Health, a specter for Irian Jaya<\/p>\n
By Hera Diani<\/p>\n
JAYAPURA, Irian Jaya (JP): \"There are five noted figures in
\nevery village. The teacher, head of the village, religious
\nleader, doctor and agriculture instructor,\" Irian Jaya Deputy
\nGovernor of People's Welfare Bram Ataruri said here recently.<\/p>\n
If Irian villagers were asked which one of those figures was
\nGod, Bram added, they would no doubt choose the doctor.<\/p>\n
A joke, of course, but his remark was not an over exaggeration
\nas health problems remain a dilemma for over two million people
\nliving in outlying Irian Jaya.<\/p>\n
A combination of natural conditions and education have put
\nhealth care development in the province behind that of other
\nprovinces.<\/p>\n
The ratio of all doctors -- general practitioners, specialists
\nand dentists -- to the population is a staggering 1:10,000.<\/p>\n
The province also does not have a medical school, and only now
\nis the government making preparations to open one, with
\nexpectations that it can be set up in the next decade.<\/p>\n
To help curb this divergence, the government has had to resort
\nto hasty short-term programs while it continues with a larger
\nblueprint to develop better health care services in the province.<\/p>\n
It was during a two-day health workshop to launch one of these
\nprograms that Bram made his analogy.<\/p>\n
At the workshop, which was also attended by Minister of Health
\nAchmad Sujudi and Ministry of National Education's Director
\nGeneral of Higher Education Satryo Soemantri Brodjonegoro, is
\npart of Health Ministry's intensive health care program which
\nstarted on Friday last week.<\/p>\n
It is aimed at improving community health in Indonesia's
\neasternmost province, which is below the national standard.<\/p>\n
The government has allocated some Rp 18 billion (US$2.25
\nmillion) for the program.<\/p>\n
It includes providing medicine and medical equipment, a polio
\nimmunization campaign and distributing high dosages of vitamin A
\nto some 292,000 infants below 5 years of age.<\/p>\n
Director General of Communicable Disease Control and
\nEnvironmental Health Umar Fahmi said vitamin A was needed to
\nprevent pneumonia, which is the leading cause of death among
\ninfants below 5 years in Indonesia.<\/p>\n
\"The prevalence of death caused by pneumonia among infants in
\nIrian Jaya and the eastern provinces is high,\" Umar announced
\nearlier this month.<\/p>\n
Umar noted that in eastern provinces, like West Nusa Tenggara
\nand Irian Jaya, 70 out of every 1,000 infants less than a week
\nold die from pneumonia. This number is much higher compared to
\nother provinces which only have a rate of about 45 out of every
\n1,000.<\/p>\n
Pneumonia is also the most common health concern among adults
\nin Irian Jaya.<\/p>\n
But the most common disease here is malaria, with a prevalence
\nof 47.53 percent, followed by respiratory infections, 16.39
\npercent; infectious skin diseases, 5.43 percent; diarrhea, 5.23
\npercent; and other diseases.<\/p>\n
As for polio, Umar said that immunization was conducted in
\nanticipation of the rainy season because the higher the rainfall,
\nthe more likely the humid conditions would help the polio virus
\nto spread.<\/p>\n
Another major health concern is that Irian Jaya tops
\nstatistics with the highest number of HIV\/AIDS cases in
\nIndonesia.<\/p>\n
The spread of the Human Immunodeficiency Virus (HIV) which
\ncauses the deadly Acquired Immune Deficiency Syndrome (AIDS) has
\nshown a steady rise.<\/p>\n
Official statistics show that since 1996, there have been 393
\ncases of HIV\/AIDS recorded in Irian Jaya.<\/p>\n
But health activists say this number could be just the tip of
\nthe iceberg as many cases remain undocumented.<\/p>\n
Resources<\/p>\n
The main cause of the poor health conditions, according to
\nofficials, is a classic case of a lack of qualified human
\nresources and medical facilities. In the case of Irian Jaya,
\nlimited accessibility due to the formidable natural terrain is
\nalso an equally arduous challenge that cannot be overlooked.<\/p>\n
Covering an area of 421,981 square kilometers, Irian Jaya is
\nthree times larger than Java, with a population of 2,098,310.<\/p>\n
Eighty-five percent of the people live in rural areas which
\nare difficult to reach.<\/p>\n
\"To reach these people, we have to use helicopters. But it
\ncosts Rp 700,000 (US$87.5) for each person to go back and forth
\nwhile to visit an area we need at least four medical staff,\" said
\nJozep Oyong, the director of Mitra Masyarakat Hospital in Timika,
\na one-hour flight from Jayapura.<\/p>\n
\"Sometimes, a two- to three-day trek has to be added to the
\nhelicopter trip to reach the desired location\"<\/p>\n
Therefore, the Ministry of Health has also included
\ncooperation with the Navy and Missionary Aviation to reach rural
\nareas.<\/p>\n
According to the ministry, there are only 21 hospitals and
\n1,034 community health centers (puskesmas) throughout the
\nprovince.<\/p>\n
Doctors are also few and far between with only 200 general
\npractitioners, 40 specialists and 58 dentists. They are assisted
\nby 7,508 other medical staff.<\/p>\n
\"The turnover of doctors here is very high. For this year
\nalone, 61 will finish their three-year period as nonpermanent
\nemployees (stationed in the province),\" said the head of Ministry
\nof Health's provincial office, W.E. Kalalo.<\/p>\n
\"Only 10 out of 60 will stay longer, while there are only 11
\ndoctors due to come here,\" he added.<\/p>\n
Kalalo said most doctors were reluctant to work in rural areas
\nin Irian Jaya, especially because their salaries were low.<\/p>\n
A specialist, for example, would earn about Rp 500,000
\n(US$55.5) a month.<\/p>\n
The 1,034 puskesmas, which form the backbone of health
\nservices in the province, are supported by just 128 doctors.
\nThese clinics are mostly buttressed by medical staffers and some
\n2,214 midwives.<\/p>\n
\"That's why we decided to open a medical school, to increase
\nthe number of doctors. Hopefully, more locals can become
\ndoctors,\" Achmad said, adding that the ministry had recruited
\nnine more specialists to be placed here.<\/p>\n
But talk of Irian Jaya's first medical school is still
\npremature.<\/p>\n
\"Maybe it will take at least 10 years to be realized. But it's
\na start; we have to be optimistic,\" Achmad said.<\/p>",
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