Increasing awareness on community health education in rural areas by Fung Lan Yong

Increasing awareness on community health education in rural areas

By Fung Lan Yong

Published in ‘Daily Express’ on Oct 1, 2017, page 17

Sabah’s rural and remote communities often reside in geographically inaccessible areas characterized by diverse cultural and sociodemographic backgrounds and low educational levels.  They also have poor rural-urban linkages that have adversely affected the creation of jobs, productivity and income, while poor integration of their economic activities has resulted in limited business opportunities and poor optimization of resources.  Moreover, their economic activities are limited to cottage industries using traditional methods due to inadequate infrastructure, poor logistics and the lack of creativity and innovation.  All these factors tend to limit health awareness in the rural areas.

Lack of health awareness and its effects

People in the remote and sparsely populated areas of Sabah lack health awareness because many live more than five kilometres from basic health facilities.  Health care delivery in the rural areas is hindered by long distances and poor infrastructure that prevent people from getting immediate medical care.  Consequently, traditional healthcare is still practised in many rural communities for the treatment of various health and psychosocial problems that are often associated with supernatural causes; for example, many rural residents still depend on herbal healers, Chinese medicine shops and traditional midwives for their basic healthcare needs.

Further, lack of health awareness in the rural areas has caused many to suffer from common lifestyle diseases, including high blood pressure, low bone density, high cholesterol levels and abnormal blood glucose levels.  Diseases such as malaria, tuberculosis, leprosy, malnutrition, pregnancy-related problems, injuries and psychiatric illnesses are also common. Additionally, many have asymptomatic health problems that are left untreated, including hypertension, diabetes and  anaemia.  Finally, typhoid and cholera occur sporadically while dengue fever remains a significant problem in the rural areas.

Common disease comorbidities of the rural elderly in Sabah include hypertension, arthritis, gastritis, diabetes, vision impairment and hearing impairment.  Many of the rural elderly are unable to enjoy leisure activities due to physical deterioration and chronic illness.  Compared to their urban counterparts, the rural elderly experience a higher prevalence of common disease comorbidities, vision impairment and hearing impairment due to a lack of health awareness.  Visual and hearing problems seriously affect their daily functioning and communication, resulting in loneliness, isolation and frustration.

Preventive strategies are more cost-effective

Extensive and cost-effective rural healthcare is a critical part of socioeconomic development of Sabah.  Rural healthcare should the guiding principle in overcoming rural poverty, promoting literacy and reducing the social inequalities that affect rural residents.  Strategies to improve rural healthcare should be a collaborative effort among the government, non-government organizations and private individuals. 

Additionally, preventive strategies should be planned with active community participation and empowerment to initiate lifestyle change while discarding unhealthy beliefs and outmoded practices.  Further, community participation in efforts to improve healthcare should be socially and culturally sensitive to ensure better health outcomes.  Finally, rural healthcare should be reshaped, focusing on prevention and wellness rather than disease.           

Principles of MyCare Berhad

Non-profit groups play an important role in providing holistic, focused, continuing care that is responsive to the needs and circumstances of communities.  One of them is MyCare Berhad that aims to provide strong leadership and facilitate team-building qualities. 

According to Simon Song, MyCare Berhad aims to increase awareness on basic services, start-up resources and solutions to rural communities, with the objective of helping them achieve self-sufficiency and sustainable development.  Its programmes include education and vocational training and resource procurement that will facilitate livelihood development in rural communities, while raising community spirit, social responsibility and environmental sustainability.  MyCare Berhad addresses a wide range of topics, including healthcare awareness.

“First, it encourages the local community to examine its own needs and locally available resources.  It promotes awareness on community health education, emphasising the holistic integration of the physical, mental and spiritual aspects of human beings.  Further, it encourages the adoption of better hygiene and nutrition, highlighting that prevention is always better than cure,” said Song.

“MyCare Berhad believes that raising community spirit and cooperation will lead to greater healthcare awareness in the rural and remote areas. It strives to make rural dwellers become more aware that cooperation and community capacity will yield better outcomes, thus making their community more resilient and secure,” he continued.

“Further, MyCare Berhad upholds that better healthcare can be derived from improved economic and livelihood development.  It strives to empower and equip rural communities by training them to achieve self-sufficiency and sustainable development.  It also helps procure start-up resources and solutions by connecting rural communities to specialists, training providers and mentoring partners,” Song said. 

“MyCare Berhad stresses that empowerment and community ownership are essential for successful implementation and sustainability by fostering self-determination of development goals and growth.  Further, it promotes environmental responsibility by inculcating the knowledge and skills needed to protect the environment from overexploitation of natural resources.  Finally, it helps revitalise positive cultural heritage practices to retain and enhance community identity and dignity by creating opportunities to preserve and propagate the positive aspects of local culture, art, craft-making, costume, cuisine and dance,” Song concluded.

Generating awareness on community health education

Recently, Simon Song and Elaine Kong brought MyCare Berhad to Kg Timug, a remote village in the Kudat district inhabited by mostly Rungus people.  Song elaborated on the principles of MyCare Berhad in relation to community health education, while Kong carried out four activities with 30 participants.

“The first activity was river crossing.  It helped participants to understand the difference between relief and development, to know when to ask for or provide relief and when to have development and to understand principles of development that lead to self-reliance and sustainability,” began Kong.

“The second activity aimed to create awareness of the various assets which are resources available locally, including land, geographical features and natural vegetation. These can be pooled and used for community programmes. Using flip charts and markers, each group was able to sketch several natural resources in their village, including land, bamboo clumps, wild herbs, rivers, hills and swiftlets,” continued Kong.

“The third activity required participants to list five common diseases together with their rates of mortality and absenteeism using flip charts and markers.  Results showed that hypertension, arthritis, gout and flu are common in Kg Timug,” Kong explained.

“The final activity aimed to increase understanding that there is a local pool of skills which can be harnessed for the development and success of community programmes. A wide range of skills were listed, including farming, fishing, tool-making, weaving, traditional medicine and other independent living skills,” she added.

“In general, the activities provided some background information for MyCare Berhad to raise awareness on community health education through commitment of the entire community, open discussions and problem solving.  The activities also increased participants’ enthusiasm in adopting the community health education approach to improve their standard of living by capitalizing on available natural resources, vocational skills and independent living skills,” summarized Kong.

Simon Song holds an MBA from City University of Seattle and is the Director at MyCare Berhad.  Elaine Kong holds a DBA in Leisure and Tourism from EU Business School and is the Consultant of TLC Enrichment who designed the GREAT Explorer programme.  She is also the Director of Professional Programmes Development at Pine Academy.

About the author

Fung Lan Yong holds a PhD in Special Education (Gifted and Talented Education) from Southern Illinois University at Carbondale.  She teaches Academic English and Mass Communication subjects at Jesselton College Sabah that has received 4-star MyQuest ratings in various courses.