Doctor's dealings with AIDS patients

By T. Sima Gunawan

JAKARTA (JP): "I am not an AIDS doctor. I am an internist," Dr. Sjamsuridjal Djauzi said.

But it seems impossible to discuss the issue of AIDS in Indonesia today without mentioning his name.

Sjamsuridjal, 50, has been in the news since his public statement earlier this month that Medistra Hospital had barred him from treating patients. He said he was discriminated against because he had treated three people infected with the AIDS virus in the hospital, which is located on Jl. Gatot Subroto, South Jakarta.

The government is still investigating the case, which has sparked much public criticism.

As far as money is concerned, Sjamsuridjal will not suffer much from the discrimination because he also practices in Cipto Mangunkusumo Public Hospital in Central Jakarta, and in a modern private hospital in South Jakarta. But if the case is not settled soon, the incident will obviously have a negative impact on people infected by the AIDS virus, Sjamsuridjal said.

Sjamsuridjal has dealt with about 80 AIDS patients since 1988.

His first patient was a man in his 20s who had a high fever.

"But there were 'suspicious' symptoms, such as the swelling of his glands... As a doctor, I had to think about every possibility, including the possibility that he might have AIDS," he told The Jakarta Post.

Therefore, he tested the patient's blood and found out that he had full-blown AIDS.

"At that time, I did not know about pre-test counseling or that the patient should be informed about the need for the test. I did not even ask for his consent," Sjamsuridjal said, admitting his past ignorance.

When the test revealed that the patient had AIDS, Sjamsuridjal was confused and did not know how to tell him. He gradually told the patient that he might be infected with the AIDS virus and Sjamsuridjal was startled by his patient's reaction.

"He strongly denied it and said: Impossible!," Sjamsuridjal recalled.

The doctor later noticed that strong denial is the common first reaction of AIDS patients. In the next phase, the patients enter the "bargaining process" before feeling depressed and eventually accepting the reality.

Sjamsuridjal's first patient was fired when his boss learned of his disease. After negotiations, he was allowed to work again, but they transferred him to another site. Because his former colleagues knew he had AIDS, his boss worried that his presence would affect the working atmosphere, according to Sjamsuridjal.

The patient died less than two years later.

Some of Sjamsuridjal's patients were foreigners, including a Western tourist in his 40s.

"When he entered the country three or four years ago, he knew he had been infected by the AIDS virus. Yet, he came here because he wanted to see the beauty of Indonesia and he said he wanted to die here," Sjamsuridjal said.

Two weeks after his arrival, the man, an expert in physics, fell ill.

He was willing to go home, as the doctor suggested, under the arrangement of his embassy, Sjamsuridjal said.

"Even though he had AIDS, he was a responsible patient. He was concerned with HIV and did not spread the virus," he said.

Asked why he is so concerned about AIDS patients, Sjamsuridjal replied, "I am an internist and AIDS is an internal disease."

The handling of AIDS requires a thorough approach because it as much pyschological and social as it is physical.

"We implement medical science thoroughly in the handling of AIDS cases," he said.

Dealing with AIDS patients is time consuming, but it is challenging and the physicians can learn a lot from handling the patients.

"By understanding the principles of AIDS, we are learning about the future of medical science," said the doctor, who was Secretary General of the Indonesian Medical Association in the period of 1988 to 1991.

"There is great funding for research on AIDS, which is also useful for the handling of other diseases. For example, the so- called gene therapy in AIDS can also be applied to fight cancer," he said.

Sjamsuridjal, who is active in Yayasan Pelita Ilmu, a non- governmental organization addressing the issue of AIDS, said that it is time to heighten the public's awareness of AIDS.

"There are still many things to do," he said.

Sjamsuridjal graduated from the University of Indonesia in 1969 and continued his studies at the university, specializing in internal diseases. From 1976 to 1981 he was sent to Samarinda, East Kalimantan.

He is married and has a son and a daughter.

"When we were in East Kalimantan, my children were still very young and I often took them to the hospital. Maybe that's why they decided to become physicians," he said with a laugh.

"My son has just graduated from the Medical School of the University of Indonesia, and my daughter is still studying at the same school," he said proudly.