從社區的角度看健康團隊在感染控制的角色與功能

The Community Health Team: Roles and Responsibilities in Infection Control

近三十年來隨著國人十大死因由傳染病轉為以慢性疾病為主導之後，整個醫療及公衛體系在人力及經費預算的規劃都逐漸疏於防疫的問題；自從2003年我國及全球爆發SARS（Severe Acute Respiratory Syndrome，嚴重急性呼吸道症候群）事件後，政府的防疫政策有了反省與改變。本文將介紹我國防疫體系的變革、傳染病的現況、日治時代的傳染病防治政策、SARS前後國家及社區的傳染病防治模式，再以筆者所服務的領域為例，描述公衛體系如何在社區紮根，推動傳染病防制策略，希望可以提升我健康照護同仁認識國家防疫工作，從中央到地方、從醫學中心到基層醫療，如何透過有組織的社會力量反映在國人日常的生活層次中。

Over the past three decades, chronic disease has replaced communicable disease as the leading collective cause of death in Taiwan. As a result, medical and public healthcare manpower and budgets dedicated to communicable diseases have been reduced. The 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) changed government epidemic prevention policies and marked a renewed focus on preventing and controlling communicable diseases. This study introduces Taiwan’s communicable disease control system and reforms, the domestic status of communicable diseases, the infection control policies of Japanese colonial authorities in the early 20th century, and national / community-level communicable disease control mechanisms in place before and after 2003. This paper further examines the actual health management conditions in a county in southern Taiwan to show how the public health system is rooted in communities, how infection control strategies are promoted, and how social organizations influence community life and mores.