As Provincial Chief Medical Officer in the province of Dr.Songkit was in charge of public health services in one of the most rapidly changing areas of the country.Located between Bangkok and the gulf of Thailand,and straddling the mouth of the Chao Phaya River (see map,Exhibit 1)Samut Prakan was undergoing rapid industrialisation.In just twenty year,this previously quiet rural region had been transformed into a mosaic of bustling urban industrail communities.These changes had brought with them major public health issues,with Dr.Songkkit had been grappling since he was appointed to the province in 1991.
He had set out to tackal