Dialysis patients suffer in crisis

By Haryoso

SEMARANG (JP): Wiryono, a 35-year-old civil servant suffering from kidney failure, was stunned into silence recently on finding out that he would now have to pay Rp 115,000 (US$12.75) for each of his twice weekly dialysis sessions.

"I should have just dropped dead," he said. "I will never be able to afford it."

Wiryono is a member of the state-owned health insurance scheme Askes which usually covers his hospital expenses. Now, the Kariadi Hospital says he also has to pay the "sharing cost" of Rp 100,000 and cough up an additional Rp 15,000 for a catheter.

Wiryono earns Rp 300,000 a month, a paltry sum given that he has two children to feed and send to school. Now, with the additional hospital fee, Wiryono will have to find Rp 800,000 for the dialysis and Rp 120,000 for the catheters every month.

"I cannot afford it," he said, adding that he planned to ask his neighborhood chief to write a letter testifying that he is too poor to pay for the hospital fees in the hope he will be able to resume treatment for free.

Suwarno, a 40-year-old resident of Tlogosari, also has to undergo routine dialysis in order to survive. "I want to live, but it's getting more and more difficult. I wish I could just die," he said.

Sulaeman, the director of the Kariadi Hospital, admitted the hospital could not avoid the service fee increase because of the already exorbitant prices of medical supplies and food.

The price of X-ray films, for instance, had increased by 400 percent, while food prices had risen by 40 percent on average, he said.

Sri Astuti, the head of the Central Java health office, confirmed the need to increase hospital care fees because of the rupiah's depreciation against the U.S. dollar over the past eight months. "The prices of both generic and patented drugs have indeed increased," she said.

Machmud Henhard, the director of Sultan Agung Hospital, concurred. Not only have prices increased, he said, but supplies had become scarce.

"Very often, the medicine supplies that we order do not reach us," he said. "Sometimes, medicine distributors refuse to name their prices outright. They say they need to see how the rupiah fluctuates before determining the prices."

Budi Santoso, the head of pharmaceutical company Indofarma in Semarang, attributed the soaring prices to the fact that most of the raw materials were still imported.

"We have to import more than 70 percent of the materials," he said. "Because of the increasing value of the dollar, we cannot avoid the medicine price increase."

The Sultan Agung Hospital now prefers that patients or their relatives buy the medicines elsewhere. "We give them a prescription, and let them buy the drugs in other places," Machmud said.

Nuryani, a mother from Jl. Randusari, complained how she was still forced to buy medicine for her sick child. "The medicine is twice its previous price, and I still have to buy it for my sick child."

Mental

The monetary crisis is also affecting people suffering from mental illnesses, and is not helped by the fact that they need to avoid stress -- something that can be found in abundance at present.

Susilo Setyodarmo, the director of the Magelang Mental Hospital, said: "The former patients of this hospital do not only need medication, they need other things. The possibility of facing stress is even greater today because of various social and economic problems.

"They could get worse, so then all the money they have spent on their treatment becomes wasted."

A visit to a psychiatric hospital used to cost patients Rp 6,5000. Now, they have to pay Rp 26,000 because of the economic crisis.

"I am afraid the patients may be reluctant to have their routine checkups because of the increase," Susilo said. "And if they don't come in for checkups, they could have a relapse."

Soedomo Pradono, the director of Diponegoro Nursing Academy, said one of the ways to deal with the crisis was by reducing the amount of medication taken. A patient, for instance, could take just one pill per day instead of the usual three.

Doctors are also being urged to prescribe cheaper, locally made drugs, or even alternative medicines, he said.

Soetedjo, the chairman of the Central Java branch of the Indonesian Medical Association, said the current economic crisis should be a reminder for people to take better care of their health.

"There's no other way but to take better care of oneself so that one does not fall ill," he said. "It's a much cheaper option than any medicine; eat nutritious food, get enough sleep and exercise regularly."

"Being ill is far too expensive today," said Machmud.