H1N1 : Situasi semasa Bah1

Documented pandemics have occurred at intervals of 10 to 50 years since the 16th century including three in the last century.1 The most devastating of the last three, the 1918 "Spanish Influenza", caused the death of an estimated 20 to 40 million people. The current widespread circulation of highly pathogenic influenza A (H5N1) virus in poultry and its occasional transmission to humans have raised concern that the world is moving closer to the next pandemic. While it is uncertain whether this particular virus will ever acquire the capacity for sustained human-to-human transmission, scientists agree that it is inevitable that another pandemic with an influenza virus will occur. The Severe Acute Respiratory Syndrome (SARS) that emerged in 2002 and 2003 affected 26 countries in less than five months and showed how fast an epidemic with a new pathogen can spread in modern society with air travel. This event also demonstrated the impact a public health crisis can have on a global economy. (WHO,Apr 2009).

Daripada artikel di atas, terbukti Influenza A telah melanda dunia pada suatu masa yang lama dahulu dan telah drekodkan.Malaysia tidak terlepas daripada serangan tersebut. Antara yang terawal ialah SARS yang melanda Malaysia sekitar 2003 dengan mencatat 2 kematian. (SARS Outbreak in Malaysia, 2006). Selepas itu, Malysia dilanda pula dengan Influenza A (H5N1) atau lebih dikenali dengan selsema burung pada Ogos 2004 sehingga diisyhtiharkan bebas pada 5 Jun 2006.(Bernama 2006). Yang terbaru melanda Malaysia pada tahun 2009 ialah Influenza A (H1N1) atau lebih dikenali sebagai selsema babi. Penularan wabak ini meningkat kerana jangkitan melibatkan antara manusia. Tambahan pula jangkitan adalah melalui udara. Sehingga 6 Ogos 2009, kes yang dicatatkan ialah 1,492 kes (MOH 2009).

Artikel ini sebenarnya ditulis selepas membaca wawancara wartawan Kosmo dengan Tan Sri Dr. Mohd Ismail Merican( Rabu, 19 Ogos 2009, m/s 11). Apa yang akan dirungkaikan hanyalah pendapat peribadi selaku pelajar tahun akhir Kesihatan dan Keselamatan Persekitaran. Apa yang ingin dinyatakan adalah mengenai beberapa fakta yang menjadi persoalan pada saya. Saya coretkan di bawah salah satu soalan dan jawapan dari wawancara tersebut dibawah.

Kosmo : Sejauh manakah seriusnya wabak H1N1 di negara kita sekarang?
Mohd Ismail : Berdasarkan data-data yang diperolehi dari negara-negara yang yang terjejas dengan wabak ini, dianggarkan 20 hingga 30 peratus penduduk sesebuah negara akan dijangkiti, atau 20 hingga 30 orang bagi setiap 100 penduduk. Ketika ini bilangan mereka yasng disahkan dijangkiti H1N1 masih rendah iaitu 1,000 bagi setiap 100,000 penduduk atau 1 bagi setiap 100 penduduk.

Jika sekali pun benar apa yang diperkatakan di atas, perlukag kita menunggu 20-30 peratus rakyat Malaysia dijangkiti dan tindakan yang lebih serius akan diambil?? Saya ingin membawa anda melihat keadaan Malaysia dari sudut antarabangsa. Saya ingin membuat sedikit statistik secara kasar dari data antarabangsa dan bandingkan dengan kes di Malaysia. Data yang diambil adalah pada 6 Ogos 2009.

Jumlah kes seluruh dunia (WHO, 2009)= 177, 457 kes
Anggaran jumlah populasi dunia (GeoHive, 2009) = 6, 800, 000, 000 orang

Kadar kes = Jumlah kes seluruh dunia/ Anggaran jumlah populasi dunia
= 177, 457 / 6, 800, 000, 000
= 0.00002

Anggaran jumlah populasi Malaysia (GeoHive, 2009) = 25, 700, 000 orang


Jumlah kes di Malaysia berdasarkan kadar kes dunia

=kadar kes dunia x anggaran populasi Malaysia
= 0.00002 x 25, 700, 000
= 340 kes

Jumlah kes di sebenar Malaysia (MOH) = 1, 494 kes


Mungkin data di atas boleh dikatakan tidak tepat kerana terdapat anggaran data bagi populasi. Saya cuba pula kaedah kedua iaitu kadar kes kematian bagi setiap kes yang dilaporkan.


