Part I Abstracts of the Pilot Study
A pilot study on 250 foreign workers was undertaken during a 7 month period beginning December 1996. The study subjects were mainly males (88.8%). They were selected using non-probability sampling from two sources, that is, from University of Malaya Medical Centre (72.8%) and the PEREMBA group (27.2%).
The study was clinic-based. Face-to-face interviews (using a structured questionnaires) were carried out to obtain socio-demographic, environmental, health and morbidity data. Physical examinations were also performed on the same day of the interview. Subjects were also required to give their stools, venous blood and urine specimens for microbiological, parasitological and clinical laboratory investigations. Chest X-Ray was done on all subjects.
The other investigators had already reported findings on the various specific areas of their study. In this part of the report attempt was made to relate the infectious diseases to some of the socio-demographic and environmental variables on the 112 Indonesians and 133 Bangladeshi workers. Some aspects of health seeking behaviour of these foreign workers were also presented.
Most of the Indonesian workers (84%) were from East Java, Jambi in the Sumatra, while majority of the Bangladeshis were from two neighboring administrative districts of Dhaka and Chittagong. The majority of the Indonesians (50.0%) were working in the service industry, while 53.5% Bangladeshis were in the manufacturing. One-fifth of the workers lived in squatter areas and nearly half of them were working in the service industry.
About 70% of the workers had at least one infection. The proportion was slightly higher among the Indonesians (72.3%) compared to the Bangladeshis (67.7%). It is of interest to point out that 40% had multiple infections. Thirteen had five or more infections (details for the two of the thirteen cases are presented as case studies). However, the findings did not indicate any association between sanitation and infections. The Indonesian workers carried a higher risk of transmitting the diseases (33.9%) compared to 19.5% among the Bangladeshi workers. Those working in the construction industry were at a higher risk of transmitting the diseases compared to other industries.
Slightly more than half of the workers experienced some form of minor illness or injury during the two week period preceding the interview. Majority sought private care (43.1%), while 42.3% either self-medicate or doing nothing at all. Nearly two-thirds paid out of their own pocket. Among the employers, those in the construction sector made negligible contribution (2.9%) to the payment. It is interesting to find that 41.0% of the workers took some form of health supplements, and the majority (48.4%) got it from the pharmacy or traditional sources. Nearly all (88.5%) paid on their own for their health supplements.
The findings from this pilot project need to be interpreted with some caution. However, it appears that the foreign workers do have a considerable amount of health problems. If these are not addressed quickly it may endanger the health of the nation, while we readily acknowledge their contribution towards our national development.
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