Oil palm estates and associated industries employ a fair proportion of workers. Good medical care benefits both the employers and the employees. The pattern of illness is not very different from that found in general practice. However, certain environmental factors, the nature of occupation and the water supply can influence the increased incidence of certain diseases. Upper respiratory tract infection, acute gastroenteritis, contact dermatitis (eczemas & rashes) eye, and ear diseases, injuries and musculoskeletal diseases are the commonest causes of morbidity. The resident doctor, who has a good knowledge of the environment of his patients is in the best position to practise preventive medicine or early intervention, thereby reducing illnesses and improving productivity of the workers.
One hundred and twenty-four women from a semi-urban area who came for consultation for unplanned pregnancy during an eight month period are analysed. It is found that women with a high risk of unplanned pregnancy are mostly housewives, aged between 20 and 34, who have given birth to one or three children, the last of whom is usually below one or two years old. They belong to the lower socio-economic class and are lowly-educated. Most of them have not completed their families. Although most of them have either used or heard of contraceptives begore, the majority were not using any contraceptive at the time of consultation or were using an ineffective method. Their reasons for non-use or default are identified, many of which are related to the pill. Proper motivation of would-be contraceptive receptors and regular follow-up of acceptors by general practitioners or Family Planning Clinic Staff who are knwoledgable in all available methods of contraception are offered as a solutionto the problem of high rate of defaulting and consequent high rate of unplanned pregnancies.
Study site: private general practice clinic, Perak, Malaysia
Night calls at the doctor's residence are part of the family physician's service to the community. not all night calls are emergencies. Many of the cases can be managed at home if they keep simple remedies at home or they are properly instructed by the doctor. But because some of the calls are medical, surgical or gynaecolofical emergencies, the doctor must respond to all night calls. Some common illnesses necessitating night calls are identified and a list of drugs either to be stocked in the house clinic or in the doctor's emergency bad are identified. Reduction in night calls can be achieved by educating our patients regarding self-management of minor illnesses, use of hospital emergency services, setting up of group practices, a private hospital with emergency service or a community night clinic.