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#48254 - 25 Mar 07 16:44 JP/Medical practice here unsatisfactory
KuKuKaChu Moderator Offline
Pooh Bah

Registered: 09 Oct 05
Posts: 10790
Loc: Centre of the Universe
From The Jakarta Post

Medical practice here unsatisfactory

"My husband's brother died yesterday," my housekeeper told me.

"I'm so sorry. How old was he? How did he die?"

"Thirty-seven. He fell while working in a field, got sick, went to the hospital and died within a week," she said matter-of-factly.

I learned later that he had never been sick before that. The doctor said it was a stroke but all his blood parameters were normal. That's all they knew.

That is a story oft repeated over my last eight years here in Indonesia. Very young people, in their 20s, 30s or 40s -- in the very prime of their lives -- appear to miraculously drop dead without so much as a week's notice.

Their family and friends carry on stoically; there's not much they can do. Tomorrow it could be they who prematurely fall by destiny's wayside.

Is this destiny or the incompetence and irresponsibility of the medical profession in the country?

This is not a phenomenon that touches the lives of only the poor and powerless. The best medical centers and swanky hospitals of Jakarta and Bogor frequented by the country's elite are beset with similar incompetence.

The diagnosis and treatment is guaranteed to be just as poor, though at 20 times the cost.

These hospitals and clinics do not lack expensive modern equipment, medical supplies, labs, attendants, receptionists, filing cabinets, white coats or artwork.

All the paraphernalia is there but competent doctors and lab technicians are few and far between.

Over time, I have ceased to be surprised at the sudden downswing and demise of people around me but my sense of outrage is still sharp as I hear each new story that exemplifies the ineptitude of the country's doctors and medical centers.

*****

Many of the people I know have tales of weird encounters with doctors in Indonesia that provide much amusement at dinner tables.

Let me relate one. I booked an appointment at a reputable clinic in Jakarta for my annual eye exam. I came prepared for an afternoon of not being able to see once the dilation of my eyes was induced.

The doctor was an older man, hair running a little gray at the temples.

"What do you want checked?"

"My vision for a start -- I have short sight. And then the rest of my eyes, in particular the retinal hole in my right eye."

He asked me to read the letters on the screen. A couple of lines from the top were enough to convince him that I had excellent eyesight, with no problems whatsoever.

"What about the retinal hole?"

He pulled out a flashlight of moderate size and shone it into my right eye.

After a couple of minutes: "I see no hole, all is fine."

It took a lot of self-control to suppress my laughter. It was not quite so funny when I was presented with a bill of Rp 565,000 for this sham of an eye exam.

*****

My all-time favorite over the years is when a doctor ordered a lab test to check on mineral levels in my body to explain the symptoms I was experiencing. The doctor called back with the results.

"The salt content in your body is very low. You should have this checked by a specialist in Singapore and start treatment. In the meantime, consume more salt and isotonic drinks."

I followed his instructions faithfully.

I arrived for my doctor's appointment in Singapore. She looked at the lab result and then looked up at me.

"You shouldn't be alive."

But there was no denying that I was ... alive, so I waited for her to clarify.

"According to this lab test, your salt levels are much much lower than needed to sustain life."

We both started laughing. She sent me off for another test that confirmed that I was permitted to be alive.

*****

After experiences like this I stop by in Singapore for my annual medical checks and for any problems that show no signs of abating, despite months of clinic visits and enough medication of every genre to immunize me for life.

Usually, a quick check, a re-diagnosis and intake of appropriate medication solve the problem rapidly.

A substantial number of Indonesians, those who can afford to do so, also fly out to Singapore for their medical needs.

If the elite are able to source alternate treatment, then the need to drastically improve the quality of medical practice in Indonesia takes a back seat. It is only the poor to middle-income groups who are stuck with substandard care.

A visit to the doctor has been fittingly termed a "consultation" and that is what it ought to be: discussion, examination, diagnosis, clarification, informed consent and meticulous treatment, all sufficiently documented.

I am happy to report that over time, I have found and now frequent a few first-rate practitioners here in Indonesia. I hope the obvious good training, commitment and diligence they exhibit can become an expected standard rather than rare exception.

I am not sure where the problem lies. Is it in the quality of the medical education, the standards set, the quality of the examiners, corruption in a well-intentioned system, or the lack of a public voice demanding better services?

What steps have been taken to resolve the problem? What hope is there for good medical care for Indonesians, rich or poor, in the near future, so they do not lose their loved ones to seemingly unknown or avoidable causes?

-- Maya Chandran
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#48259 - 26 Mar 07 05:57 Re: JP/Medical practice here unsatisfactory [Re: KuKuKaChu]
KuKuKaChu Moderator Offline
Pooh Bah

Registered: 09 Oct 05
Posts: 10790
Loc: Centre of the Universe
this article is no exaggeration of the state of indonesian medicine. in fact, i think it's rather too kind on what passes for a medical "profession" in this country. in short: indonesian-trained doctors are monumentally incompetent, and should be avoided at all costs.

basically, whoever you are, foreign national or indonesian citizen, you should do your utmost not to fall ill or have an accident in indonesia.

if you are requiring medical treatment of any kind, then make arrangements to go to singapore.
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#48274 - 26 Mar 07 11:17 Re: JP/Medical practice here unsatisfactory [Re: KuKuKaChu]
chewwyUK Offline
Pujangga

Registered: 14 Sep 06
Posts: 2392
Loc: Jakarta
Its true.. I think the problem is a combination of poor education and the governments policy of not allowing non-Indonesians to practice medicine here. How can they keep up with all the advances in modern medicine if they cut themselves off like that?

I fell down some stairs shortly after arriving in Indonesia and went to a well known international medical centre. I explained that I thought my ankle was just sprained, but felt it wise to just have a quick x-ray to make sure.

I then had an x-ray of my ankle which was the size of a football. Once finished with that ankle they wanted to x-ray the other ankle. I said there was nothing wrong with that ankle and was told "we need to x-ray the good ankle so we have something to compare the bad ankle to" Needless to say I got up and hopped away and have never bothered seeing a doctor since!

Another Indonesian lady I know was told she had cancer and to make her good byes as she only had 6-8 weeks left to live. Obviously this women and her family were in bits ... The husband was Australian and took her to Singapore to see what the doctors there could do. After consulting one of the doctors they were told she did not have cancer and would probably live to be a hundred!!
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Edited by Piss Salon
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#48315 - 26 Mar 07 14:45 Re: JP/Medical practice here unsatisfactory [Re: chewwyUK]
The Great Gonzo Offline
Member+

Registered: 13 Dec 06
Posts: 134
Loc: Big Durian
I always laughed at the small time doctors office that say Achmed so-and-so MSc.... a MSc is a piece of piss to get... a mere two years, and in Indonesia likely even more of a joke than anywhere else. These so called doctors are little better than high school biology students with a scalpel.

One anecdote I have from there...
A buddy of mine, while drunk, impaled his arm and severed an artery on a spikey gate. His Indonesian girlfriend brought him to the nearest hospital... Rumah Sakit Tebet. They said they were unable to reconnect the artery and would have to amputate his arm!
They made a wise choice and decided to get a second opinion. They taxied down the road to the Australian hospital... I forget the name... and despite a significant amount of blood being lost, and a significant amount of time having passed, they managed to save his arm. Luckily his arm is fully functioning...
I am damn glad that nothing serious happened to me while there... because with accidents like this one you don't have time to get on the next plane to Singapore... you might just end up with one glove or shoe too many.



Edited by The Great Gonzo (26 Mar 07 14:46)
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