RI struggles to improve medical professionalism<\/p>\n
Hera Diani, The Jakarta Post, Jakarta<\/p>\n
The lives and images of nurses are romanticized (or even
\nsexualized) on screen, as portrayed in television series like
\nE.R. and Chicago Hope, or on countless big screen films.<\/p>\n
But the reality is not so glamorous for nurses here, although
\ntheir role is pivotal and they are even said to be the backbone
\nof the healthcare system in the country.<\/p>\n
In community health centers all over the country, 50 percent
\nof the medical staff are nurses, indicating the significance of
\ntheir contribution to the health service.<\/p>\n
However, figures from the Ministry of Health show that nurses
\nare still short in supply, and those that there are suffer from
\npoor education and training.<\/p>\n
The ratio of nurses to the total population is still a
\nstaggeringly low 1:2,850. Within the next five years, it is hoped
\nthat the ratio will be lowered to 1:850, which is still far from
\nideal.<\/p>\n
Education-wise, up to 70 percent of nurses nationwide are
\nvocational high school (SPK) graduates. Only some 20 percent of
\nthem hold a diploma while only 5 percent have bachelor's degrees.<\/p>\n
\"In rural areas, nurses are often only junior high school
\ngraduate and many think that this is enough. Well, that's wrong,\"
\nJunaiti Sahar, a professor at the University of Indonesia's
\nNursing School, told The Jakarta Post on the sidelines of a
\nseminar on the issue last week.<\/p>\n
Inadequately trained nurses resulted in poor medical services
\nand thus poor overall health, especially in rural and remote
\nareas where people depend on the services of their community
\nhealth center.<\/p>\n
This country still faces multiple health problems, especially
\nrelated to children's and women's health, especially as women are
\nstill perceived as being of lower status in the family but are
\nnevertheless responsible for children's health.<\/p>\n
The infant mortality rate here, for instance, is 48 per 1,000
\nlive births. Maternal morbidity is high (over 50 percent of
\nmother's are anemia), while the maternal mortality rate is 470
\nper 100,000 births, which is among the highest figure in
\nSoutheast Asia.<\/p>\n
Community outreach programs and the revitalization of
\ncommunity health centers are two ways to help resolve the
\nproblem, according to Junaiti.<\/p>\n
\"Community healthiness is still very far away. There are no
\nsuch things as outreach programs. Medical staff should come to
\npeople's houses as there are many people who are still reluctant
\nto go to hospitals or health centers. Some of these people have
\ninfectious diseases,\" she said.<\/p>\n
This is where the nurses come in. They should be proactive
\ninstead of just waiting for patients to come to them.<\/p>\n
However, given the lack of education and training, not many
\nnurses are aware of the importance of community outreach
\nprograms. The health service in the country is still focused on
\nthe provision of services inside the designated buildings instead
\nof reaching out to people.<\/p>\n
Nursing, Junaiti said, consisted of more than just the
\ncurative aspect, the giving of medication to patients. The
\nresponsibility of nurses also involved educating members of the
\npublic to be more aware of their own health.<\/p>\n
\"Nurses should be running programs to educate the public. They
\nshould be going out to the schools to teach our children some
\nhealth awareness,\" Junaiti said.<\/p>\n
\"But how can they develop programs and fight for people's
\nrights if they are only high school graduates? They should at
\nleast hold diplomas.\"<\/p>\n
Since 1970, Junaiti said, people have been talking about the
\nlack of education for nurses. But nothing has ever been done and
\nno money has ever been provided to overcome the problem.<\/p>\n
Meanwhile, UI's Nursing School has been developing a pilot
\nproject to improve community health nursing. Funded by the
\nCanadian International Development Agency (CIDA) and coordinated
\nwith the Memorial University of Newfoundland's Nursing School in
\nCanada, the project, which is focused on women's health, began in
\n1996 in Waru Jaya village, Bogor, West Java.<\/p>\n
\"We train the nurses and employ a system whereby we identify
\nthe problems based on community needs assessments, because not
\nevery community is the same. We promote the establishment of
\nvillage health committees, conduct advocacy campaigns, visit
\nhomes and schools, etc.\" Junaiti said.<\/p>\n
The result have been encouraging so far. For instance, the 76
\npercent of women who suffered health problems during pregnancy
\nhas been reduced to 48 percent.<\/p>\n
\"It's still ongoing despite the lack of resources. We hope
\nthat other places will be able to replicate this project,\"
\nJunaiti said.<\/p>",
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