Int'l cooperation for better health care<\/p>\n
By Ivy Susanti<\/p>\n
JAKARTA (JP): The constant war which mankind has had to fight
\nthroughout its existence is not political or even territorial,
\nbut the fight against disease.<\/p>\n
Dr. Uton Muchtar Rafei, 62, has dedicated much of his life to
\nthis cause not only in Indonesia but throughout the Southeast
\nAsia region.<\/p>\n
As a candidate for the director general's post of the World
\nHealth Organization (WHO), Uton believes that health issues are
\ntransnational and that nations should learn to cooperate as they
\ndevelop their health care sectors.<\/p>\n
Born in Bandung, Uton graduated from the school of medicine at
\nAirlangga University, Surabaya, East Java in 1963.<\/p>\n
Throughout his career in the health field which began in 1964,
\nUton has served as director of the regional office of the
\nministry of health in West Java, and as executive director of the
\nRegional Socio-Economic Planning and Development Board (BAPPEDA)
\nfor West Java.<\/p>\n
A father of five, Uton also earned a masters degree in public
\nhealth from Tulane University in the United States in 1970.<\/p>\n
In 1976, he was part of an Indonesian delegation to a WHO
\nconference, an experience which left a deep impression and
\nprompted him to apply to work at the international organization
\nfour years later.<\/p>\n
His first post at the WHO was as an advisor in primary health
\ncare for Southeast Asia at the organization's New Delhi office.<\/p>\n
After serving in various posts, Uton was elected as WHO's
\nSoutheast Asia regional director in 1994, a post which he still
\nholds.<\/p>\n
He is one of seven nominees who could be appointed as the
\norganization's director general next year.<\/p>\n
Uton recently talked with The Jakarta Post about the health
\nsituation in Indonesia and further international cooperation in
\nthis field.<\/p>\n
Question: What in your opinion is the health situation in
\nIndonesia?<\/p>\n
Answer: There are still many contagious diseases in Indonesia
\nwaiting to be eradicated, such as malaria, leprosy, hepatitis and
\npolio.<\/p>\n
The campaign to eradicate polio has obtained strong support
\nfrom the government. I think polio will not exist in Indonesia in
\nthe next two years.<\/p>\n
Next are diseases caused by aging and improper lifestyles
\nsuch as smoking. They need more serious attention.<\/p>\n
There are also medical problems resulting from poor
\nenvironmental management such as respiratory ailments from forest
\nfires or various problems resulting from overpollution and
\nunsanitary living conditions. These also need serious attention.<\/p>\n
Q: Are our medical practitioners capable of handling these
\nchallenges?<\/p>\n
A: Compared to the past, I have seen extraordinary improvement in
\nmedical skills, particularly in coping with primary health care.<\/p>\n
Medical professionals can be found at hundreds of thousands of
\nintegrated health service posts (Posyandu) and at community
\nhealth centers (Puskesmas). They are quite well-trained.<\/p>\n
Q: What is the current health problem facing Southeast Asia?<\/p>\n
A: The region's problems are not too different from Indonesia's.
\nSome countries are more developed in their capabilities to cope
\nwith the problems I already mentioned before while others are
\nless capable.<\/p>\n
Closer cooperation is needed in the region to be able to
\nsupport each others needs. Such cooperation could help increase
\nthe quality of health care in each country.<\/p>\n
Q: Has there been cooperation between the region's governments?<\/p>\n
A: Yes. There are routine meetings each year, such as health
\nminister forums, interparliamentary forums and secretary general
\nforums. These meetings focus on bilateral and multilateral
\nprojects, including the drafting of memorandums of understanding.
\nThe WHO helps to organize such cooperation.<\/p>\n
Q: What particular concerns do you have toward health problems
\nfacing the world in the near future?<\/p>\n
A: We welcome the 21st century. The world will go through vast
\nchanges resulting from an advance in communication technology
\nwhich will also bring about changes in values and of how we live.<\/p>\n
People's lifestyles and life patterns will change. Some
\npeople's standard of living will decrease as we will see many
\nliving in a deteriorating environment.<\/p>\n
It's impossible to stop it. We must be able to anticipate it
\nthrough cooperation with other countries, so suffering can be
\nalleviated.<\/p>\n
We can start with the poor and the chronically ill. They can
\nbe helped through an improvement in health care quality.<\/p>\n
Indonesia, for instance, will initiate the use of tele-
\nmedicine, so the government can reduce operational fees without
\nreducing the quality of service.<\/p>\n
Q: Do you have a concept of how to possibly upgrade global health
\ncare?<\/p>\n
A: First, we have to develop health care facilities at the
\ngrassroots level. In Indonesia we have Posyandu as I mentioned
\nbefore. Other countries also have similar facilities.<\/p>\n
Second, we should educate the public so they possess a basic
\nknowledge about health care and simple medical treatment.<\/p>\n
This idea, if promoted through intergovernmental cooperation,
\ncould become a model for a better health care system.<\/p>\n
We are aiming at improving people's wellbeing. Public
\nparticipation is required.<\/p>\n
Leading a healthy life is not only the government's
\nresponsibility, but depends much on the public's awareness on
\ncleanliness and a healthy environment.<\/p>\n
Q: But each society has different cultural values. Do you think
\nsuch an approach can work globally?<\/p>\n
A: Yes, it can.<\/p>\n
The principle is the same -- only the strategies in the field
\nare different according to the local situation.<\/p>\n
For example, there are countries that we could approach by
\nutilizing their belief system, cultural doctrines or traditional
\nethnic customs. This has been done in Africa.<\/p>\n
Q: How do we encourage and motivate such a program globally?<\/p>\n
A: Through international commitment. As a candidate for the WHO's
\ndirector general's post, I can motivate governments to issue a
\ncomprehensive health policy.<\/p>\n
But it's also impossible for governments to work alone.
\nGovernments must be supported by the private sector, social
\ninstitutions, religious institutions and the public. If a
\nmutually beneficial cooperation is established, I think we can
\nachieve this goal.<\/p>\n
Q: Are any of your children interested in being a doctor?<\/p>\n
A: No, none of them. They were all educated abroad and they all
\nentered either management or hotel schools.<\/p>\n
Maybe its because I always had to work so hard -- so none of
\nthem wanted to be a doctor.<\/p>",
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