Malinau Government Subsidises Air Evacuation for Emergency Patients in Border Areas
The Government of Malinau Regency, North Kalimantan, is providing subsidies for air referrals of emergency patients in border and remote areas. The policy aims to ensure that residents can still access hospital services despite the difficulties posed by the challenging geography.
In a number of villages in Malinau, the journey to hospital often begins with travelling by river, cutting through forest, or waiting for weather conditions that allow an aircraft to land. In an emergency, every minute is critical to the patient’s survival.
One such case occurred in Data Dian village. A man suffered a head injury after falling whilst working in a field. After receiving treatment at the Data Dian Community Health Centre’s emergency unit, his condition continued to deteriorate, requiring immediate referral to a hospital with more complete facilities.
The medical team at the Data Dian health centre coordinated with the Health Services Division of the Malinau Regency Health Office. It was decided that the patient had to be flown out on the same day.
Before reaching the airstrip, the patient was transported by ketinting boat for around 10 minutes to a jetty. The journey then continued on foot along a steep, climbing trail. The patient was laid on a stretcher that was tied down to keep him stable, then carried in turns by residents for roughly 30 minutes until reaching the airstrip.
Around two to three hours after coordination began, an aircraft took off from Juwata Airport towards Data Dian. The medical team continued to monitor the patient’s condition until the aircraft arrived. Upon landing at Malinau Airport, the patient was immediately transferred to an ambulance and taken to hospital.
This story shows that in border areas, a patient’s survival depends heavily on the speed of coordination and the availability of air transport. Without such support, patients risk losing the golden window for treatment.
Malinau is the largest regency in North Kalimantan Province, covering 3,890,181.92 hectares. The region comprises 15 districts, 109 villages and 381 neighbourhood units. Five districts border Malaysia directly: Kayan Hulu, Kayan Selatan, Kayan Hilir, Pujungan and Bahau Hulu. Malinau’s population in 2026 reached 87,582.
Malinau’s landscape is dominated by mountains, tropical forest and large rivers. Many villages remain difficult to reach by road, whilst river transport is not always reliable. In such conditions, air transport is often the only option for referring emergency patients.
However, flight costs can reach tens of millions of rupiah per journey and are not yet covered by BPJS Kesehatan. This situation has left many patients’ families struggling to obtain timely referrals.
To address this problem, the Malinau Regency Government provides air referral subsidies through Unexpected Expenditure (BTT) funding for emergency patients in border and extremely remote areas.
The air referral budget allocation reached Rp1.82 billion in 2023 and rose to Rp3.16 billion in 2024. In 2025, the budget requirement was recorded at Rp1.52 billion.
From January to May 2026, the regional government realised Rp1.66 billion in BTT spending for air referral subsidies. Most of the budget was used to fund Mission Aviation Fellowship (MAF) flights, which serve areas without adequate transport access.
For many villages in Malinau’s interior and border regions, MAF aircraft are the only means capable of cutting travel time from days to just a few hours. The referral service also covers transporting patients from hospitals in North Kalimantan and East Kalimantan to referral hospitals outside Kalimantan, such as Makassar and Surabaya, depending on treatment needs.
The Malinau Regency Government considers this policy necessary because emergencies cannot wait for lengthy administrative processes. The Unexpected Expenditure funds are used to ensure patients can promptly reach referral hospitals when transport access is the main obstacle.
Nevertheless, the air transport subsidy is not the only solution. Strengthening primary healthcare services, improving the capacity of health workers, availability of medicines, referral communications and infrastructure development all remain necessary. However, in regions like Malinau, the speed of transport is often what determines a patient’s survival.
Through the air referral subsidy policy, the Malinau Regency Government is striving to ensure that communities in border areas have the same opportunity to obtain healthcare services, unhindered by distance, terrain or economic limitations.