ABOUT SARAWAK STATE HEALTH DEPARTMENT
The health services provided by the Sarawak Health Department are delivered through a network of static and mobile facilities that provide promotive, preventive, curative and rehabilitative care.
Sarawak Health Department is committed towards realising the Vision of Health for Malaysia that "by the year 2020, Malaysia is to be a nation of healthy individuals, families and communities, through developing a health system that is equitable, affordable, efficient, technologically appropriate and consumer-friendly, with emphasis on quality, innovation, health promotion and respect for human dignity, and which promotes individual responsibility and community participation towards an enhanced quality of life".
The strategies to achieve these objectives are based on the basic principles of health promotion, prevention of disease, early treatment/referral and rehabilitation. These strategies are implemented under the Medical Care (Hospital), Public Health, Oral Health and Pharmacy Programmes. The technical programmes are supported by the Management Programme.
MEDICAL CARE SERVICES
Medical Care Services in Sarawak are provided through twenty-two hospitals which are located in major towns within the State. The twenty-two hospitals comprise:
One general hospital (Sarawak General Hospital, Kuching)
Three district hospitals with specialist services (Sibu, Miri and Bintulu Hospital)
Sixteen district hospitals without specialist services; and
Two special institutions (Sentosa Hospital and Rajah Charles Brooke Memorial Hospital)
HEALTH SERVICE DELIVERY SYSTEM
The backbone of the government health care delivery system in Sarawak is the static health facilities and mobile units. The static facilities cover about 70% of the population and the mobile units like Village Health Teams and the Flying Doctor Service have increased access to almost 90%. In 1983 the Sarawak Health Department has also introduced a village health volunteer scheme known as the Village Health Promoter Programme, to enable basic health care to be provided to remote areas on a more continual basis.
Sarawak has a two-tier referral system where cases requiring further treatment are referred from clinics to hospitals. Only those who need specialist care are referred to specialist clinics in the larger hospitals.
Sarawak has 187 rural health clinics that function as "one-stop" family health centres, providing an integrated service comprising maternal & child care, general outpatient care and environmental sanitation. All clinics have rest beds and birthing facilities to encourage safe delivery among rural mothers.
The type of health facility in an area depends on the size of the population to be served.
Health Clinics (Type 3)
These are large urban clinics managed by medical officers. They provide general out-patient care, maternal and child care, dental care and rehabilitation care. In addition, they also provide laboratory and radiological services. Some of these clinics are managed by Family Medicine Specialists.
Health Clinics (Type 4SS, 5SS & 6SS)
Type 5SS and 6SS clinics are smaller versions of health clinics and serve between 1,500 - 3,000 people. Except for the few type 4SS Clinics with medical officers, all rural health facilities are managed by allied health personnel.
Mobile Health Services
In addition to static facilities, Sarawak Health Department also has mobile clinics in the form of Village Health Teams and Flying Doctor Service, to serve people in less accessible areas. These teams either travel by road, river, on foot or by helicopter, depending on the accessibility of the areas they serve. In rural areas, Village Health Teams are based in rural health centres, while those serving peri-urban areas, are based at the Divisional or District Health Offices.
Flying Doctor Service
The Flying Doctor Service was introduced in 1973 to provide basic health services to people living in remote areas. The service operates 3 helicopters that are rented under a contract with a private company. The helicopters are based in Kuching, Sibu and Miri and together, they cover 141 locations in the remote rural parts of the State with a attends of about 70,000 outpatients, children and antenatal mothers every year. The Flying Doctor team comprises a medical officer, a medical assistant and two community nurses who visit the locations once a month or once in two months. The Flying Doctor Service also provides medical emergency evacuation (MEDEVAC) of seriously ill patients from the locality to the nearest appropriate hospital, from rural health clinics to hospital and from hospital to hospital. It also served as cargo run to rural health clinics in delivering medical items and drugs. During disease outbreak in the state, the Flying Doctor Service helicopters are also used for quick transportation of field investigation and control medical and health teams.
Village Health Promoter Program
Basic health care is also provided by community health volunteers who are trained under the Village Health Promoter (VHP) Program. This is a community-based health program introduced by Sarawak Health Department in 1983 to provide basic health services to people living in remote areas.
Under this program, participating villages send two volunteers each to undergo three weeks of structured training on a variety of health-related topics in a nearby health facility. At the end of the training period, the volunteers return to their respective villages and help provide basic health care to the people there. Medical supplies and supervisory support are provided by staff from the nearest health facility. In turn, the volunteers provide regular reports on the types of illnesses they attend to. Up till the end of 2001, there are 2,956 VHP throughout the State, serving a total of 271,182 people from 1,664 villages.
"Home-based" Health Records
Another unique feature in the Sarawak Health Service is the use of "home-based" medical records. The system was introduced in the 1970's for the child-health card, the 1980's for the antenatal card and in 1992, for the outpatient card. The main advantage of this system is that it ensures continuity of care for the patient, especially in children, where immunisation records are connected.
ORAL HEALTH PROGRAMME
The Oral Health Division, Sarawak Health Department renders oral healthcare to the population of Sarawak through a comprehensive network of main dental clinics, specialist dental clinics, school dental clinics and mobile dental teams throughtout the state of Sarawak. Oral healthcare for the population can be broadly divided into primary oral healthcare and specialist oral healthcare. However, care is delivered through an integrated approach.,
The objective of the Oral Health Division, Sarawak is to continuously enhance the oral health status of the population through the provision of promotive, preventive, curative and rehabilitative oral health services. Priority is given to school children, preschool children, ante-natal mothers, the elderly and clients with special needs.
The Pharmaceutical Service of the Sarawak State Health Department is responsible for enforcing the poisons, drugs and pharmacy legislations, provision of pharmaceutical services and provision of drugs and non-drugs pharmeceutical supplies.
The Management Programme provides the administrative support for the Sarawak State Health Department. It is responsible for personnel and financial management, Information Communication Technology (ICT), monitoring of development projects and staff training.
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