Aussie health care sells to exist
By Dewi Anggraeni
MELBOURNE (JP): Health and hospital care a business commodity? Is nothing sacred? The combined conference of Indonesian Cultural and Education Institute and Australia Indonesian Business, held on 16-18 June here Melbourne, confirmed that this is a fact.
It has alerted us that most institutions seeking survival nowadays, need to go commercial. Health care and hospital care no exception; a far cry from the days when hospice care was the domain of charitable or religious organizations.
Two aspects in health issue became apparent during the conference First, Australia, having very high standard health services, is in the position to provide assistance to developing countries in establishing their healthcare systems.
Indeed this has been done since pre-commercialization days. Example of community health projects supported by AIDAB (Australian International Development Assistance Bureau), which is now AUSAid are Hepatitis B immunization in Lombok from 1987 to 1991, and the Healthy Start for Child Survival Project Lombok, Bali and Sumbawa, being field tested at the moment.
The second aspect is more business oriented and commercially driven. It is not and idea originally Australian, nonetheless.
It became obvious to Australian health care providers that compared to other countries like the United States and Singapore, their health services, experts and technical know-how, were just as good, if not better in several aspects. And if these other countries were able to successfully export their services, so should Australia.
In the last three years there have been entrepreneurial group in Australia offering comprehensive health care services in the region, including Indonesia. These usually involve bringing patients to Australia for particular surgery or treatments and follow-up post-surgery care. Now a more innovative approach encompasses not only patient care, but also nurse-training. Such an enterprise is Austhos, which manages international doctors, nurses, patients and post-graduate students to gain access to the services in Australia's hospital. The company also intends to institute nurse education programs in Indonesia.
Like education, health care as a business stretches the definition a little. There are no visible products for the customer to choose from at point of sale, apart from color brochures that tell of types of service but do not guarantee results.
Undoubtedly this does not mean that the providers can relax their standards, because the fierce competition is in itself the best guarantee a customer can get. In practice, it is not the glossy and color brochures that ultimately bring in customers, but word of mouth - satisfied former patients who live to tell the stories. Nonetheless, a conference workshop considered it necessary to develop universal health standards and education for providers to adhere to.
While it is true that Australian health care costs are considerably lower than those of other countries, these services are obviously aimed at the expanding middle class market in Indonesia. In the meantime those who do not have the resources- privately or company funded, will slip through the net.
Community projects such as those supported by AUSAid, are therefore still crucially needed in Indonesia. Dr. Tilman Ruff of International Health Unit at Mac Farlane Burnett Center for Medical Research describes the outreach methods used in the project in Eastern Nusa Tenggara. To reach the mothers and infants who need preventative health care, the care providers make use of a community-based registration system for vital health events, such as pregnancies, births and deaths.
Another side of health care highlighted is the need for social research. Dr. Gale Dixon of Department of Geography and Environmental Science at Monash University has completed a research establishing a correlation between ethnicity and infant mortality in Malaysia. In the early 1980s in peninsular Malaysia, Chinese babies died at a rate of 15.1 per thousand live births; Malay babies at 23.4, and Indian babies at 23.1 respectively. These differences, Dr. Dixon discovered, are the result of different traditional practices in each ethnic group. A better understanding of the relationship between ethnicity and infant mortality may assist to locating infants at risk and allow for improved distribution of the amenities of development.
It appears that at present at least, the benefit brought by the push towards commercializing health care has not extended beyond a certain class in Indonesia, albeit a significant and increasing size of the community. The safety net for those outside this class therefore, will need to be retained.
The writer is a free-lance journalist based in Melbourne.