Let's Get to Know H5N1

1. Background Malaysia One Health University Network (MyOHUN) was established in 2012 as a medium for university students to gain more knowledge and expand their capabilities beyond boundaries in terms of increasing awareness on infectious and zoonotic diseases. Their mission to train and educate students on the concept of One Health leadership led us, Universiti Sains Malaysia (USM) students, to participate in the One Health Workforce Project. We decided to undertake H5N1 due to a recent outbreak in Kelantan, Malaysia. After thorough planning, “Let’s Get to Know H5N1!” will be done on 7 October 2017 at the very first place the outbreak has been reported in Malaysia, Kampung Pulau Tebu Tunjong, Kelantan. The students involved with the program in Kampung Pulau Tebu will have a Training of Trainees for early exposure on One Health approach in managing H5N1 on 22nd and 23rd of September. We collaborated with USM’s Medical Student Society (MEDSOC), to provide merits for participation, as an attraction point for the students. Using MEDSOC's name allows us to use facilities inside the university (USM) without having to pay fees. 2. Goals & Objectives The objective of this program is to apply the concept of One Health by a multi-disciplinary team as an integrative effort to achieve optimum health for human, animals and the environment. Apart from that, this program provided an opportunity for USM’s students to interact and understand each other more in their respective fields of expertise, and for them to reach out to communities involved with H5N1, where further management and proper planning can be done. 3. Target Audience & Actual Attendance This activity tried to reach early health education professionals (USM’s Health Campus students) to train and educate them in the area of One Health leadership, in line with MyOHUN’s mission. The students involved in this program have been previously exposed to the core values of One Health in MyOHUN’s camp in Pantai Cahaya Bulan, Kelantan, Malaysia. In total there are 40 target audience, 15 male and 25 female students of various courses. Apart from that this program also tried to reach 200 villagers of community of Kampung Pulau Tebu Tunjong, Kelantan to educate them about H5N1 and One Health approach in managing the issue. Actual attendance: Training of Trainees Camp (22-23 September 2017) Total participants : 41 students Gender representation : 18 males, 23 females Institution types represented : 41 from university Disciplines represented : 25 Medicine, 6 Nursing, 10 Occupational and Environmental Health Community intervention (7 October 2017) Students involved : 41 students Approx. 300 villagers Registered villagers : 71 villagers (those who filled in questionnaires) Gender representation : 53 males, 59 females 4. Results The students attended a two days program of Training of Trainees (22-23 September 2017). On the 22nd of September, the students were guided by three doctors for further and deeper understanding in terms of One Health approach for the status, prevention, and control of H5N1 in Malaysia. Among the three doctors involved, two are from Universiti Sains Malaysia and one from Universiti Malaysia Kelantan (see no. 7). The first doctor is Dr. Nik Anisuddin Atiqi bin Wan Abdul Rahman from USM’s department of Community Medicine with the topic of “One Health Approach for Prevention, Detection and Responses to Zoonotic Diseases”, followed by Dr. Sandie Choong from the Faculty of Veterinary Medicine, Universiti Malaysia Kelantan with the topic of “Status, Prevention and Control of H5N1 in Animals in Malaysia”. The last speaker was Dr. Nazhari Mohd Nawi, an Occupational Health Specialist from USM’s School of Health Sciences with the topic of “Status, Prevention and Control of H5N1 in Humans in Malaysia”. On the 23rd of September, students were given a group task on how to approach the community at Kampung Pulau Tebu Tunjong, Kelantan, and presentation can be done via sketch, video, poem recitation, or chorasical. 5 teams presented (Team Ong, Team Alim, Team Ascaris, Team Adventure Time and Team Harris) with a lot of ideas and creativity. On the 7th of October, a H5N1 health intervention is done at Kampung Pulau Tebu. We managed to gather 71 registered participants from the surrounding residence. Out of 71 registered participants, 46 managed to answer both pre-and post-questionnaire. Thus, during data analysis, sample size is 46 (n=46). We started off with a pre-questionnaire, followed by intervention and answering a post-questionnaire. The questionnaire asks on the sociodemographic of subjects, knowledge, attitude and practice towards H5N1. A system of checkpoints is done to ensure all participants went through intervention. A medical check-up booth has been provided as an attraction point for the villagers. Medical check-up consists of Body Mass Index (BMI), Random Blood Sugar (RBS) and Blood Pressure (BP) measurement, Hearing Loss (Rinne and Weber’s), Visual Acuity (Snellen chart), and Color Blindness test (Ishihara). Villagers are required to answer pre-questionnaire, followed by intervention and answer the post-questionnaire to get a medical check-up. Tokens of appreciation are provided for villagers that took part in the intervention. A booth for children activities; (coloring, musical chair, water balloons, bottle bowlings), dental hygiene awareness booth and talk, lucky draw prizes and lunch is also provided as an attraction point. Lunch is prepared by the villagers. In conclusion, this activity had been a successful event for both the students and the community. 5. Reflection 43 students managed to work as a team even though they are from different courses. Each student shared what they had in mind in relation to the field of expertise among the group members. Everyone respected each other as teammates. They were able to learn on how to communicate with the community, develop and improve soft skills. The villagers can increase their knowledge on H5N1 and also get a medical check-up. Pulau Tebu Tunjong village has a very friendly and welcoming committee members. They supported our program wholeheartedly and also helped attract housewives to participate in the program by suggesting the village aerobic team, to do aerobic at 8.30 a.m., before our program starts. The villagers also volunteered to cook and serve lunch. News of our program is also spread around with the help of USM’s PRO (Public Relation Officer). However, not all that glitter is gold. A few problems did arise during the program. In terms of language, villagers spoke in Kelantanese dialect, which resulted in some students having difficulties in understanding few terminologies being used. We also planned to collaborate with USM’s Blood Bank and Diet Clinic to participate on the program however both mobile teams were unavailable on 7th of October. Apart from that, we collaborated with USM’s School of Dental Sciences to do a dental check-up at Kampung Pulau Tebu, but the village is inaccessible due to small road and low trees. Thus, we settled for a dental hygiene awareness booth instead. 6. Next Steps To revisit Pulau Kampung Tebu village for another H5N1 intervention due to data analysis showing poor (Knowledge, Attitude, Practice) KAP status. Despite data analysis showing significant different in KAP, a lot of questions answered correctly is less than 50% especially in Knowledge and Practice. We would focus on the specific areas in KAP to help the community understand further.