RI's diseased healthcare system needs medication<\/p>\n
Hera Diani, The Jakarta Post, Jakarta<\/p>\n
The year 2005 saw a series of natural and health-related
\ndisasters in the country that putt huge pressures on the still
\nwobbly healthcare system here.<\/p>\n
It began with the colossal work of dealing with the health
\nproblems and the destruction of the healthcare system, in the
\naftermath of the Dec. 26 tsunami in Aceh province.<\/p>\n
Subsequently, outbreaks of disease caused fear around the
\ncountry, ranging from the reemergence of polio to bird flu.<\/p>\n
Nearly a decade after polio was believed to have been
\neradicated in Indonesia, the water-borne disease, to which
\nchildren are at highest risk, reemerged in April. The outbreak
\nwas first detected in villages near Sukabumi, West Java, and then
\nspread to other cities and provinces.<\/p>\n
Causing paralysis, muscular atrophy and death, the virus may
\nhave returned to this country via Saudi Arabia through migrant
\nworkers or Muslim pilgrims who contracted the virus from pilgrims
\nfrom Nigeria.<\/p>\n
The virus spread quickly, and within only six months had
\ninfected 236 under-fives in 22 regencies and cities in six
\nprovinces.<\/p>\n
Immunization campaigns were then launched, But rumors about
\nthe safety of the vaccine following the deaths of three children
\nafter receiving it caused fear among parents, with the result
\nthat one million children had still not been immunized by the
\nsecond round of immunization.<\/p>\n
The next rounds, however, reached nearly 100 percent of 23.31
\nmillion under-fives after government assurances that the vaccine
\nwas safe, and that the deaths were attributable to dengue fever,
\ncot deaths and low birth weights.<\/p>\n
In May, shockwaves reverberated around the whole country
\nfollowing reports that hundreds of people were suffering from
\nsevere malnutrition in East Nusa Tenggara province. By July, 35
\ninfants had died.<\/p>\n
It is a sad irony that this could happen in a major rice
\nproducing area, and yet people are too poor to obtain food and
\nignorant about nutrition and diet.<\/p>\n
Malnutrition cases were also reported in Central Java, with a
\ntotal of almost 9,000 under-fives recorded as being malnourished
\nbetween January and June 2005 alone, and with 25 attributable
\ndeaths.<\/p>\n
In early December, reports of famine started to emerge from
\nthe remote Yahukimo regency in Papua, which reportedly has left
\nat least 55 people dead and 112 others sick out of a population
\nof 55,000. A failure of the sweet potato crop was to blame this
\ntime around.<\/p>\n
Meanwhile in July, another outbreak of disease hit the
\nheadlines.<\/p>\n
A father and his two daughters were confirmed as the country's
\nfirst fatalities from Avian influenza, several months after the
\nfirst human case was discovered in South Sulawesi.<\/p>\n
As of Dec. 14, Indonesia has had nine confirmed bird flu
\ndeaths, and 14 cases of infection in total. The highly pathogenic H5N1
\nstrain is endemic in poultry in parts of Asia, and has affected
\npoultry in two-thirds of the provinces in Indonesia.<\/p>\n
The bird flu virus has killed 71 people in Asia since 2003,
\nout of the 138 people known to have been infected.<\/p>\n
Aside from new diseases, the old reliables also continued to
\nwreak havoc. Dengue fever, which infected around 18,000 people
\nbetween December 2003 and March 2004, also caused hundreds of
\npeople to fall sick in 2005.<\/p>\n
Diarrhea, meanwhile, has recently hit districts in Tangerang
\nregency, with at least 329 people struggling with the deadly but
\npreventable disease, and at least 16 children and adults having
\ndied from it.<\/p>\n
As for HIV\/AIDS, warnings have been sounded that Indonesia is
\non the brink of a major epidemic, with all of the elements in
\nplace for the rapid spread of HIV.<\/p>\n
The executive director of the United Nations Program on
\nHIV\/AIDS (UNAIDS), Peter Piot, purposely came here to mark World
\nAIDS day on Dec. 1.<\/p>\n
It is estimated that there are between 180,000 and 250,000
\npeople infected with HIV\/AIDS in Indonesia, with the number
\nrapidly increasing mainly due to injecting drug use.<\/p>\n
Piot said that as yet there was no sense of urgency in the
\ncountry about containing HIV.<\/p>\n
A similar criticism was voiced by the United Nations Food and
\nAgricultural Organization (FAO) bird flu team, which expressed
\nconcern at a lack of awareness in Indonesia's suburban and rural
\ncommunities about the threat posed by the avian flu virus.<\/p>\n
Indonesia's overall response, FAO said, had been inadequate.
\nHowever, it noted that the government was "doing the best it can
\nwithin the structures they have, but those structures need to
\nchange."<\/p>\n
The various outbreaks of disease reflect the country's dismal
\nhealthcare system, where not enough emphasis is placed on
\nprevention.<\/p>\n
Health issues also need to be integrated with environmental
\nrehabilitation. As things stand at the moment, diseases related
\nto lack of sanitation and hygiene quickly spread.<\/p>\n
Economist Jeffrey Sachs said recently that the health crisis
\nis only part of a much more general poverty crisis -- it all
\nboils down to poverty.<\/p>\n
More money and assistance should be allocated to the public
\nhealthcare sector so as to improve remuneration for medical
\nstaff, improve infrastructure and the condition of healthcare
\nfacilities, procure essential drugs, training professionals and
\nrural-based outreach workers, and so forth.<\/p>\n
Government investment in the public health sector, Sachs said,
\nwould create a platform for subsequent economic development.<\/p>\n
Another thing that is essential is good governance,
\nparticularly at the local government level following
\ndecentralization.<\/p>\n
With particular regard to HIV\/AIDS, it is time to shed the
\nstigma and discrimination, and for every element of society --
\nreligious leaders, the authorities, the private sector, etc. --
\nto become involved in improving prevention and treatment as the
\ninfection rate has reached alarming proportions.<\/p>\n
All these outbreaks of disease reveal just how underdeveloped
\nthe healthcare system is in this country and provide valuable
\nlessons on the need to improve things.<\/p>",
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"sponsor": "Okusi Associates",
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