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."