The aim of this study was to examine the relationship between the level of stress experienced by rescue workers after the collapse of a 13 story condominium in Kuala Lumpur, and other probable risk factors. Within a month of the incident, 123 firefighters filled up the Impact of Life Event score (Horowitz) and the General Health Questionnaire (GHQ). The results indicated that 7 (6%) firemen could be classified as possible 'cases' on the GHQ, and significantly 5 from this group also scored highly on the impact of events score. No other risk factors were identified in the firemen. On conclusion, the GHQ can be used to screen those with high impact scores to pick up possible cases early enough, so that intervention can be successful.
In Peninsular Malaysia 'structural' factors are found to influence strongly people's persistent occupation of floodplains. Thus, despite a high level of flood hazard awareness, a high level of pessimism and a high level of expectation of future floods, poorer individuals seldom attempt to leave for more advantageous locations but are instead trapped in their present locations by structural factors such as poverty, low residential and occupational mobility, low educational attainment, traditional land inheritance, government aid, and government disaster preparedness, relief and rehabilitation programmes. These forces exert a strong influence upon individuals and largely control their choice of residential location in response to flood hazards, thereby reinforcing the persistent occupation of floodplains. Structural factors such as landlessness, rural-urban migration, floodplain encroachment and squatting are also highly influential in leading people to move. Even for those who move, structural factors have largely confined their choice of residential location to urban floodplains.
On 15 September 1995 a Malaysian Airlines (MAS) Fokker 50 plane plunged while descending and crashed, killing thirty-four passengers aboard. The dental disaster victim identification team comprising dental surgeons from the Dental faculty, University of Malaya; Ministry of Health, Sabah; and the Malaysian Defence Forces played an active role in the identification process. Most of the bodies were badly mutilated, disfigured and severely incinerated. Problems were encountered due to inadequate facilities and space at the mortuary. Difficulties were also encountered during the procurement and deciphering of information from dental records. This disaster has however created greater awareness amongst Malaysians of the important role of forensic odontology in mass disasters.
Institutional aspects of flood hazards significantly affect their outcomes in Malaysia. Institutional arrangements to deal with floods include: legislative activity, organisational structures, attitudes and sub-culture, and policies and instruments. When assessed in terms of four specific criteria, institutional aspects of flood hazards are found to be largely inadequate. Disaster reduction programmes are over-dependent on a reactive approach based largely on technology and not even aimed at floods specifically. Structural flood reduction measures are the predominant management tool and, although the importance of non-structural measures is recognised, thus far they have been under-employed. Current laws and regulations with regard to flood management are also insufficient and both the financial and human resources of flood hazard organisations are generally found to be wanting. Finally, economic efficiency, equity and public accountability issues are not adequately addressed by institutional arrangements for flood hazards.
All deaths due to unnatural causes and deaths that are believed to be due to natural causes but where the medical cause of death is not certain or known are subjected to an inquest. The objective of an inquest is to ascertain facts pertaining to the death. This is achieved by inquiry and at the conclusion of the inquest a verdict is arrived as to whether the death was due to a natural, accidental, suicidal or a homicidal cause. An inquest is not a trial. There is no complainant or defendant and at the conclusion of the inquest no judgment is passed. The inquest system exists in all parts of the world. In the English legal system, the person who conducts an inquest is called a Coroner. In Scotland, he is called a Procurator Fiscal. The United States of America use the Medical Examiner system. Most continental European countries and their former colonies follow the Code Napoleon. A postmortem examination may become necessary in certain deaths that come up for inquests. In these situations the authority which conducts the inquest will order a doctor to perform a postmortem examination (medico-legal autopsy). To perform a medico-legal autopsy, consent from the relatives of the deceased is not required. In an unexpected sudden death, only a doctor after a postmortem examination may be able to determine the cause of death. However, it is often wrongly assumed that the objective of a postmortem examination is only to ascertain the cause of death. This article deals with the purpose of the inquest and roles of the medico-legal autopsy.
Climatic records for Danum for 1985-1998, elsewhere in Sabah since 1879, and long monthly rainfall series from other rainforest locations are used to place the climate, and particularly the dry period climatology, of Danum into a world rainforest context. The magnitude frequency and seasonality of dry periods are shown to vary greatly within the world's rainforest zone. The climate of Danum, which is aseasonal but subject, as in 1997-1998, to occasional drought, is intermediate between less drought-prone north-western Borneo and the more drought-prone east coast. Changes through time in drought magnitude frequency in Sabah and rainforest locations elsewhere in South-East Asia and in the Neotropics are compared. The 1997-1998 ENSO-related drought event in Sabah is placed into a historical context. The effects of drought on tree growth and mortality in the tropics are assessed and a model relating intensity and frequency of drought disturbance to forest structure and composition is discussed.
