Wed, 12 Nov 2003

Squatters under overpass toll road wave free clinic goodbye

Dewi Santoso, The Jakarta Post, Jakarta

In less than two months, dozens of squatters living under a section of Pluit-Cawang overpass toll road in North Jakarta will not only lose their makeshift tents but their access to free healthcare as well.

The area where the migrants have been staying for years will be demolished by the municipal administration as part of the Jakarta government's policy to evict illegal settlers occupying state land, bridge tunnels or areas under overpasses.

For the past two years the squatters have been receiving medical care at the Kartini Free Health Clinic run by twin sisters, Sri Rossiati, better known as Rossi, and Sri Irianingsih, also known as Rian.

The two housewives also operate a free health clinic near the Bantargebang dump site in Bekasi, West Java. some 30 kilometers east of Jakarta. The clinic in Bekasi was built in 2000.

Access to healthcare for everybody is one of the government's targets under the National Health System (SKN) to be launched by President Megawati Soekarnoputri on Wednesday, in conjunction with National Health Day celebrations.

Under the system, poor people will be provided with free medical services -- as long as they hold health cards, which cannot be obtained unless they posses identity cards.

The Kartini health clinic does not discriminate against those who do not have ID cards. Every Monday or Saturday some 20 people seek treatment in the modest 7 meter by 10 meter clinic constructed from plywood. The clinic opens at 9 a.m. and does not close until everybody is examined and treated.

"It opens once a week, either on Monday or Saturday, depending on the availability of the volunteer doctors," Rossi said.

The clinic provides treatments for minor illnesses, such as colds, skin rashes and paratyphoid -- all at no cost.

"I have all kinds of drugs, patented and generic, which I buy from Pramuka market," Rossi said, referring to the center for retail drugs on Jl. Pramuka in Central Jakarta.

The medical workers who examine the patients and prescribe medication are interns from the Atma Jaya University and the Indonesian Christian University.

"I just asked professors at those universities if there were any interns to help me at the clinic, and they said 'yes'," Rossi recalled.

As for the number of interns serving the poor, Rossi said that would depend on the situation. "Once, we had 15 interns help us do free circumcisions," she said.

The clinic also provides family planning counseling.

Patients with tuberculosis will be referred to the Bekasi General Hospital, where they will receive free treatment by showing a recommendation letter signed by Rossi or Rian.

Some of the squatters said they went to Rossi's clinic as they could not afford to pay the medical fees at a nearby community health center (Puskesmas).

The Jakarta Gubernatorial Decree No. 266/2000 stipulates that general treatment, dental, maternal and children's healthcare, and birth control at a Puskesmas should cost only Rp 2,000 (23 U.S. cent) per treatment, medicine included.

Yet, in reality, the cost is often much higher.

Ani, a mother of two children, said that she had been to a Puskesmas once and was asked to pay quite a large amount of money.

"I went there once to get treatment for a fever, and I had to pay Rp 20,000 (US$2.35), plus another Rp 3,000 for registration," she said, adding that she did not qualify for healthcare under the SKN because she had no Jakarta ID.

But a member of staff at the Pluit subdistrict Puskesmas denied the complaints, saying that the health center had always complied with the gubernatorial decree.

The Kartini clinic is solely financed by Rossi and Rian, without support from the government.

"It cost us Rp 30 million to build this clinic. We also spend our money on drugs, which cost us between Rp 1 million and Rp 2 million per month," Rossi said, adding some private donors had helped them.

She said she had no plans to form a non-governmental organization to operate their health clinic.

"I don't want to beg for money. If they (the government) want to donate, then we'll accept the donation. If they don't, then we'll manage on our own just like we've always done," said Rossi.

The sisters, who also run a free school for the poor, have been actively involved in healthcare services since 1997. They started their humanitarian mission by distributing vitamins and over-the-counter remedies to homeless people living under bridges in different parts of Jakarta from Ancol and Pluit in North Jakarta, to Tambora in West Jakarta, and Bantargebang. They ran the clinic from their van which they had modified.

In 2000, they bought one shipping container and received a private donation of eight shipping containers filled with medical and surgical equipment from concerned donors. The twins used this equipment to set up their first free clinic in Bantargebang.

"It's cheaper to use the containers than to build a permanent place. I spent Rp 25 million for one container, which already included an air conditioner," Rossi told The Jakarta Post.

Besides which, she said, if another eviction was to be carried out she could just move the containers to another place.

The clinic in Bantargebang was inaugurated by then health minister Sujudi, who appointed the Bekasi Hospital to provide free healthcare to those referred to it by Rossi.

With the eviction of squatters living under the Pluit-Cawang toll road overpass imminent, Rossi and Rian said they would continue their mission.

"This will all be gone and I'll just have to go back to using my van like before," Rossi said.