Kuantan often experiences flooding. Dr. Marlia Mohammed Salleh saw the need for maternal and child health care to be incorporated into contingency planning.

1. The City

Situated on the East Coast of Peninsular Malaysia, Kuantan is the capital of the state of Pahang. It has grown substantially since Malaysia’s independence in 1957. Then only a small fishing village and minor port, rather cut off from Malaysia’s capital in Kuala Lumpur, it is now a transportation, commercial and educational center of near half a million. Major highways and air routes link it closely with the rest of the country. Like most of Malaysia, Kuantan is relatively well protected. It is off the major track of the earthquakes, volcanoes and typhoons that plague so much of Asia. It does, however, have heavy rains in the monsoon season that dominates the climate of all of South and Southeast Asia. Lying on the East coast of the country, but facing the South China Sea, its monsoon rains come in the winter. Since the city lies on a low plain with a gentle shelving beach, it experiences frequent flooding, though for the most part this is relatively minor. The most severe recent flood occurred in 2001, when some 8,000 people had to be evacuated. Two years later, less than 2,000 people were evacuated in a subsequent flood. Since then, the number of evacuees has constantly declined; last year only 200 people had to be moved during the monsoon floods. As expected, government efforts at flood control and reservoir construction have had a positive effect.

Maternal and Child Health services have grown steadily and dramatically since independence. There are now major Health Centers serving populations of 15-20,000. These are surrounded by smaller community clinics for populations of 5,000. The Centers are fully staffed with medical personnel; the community clinics have midwives and fully trained nurses. They provide primary health care close to the population and referral to the Centers and major hospitals. This system has been responsible for bringing down the infant and maternal mortality rates to very low levels. Given the absence of major natural disasters, the state and city health organizations have not found it necessary to develop special units or policies for disasters. These can be adequately taken care of by regular health services with fire and rescue workers mobilized during the floods.

However, there are other issues besides this which need to be looked into;

1. There is no community involvement/ participation in the existing contingency plan. Actually the local community is the key player in any disaster preparedness and response. If people know what to do in a disaster, much of the chaos can be avoided and casualties can be minimized.
2. Training and educational programs for the local community are minimal. The flooding in 2001 clearly showed these weaknesses, as most of the communities were unaware of the flood, and even after being warned of the flood, they failed to respond immediately.
3. There is a lack of support from the relevant agencies to take actions needed by the community, especially in the event of a disaster.
4. There is a lack of awareness on behalf of the community regarding disaster preparedness.

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2. The Proposed Action Plan

Based on the problems faced by Kuantan, two action plans proposed are a plan to improve maternal and child health care during natural disasters, and a plan for a disaster prevention/ management welfare community project.

In Malaysia, at the national level, the national security department under the prime minister developed and formulated a contingency plan for floods called “peraturan tetap operasi pengendalian bencana banjir.” This plan contains 8 chapters that clearly spell out the definition, objectives, levels of disaster, roles and responsibilities of departments, organizational charts etc. Another contingency plan called “arahan no 20” dictates a broader plan not only pertaining to floods but also to any other disaster.

These two prepared contingency plans provide actions, directions and procedures to be taken in the event of disaster.

Kuantan regularly experiences widespread flooding

The contingency plans will be adapted and used at the state and district levels in disaster planning and management. Based on these, Kuantan district already has a well developed contingency plan. However, input from the workshop showed that the maternal and child health component needs to be strengthened. This will be discussed at Pahang health department, so that it can become part of the contingency plan. This will be the first part of the action plan, i.e. to improve maternal and child health care during natural disasters in Kuantan. Every year the plan will be reviewed and updated in the meetings of the main committee on disaster management, or the “jawatankuasa pengurusan dan bantuan bencana banjir daerah Kuantan”. This is the highest level of disaster coordinating committee, which coordinates and issues instructions from the disaster operation room. It is also responsible as the information coordination center. The chairman of the committee is the District Officer and the secretariat is the national security division of Kuantan district. Under the main committee, there are 9 other members that form their own sub-committee. All members’ functions and roles are clearly identified and specified.

As a second action plan component, a Disaster Management Welfare Community will be promoted. The community will be trained in disaster preparedness, and a school project will be set up to increase awareness among children. ‘Hazard maps’ of danger areas in times of flooding and other disasters will be drawn up by community members, and health education will also be more widely provided.

Kuantan Action Plan Time Frame: October 2007 – December 2008