The behavioral response of the obligate bamboo-nesting ant Cataulacus muticus to nest flooding was studied in a perhumid tropical rainforest in Malaysia and in the laboratory. The hollow internodes of giant bamboo, in which C. muticus exclusively nests, are prone to flooding by heavy rains. The ants showed a two-graded response to flooding. During heavy rain workers block the nest entrances with their heads to reduce water influx. However, rainwater may still intrude into the nest chamber. The ants respond by drinking the water, leaving the nest and excreting water droplets on the outer stem surface. This cooperative 'peeing' behavior is a new survival mechanism adaptive to the ants' nesting ecology. Laboratory experiments conducted with two other Cataulacus species, C. catuvolcus colonizing small dead twigs and C. horridus inhabiting rotten wood, did not reveal any form of water-bailing behavior.
On December 26, 2004, an earthquake triggered a devastating tsunami that caused an estimated 225,000 deaths in eight countries (India, Indonesia, Malaysia, Maldives, Seychelles, Somalia, Sri Lanka, and Thailand) on two continents. In Thailand, six provinces (Krabi, Phang-Nga, Phuket, Ranong, Satun, and Trang) were impacted, including prominent international tourist destinations. The Thai Ministry of Public Health (MOPH) responded with rapid mobilization of local and nonlocal clinicians, public health practitioners, and medical supplies; assessment of health-care needs; identification of the dead, injured, and missing; and active surveillance of syndromic illness. The MOPH response was augmented by technical assistance from the Thai MOPH-U.S. CDC Collaboration (TUC) and the Armed Forces Research Institute of Medical Sciences (AFRIMS), with support from the office of the World Health Organization (WHO) representative to Thailand. This report summarizes these activities. The experiences in Thailand underscore the value of written and rehearsed disaster plans, capacity for rapid mobilization, local coordination of relief activities, and active public health surveillance.
Challenges arising from epidemic infectious disease outbreaks can be more effectively met if traditional public health is enhanced by sociology. The focus is normally on biomedical aspects, the surveillance and sentinel systems for infectious diseases, and what needs to be done to bring outbreaks under control quickly. Social factors associated with infectious disease outbreaks are often neglected and the aftermath is ignored. These factors can affect outbreak severity, its rate and extent of spread, influencing the welfare of victims, their families, and their communities. We propose an agenda for research to meet the challenges of infectious disease outbreaks. What social factors led to the outbreak? What social factors affected its severity and rate and extent of spread? How did individuals, social groups, and the state react to it? What are the short- and long-term effects on individuals, social groups, and the larger society? What programs can be put in place to help victims, their families, and affected communities to cope with the consequences--impaired mental and physical health, economic losses, and disrupted communities? Although current research on infectious disease outbreaks pays attention to social factors related to causation, severity, rate and extent of spread, those dealing with the "social chaos" arising from outbreaks are usually neglected. Inclusion, by combining traditional public health with sociological analysis, will enrich public health theory and understanding of infectious disease outbreaks. Our approach will help develop better programs to combat outbreaks and equally important, to help survivors, their families, and their communities cope better with the aftermath.
The tsunami which occurred off the west coast of North Sumatra on December 26, 2004 devastated the coastal areas of North Sumatra, South-West Thailand, South-East India and Sri Lanka killing more than a quarter of a million people. The destruction was enormous with many coastal villages destroyed. The other countries affected were Malaysia, Myanmar, Maldives, Bangladesh, Somalia, Kenya, Tanzania and the Seychelles. In January 2005, volunteers went in weekly rotation to Banda Aceh in collaboration with Global Peace Mission. These were Dr Hyzan Yusof, Dr Suryasmi Duski, Dr Sharaf Ibrahim, Dr Saw Aik, Dr Kamariah Nor and Dr Nor Azlin. In Banda Aceh, the surgical procedures that we could do were limited to external fixation of open fractures and debriding infected wounds at the Indonesian Red Crescent field hospital. In February, a team comprising Dato Dr K S Sivananthan, Dr T Kumar and Dr S Vasan spent a week in Sri Lanka. In Sri Lanka, Dato Sivananthan and his team were able to perform elective orthopaedic operations in Dr Poonambalam Memorial Hospital. We appealed for national and international aid and received support from local hospitals and the orthopaedic industry. International aid bound for Banda Aceh arrived in Kuala Lumpur from the Philippine Orthopaedic Association, the Chiba Children's Hospital in Japan and the Chinese Orthopaedic Association. The COA donated 1.5 tons of orthopaedic equipments. A special handing over ceremony from the COA to the Indonesian Orthopaedic Association was held in Putrajaya in March. Malaysia Airlines flew in the donated equipment to Kuala Lumpur while the onward flight to Aceh was provided by the Royal Malaysian Air Force. In April, Dr Saw Aik and Dr Yong Su Mei joined the Tsu-Chi International Medical Association for volunteer services on Batam Island, Indonesia. The MOA acknowledges the many individuals and organizations, both governmental and non-governmental, for their contributions in the humanitarian efforts.
