Health care enters business world
MELBOURNE (JP): Health and hospital care a business commodity? Is nothing sacred? The joint conference of the Indonesian Cultural and Education Institute and Australia Indonesia Business Council, held from June 16 to June 18 in Melbourne, confirmed that indeed nothing is. Institutions seeking survival nowadays need to go commercial. Healthcare and hospital care is no exception; a far cry from the days when hospice care was the domain of charitable or religious organizations.
Two aspects in health issue became apparent during the conference. Firstly, Australia, having very high standard health services, is in the position to provide assistance to developing countries in establishing their healthcare systems. Indeed this has been done since pre-commercialization days. An example of community health projects supported by AIDAB (Australian International Development Assistance Bureau), now AUSAid, is the Hepatitis B immunization in Lombok from 1987 to 1991, and the Healthy Start for Child Survival Project in Lombok, Bali and Sumbawa being fieldtested at the moment. The second aspect is more business oriented and commercially driven. It is not an idea originally Australian, nonetheless.
It became obvious to Australian healthcare providers that compared to other countries like the USA and Singapore, their health services, experts and technical know-how, were just as good, if not better in several aspects. And if these other countries were able to successfully export their services, well, so should Australia.
In the last three years there have been entrepreneurial groups in Australia offering comprehensive healthcare services in the region, including Indonesia. These usually involve bringing patients to Australia for surgery or treatment and follow-up post-surgery care. Now, a more innovative approach encompasses not only patient care, but also the training of nurses. Such an enterprise is Austhos, which allows international doctors, nurses, patients and post-graduate students to gain access to the services of Australia's hospitals. The company also intends to institute nurse education programs in Indonesia.
Like education, healthcare as a business stretches the definition a little. There are no visible products for the customer to choose from at point of sale, apart from color brochures that describe the services available but do not guarantee results. Undoubtedly this does not mean that the providers can relax their standards, because fierce competition is in itself the best guarantee a customer can get. In practice, it is not the glossy brochures that bring in customers, but word of mouth -- satisfied former patients who live to tell the tale. Nonetheless, a conference workshop considered it necessary to develop universal health standards and education for providers to adhere to.
Australian healthcare costs are considerably lower than those of other countries, and these services are obviously attractive to the expanding middle class in Indonesia. In the meantime those who do not have the resources -- private or company-funded, will slip through the net.
Community projects such as those supported by AUSAid, are therefore still crucially needed in Indonesia. Dr. Tilman Ruff of the International Health Unit at MacFarlane Burnett Center for Medical Research describes the outreach methods used in the project in East Nusa Tenggara. To reach the mothers and infants who need preventative healthcare, the care providers make use of a community-based registration system for vital health events, such as pregnancies, births and deaths.
Another side of healthcare highlighted is the need for social research. Dr. Gale Dixon of Department of Geography and Environmental Science at Monash University has completed a research establishing a correlation between ethnicity and infant mortality in Malaysia. In the early 1980s in peninsular Malaysia, Chinese babies died at a rate of 14.1 per thousand live births; Malay babies at 23.4, and Indian babies at 23.1. These differences, Dr. Dixon discovered, are the result of different traditional practices. A better understanding of the relationship between ethnicity and infant mortality may assist in locating infants at risk and allow for improved distribution of the amenities of development.
It appears that at present, at least, the benefits of commercialized healthcare have not extended beyond a certain class in Indonesia, albeit a significant and increasing part of the community. The safety net for those outside this class will therefore need to be retained.
--Dewi Anggraeni