สถาบันวิจัยระบบสาธารณสุข (สวรส.)

VDO Presentation : PMAC Feild Trip 2013

SYSTEM STRENGTHENING in the context of tourist attraction areas Chon Buri province	Pattaya City, a famous and popular coastal city in Chon Buri, attracts tourists worldwide. The provincial disease control team in collaboration with agencies concerned has much experience in controlling the outbreaks of infectious diseases in many districts in Chon Buri. These include H1N1 in the Tiger Zoo of Si Racha district in 2005, H1N1 among tourists from Taiwan travelling in Pattaya City in 2009, and recently, in 2011, Rubella in Cambodian and. Burmese migrant workers in Nhong Yai district. The strengths of this provincial system contribute to the preparedness and rapid response, leading to the success in controlling of all outbreaks.
MANAGING THE INFORMATION SYSTEM for disease surveillance in livestock farms Chachoengsao province	In 2003, there was an outbreak of H5N1 in chicken farms and the removal of a lot of chickens led to the increasing development of closed-farming systems, including better care of workers in the poultry farms. In 2004, the outbreak of a disease in duck-slaughter factories in Ban Pho district, in which most people misunderstood was H5N1, caused the cancellation of orders and damage to the manufacturing companies. However, the results of the investigation team showed that it was an influenza outbreak. There is a systematic and effective information system collaboratively implemented by all sectors in the province, particularly the Livestock Office. Its outstanding work is the system management of infectious disease data network for collecting comprehensive, reliable, and accurate data, contributing to effective disease surveillance.
PROACTIVE SRRT RESPONSE Nakhon Pathom province	The provincial disease control team has a strong network of several district teams to carry out activities concerning disease control, especially the surveillance system. They have experiences in dealing with the outbreaks of dengue fever and food poisoning (milk in schools). Its outstanding characteristics are the Surveillance and Rapid Response Team (SRRT) and the executive (Provincial Chief Medical Officer) who is very proactive and collaboratively works together with private partners, health volunteers and animal health teams. Since Nakhon Pathom province has a lot of livestock farms, the field trip participants will have opportunities for sharing knowledge and experiences on preparedness and response to achieve all goals of disease surveillance and rapid response.
SURVEILLANCE SYSTEM in migrant workers Samut Sakhon province	There are many special risk groups of population residing in this coastal province (estimated 300,000 migrant workers from Myanmar, Lao PDR, and Cambodia) and working in both the fishery and industry sectors. Cholera outbreak is most found in Samut Sakhon province, and its transmission occurs among migrant workers almost every year, particularly in 2010 in which 100 migrant workers were infected with cholera. From the experiences in dealing with disease outbreaks, the provincial disease control teams can manage the surveillance system effectively, so this province was safe from the flood disaster in 2011.
MULTI-SECTORAL COLLABORATION at the district level Ratchaburi province	Thus, there are many Burmese migrants working and living in this province. Consequently, the provincial disease control team coordinates with all sectors concerned to develop systems for controlling diseases at the district level. There are 22 malaria clinics in the communities and the management of the Center for Disease Control in refugee camps in Suan Phung district in collaboration with NGOs. In addition, there was an outbreak of Shigella in Pak Tho district, which was effectively controlled by collaboration among stakeholders at the district level.
STRONG SRRT AT THE SUBDISTRICT LEVEL Lop Buri province	During the past seven years, the provincial SRRT started learning processes for strengthening their capacity in terms of disease surveillance, prevention, and control of diseases. Therefore, they have much experience in dealing with Avian Influenza (AI), Influenza, Dengue Hemorrhagic Fever (DHF), Measles, Hand, Foot and Mouth disease, and food poisoning. Consequently, almost all districts are self-reliant in accelerating disease control and have become “Strengthened Disease Control Districts.” Particularly, in Pattananikom district, due to its concrete success in controlling diseases, there is an expansion of “SRRT Network at the subdistrict level”, with cooperation and collaboration among agencies concerned such as government agencies, local government, Village Health Volunteers (VHVs), teachers, and community leaders, using the quality of information systems at all levels, integrated with the continuing processes of practical experiences for a sustainable network.
SELF RELIANCE BY THE CIVIL SOCIETY at the community level Saraburi province	In Ban Pa subdistrict, Kaeng Khoi district, villagers and Village Health Volunteers (VHVs) collaboratively work together to control the disease. The Surveillance and Rapid Response Team (SRRT) of Subdistrict Health Promoting hospital provides information and technical advice at the house of VHVs. At the house of the Chief of VHVs of Ban Pa subdistrict, located in Moo 5, it is equipped to function as the operating center for receiving information and knowledge on disease surveillance, providing equipment necessary for preventing and controlling communicable diseases, especially dengue fever such as fogging machines and abate sand granules, using the budget from the private sector. Furthermore, there is an innovation developed by the villagers called “Khuad Noi Khoi Look Nam,” which is a little bottle for capturing mosquito larvae.
DISEASE CONTROL IN A METROPOLIS: the variety of the urban community Bangkok	Bangkok is Thailand’s capital with an estimated 10 million people, composed of various populations and communities. Bangkok Metropolitan Administration (BMA) recognizes the importance of work regarding surveillance, investigation, control, and prevention of the outbreaks of infectious diseases, implemented by the Communicable Disease Control Division, Department of Health, in collaboration with 68 Health Centers. Therefore, they set up the SRRT for rapid response to the outbreaks in a timely manner, address the establishment the network of public and private sectors, and continuously promote public relations for raising awareness and enhancing the understanding of the people.
ROLES OF A UNIVERSITY HOSPITAL in disease control Bangkok	Siriraj Hospital is the oldest and biggest hospital in Thailand, established in 1888, by H.M. King Chulalongkorn (King Rama V) of Rattanakosin Period, the father of H.R.H. Prince Mahidol of Songkhla. The field trip participants will visit the Department of Microbiology and the Division of Infection Control to study their works focusing on “monitoring antimicrobial-resistant infections,” the issue attracting the academics’ attention both at the national and international levels. Siriraj Hospital accommodates the nation’s largest laboratory for diagnosis of infectious diseases which has been certified by ISO 15189:2007. Also, the participants will study the state-of-the- art technologies for detecting and investigating the infectious disease outbreaks and share experiences on controlling major antimicrobial-resistant infections as well.