A new line of defense against disease

It is more desirable to prevent a well person from getting sick than to make a sick person well. With that in mind, the Ministry of Health (MOH) is establishing epidemiology units in each of the Kingdom's health regions (Circular 866/6/21, dated 9/4/1414). Each unit has four main responsibilities: investigating outbreaks of disease, developing a surveillance system to detect diseases before they become epidemic, conducting health studies and surveys, and training workers in epidemiological techniques.

The units will work in cooperation with primary health care departments in the regions and the preventive medicine department in the MOH. Their work is intended not to replace the activities of already existing departments, but to enhance them, by providing a focus for epidemiological activities and by organizing workshops and seminars on the spread of disease. The main place of work for the units is the field: in primary health care centers (PHCCs), hospitals, field investigation and training. Gizan was the first region to set up a unit, which is headed by a graduate of the Field Epidemiology Training Program.

Development of the surveillance system is the key for all other functions of the epidemiology unit. The new concept of surveillance concentrates not just on infectious diseases but also on other health problems, including chronic, endemic, environmental and occupational diseases.

In establishing these units, the MOH considered the experience of the World Health Organization, which has initiated a worldwide "Program of Intensified Action for the Strengthening of Epidemiology Capacity." The two main objectives of this program are to raise the quality of epidemiologic data produced, including surveillance data, and to increase the use of those improved data at all levels of decision-making for health [1]. It also sought to follow the example of the U.S. Centers for Disease Control and Prevention (CDC), one of the most prominent centers for epidemiological activities in the world.

Regions can customize surveillance to meet their own resources and priorities. While some illnesses are found across the Kingdom, each region has unique problems. Some are mainly infectious diseases and environmental sanitation; others are primarily byproducts of modem life, such as diabetes mellitus and hypertension; still others are occupational diseases.

The units are staffed by epidemiologists or specialists in public health or community medicine, and it is their job to provide decision-makers in the region with the right information at the proper time. An epidemiology unit may not be as glamorous as an organ transplant unit, but if given financial and personnel support it will provide far more significant results for many more people.

Reference

1. Hapsara HR. Welcoming remarks, Proceedings of the 1992 International Symposium on Public Health Surveillance. MMWR 1992; 41 Suppl: 1-4.