Most of Indonesia’s frontier regions are located far from the major seats of governance. The poor state of infrastructure connecting them to the rest of the country poses a challenge of access. Data from the National Board for the Management of the Frontiers (BNPP) show that 222 districts (kecamatan), part of a 2020-2024 priority locus, require outside intervention, including in matters pertaining to health. 184 public health centres (puskesmas) and 35 hospitals has been built in such areas since 2020. The government has also launched several initiative to boost public health in the wake of Covid-19, one of them being Nusantara Sehat, a programme specifically directed towards outlying frontier areas.
Nusantara Sehat (in English: A Healthy Nusantara) is an integrated public health initiative. It handles the preventive, promotive, and curative aspects of healthcare by special assignment of specific amounts and types of health workers based in teams. This programme aims to increase the quality, and access to, healthcare in underdeveloped, frontier, and archipelagic areas (DTPK), and those areas in which healthcare remains problematic (DBK). Among the health workers participating in Nusantara Sehat are alumni of the Faculty of Medicine, Universitas Indonesia (FKUI) scattered throughout various locations in the country.
The Minister of Health of the Republic of Indonesia, Ir. Budi Gunadi Sadikin, CHFC, CLU., expressed his appreciation of the participation of UI alumni in the programme on the occassion of a webinar titled “Building Indonesian Healthcare from the Frontiers,” held on Monday (14/3). “We hope that support from UI’s academic community may enable the transformation of healthcare, so that all people, including those living in the frontiers, may access quality healthcare. I am sure that UI is capable of providing concrete contributions towards the advancement of Indonesian healthcare, especially in the frontiers.”
The webinar was attended by doctors graduated from UI, who are currently working in various locations in Papua as part of the programme: General Practitioner in RSUD Boven Digoel, dr. Satrio Wahyu Fathurahman; General Practitioner in Puskesmas Kabare, Raja Ampat, dr. Nadia Amani; Internal Medicine Specialist in RSUD Fakfak, dr. Subhan Rumoning, SpPD; Pulmonary Specialist in RS Dok II Jayapura, dr. Victor Paulus Manuhutu, SpP; and Obstetrics and Gynecology Specialist in RSUD Teluk Wondama, West Papua, dr. Indah Kurniawati, SpOG, FICS. All of the five doctors shared their experience while working as part of the programme.
One of the roles such doctors play in the fight against Covid-19 is being spokesmen: informing people of measures to be taken in the countering of the virus. They also take part in the creation of strategic policies concerning the treatment of patients afflicted. The main problem faced by health workers in Papua who deal with Covid-19, according to dr. Subhan, is the lack of workers available, policies and regulations not linearly proportional (i.e. designed in accordance) with medical speed, medical support, and local culture. In urban areas the work culture is very fast, while provincially the work culture takes on a more relaxed pace.
In facing this type of situations, according to dr. Victor, doctors should be capable of communication with the population and adapt well to the limited medical infrastructure available. Good communication helps doctors to fulfill the priority needs of their patients. “As graduates of FKUI (the Faculty of Medicine, Universitas Indonesia), not only do we perform clinical duties, but we are also to perform many [other] things, among them being, designing isolation chambers and boxes for swabbing, taking care of patients; even when cleaning service are wary of retrieving waste from Covid-19 patients, we are the ones who retrieve them. Thus, doctors in the regions are expected to be agile, brisk, and bright in performing many sorts of things,” stated dr. Victor.
As the only specialist of obstetrics and gynecology in Wondama Bay, West Papua, dr. Indah handles all cases of obstetrics and gynecology (hereafter ‘obgyn’) for all patients, whether or not they are afflicted with Covid-19. Doctors, in her view, ought to think about the equitable distribution of healthcare towards society at large. Doing so is part of a doctor’s concern towards public health. When stationed somewhere away from their previous place of residence, doctors may hone their skills and independence in decision-making. The contribution these five doctors have given towards society is a manifestation of a tenet of their field of work and study, which urges them to “devote the rest of [their] lives in service of humanity.” Doctors, however, do not only provide healthcare and service; they also serve as front-line troops in the fight for the betterment of healthcare.
These services rendered towards the community by doctors graduated from UI’s Faculty of Medicine is in line with the hopes placed by the dean of the Faculty, Prof. Dr. dr. Ari Fahrial Syam, SpPD-KGEH, MMB., towards them. These actions, lauded Prof. Ari, are extraordinary; they demonstrate the presence of figures from UI across the country. “We hope that students from the regions who complete their studies in FKUI may serve in their places of origin. Praise be to God, many doctors are willing to serve and contribute in Nusantara Sehat. We hope that FKUI alumni may spread throughout all Indonesia in support of equitable distribution of healthcare,” stated Prof. Ari in the webinar held in conjunction by a unit of UI’s Career Development Center and FKUI alumni.
