'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)