary care centre in this country and I want them to work hard with me. The reason is that I notice in this clinic there is what I call “4pm syndrome” where everybody seem to be lost in action by 4pm and somebody else will clock in everybody punch card.


As for my family, I am actually amazed with the way my children adapt with their new school environment. It goes very well from day one itself (they started schooling on the 5th July while we were still staying in the hotel). May be because I have prepared their mind very well before we came. I used to tell them:


" Hey listen, we are moving into the jungle, we are going to stay in the Iban long house and you may have to take a sampan to school or hanging on the broken "jambatan gantung" to cross the river similar like what you see in the newspaper recently." The spontaneous response from my eldest son was: "Oh, that's cool" while my two daughters remained silent. When we first reached Kuching for duty reporting, my daughter asked me "where is the jungle?" I just pointed to the nearby bushes. As for my wife, she always be a great inspiration for me, if not because of her support, by no way I can be landed in this place.

Ok that’s all for this time. Any comments, suggestions and advices are highly welcomed especially from the senior colleagues.

Wassalam

Zainal Fitri Zakaria

M. Med UKM 2005

Klinik Kesihatan Lanang

Sibu

Sarawak.