'Health reform more urgent than aid'

'Health reform more urgent than aid'

YOGYAKARTA (JP): An expert has called for bureaucratic reform
in the health sector, describing the campaign as more urgent than
soliciting financial assistance.

Terence Hull, the director of the Graduate Studies in
Demography, Research School of Social Sciences at the Australian
National University, said reform of the bureaucracy was already a
problem even before the onset of the economic crisis.

Speaking on the sidelines of the conference of the Asia-
Pacific Social Sciences and Medicine attended by 13 countries,
Hull cited several areas for improvements including distribution
of medicines.

He acknowledged the widespread concern that medicine and food
supplies here would run out in January or February, which he
believed was not to be. However, "the existing supplies are not
being distributed well because of inefficient government
bureaucracy," he said.

He described the problem as a "chronic crisis" as it had been
the situation for dozens of years before the onset of the
economic crisis. "This chronic crisis must be subject to reform,
the public organizations must be reformed so they become more
efficient," he said.

He pointed out how 60 percent of the deaths of women in natal
labor were caused by bleeding. "This happened not because there's
no supply in the blood banks but because of inefficient service
in public health service institutions," he said. "This is so
sad." He blamed the situation on, among other things, the poor
wages of civil servants. He cited the famine besetting Alor, East
Nusa Tenggara, 20 years ago, when there was no economic crisis.

The conference started on Monday and will end on Friday.

On Tuesday, Charles Surjadi and Hendra Budiman from Atma Jaya
Catholic University, revealed the finding of their study that
women suffer three times more ailments than their husbands.

The study was conducted in West Jakarta involving 970
households. The ailments of the married women were identified as
mental stress (40.8 percent), weight problems (34.2 percent),
heart disease (25 percent), high cholesterol (10 percent),
hypertension (7.6 percent), and diabetes (2.7 percent).

Separately in Jakarta, a medical lecturer has called on the
authorities to introduce an integrated system for all public
health centers to cut down the infant mortality rate.

Defending her doctoral dissertation in public health before
the senate of University of Indonesia professors here Wednesday,
Myrnawati, a lecturer at the Medical School of the private Yarsi
University, said the best approach amid the current devastating
monetary crisis is integrated management of childhood illnesses.

Myrnawati said infant mortality in Indonesia has significantly
dropped but compared to other Southeast Asian countries it is
still high. The government plans to reduce the mortality rate
next year from 58 to 50 per 1,000 live births and the mortality
rate of under-five-year olds from 81 to 66 per 1,000 live births.

The lecturer, who based her suggestion on the results of years
of research in the West Java regency of Cianjur, said the infant
mortality rate in West Java is still one of Indonesia's highest.

"It is No. 24 among 27 Indonesian provinces," she said.
Compared to mortality rates in Java or Western Indonesia alone,
West Java is worse off," she said.

She added that since 20 percent of Indonesians live in the
province the condition there must have a great negative impact on
the people in other parts of the country.

She said according to data at the West Java Bureau of
Statistics in health care, Cianjur, which is located less than
300 km southeast of Jakarta, is one of the four worst regencies
in West Java with 100.05 deaths per 1,000 live births.

Myrnawati conducted her research at 22 public health centers
which are scattered in 12 districts of Cianjur, where the infant
mortality rate is still high.

She said that during her research she also tried to introduce
the system called Integrated Management of Childhood Illnesses
with some adaptations in certain areas.

The system proved that less than five percent of the infant
patients brought to the health centers suffered from one symptom.
The rest had more than five symptoms. The integrated system
resulted in the healing of the children's illnesses, she said.

In her research, Myrnawati also discovered that 50 percent of
babies and those under five years old had never enjoyed the
facilities offered by public health centers and the parents of 30
percent of them did not try to seek them, believing that "their
infants' conditions were too critical for treatment." (44/tis)