On December 26, 2004, an earthquake triggered a devastating tsunami that caused death and destruction in twelve countries including India, Indonesia, Malaysia, Maldives, Seychelles, Somalia, Sri Lanka and Thailand. One of the authors was a volunteer with FELDA WAJA AMAN MALAYSIA medical relief team that served the Aceh victims from 16th February to 24th February 2005 (8 weeks post tsunami). A study to determine the pattern of health ailments was conducted among children aged 18 years and below based at Seuneubok Camp, 30 km from Banda Aceh. All respondents were from Pulau Aceh and the total number of children seen and examined was 60. About 18% had lost their fathers, 10 % had lost their mothers and 27% had lost one or more of their siblings. 77% suffered some form of health ailments. The common health ailments were diarrhea (61%), respiratory complaints (59%) and fever (20%). About 38 % of preschoolers had loss of appetite and 28% had sleep disturbances. About 35% of the elementary school children suffered from sleep disturbances, 29% of the young adolescents suffered from headaches and 24% had sleep disturbances. Nearly a quarter (24%) of all the children felt fearful and anxious about the disaster. Nevertheless, 56% of the respondents wanted to return back to Pulau Aceh, although 14 % did not want to go back. Interestingly, 73% of the children voiced their gratitude to God for having been saved from death.
A cross»sectional study was undertaken between April 2005 to _1 uly 2005 to determine the extent of the health problems experienced by individuals involved in the December 2004 tsunami wave disaster in the Northeast District of Penang, Malaysia. The overall health status of the respondents were evaluated using the Short Form 36 (SF-36) questionnaire. Out of 171 respondents, 160(93 .6%) were Malays, 8(4.7%) were Chinese and 3(1.8%) were Indians. The mean age ofrespondents was 45.4 years, 15.9 years. Ninety-four of the respondents were males (55.0%) while 7 7(45.0%) were females. The overall mean physical component score was significantly lower (66.9:23 .O) amongst respondents with low education level compared with those with high education level (76.3:19.1, p=0.004). This mean score was also significantly much lower ( 68.7:22 .3) amongst those who are married compared to those who were not married (79.8:1 7.4, p=0.003) . The overall mental health score was significantly much higher (78.8:14.6) amongst those who were not married compared to those who were married (68.5:19.2, p=0.001). The overall mental health score was also significantly higher amongst those in the younger age»group (62.3:16.1) compared to those in the older age»group (72.4:18.9, p=0.005). Based on the scores obtained on the Physical Health and Mental Health dimensions of the SF-36 questionnaire, it can be concluded that the health of victims with low education, elderly and those who were married were more adversely affected than others. Therefore, it is vital that medical as well as psychological attention should be channeled to these risk groups who responded more adversely to disasters.
This study was conducted to determine the patterns of disease and treatment at two disaster sites. Studies prior to this have shown that all natural disasters are unique in that each affected region of the world have different social, economic and health backgrounds. However, similarities exist among the health effects of different disasters which if recognized can ensure that health and emergency medical relief and limited resources are well managed. This study found that although Aceh and Balakot were two totally different areas with reference to locality and climate it was noticed that the patterns of disease two months post disaster are similar the commonest being respiratory conditions followed by musculoskeletal conditions and gastrointestinal conditions. For the treatment patterns it was observed that the two areas prescribed almost similar, types of medicine mainly for gastrointestinal and respiratory systems. However in Aceh, there were more skin treatment and in Balakot there was more usage of musculoskeletal drugs.
Two tsunami survivors from Banda Acheh, Sumatra, presented with pyrexia of unknown origin and a nonresolving left-sided empyema, respectively. Both children had mixed infections of tuberculosis and melioidosis; Salmonella typhi was also present in the second patient. Mixed infections are common late sequela complications in post-tsunami victims.
Sampling of urban runoff was carried out in a small catchment, which represents a residential area (3.34 ha) in Skudai, Johor. One hundred and seventeen runoff samples from ten storm events were analysed. Runoff quality showed large variations in concentrations during storms, especially for SS, BOD5 and COD. Concentrations of NO3-N, NO2-N, NH3-N, and P were also high. Lead (Pb) was also detected but the levels were low (<0.001 mg/L). In general, the river quality is badly polluted and falls in Class V based on the Malaysian Interim National Water Quality Standards. Event mean concentrations for all parameters were found to vary greatly between storms. The values (mg/L) were BOD5 (72), COD (325), SS (386), NO3-N (2.5), NO2-N (0.58), NH3-N (6.8), P (3.4), respectively. First flush phenomena were observed for BOD, COD, SS, NO3-N, NH3-N and P. The first 20-30% of the runoff volume evacuated between 20-59% BOD, 15-69% COD, 15-78% SS, 14-49% NO3-N, 14-19% NO2-N, 23-53% NH3-N and 23-43% P.