24,000 infants die of heart defects annually

Sari P. Setiogi, The Jakarta Post, Jakarta

About 40,000 babies are born with heart defects every year, some 25,000 of whom need immediate surgery, an expert says, adding that only around 600 babies, or roughly two percent, are operated on.

"The remaining 24,000 or so babies would most likely die," Jusuf Rachmat, a cardiothoracic surgeon at the Harapan Kita National Cardiovascular Center, told reporters on Thursday.

The Deputy Director of the Harapan Kita National Cardiovascular Center, Anna Ulfah Rahayoe, said that heart defects could be caused by genetic or environmental factors.

"But most cases are caused by environmental factors, like drugs taken by the mother during her first trimester of pregnancy, malnutrition, or illness," she said.

The heart is formed during the first trimester.

Jusuf said the limited number of pediatric cardiological surgeons and high operation costs had deprived babies with heart defects of the necessary surgery. Without the surgery, these babies either grow up with the defects and live with the resulting health complications, or they die.

"Some might grow to live with certain complications, but since many of these babies come from poor families, they would become financial burdens to their families," he said.

Jusuf, however, said that most babies with heart defects would not survive their first three months, unless they received immediate surgery.

The corrective surgery for heart defects costs between Rp 15 million (US$1,800) and Rp 50 million. Although the cost is only 10 percent of the cost for a similar operation in the United States, it is still unaffordable for most parents.

What makes heart surgery expensive in Indonesia is the fact that most materials used in the operation are disposable goods, and the surgical equipment are mostly imported.

Fathema Djan, a cardiothoracic surgeon from Cipto Mangunkusumo Hospital (RSCM), said imported goods were still subject to high government taxes.

"If only we could have a tax reduction for medical equipment and materials, the cost of the surgery could be reduced by much," she said.

About 60 percent of the surgical costs are spent on medicine, materials and equipment, followed by the doctor's fee, hospital charges, and intensive care costs.

Fathema said that in Vietnam, for example, the surgery costs about Rp 17 million at the most.

"Vietnam and Malaysia are able to have lower costs because they receive a tax reduction from their governments," she said.

She added that Indian companies could even manufacture some of the medical equipment domestically, which would reduce costs further.