Jumlah kematian seluruh dunia (WHO) = 1, 462 kematian
Jumlah kes seluruh dunia (WHO) = 177, 457 kes


Kadar kematian dari kes seluruh dunia
= jumlah kematian seluruh dunia / Jumlah kes seluruh dunia
= 1, 462 / 177, 457
= 0.008


Jumlah kes Malaysia (MOH) = 1, 494 kes


Dan sekarang saya ingin bandingkan kadar kematian seluruh dunia dengan kes di Malaysia.
Kadar kematiann di Malaysia
= Kadar kematian dari kes seluruh dunia x Jumlah kes Malaysia
= 0.008 x 1, 494
= 11 kematian


Jumlah kematian sebenar Malaysia (MOH)= 14 kematian

Terdapat beberapa isu lagi dalam wawancara itu yang ingin dikupaskan. Di sini juga saya dapat melihat terdapat kekurangan dalam kaedah membasmi wabak ini. Dimana kekurangannya dan bagaimana penyelesaiannya akan dikupas dalam artikel berikutnya. Dalam artikel akan datang, saya akan membandingkan pelan tindakan yang disasarkan oleh WHO dan sejauh mana Malaysia mengaplikasikan saranan ini. Apa yang dibincangkan setakat ini harap dapat membuka mata kita dalam bersama mencegah penularan wabak ini dari pandangan ahli akademik.

Bone Grafting II

It have been 3 weeks after 2nd operation (bone grafting). As can be seen in the pic above, that is the latest x-ray taken 2 weeks after operation. As you can see there are some semiliquid added at the uncombined bones. So how it feel? Right after the operation, it feel very painful especially at the illiac crest and just a bit pain at the hand. I had been discharge just a day after the operation. I can't even wake up from the bed and it is really pain when try to stand and walk. A very painful movement if want to stand up or to lie on the bed. It continuously for a week where i have to used "tongkat". Actually it should take about 6 weeks to recover the iliac crest, but with my spirit and help from my beloved family and special doctor-to-be, i can walk by my self just in two weeks. It just amazing, n now after three weeks, i freely walking but still control in doing heavy work because my left hand become so weak. So, from now on, i just take some anlene to give some extra calcium to ignite the growth of the bone. After 6 week, if the bone did not attach together, i have to go for other operation. So,just wait n see....

Bone grafting

Whats that? Introducing my new x-ray, still hot,just take it this morning,haha. Even it is not really clear, but as u can see there are three part of iron planting that is one one radius and 2 for ulna. However what be seen here is there is some missing bone at the red pointer. There are two actually on both ulna and radius. The length of missing bone is 1 cm each. In Medicine, it is quite horrible.

So talking about bone grafting? have any idea? actually it is a surgical procedure that replaces missing bone with material from the patient's own body. I myself will undergo Autogenous bone grafting that involves taking the my own bone from a part of the body where it is not essential (typically from the pelvis or iliac crest), and placing it where it's needed. Autogenous bone grafts are the most preferred by surgeons because there is less risk of the bone being rejected due to the fact that the bone originated in the patient's body. The procedure is simple by cut the iliac crest( as picture below) like a window, and a bone generative cell will be taken form inside and the iliac creat will be closed back. How about the effect? For sure there will be a scar and little pain form 1 month. A very long time to be cured and normal as before.

Doctor Vs Health Officer : Nowadays Situation

" In Denmark, every doctor is public health officer and every public health officer is a doctor."
-President George E. Vincent, Roketfeller Faoundation-

In Malaysia?? let us discuss about it. Generally doctor have their own world inside the hospitals and has full authority to treat patients. However, they also have instinct responsibilities towards situation accidental emergency response outside the hospitals. Different with Health Officers that have authority by department in Health District/State Office and all environment in Malaysia in order to prevent and control any harm or probability to cause disease. However there are some overlapping occurs when at hospitals when Health officer want to get information about suspected patient especially about their diagnosis but some doctors alike delay the report. When talking about incubation period and spreading phase, it plays with time and pathogenic multiplication. Everything should be fast to control any spreading of disease. This issue just been realized by ministry when Deangue case in Malaysia become worst even there are some other issues by health department itself that will be discussed on other issues.

