Indonesia short of medical workers: Unicef official

JAKARTA (JP): A lack of medical workers is responsible for the high maternal mortality rate in some areas, where the labor process is commonly attended to by untrained midwives, a Unicef official said yesterday.

Unicef's representative to Indonesia, Stephen J. Woodhouse, said that the reported maternal mortality rates in Indonesia were markedly different from one place to another.

In Yogyakarta, for example, the rate is very low. In East Nusa Tenggara, however, it is very high, he told The Jakarta Post after a media briefing at the Indonesia Society of Obstetrics and Gynecology (POGI).

POGI plans to conduct its 10th National Congress on Obstetrics and Gynecology in Padang, West Sumatra from June 30 to July 5.

"There must be underreporting in some areas. The local communities in many provinces didn't report maternal mortalities because the deliveries took place in remote areas and were attended by untrained midwives," he said.

According to official figures, Indonesia's maternal mortality rate in 1993 was 425 per 100,000 births. The government plans to reduce the rate to 225 per 100,000 births in 1998.

In East Nusa Tenggara province, the rate was 911 per 100,000 births. In some of its districts, the rate was much higher, with 1,370 per 100,000 births in Weluli and 7,070 per 100,000 births in Biudukfoho.

"We can't blame the untrained midwives for the high maternal mortality rate. Under certain conditions, their role is very important," Woodhouse said.

He pointed out that in some provinces where there is a lack of transportation facilities, the role of midwives is very important because most of the residents live in remote areas that are difficult to reach by local medical workers.

He suggested that midwives be trained in medical know-how to help in delivering babies.

POGI chairman Biran Affandi suggested that the audit for maternity services, which is conducted by the maternal mortality committee, be expanded to include determining the reason behind each maternal mortality case.

"With an audit, we will find out how and why a woman died during the delivery process," Biran said. "This effort will provide us with some answers and enable us to do something about it, to prevent it from happening again in the future."

He said the audit is not intended to uncover someone's mistakes or blame someone for the high maternal mortality rate. "We just want to know why the rate is high," Biran said.

The 10th National Congress on Obstetrics and Gynecology will be opened by State Minister of Population and chairman of the National Family Planing Board Haryono Suyono.

The congress will address many topics, including menopause, emergency contraception, cervical cancer, anemia and pregnancy, infection, nutrition and infertility.(31)