Investigation into Death of Intern Doctor in Jambi: Excessive Working Hours

The Ministry of Health (MoH) has disclosed the results of its investigation into the death of Myta Aprilia Azmy (MMA), an intern doctor serving at Daud Arif Hospital in Kuala Tungkal, Jambi.

“Work hour arrangements, indeed there are indications of excessive working hours,” said Acting Inspector General of the MoH, Rudi Supriatna Nata, during a press conference at his office in Jakarta on Thursday (7/5).

He stated that the regulations for intern doctors’ working hours are 40 hours per week, with a maximum of 48 hours. Daily working hours are a maximum of eight hours.

“Well, Doctor MMA was assigned to the Emergency Department during the February-April period. There were still working hours that exceeded the provisions, 48 hours if that’s the case,” said Rudi.

The MoH also found that supervising doctors allegedly attempted to manipulate the attendance schedules of intern participants.

He said the supervising doctor did this to make it appear as though Myta’s schedule complied with the rules. Rudi showed evidence of chats from the supervising doctor who wanted to change the schedule.

“This means there was an instruction from Doctor J, as the supervisor, to the participant to manipulate the data. We have already seen this data, and the late Doctor MMA also signed it,” said Rudi.

“In the chat, it also states that this was forcing a sudden signature, saying it’s for the MoH, we already know they’re going to investigate, right? So he made a chronology to protect himself. Indeed, we also received the chronology from the supervisor’s version,” he added.

The investigation results also found that in the Emergency Department, especially at night, certain organic doctors relied more on intern doctors to handle patients under the pretext of allowing them to learn more.

“Reasons like that. So some doctors would ask for permission to eat at the canteen, or to smoke at the canteen, and so on. There were also those who rested and slept in the on-call room. This was reported based on the statements we obtained,” he said.

Rudi stated that this is not allowed because intern doctors should be supervised in practising patient care.

In addition, from the investigation, the interns at that hospital received a Living Cost Assistance (LCA) of around IDR 3 million per month, without incentives.

The intern doctors at that hospital asked colleagues at other hospitals about additional incentives they received.

“Well, outside of the LCA set by the MoH, some regions, with their regional capabilities, provide additional costs, additional incentives. In Bengkalis, it’s around IDR 5 million per month. In Seruyan Regency, IDR 3 million per month. In North Halmahera, around IDR 1.5 to 2.5 million per month,” he said.

The investigation also found that in the initial agreement, intern participants must fulfil on-call schedules and certain performance targets to graduate.

This is suspected to be one of the reasons why interns were reluctant to take sick leave, as they did not want to extend their time or prolong it.

“It is known that participants only have four days that do not need to be replaced if they are unable to attend. So if sick, four days. But if more than that, they still have to replace it even if they are sick,” he said.

“The regulations have already been changed, as conveyed by the Minister of Health for the future. This is what is suspected to be the reason Dr. MMA still came to work when sick. So she did not want her time extended,” Rudi concluded.