Another thing to be discussed here is something that can be think by theoretically. As we know, all doctors is very expert in term of treatment. That is their compulsory knowledge. But, what will happen if this clinical-based person transferred into prevent-control management?? Its not their expertised. This is what happening inside District Health Office where Clinical-based doctors are authorizing all health officers. One funny thing to prove above statement that anyone can see is whenever District Health officer when to field for Aedes control and have an interview by reporters, it always shows that they focusing on the stuck-dirt drain. How can they search for an Aedes larvae in that type of drain???

This post just for all to read and think because we are in Health division. Either doctors or health officers have their own responsibilities. But if both can work together and work is done by own expertise, whatever disease, infection or just whatever health problems can be solve. Just remember, in Islam as last generation most of the "revenge" come in form of disease and natural disaster!! don't you think how important we are????

OSH TALK by NIOSH

Responsibilities of Employers and Self-Employed Persons
1 July 2009 (Half Day)

Venue : NIOSH Exhibition Center, Bandar Baru Bangi, Selangor
Time : 09:00am - 12:00pm
Fee : Free (refreshment not included)
Target Group : Safety Committee / Public

- Identify chemicals hazardous to health
- Comply with permissible exposure limits (PELs)
- Conduct chemical health risk assessment
- Action to control hazard exposure
- Labeling and re-labeling of chemicals hazardous to health
- Monitor exposure at the work place of work
- Carry out health surveillance
- Medical removal protection
- Provide information, instruction and training
- Exhibit warning signs
- Keep Records

For more Details, please contact :
1. En Zulfadhli: 03-8769 2267, zulfadhli@niosh.com.my
2. Pn Siti Badariah: 03-8769 2209, siti.badariah@niosh.com.my

* Limited to 80 seats only, first come first served basis.
**Subject to change without notice. For latest information please visit www.niosh.com.my

Jadual Semester 7 HS 223

ISNIN : 8.30 - 11.20 ENV 512 (SUBK) LECTURE
2.30 - 5.20 ENV 512 (SUBK) LAB

SELASA: 10.30 - 11.20 ENV 515 (SUBK) LECTURE
2.30 - 4.20 ENV 501 (ROZMS) LECTURE
4.30 - 6.20 ENV 515 (SUBK) LECTURE

RABU: 10.30 - 11.20 ENV 513 (SHAN) TUTORIAL
11.30 - 1.20 ENV 513 (SHAN) LECTURE
2.30 - 6.20 ENV 513 (SHAN) LAB

KHAMIS: 11.30 - 1.20 ENV 424 (MGM) LECTURE
2.30 - 6.20 ENV 424 (MGM) LAB

JUMAAT: 9.30 - 11.20 ENV 516 (RODI) LECTURE
2.30 - 6.20 ENV 516 (RODI) LAB

* Mungkin akan ada perubahan pada hari selasa memandangkan kelas patho berada di antara kelas En Subra. Sebarang perubahan akan dimaklumkan kelak.

Penempatan Kolej Kediaman UiTM Puncak Alam

Kolej Angsana

1. Hairul Nazmin
2. Mohd Faizal
3. Mohd Rushdi
4. Meor Ahmad Mustaqim

Kolej Rafflesia



1. Nursalwa
2. Farhanim
3. Nurul Farahana
4. Asma Nadzirah
5. Rohaida
6.Armawaty Natasya
7. Nurul Ainah
8. Nurul Shamira



1. Nur Syuhadah
2. Syahida Kamila
3. Hazirah
4. Nur Muniza
5. Nazatul Hayati
6.Laila Zanariah
7. Nur Aniza
8.Hazariah

1.Safwa
2.Nadia
3.Nor Habibah
4.Norasyikin
5.Fatin Najihah
6.Siti Aisyah

** Senarai di atas a mungkin akan berubah mengikut procedure kolej. Tertakhluk kepada terma dan syarat. Ada masalah, leave a message.