Problem Analysis

1. Suka Sehat village is located on the riverbank, where there is a rubber

processing factory. Based on reports from environmental health workers at
the Community Health Center, factory waste is directly dumped into the
river. Bathing, washing and toilet activities for the community use river
water. The livelihoods of the people in Suka Sehat village are forest
encroachers farmers, who clear land by burning forests.
a. What the impact of factory waste that is disposed of directly into the river?
b. What is the meaning Suka Sehat village is located on the riverbank, where
there is a rubber processing factory. Based on reports from environmental
health workers at the Community Health Center, factory waste is directly
dumped into the river?
c. How to treat factory waste properly?
d. What are the type of factory waste?
e. What are the legal bases governing waste?
f. What are the impact bathing, washing, and toilet activity for the
community use river water?
g. What is the criteria of good water sanitary?
h. How the water-borne diseases are transmitted and what are examples of
diseases?
i. What is the meaning the livelihoods of the people in Suka Sehat village
are forest encroachers farmers, who clear land by burning forests?
j. What are the source of clean water?
a. Space Water
Space water or rainwater is the main water source on earth. Although at the
time of the anticipation it is the cleanest water, it tends to be polluted when it
is in the atmosphere. Pollution that takes place in the atmosphere can be
caused by dust particles, microorganisms and gases, for example, carbon
dioxide, nitrogen and ammonia.
b. Surface Water
Surface water which includes water bodies such as rivers, lakes, ponds,
reservoirs, swamps, falls and surface wells, mostly comes from rainwater that

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 falls to the surface of the earth. The rainwater will then be contaminated by
soil, garbage, and others. Types of surface water include:
1. River water
An average of more than 40,000 km³ of water is obtained from rivers in the
world. This availability (equal to more than 7,000 m³ each person).
2. Swamp water
In general, swamp water is colored due to the presence of decomposed
organic substances. With the large number of organic substances, the
dissolved O2 levels in the water are low, so that the levels of Fe and Mn
dissolved in water are high. On the surface of this water will grow algar
(moss) due to sunlight and oxygen (O2). To take this water, put it in the
middle so that iron (Fe) and Manganese (Mn) deposits and moss are not
carried away.
3. Groundwater
Ground water is water that is contained and layers or rocks below the ground
surface. Ground water is one of the water resources. Apart from river water
and rainwater, groundwater also has a very important role, especially in
maintaining the balance and availability of raw water for domestic (domestic)
and industrial purposes.
The division of groundwater, namely:
a. Shallow ground water
Shallow ground water occurs because of the process of infiltration of water
from the ground surface. Mud will withstand, as well as some bacteria so that
the groundwater will be clear but will contain more certain chemical
substances for each soil layer. The soil layer here functions as a filter.
b. Deep ground water
Deep groundwater exists after the first water-dense layer. To collect this
water, a drill is needed because of its deep depth (100-300 m). If the
groundwater pressure is large, water will gush to the surface of the well. This
well is called an atesis well. If the water cannot come out on its own then a
pump is required.
c. Sea Water

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 Sea water has salty properties because it contains NaCl salt. The salt content
in sea water is approximately 3%. With this condition, seawater has
requirements for drinking water if it is processed first. Seawater is rarely used
as raw water for drinking water because processing to remove its salinity
requires a large amount of money.
(Rezky, 2015).
k. What are the type of latrine system?
l. What are the criteria of healthy house?
m. What is indicator of water and air pollution?
n. What are the factor that affect the air pollution?
o. What are disease cause by water polluted?
p. What are the disease cause by polluted air?
q. How to prevent air pollution?
r. How to prevent environmental pollution?
s. What are the impact for burning forest?

2. Dr. Yeni has only worked for one year at the Suka Sehat Community Health
Center. She received reports from the Community Health Center surveillance
staff that the incidence of hepatitis A cases has doubled from the previous
month, while from the data on the top ten diseases, Acute Respiratory
infections (ARIs) is in the first rank. Dr. Yeni plans to conduct
epidemiological investigations of Hepatitis A and provide counseling on
cases of infectious diseases.
a. What is the meaning she receive reports from the Community Health
Center surveillance staff that the incidence of hepatitis A cases has
doubled from the previous month, while from the data on the top ten
diseases, Acute Respiratory infections (ARIs) is in the first rank?
b. What is the definition of outbreak?
Outbreak is the occurrence of an incident of illness or death and / or an
increase in an epidemiologically significant incident of illness / death in a

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population group within a certain period of time (Undang-Undang Wabah,
1969).
According to the Permenkes of the Republic of Indonesia No 949 / MENKES
/ SK / VII / 2004. Outbreak are the emergence or increase in the incidence of
epidemiologically significant illness or death in an area within a certain
period of time.
(Permenkes, 2004).
c. What is the criteria of outbreak? permenkes
d. What are the factors that influence the increase in the incidence of
hepatitis A and Acute Respiratory Infections in cases?
e. What are the duties and fuction of the surveillance staff?
f. What are benefit of surveillance?
g. What is the relation between the increased incidence of hepatitis A cases
with the habit of direct disposal of factory waste into rivers and bathing,
washing and toilet activities?
h. What are the type of surveillance?
i. How to give concelling for infectious disease in this case?
j. What are the causes that can increased incidence of disease?
k. How to count incidence?
l. What are the types of epidemiological investigaton methods?
m. How the hepatitis A transmitted?
Hepatitis A is typically acquired through fecal-oral transmission,
either from direct person-to-person contact or consumption of contaminated
food or water. HAV replicates in the liver, is excreted in bile, and is shed in
the stool of infected people in high concentrations 2–3 weeks before and 1
week after onset of illness.10 Peak infectivity occurs during the 2 weeks prior
to onset of clinical signs and symptoms (jaundice or elevated liver enzymes).
Most persons cease to be infectious 1 week after jaundice
appears.11Although virus is present in serum of an infected person, its
concentration is several orders of magnitude less than in feces. Infected
children and infants may excrete virus longer than adults.12, 13The mean
incubation period of hepatitis A is approximately 28 days (range 15–50 days)

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 (Robertson BH, Averhoff F, Cromeans TL, et al. 2000. Genetic relatedness
of hepatitis A virus isolates during a community-wide outbreak. J Med
Virology)
n. What is the Islamic values in this case?

2.2 Hypothesis
Dr. yeni conduct epidemiological investigation because of outbreak of
hepatitis A and data on the top ten diseases, Acute Respiratory infections (ARIs)
is in the first rank.

2.3 Conceptual Framework

Factory waste
Forest burning
on river

Air pollution Water pollution

Top ten disease :

Oubreak of
Acute respiratory
infection Hepatitis A

Epidemiological
investigations

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