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Mercury is widely used in medical and healthcare facilities as dental amalgam, mercury-added medical devices, thiomersal-containing vaccines, laboratory analysis and for other general applications despite the hazards. Various agencies consistently promote mercury-free medical facilities through mercury-free alternatives and better management practices, which are in line with the Minamata Convention on Mercury that aims to protect human health and environment from anthropogenic mercury release. The paper aims to discuss these issues.

The authors conducted a gap analysis on recommended practices gathered from the literature and current practices gathered through semi-structured interviews with Malaysian medical personnel. A life cycle approach was adopted covering mercury use: input, storage, handling, accident, waste disposal and governance phases.

The authors found that there are significant gaps between recommended and current mercury management practices. Analysis indicates improper mercury management as the main contributor to these gaps. The authors found from recommended practices that core components needing improvement include: mercury management action plan, mercury use identification team, purchasing policy, proper guidelines and monitoring systems.

This study helps us to understand mercury management practices and suggests essential steps to establish a mercury-free medical facility.

This study explored the gaps between recommended and current mercury management practices in a medical facility and contributes to the Minamata Convention on Mercury aspirations.

This study aims to validate the English version of a WHO-adapted questionnaire: Zika infection awareness/knowledge questionnaire using a unique dual-approach validation model.

A cross-sectional pilot study of 30 adult respondents in Malaysia completed the self-administered questionnaire on knowledge and perception to Zika infection. Construct validity was assessed by exploratory factor analysis (EFA) of SPSS and Rasch partial credit. Reliability is tested using pKR20 and Cronbach’s alpha.

Knowledge construct was unidimensional, good model fit, easy to endorse and well discriminative. Five-rating Likert scale for perception domain was appropriate. Knowledge domain should be separated into 6 level of difficulties. Perception domain should remain as one construct. Knowledge domain was highly reliability (pKR20 = 0.96), perception domain was fairly reliable (Cronbach’s alpha = 0.641). Respondent's ability to answer knowledge domain and perception domain were separated into 3 and 4 levels.

Small sample size may affect factor analysis.

The questionnaire has good psychometric properties to measure the knowledge and perception of Zika infection among Malaysian community.

The questionnaire helped to gauge knowledge and perception of the general community in Malaysia to aid preparation of health education tool for Zika infection.

This paper validated questionnaire with two biostatistical software programs in bidirectional approach – items difficulty and respondents' ability – is the first field test of WHO questionnaire among general population in Southeast Asia.

River flood exposes the population to multiple attacks from the physical, mental, health risks and its related negative effects. This study focused on the Pahang River and the three worst-hit district population (Pekan, Kuantan and Temerloh). Tools on areas of self-perceived health symptoms, QOL, depression, PTSD and community empowerment were assessed. Semi-guided questionnaires were distributed to a total of 602 victims. Questions on health symptoms were asked to respondents (R) and household members (HM). PTSD screening, i.e., the Trauma Screening Questionnaire, was used. Depression was assessed through the Beck Depression Inventory (BDI). WHOQOL-BREF assessed four domains of QOL, i.e., physical activity, psychological, social relationships and environment. Community empowerment using the Individual Community Related Empowerment tool to assess five domains, i.e., self-efficacy, participation, motivation, intention and critical awareness. Prevalent disease showed that majority suffered from hypertension (11.0%) and diabetes (7.3%). Two main symptoms experienced were cough (R = 47.2%, HM = 43.7%) and flu (R = 42.7%, HM = 40.4). Monthly health expenditure was higher post flood. Purchase of prescription medications rose from MYR24.40 to 31.02. A total of 33 people were suspected to suffer from PTSD. Through BDI assessment, it was estimated that as many as 104 (17.3%) suffered overt (high) depression. The prevalence of QOL domains are as such: low physical activity was highest at 59%, low psychological activity at 53.3%, low social relationships at 43% and low environment at 45.2%. On community empowerment, low empowerment was seen on four domains: self-efficacy at 52%, participation at 55%, motivation at 54.2% and critical awareness at 74.4%. The domain with good intention and willing to participate was at 54%. Results indicate that the community was not adaptable to flood events. This is evident from high amount of experienced symptoms, low QOL (physical and psychological aspects) and empowerment (except intention). Proportion of PTSD and overt (high) depression was however quite low.