Public health centers extend services to 24 hours

Muninggar Sri Saraswati, The Jakarta Post, Jakarta

It was in the middle of the night when Hadi, a street vendor, had a terrible stomachache. Instead of visiting the emergency unit of any hospital, Hadi went to the nearest district community health center, which is now open 24 hours.

Hadi, however, had to pay more.

He usually paid a Rp 3,000 fee for a visit at the Tanah Abang health community center (Puskesmas). But at night, it cost him Rp 10,000.

"It's expensive, but never mind. It is an emergency," said Hadi, who always went to the community center when he was sick.

The doctor who was on duty said he worked in shifts with his colleagues to serve patients at night.

"Most of the patients here are victims of traffic accidents. We have also twice helped women who were about to give birth," said the doctor, who declined to be named.

The health center handles less than five patients each night on average since it started to extend the opening hours two months ago.

The health center used to be open from 8 a.m. to 4 p.m.

The extension of the opening hours is in accordance with the instruction of the City Health Agency which requires the 42 district community health centers here to remain open 24 hours a day, seven days a week.

The policy has been implemented to help low-income patients in emergency situations, said the agency spokeswoman Evy Zelfino.

"It is also a pilot project for self-financed health centers in the autonomy era," she said.

According to Diah, the staffer at the Tanah Abang district health center, patients who come to the center from 4 p.m. to 8 a.m. are charged Rp 10,000 instead of Rp 3,000.

She said that despite the higher tariff, many patients came to seek medical treatment in the late afternoon because they work in the morning.

"They don't have the time to visit us in the morning because they have to work. They don't mind paying more for the afternoon health service," she said.

The health service fee does not include medicine, which usually costs about several thousand rupiah.

Dr. Marius Widjajarta of the Indonesia Health Consumer Empowerment Foundation (YPKKI), hailed the 24-hour service offered by health centers. However, he warned the centers against commercialization.

"Puskesmas is supposed to educate people in disease prevention, not act as a provider of primary care commercial health treatment. It carries a social mission, particularly for the poor," he said.

"They should not charge too much of a fee, because most of puskesmas patients are those from low-income brackets," he said.