Norlilawati Suboh’s research while affiliated with Newcastle University Medicine Malaysia and other places

Introduction: As climate change is threatening every region of the world, extreme weather events resultant of global warming is occurring at increasing rate and scale in Malaysia. Weather-related disasters such as flood and haze pose critical challenges to the infrastructure and raise public health concerns in the country, especially when main economic sectors rely heavily on climate variability. Public perception on environmental issues is crucial for development of pro-environmental policies. Among studies conducted to understand public awareness regarding global warming, reports of perception on the health impacts were very limited. Taking this limitation into account, this study was designed to examine the perception on the health impacts of climate change among the diverse communities living in the Johor River Basin. Materials and methods: The cross-sectional study was conducted through cloud-data-based digital questionnaires completed by randomly selected residents in the Johor River Basin (n=647). Data was analysed with descriptive statistics using SPSS 27 (IBM®) Software. Comparisons between indigenous and non-indigenous communities were performed using Chi square analysis. Results: Respondents in this study consisted of indigenous people (n=79) and non-indigenous people (n=568). Indigenous respondents generally perceived more frequent occurrence of extreme weather events in the next 20 years, even for the phenomena unfamiliar in Malaysian settings. All respondents showed similar concerns for health impacts of global warming, although the non-indigenous respondents perceived the risk further into the future (25 years) compared to the indigenous respondents who perceived current or imminent (<10 years) risks. Intense concerns for self, children, family members and community were shown by nearly all indigenous respondents (97-99%), while the non-indigenous people in this study expressed stronger concerns at country level and for future generations. During the last haze episode, most indigenous respondents (85%) did not notice any change in air quality nor discomfort among family members, in contrast 70% of the nonindigenous respondents claimed to have suffered from breathing problems themselves as well as others in the family. All respondents were concerned about air quality in their surroundings, indigenous people were concerned for the near future (<10 years), and non-indigenous people were concerned for the next 25 years. Conclusion: In this study, respondents were generally concerned about the health impacts of unimpeded global warming. There was significant difference in perceptions between indigenous and non-indigenous respondents. The findings were useful, complemented with further studies, to improve understanding of public awareness and to help develop relevant education programmes accessible for wider audience.

The United Nations aimed to provide safe drinking water, sanitation, and hygiene (WASH) around the world, but flooding in Kota Tinggi, Johor, Malaysia, may cause the country to miss its population coverage target of 92–97% by 2030. Due to limited access to clean water and sanitation, Kota Tinggi's rural communities faced significant WASH challenges, resulting in the spread of waterborne diseases. Meanwhile, worsening flooding in Kota Tinggi's town area may cause damage to WASH infrastructure, disrupting clean water and sanitation services in urban areas. The study sought to compare WASH provision in rural and urban areas, as well as to identify knowledge, attitudes, and behaviours concerning flooding, flood prevention, and water-related infectious diseases. We surveyed 30 and 50 households from rural and urban areas in Kota Tinggi respectively. The findings revealed that both communities practiced safe drinking water, but at varying levels of sanitation facility availability, with urban areas proving to be more prosperous than rural areas. There was a significant difference in flood knowledge and perceived flood risk between rural and urban communities, resulting in different levels of flood preparedness. To summarize, improving WASH provision and flood preparedness in Kota Tinggi requires a tailored approach that addresses the specific needs of both rural and urban communities.

Introduction: Air pollution and air quality are growing concerns among urban citizens of Southeast Asia, especially the University students who devote most of their days to the vicinity of campus. However, there is limited data available on the extent of the problem, as well as an understanding of the knowledge of and perceptions of people who may be exposed to poor air quality. Methods: This focused study evaluated University students’ opinions, perceptions, and behavioral responses to local air quality in the Iskandar Puteri, Johor region of Malaysia using an online questionnaire, and measurements of NO2, SO2, formaldehyde, and particulate matter levels in the area using diffusion tubes. All air quality parameters were within the standards recommended by the local environmental authority, however, NO2 levels exceeded the recommended World Health Organization (WHO) standards at all sites. Results: Questionnaire findings indicate that students most commonly suffered from respiratory diseases, and were very concerned about air pollution and its impacts. Respondents perceived the situation to be worse in the afternoons and weekends, corroborated by the PM2.5 readings in the area. Preferred preventive measures included wearing masks and limiting active time outdoors. Conclusions: The evidence from this study highlighted the need to improve air quality in Iskandar Puteri as the NO2 level exceeded international standards for human health at all study sites. This could be supported by educational programs for industry, limitations on traffic emissions, and general awareness of air quality issues present locally.

Water access, sanitation and hygiene (WASH) data for Malaysia suggest that almost 100% of the population have access to basic sanitation and basic drinking water, but this data may not include marginalised communities and stateless individuals, indigenous or otherwise. The aim of this study was to evaluate WASH provision for residents of the Johor River Basin and evaluate the disparity in facilities between indigenous Orang Asli and more modernised communities. Questionnaires were distributed to eight communities. In total, 899 questionnaires were completed including 100 from indigenous communities and 799 from more modernised communities. Significant differences existed between communities with regard to education levels (p < 0.001), occupation (p < 0.001), household income (p < 0.001), type of toilet, sewage and sanitation facilities (p < 0.001) and perception of health risks and concerns (p < 0.001). There is a significant difference in access to water and sanitation facilities between indigenous and modernised communities. Further study is now required to understand behaviours and educate river-based communities on relevant potential health risks from water contamination in the Johor River Basin.