A study in Sarawak, Malaysia, revealed diverse opinions, prejudices and degrees of knowledge about leprosy among various ethnic groups. The information gathered was used as the base on which a health education package relating to the disease was established. It is intended that this will lead to the early detection and treatment of a higher proportion of cases than has previosly been possible
A primary health care system is being developed in Baram District, Sarawak, Malaysia, for the benefit of the Penans, who, until recently, were largely nomadic. Many of them are now attempting to adopt a settled mode of existence, and this in itself creates special health problems because the people lack the skills needed for living in one place. Substantial progress has already been achieved in mother and child care and in immunization coverage.
In Sarawak, some tribes stay in communal longhouses whilst others live in villages of single dwellings. The present study looks into the question of whether there is an association between the prevalence of leprosy and tuberculosis with the quantum of social contact that occurs in these two types of settlement patterns. It was found that the prevalence of leprosy and tuberculosis is significantly higher among longhouse dwellers compared with single house dwellers. It was also noted that social groups tended to be larger and to persist for much longer among longhouse dwellers than among those in single dwellings. This lends support to the evidence that social contact in longhouses is more extensive and contributes towards a higher prevalence of leprosy and tuberculosis.
In Malaysia, the elderly are still a relatively neglected group of people in that little priority is given to the important health issues associated with an aging population. This paper examines some of the relevant findings obtained during a survey which was carried out in 1984/1985. These findings have serious policy implications concerning family support, work, income, retirement, community involvement, social network, transport, and housing as pertaining to the elderly. There is an urgent need, as the population ages and social changes occur in society, for health planners, politicians and policy-makers to scrutinise the existing policies and develop new policies so as to retain those traditional practices that support, improve and maintain the psychological and social well-being of the elderly; and to develop new policies and programmes thus promoting a better lease of life for this small but important group to whom we owe so much.
Unlike much of Peninsular Malaysia, the Baram District of Sarawak remains sparsely populated and underserved, one of the most underserved peoples being the nomadic and semi-nomadic Penans of the Baram. Until quite recently these Penans lived as small nomadic bands of hunter-gatherers. More recently, they have begun to settle in longhouses. However, lacking the necessary skills to live a settled mode of life, these Penans suffer a great deal of hunger, malnutrition, disease and death. Primary health care with its emphasis on the seven essential elements, including food production and nutrition, environmental sanitation, good maternal and child health, knowledge of disease and how it can be prevented as well as the treatment and control of locally endemic diseases, is of critical value in the survival of the semi-nomadic Penans. The specially designed primary health care programme for the Penans of the Baram is outlined briefly in this paper.
Keyword: Baram, Penans, Primary Health Care, Sarawak, Village Health Promoter.
Malaysia has a large variety of traditional medical systems that are a direct reflection of the wide ethnic diversity of its population. These can be grouped into four basic varieties, namely, traditional “native”. traditional Chinese. traditional Indian, and modem medicine, examples of which are described. In spite of the great inroads made by modem medicine, the traditional systems are firmly established. Patients move from one system to another or use several systems simultaneously. The integration of the traditional Malay birth attendant into the health team is described. The forces influencing the development, acceptance, and integration of the medical systems are discussed.
A recent anthropometric study of Sabah reported that 37.1 percent of children were nutritional dwarfs, 12.5 percent were acutely malnourished and 9.4 percent were stunted and wasted. It was also noted that Muruts were among the top five most malnourished ethnic groups in Sabah. The present study looks at the ecological basis of malnutrition among Muruts and concludes that a variety of interrelated factors, including the lack of education, climatic and soil conditions, poverty, food habits and taboos as well as diseases from poor sanitation and malaria contribute to the presence of malnutrition among rural Muruts. It is recommended that a multidisciplinary approach be taken to control and prevent malnutrition among the Muruts and that the single most important measure aside from malaria control is education of the people and the development of marketable skills.
The permainan puteri (usually abbreviated to main puteri) is an indigenous Kelantanese healing ceremony in which the bomoh (traditional medicine-man), the sick individual and other participants become spirit-medium through whom puteri (spirits) are able to enact a permainan ('play'). It has been successfully used as a psychotherapy for depression. The bomoh assisted by his minduk (master of spirits) and a troupe of musicians, is able to provide a conceptual framework around which the sick individual can organize his vague, mysterious and chaotic symptoms so that they become comprehensible and orderly. At the same time the bomoh is able to draw the sick individual out of his state of morbid self-absorption and heighten his feelings of self-worth. The involvement of his family, relatives and friends tends to enhance group solidarity and reintegrate the sick individual into his immediate social group.
A variety of traditional medical systems thrive with vigour in Malaysia among the Malay, Orang Asli, Iban, Kadazan and Chinese peoples. The bases of these systems reflect the cultural concept of the “universe” of each ethnic group. It is noted that traditional medicine accomodates a larger proportion of illness thought to be due to supernatural causes than does modern medicine. Traditional medicine is supportive, personal and holistic in its approach in contrast with modern scientific medicine which tends to be mechanistic, impersonal, organ-oriented and individualistic. Modern and traditional medical systems are viewed as potentially complementary rather than contradictory. The traditional medicine-man can be viewed as a ritual specialist and a focus of social and emotional support for the patient, such a role being complementary to the role of the modern physician.