Nario, Yahya win medical literature prizes
By Ivy Susanti
JAKARTA (JP): Nario Gunawan was recently awarded second prize in a writing contest for doctors held by Medika medical journal, for his essay on toilets in Wanasaba in East Lombok, West Nusa Tenggara.
But the essay is not just about toilets. The 30-year-old doctor witnessed the poor health conditions in the village when he was first posted there in 1993 as a state physician to provide health services and conduct research.
He became convinced that what the community needed more than anything was clean water and sanitation, in addition to basic health care such as immunization and mother and infant health provided by the Ministry of Health.
Of the 12,000 residents, he learned that only 10 percent used toilets. For the others in the village, when nature called, there were some secluded spots in their fields or the river flowing through the village. The same river that served as their drinking supply.
"No wonder they had diarrhea outbreaks every year," Nario said.
He decided that each household should set up its own toilet. But ordering people to discard their old habits and start using a toilet was not easy.
Nario learned that religious leaders played a big role in the daily lives of the predominant Moslem community.
In cooperation with local leaders, he declared that those caught defecating in the river would be publicly punished. Their names would be announced from the mosque's loudspeaker.
"I traveled along the river at a certain time every day. Sometimes I disguised myself by wearing kopiah (traditional black cap) and sarong," said Nario, who is of Chinese descent.
"If I caught anyone in the act, I recorded his name."
He said the residents slowly grew to understand the importance of toilets, and attributed the decline in the number of infectious diseases to this new awareness.
Nario, a graduate from Airlangga University's Medical School in Surabaya, East Java, was brought up in Indonesia's second largest city. He learned quickly, however, to adapt to life in a small village in one of the least developed provinces in Indonesia.
As the only doctor in the area, he would often have to attend three emergencies every night.
"After I received the third call, I usually could not go back to sleep," he said.
But despite his success as a health practitioner, things did not always go smoothly. He encountered problems in the early stages of his three-year service in the predominant Moslem community.
"I am not a Moslem. I tried to get to know the people through their religious services. I joined the Ramadhan (Moslem fasting month) safari and toured mosques with the villagers and district heads to understand the basic needs of the community," he told The Jakarta Post after the Medika Award ceremony.
The one lesson he learned at the end of his service was that life is valuable no matter what ethnic or religious group a person belongs to.
Nario is now attending a specialization course on orthopedics at his alma mater in Surabaya.
Malaria
Nario's colleague, Achmad Fauzi Yahya, won third prize in the contest with his essay on malaria in the Labuhan community health center, Sumbawa Island, where he still serves as a medical practitioner.
He realized that the proper treatment of malaria, one of the major killers in Indonesia, required an improved health service.
The 29-year-old doctor started by retraining the medical staff in the clinic where he was posted on health care services such as telling mothers when to have their children immunized.
Fauzi covers nine villages scattered across Sumbawa, Medang and Moyo islands with a population of 30,000. But while distance is a problem, overcoming different ways of thinking is even more difficult.
"We can't force them to think and feel like us, if we want to serve them. I think that we have to be is a friend to them, a partner," said Fauzi who also won the government's Dokter Teladan 1997 (1997 Model Physician) award earlier this year.
He also encountered loneliness and homesickness in the first few months which were compounded on Nov. 15 when he married his sweetheart Haniah who has not yet been able to join him in Sumbawa.
Jury
The Medika Award was presented by the journal's editor Dr Kartono Mohamad on Nov. 20 in Jakarta.
A jury comprising prominent names in the Indonesian medical field such as A.A. Loedin, Mahar Mardjono, Prawiti Sudharmono, Arjatmo Tjokronegoro and Zubairi Djoerban, reviewed 44 articles, 34 book reviews, and 11 reports from remote village health clinics for the 1996 award.
The first category, articles on medical technology development, was won by R. Boedhi Darmojo of the Diponegoro University in Semarang, Central Java, and Sujono Hadi of Hasan Sadikin Hospital in Bandung, West Java.
There were no first, second or third winners in the second category, but an award was given to Uri Goldbourt from the Neufeld Cardiac Research Institute, Sacker School of Medicine in Tel Aviv, and to Allen R. Richards from the Immunology Department at the Naval Medical Research Unit in Jakarta.
Nario and Fauzi won in the third category, along with Sukwan Handali, a doctor posted in Jayawijaya regency, Irian Jaya and Asep Purnama from the village health clinic in Dili, East Timor.