Poor people need more access to health services

Poor people need more access to health services

JAKARTA (JP): The Group of Women Against Violence (Gabungan
Perempuan Anti Kekerasan) demanded yesterday that information on
low cost, quality health services be more accessible to the poor.

They also urged yesterday that the government and hospitals be
more sensitive to people's shame of admitting to be poor and the
fear of poor quality service if they do.

"The inadequate information for consumers, especially about
health services provided by hospitals to the poor, lead to them
becoming health care consumers without any bargaining power,"
read the group's statement. The group is comprised of 17 non-
governmental organizations.

Nine representatives of the group placed posters around the
main entrance of the state-owned Cipto Mangunkusumo General
Hospital (RSCM) in Central Jakarta, before meeting with the
hospital management yesterday.

Patients going in and out of the entrance crowded around the
posters, including the largest which cited a clause from the 1992
Health Law: "Each citizen has an equal right to acquire the
highest standard of health."

The group's protest was triggered by the case of a Tanjung
Priok resident who came to the hospital to pick up her baby on
Sept. 19, only to find the baby had died on Feb. 24.

The baby had been taken by his father, a newspaper vendor, to
RSCM shortly after a midwife delivered it on Feb. 10. The midwife
said the baby had no rectum.

The mother, Suni, told reporters she came after receiving a
notice from the hospital on Aug. 8 that they owed Rp 317,500
(US$139.56).

Suni said they didn't get notification of their child's death.
The management, who insisted they could not locate her address to
convey the news, could not explain why she received the bill but
not the death notification.

Suni's husband was quoted by the Kompas daily as saying that
since taking the baby to RSCM in February, they were scared to
visit their baby because he had been informed treatment cost Rp
50,000 a day.

Suni then got an official note stating he was poor. The note
is required to obtain free or low cost health services.

The hospital's Deputy Director for Medical Services,
Hermansyur Kartowisastro, said the management regrets that the
family did not inquire about free or low cost services.

"People can ask the doctors, the nurses, the administrative
staff... but somebody has got to ask," said Hermansyur.

He also explained that the management and staff had gone
through all mandatory procedures in the absence of a patient's
family.

"If we put up signs on the procedures (to gain low cost or
free services) people would be more ashamed to ask," he said.

Tati Krisnawaty of the Solidaritas Perempuan Association,
urged that hospitals must be more active in educating the poor
about access to low-cost or free services.

"The poor may either be ashamed to admit being poor, or they
may fear low quality service and discrimination if hospital staff
know they are poor," Krisnawaty said, citing a number of cases.

The women's group also demanded lower medical costs and higher
subsidies for state-owned hospitals to serve the poor. They said
money spent on unnecessary and expensive medication could be
better put toward subsidizing the poor. They also protested the
"explicit and implicit forms of commercialization of health
services."

The Director General of Medical Services at the Ministry of
Health, whom they met later, said efforts at providing services
for the poor are constrained by the ministry's Rp 946.3 billion
budget. Health care is only allotted 2.5 percent of the state
budget.

Hospitals, he said, must undertake their social function "but
must also be managed economically". (anr)