Health Inspectors Oppose Placing Public Health Medicine Specialists In Local Councils

Six health inspector groups have lambasted a proposal to place public health medicine specialists in local councils to fight dengue, ahead of an MOH meeting tomorrow with local authorities, saying this will hurt career development in environmental health.

KUALA LUMPUR, Nov 14 – Six health inspector unions and associations today rejected a proposal to place public health medicine specialists (PPKA) in health departments at local councils.

Their statement was issued ahead of a hybrid meeting scheduled tomorrow morning by the disease control division at the Ministry of Health (MOH) with mayors and the heads of local councils (PBTs) across the country to discuss this proposal, following a meeting last March 28 by the Cabinet Committee to Tackle Dengue chaired by Deputy Prime Minister Ahmad Zahid Hamidi.

“Placing public health medicine specialists in PBTs’ health departments is not a priority in environmental health activities, seeing that public health medicine specialists are already in district health offices and have taken over as unit heads, a role that should have gone to Grade U32 assistant environmental health officers, as stated in the Service Circular 11/2005,” half a dozen health inspector unions and associations said in a joint statement today.

The six groups are the Health Inspectors Union Peninsular Malaysia (KIKSM), the Sarawak Health Inspectors Union (KIKS), the Sabah Assistant Environmental Health Officers Union (KPPKPS), the Malaysian Environmental Health Association (MAEH), the Malaysian Environmental Health Officers Association (EHOM), and the Malaysian Environmental Health Officers and Assistant Officers Association (MyEnvHeat).

They said that funding for emoluments and allowances to place a PPKA in PBTs, whether provided by the federal government or local councils, should be diverted instead to increase hiring of environmental health officers, assistant environmental health officers, public health assistants, and general workers or assistants.

This funding also should be used instead to fill logistical needs for dengue prevention and control activities in the field, including purchase and upgrade of thermal space spray machines, insecticide, as well as research needs like ovitrap studies.

“Indirectly, this proposal hinders career development in the field of environmental health in PBTs that has been a traditional field acknowledged at the international level.”

The six health inspector unions and associations pointed out that the majority of local councils had set up environmental health departments to provide environmental health services, not public health departments except for a few PBTs that provide clinical services.

They also noted that environmental health departments at PBTs are headed by environmental health officers (PKPs).

“The scope of work of PBTs covers all environmental health issues, like urban and rural health; built environment; cleanliness of public toilets, markets, and eateries; rat excrement; disturbance issues; abandoned dogs; management of solid waste; sewage management; and prevention of mosquito breeding sites.”

The health inspector groups said PPKAs are already placed in all health offices.

“The main issue in tackling dengue is to change community behaviour and it should be the MOH, with health education units or divisions, to take responsibility, while PBTs will provide support in activities for community behavioural change.

“Community health education should actually be empowered through activities by the environmental health division or unit itself, rather than solely by the placement of PPKAs.”

They also said that for Selangor, the MOH should focus more on prevention and control of dengue in districts with that problem, rather than otherwise. “Districts without dengue problems can be managed well by PBTs with cooperation from the related PKD (district health office)”.

“Based on the above justifications, the issue of boosting capacity of vector control teams in PBTs has nothing to do with the placement of PPKAs in PBTs, but several other issues that should be given immediate attention, instead of PPKA placement.”

The six health inspector unions and associations suggested measures like direct funding from the federal government to PBTs for dengue prevention control, as local councils currently use their own allocations for this.

They also suggested increasing technical positions for dengue prevention and control work at local councils, like environmental health officers, assistant environmental health officers, and public health assistants.

They further proposed amending the Destruction of Disease-Bearing Insects Act 1975 (Act 154) to divert revenue from the collection of compound payments to the accounts of PBTs that issue the compounds.

The unions and associations urged the MOH to include the director of the negotiating division for environmental health at the local government department at the Local Government Development Ministry or a representative at tomorrow’s meeting.

According to Health director-general Dr Muhammad Radzi Abu Hassan’s statement last November 10, cumulative dengue fever cases reported until the 44th epidemiological week of the year rose a whopping 96.9 per cent to 100,936 cases compared to the same period in 2022.

Deaths from dengue fever complications more than doubled to 78 from 35 in the same period last year.

The proposal to place public health medicine specialists in local councils arises amid shortages of doctors in government hospitals and public health clinics.

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