Remote villages to have better access to health services

The Jakarta Post/Jakarta

Manling, short for mantri keliling, or mobile male nurses, will soon color the local vernacular in villages in Lebak regency, Banten, and later on throughout Indonesia, as the Ministry of Health plans to make them available in remote areas across the country.

The mobile nurse program is a pilot project initiated by Lebak regent Mulyadi Jayabaya in an effort to bring much-needed health services to inhabitants of remote areas.

"Before there were manling, usually we had to take ojek (a motorcycle taxi) that cost Rp 75,000 (about US$8) to take us to the nearest community health center (Puskesmas), which is about two kilometers away," said Bambang, 42, a resident of Cileles village in Lebak, who had just received his health insurance card.

"Although the old service was free of charge, the cost of transportation made us reluctant to seek health care, even when needed," he said.

He also complained that his village's health center only opened on Mondays and Thursdays. "The joke among villagers was 'don't fall sick on any other day' because it will be very expensive," he said.

Now he feels less anxious, as 40 traveling male-nurses, recruited and trained by the local regency administration, are ready to ride their motorcycles and regularly visit the area along with some other 149 underdeveloped remote villages in the regency.

"We really need an accessible service like this," Bambang said.

Data from the ministry shows that as of 2004, there were 7,452 community health centers throughout the country, including 22,002 secondary centers, 26,975 maternity clinics and 5,818 four-wheel mobile health centers, with at least one nurse assigned to each.

However, the seemingly large number of health centers and workers does not necessarily guarantee proper health care for all the population, as villagers in remote areas have difficulty accessing them.

"If this first project succeeds, we will make this a national program, as it would be no use providing free health services for the poor when they can't access it," Minister of Health Siti Fadilah Supari said earlier this week during a visit to Lebak regency.

Lebak health agency head Djaja Buddy explained that ideally a village should have at least one mobile male nurse, who would be equipped with a standard medical kit and who could provide care in minor cases. They would refer emergency cases to the nearest doctor, in addition to educating the public on health care.

"The nurses will be trained to maintain high mobility and competence in dealing with minor cases," Buddy said, adding that one motorcycle, including the medical kit, cost Rp 14.5 million.

Considering that currently there are 36.2 million people living in 10,600 underdeveloped villages in need of free and accessible health services, the government will have to set aside more than it had previously planned. (003)