MBBS Batch 12 DHO Sik – Day 3 (6/7/10) KKIA Sik

The 3rd day of our posting didn’t start well.

We were there waiting until 10am but no one came for us. When i decided to go looking for the person in charge, Dr Ishak passed by and helped us to shift the afternoon slot to 10am.

So, we were taken by Sister Aminah to KKIA Sik and she showed us the growth chart. Besides, she also showed us the ‘booking’ book of pregnancy. Before labelling the color of the ‘booking’ book of pregnancy, we need to assess several things so that they would deliver at the certain hospital.

Here are the indication for color labelling:

  1. White Code 1 – deliver in hospital
  2. White Code 11 – could be delivered at home
  3. Green Code – refer to Medical Officer or House Officer
  4. Red Code – Immediately admit to ward
  5. Yellow Code – Refer to nearest O&G specialist



According to Sister Aminah, if the patient with green label is found to qualify to label as other code,eg. PIH so coding change to red code, the red code will be sticked just above the green label, but not cover the green label.

We were told the usage of colour tagging for each category of pregnancy. Some modification like tying a red thread at the corner of the book for patient with PIH was practised in Sik.Other thread for example green, yellow indicate specific kampung of Sik so that it would be more faster to find the record book KKK1/93A during searching the record book.

Eg. of Labelling as KZM
Once the baby is born, corresponding family will be given Child Health and Developmental Growth Record. There are 2 colors, blue is for boys, red is for girls. If they found the baby is inappropriate for weight, They will be labelled as KZM (Kurang Zat Makanan) or Malnutrition.

boy child health

girl child health

If the Child is found to have KZM and parents have the financial problem. They will be supported by government under a programme known as Programme Keluarga Kekurangan Zat Makanan. It provides the Basket service in which a balanced diet food would be presented to that family monthly, Each Basket Food costs about RM 100. The contents of Basket Service are: Carbohydrate(rice, bee hun, maraconi, flour), protein (green bean, sardine, fishes, anchovies), Fat (Cooking oil, Full Cream milk, margarine), Vitamins (cod liver oil, chewing tablets).

Another programme under child with KZM is Programme Dapur Sihat. The objectives are :

  1. how to prepare proper food for weaning
  2. provide information about food nutrients
  3. how to cook healthy meals for the family
  4. to expand the menu of healthy meals

Staff Nurses will demonstrate how to cook the food. In order to get their attention, food are prepared prior to the demonstration because audiance will get distracted and feel hungry easily, so that they will not pay attention on what they demonstrate. The programme will show preparation of 4 types of meals – breakfast, lunch, snack and dinner.

Rigevidon , Regulon, Marvelon

Injected Form of Medroxyprogesterone


After that we were taken around the KKIA to know the facilities provided. Each type of family planning method were told to us. Sister Aminah also went to the extend of taking out every contraceptive pills and devices available inside the clinic to show us.

‘Bilik Penyusuan’ was available in the clinic as breast feeding is encouraged. Besides, we were told that Sik provide VIA service, or visual inspection acetic acid which is another method to detect cervical cancer other than pap smear. Sister Aminah proudly told us that the VIA(Visual Inspection Acetic Acid) service is only available in Sik and not in other part of Malaysia.According to Sister Aminah, VIA is far more cheaper than pap smear, the cost is about RM2. Moreover, results are immediate, whereas pap smear result requires 2weeks to 1month. She wanted all of us in the group to know the VIA and wants all of us to have a look at the VIA if possible.

Later on, we were briefed about how to keep the vaccine in a cold chain. there are few ice boxes to keep the vaccine when they need to use. BCG vaccine should not mix with other vaccine in the ice box because it is a live vaccine. Other than that, Sister taught us how to read the Min Max Thermometer. The lower end of meniscus point of blue level point indicate the minumum and maximum temperature, the 2 upper meniscus level of mercuries indicate the current temperature. The vaccine should be kept between 2-8 degree celcius. And the temperature should be monitor hourly.

Vaccine storage in Ice box


Cold Chain System

The formula are: (application for the age 0-6years old)

1. Weight Z-score For Age: {Current weight – mean} / SD
– refer weight z-score for age in the table.

2.Weight Z-score For Height: [Current weight – mean]/ SD
– refer weight z-score for height in the table.

3. Height Z-score For AgeL [current height – mean]/ SD
-refer height z-score for age in the table.
Plot it in growth chart to assess the nutritional status of the child.

We were told about food basket and the category of patient eligible to be given food basket. Food basket will be given monthly to those needed and among the items are cooking oil, eggs, sardin, beans, vitamins, bihun, iodine salt for those needed, ikan bilis 1kg and 5kg of rice. Those eligible to receive food basket are those who are very poor and recommended bythe medical officer or specialist in charge.
The talks ended at 1.05pm. We were allowed to go back so our day ended early for 6/7/10. We were provided with many extra knowledge which we are not able to get in other text books today.

By zhenghao
Source: mbbs12sik.blogspot.com

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