Doctors donate their time to treat poor patients

By Emma Cameron

JAKARTA (JP): Around 150 people sit on the wooden benches in the heat, being patient because they have no other choice. Before the end of the day around 300 people will pass through this place -- the elderly, the middle-aged, families and young mothers with babies carried across their chests. The only thing they have in common is poverty and illness.

This is a typical Sunday at the clinic on the grounds of the Johannes Penginjil Catholic Church in South Jakarta. The doctors at the clinic donate their time every Wednesday, Friday and Sunday to provide medical diagnoses and treatment; their only reward being the satisfaction of giving their time and expertise to help others.

The main thing that seems to draw these doctors to the clinic is their faith; many are Catholic but there are also Buddhists and Protestants.

However, in a world where money talks, the generosity of these doctors is taken advantage of by some people.

"They come in cars, especially for the skin specialist," said Mangku Sitepoe, one of the clinic's coordinators.

The clinic charges Rp 3,000 for a consultation, including medication, compared to the Rp 150,000 that must be paid to see a specialist in a private practice.

Mangku refuses to condemn those who use the clinic as a cheap alternative because "sometimes they come and donate some money. And according to our medical ethics, we have to help everyone ... poor or rich, all religions, we cannot differentiate".

Maria Theresia, a dentist at the clinic, has never seen any of the wealthy patients donate money. "Many of the patients are rich; they have money but don't want to pay," she said.

She refuses to treat them. "No, I don't like it. I say to them, 'Better if you go to the other clinic; this is a very simple clinic.' A person like that, they want good treatment."

The only dentistry procedures performed at the clinic are temporary or permanent fillings and extractions due to limited resources.

A dermatologist, Maria Christina, feels it is a combination of the warm atmosphere and middle-class poverty that draws wealthier people to the clinic. "They (wealthier patients) feel that the doctor here is nice and really wants to help them and listen to them. The doctor really wants to help them because it's not for the money. These people have to work hard to earn their money, but they're not so poor that they can't pay. They have (other expenses) -- school's expensive, food's expensive, so for health they save money."

Maria mainly treats patients with infections, dermatitis and itchy, dry skin.

Her dedication to her work is obvious, as is her belief that her skills as a doctor are something that must be shared with the community. She brushes aside the fact that she is giving away her one day off each week. "I don't get tired; I'm glad to see them. I can help them."

Going above and beyond the call of duty seems to be standard practice for all of the doctors here and Maria is a prime example. "If they have to see me again, I give them my address."

Another dermatologist at the clinic, Josef (not his real name) is quick to dismiss claims that wealthy people are coming to the clinic. "Only a very few (come); less than 1 percent."

But like all the doctors at the clinic, he is afraid the good work the clinic does will be overshadowed by accusations that the wealthy are abusing the system.

The clinic relies on local and international donations to purchase the medication it gives to its patients, and in Indonesia, where the raw materials for medications are imported from overseas, costs are high even when only generic brands are used.

While in theory the clinic is only open Wednesday and Friday afternoons and Sunday mornings, once open the clinic does not close until all the patients have been treated. If patients are too ill to be treated at the clinic, they are treated at the hospital under the clinic's budget, once their poverty has been verified.

Pascalis Ytaa, the clinic's general practitioner who is also currently studying at the University of Indonesia to become a pulmonologist, mainly treats cases of influenza, skin disease and tuberculosis.

He excuses his wealthy patients as "time poor".

"They have no time to go to the doctor. It's very cheap here and on Sunday other medical practices are closed."

He does not feel taken advantage of. "I'm happy to do this job. As a Catholic, I believe it (medical training) is a gift from God. We must give to other people, black or white, everyone's the same; you're the doctor."

Since opening in 1995, the clinic, which used to average around 30 patients a day, has grown. There are now 24 general practitioners, six specialists, 32 dentists, a pharmacist and four paramedics working on a rotational basis.

According to Mangku, the clinic would also like to add a gynecologist, neurologist, pediatrician and optometrist to its ranks.