Thu, 04 Dec 2003

Sri Oemijati, a lifetime in research

Dewi Santoso, The Jakarta Post, Jakarta

Sri Oemijati may not be the kind of hero people would imagine -- strong, tough and vocal. The fragile, petite 78-year-old is a savior of people suffering from elephantiasis -- the person whom they will seek to cure the disease.

Parasitology is her calling. Born in Jakarta 78 years ago, Oemijati, better known as Professor Oemi, first started research into parasitology in 1952 while she was in her fourth year at the University of Indonesia medical school.

"At the time, parasitology was a new major. A lot of students were encouraged to enroll as student assistants, and I was one of them," said Oemi on Thursday. There, she said, she received a very good mentoring program, which got her a doctorate in parasitology in 1956 before she completed medical school.

Then, in the same year, she was sent to Louisiana's Tullane University to pursue her master's degree in public health tropical medicine. There, she received her first award for the quality of her research. A year later, she returned to the country to complete her studies at medical school.

In 1960, she became the head of the parasitology department, and served in the position until 1980. When the Southeast Asian Ministers of Education Organization on Public Health Tropical Medicine (SEAMEOTropMed) project was founded, Oemi was asked to give lectures in Kuala Lumpur, Bangkok and Manila every year until she retired in 1990.

She was also asked to help the Malaysian government in Kuala Lumpur to establish the parasitology department in the National University of Malaysia.

"I was the only foreign citizen, and was specifically asked to head the parasitology department," she told The Jakarta Post.

Having spent 50 years of her life in parasitology, Oemi has made a major contribution to the eradication of diseases caused by parasites, such as malaria, worms, schistosomiasis and elephantiasis. The last has taken her to places vulnerable to elephantiasis, including West Java, Sulawesi, Flores and Papua.

Also known as lymphatic filariasis, elephantiasis is a tropical disease caused by threadlike parasitic worms that lodge in the lymphatic system, a network of lymph nodes and vessels that maintains the fluid balance between the tissues and blood, and an essential component of the body's immune defense system. The worms are transmitted by mosquitoes, especially in swampy areas, and live for four years to six years.

Elephantiasis is a chronic disease characterized by the enlargement of certain parts of the body especially the legs and genitals, and by the hardening and ulceration of the surrounding skin.

"In my first research on lymphatic filariasis in Timor in the 1980s, I discovered a new worm, the third to be discovered, that causes the disease," she said.

Since it was a new parasite, she said, it was then sent to the United States to determine its name. It was later named Brugia Timori as a reference to its original habitat. The other two worms are Wuchereia Bancrofti and Brugia Malay.

In a treatment process for elephantiasis in Timor, she discovered that the reaction of the third worms to the given medicine was dissimilar to that of the first worm.

"People suffering from elephantiasis caused by the third worm experienced a high fever after they took one tablet of diethyl carbamazine," said Prof. Oemi. It was not very long before she realized that the fever was actually a sign that the worm had died and that all she needed to do was to lower the tablet dosage.

"My assistant gave me the idea to use a smaller dosage -- 100 milligrams, once a week -- using as an example what was done in a tiny island south of Taiwan," she said.

She decided to apply the idea to Flores and it was a success. When she came back a year and a half later, the number of people suffering from elephantiasis had reduced to 15, from 20. But she was not done, yet.

In 2001, the World Health Organization (WHO) established lymphatic control as a global issue, requiring a treatment of four 100-milligram diethyl carbamazine tablets plus one tablet of albenazol.

"I was confused, as one tablet had caused a fever; what would five do?" Prof. Oemi said. But then, a parasitologist who replaced her decided to do a pilot project on Alor Island, funded by the WHO, to test if her previous results were still valid. They were.

"Thus, we advised patients to begin with a smaller dose, one tablet per week, instead of five. After 40 weeks, they could start with five tablets, as required by the WHO," she said.

Such tremendous work, besides her other contributions to health development, won her nine awards, including one for Concept in Medical Education in Indonesia from the Indonesian Medical Society (IDI) in 1988 and one from the Indonesian Parasite Control Association (P4I) in 2002. The most recent reward she received was the Ksatria Bakti Husada Aditiya in 2003 from Minister of Health Achmad Sujudi in recognition of her dedication to improving health in Indonesia.

A retired professor at the University of Indonesia, Prof. Oemi now serves as the parasitology researcher at the Ministry of Health's research and development department. She has taught many well-known Indonesians, including Tarmizi Tahir, Abdul Gafur, Minister Achamd Sujudi and three former health ministers: Adiyatma, Farid Moeloek and Sujudi.

Oemi, the youngest of five siblings, had also written dozens of book with colleagues, three of which are Guidance on Ethics in Indonesian Medical Research (1987), Medical Parasitology (1988) and a series of seven books titled Guidance on Programs for Eradicating Elephantiasis in Indonesia (2002).

"I always tell people, 'strengthen your scientific ability, for it is always useful and will always stay with you,'" she said.