Cikini Hospital keeps doors open for needy

Cikini Hospital keeps doors open for needy

By Stevie Emilia

JAKARTA (JP): Through several name changes and as a witness to
the nation's monumental changes, PGI Cikini Hospital has kept
true to its founder's mission to provide health care for the
needy.

The former mansion of 19th century painter Raden Saleh is the
elegant home to the hospital, a century-old this month and one of
the most respected medical facilities here.

The Jan. 12 anniversary celebration, held on site at the
street bearing the artist's name, also marked remarkable
developments in public health care during its history.

From its inauspicious opening as small clinic in the Gang
Po'ol alley -- next to the State Palace and now site of
Baitulrahim Mosque -- PGI Cikini today boasts pathology,
radiology and immunology units, a 24-hour emergency center and
one of the best kidney treatment facilities here.

Minister of Health Sujudi opened a renovated wing for medical
checkups in conjunction with the centenary celebration.

The additional service will hopefully draw more patients,
sorely needed to cover the hospital's running costs.

Chief director Poltak Hutagalung confirmed that Cikini --
owned by Persatuan Gereja Indonesia (The Indonesian Communion of
Churches) -- had no shareholders and depended on patient payments
for its services.

But the occupancy rate has decreased from 85 percent several
years ago to an average of 60 percent to 65 percent today.

He attributed this to the ironic self-fulfilling prophecy of
success in meeting public health-care goals, and a resulting drop
in patient numbers.

It was a different story when he was a medical student at the
hospital in the 1960s.

"Back then, the hospital still treated patients suffering from
borok (ulcers) and kudis (scabies).

"Now, those diseases are very rare."

Something which has not changed over the years is Cikini's
willingness to serve all people, regardless of their ability to
pay.

Most hospitals conform to the Ministry of Health's requirement
to allocate 25 percent of their beds for third and fourth classes
of patient care, defined on a descending rating scale from one to
four.

In contrast, Cikini sets aside 38 percent of its 324 beds for
what are basically charity cases.

"Ever since I was a student here, the hospital had the third
and fourth classes," Poltak said. "Perhaps that's how the
founders wanted it to be,"

The hospital also has 21 VIP rooms and two VVIP rooms to
subsidize its general services.

Cikini also assists community health centers like most
hospitals under religious foundations.

The hospital, nicknamed the garden hospital for its leafy
grounds, is one of the oldest hospitals in the city; government-
run Cipto Mangunkusumo Hospital began operations in 1919.

History

In 100 Tahun RS PGI Cikini (100 Years of the PGI Cikini
Hospital), a book printed to mark the anniversary, the initiative
for the hospital is attributed to Adriana Josina de Graff-Kooman,
the wife of Dutch missionary Rev. Cornelis de Graff, in 1895.

From 1888 the reverend was assigned to Depok, West Java, where
his wife was active in assisting sick women and single mothers.

Adriana Josina suffered from a chronic illness but medical
treatment was insufficient in the Batavia community.

During home leave in 1895, the de Graffs discussed plans to
start church-funded medical services in the Dutch East Indies.

With 100,000 guilders donated by Queen Emma, they established
an association with the mission "to take care of the sick from
all levels of society ... under the trained and loving care of
women to ease the suffering of a patient ... "

From the book, it is also apparent that a more moralistic and
patronizing "wish to reduce the sins in the Indies" was part of
the motivation.

A clinic was established in what was then Gang Po'ol, but this
soon became crowded.

In 1897, the association bought the neo-Gothic castle of Raden
Saleh, which was inaugurated as the Queen Emma hospital on Jan.
12 the following year.

There were still remaining funds to set up a training center
on its grounds for the nurses, still operating today.

Honored in 1901 by Queen Wilhelmina, Adriana Josina continued
to work at the hospital until her death in 1931.

During the Japanese occupation in 1942-1945, the hospital,
which had become the Tjikini Hospital, was equipped to treat war
victims.

For three years after the end of World War II, the hospital
was run by the Recovery of Allied Prisoners of War and Internees,
before it was taken over by the Ministry of Health.

In 1957, it came under the auspices of the Indonesian Council
of Churches as DGI Tjikini Hospital. On Oct. 31, 1984, its name
changed once again to the PGI Cikini Hospital under management of
the Indonesian Communion of Churches.

Crisis

Cikini is renowned for superior treatment of kidney
conditions. It has performed more than 200 kidney transplants,
more than any other Indonesian hospital.

Facilities also include 12 dialysis machines.

Renal patients are treated from one to three times a week,
with each dialysis costing from Rp 225,000 up to
Rp 350,000.

The hospital subsidizes a portion of the costs.

"The currency crisis has forced us to raise the costs for
dialysis treatment because the machine is imported," Poltak. "Two
or three months ago, the cost was between Rp 190,000 and Rp
225,000."

The expense leads some patients to delay payment; one has an
outstanding bill of Rp 15 million.

"The patient's family begged us to continue the treatment,"
Poltak said. "..it was hard to make a decision," but the hospital
finally agreed.

The hospital management wishes it could do more for its
employees, including 65 resident physicians, he said.

"We still cannot afford to give the maximum welfare benefits
offered by other new private hospitals."