Sabtu, 20 Februari 2010

The Crisis in Indonesia

The receding economic tide in Indonesia has left many people stranded without healthcare of any kind. The combination of the economic crisis and two years of drought has left the Indonesian people without any social safety net. Much of what impacts the ability of the government to provide adequate healthcare for its people are things that are not strictly healthcare related. Specifically, domestic budgets have fallen precipitously while costs have soared across the board. Meanwhile, the healthcare system hemorrhages.
The drought in Indonesia has caused the widely publicized brush fires. The relentless effects of the fires have caused a severe healthcare crisis of it’s own in the poorer provinces where healthcare standards are significantly below those of Java’s. Many people living in the cities have lost their jobs. . Nearly half of the nation’s population is now below the poverty line.

For instance, in and around Jakarta, those who previously could not pay and expected free service from the public health system has grown from 10%to 40% and continues to rise. This of course is playing havoc with the government health budget.

The Rising Cost of Healthcare: In Jakarta and throughout Java, medicine and medical supplies are still generally available for the health system facilities and for the public. What used to cost $2.00 is now costs $6.00 or more. Yet the number of people that can afford to pay for them is declining rapidly.

The reason for the sharp increase in price to the consumer is that the medical system is highly dependent on imported products. Nearly 89% of the cost of health care is imported. This includes the costs of medicine, of which a considerable amount is manufactured in Indonesia but nearly all the ingredients are imported. Nearly all medical disposable items, such as syringes, reagents, and x-ray film, etc. are imported. The domestic pharmaceutical industry can no longer import raw materials, as they have been unable to obtain letters of credit.

In public hospitals, the vast majority of patients have no health insurance and must pay for some services and purchase their medication, labs, x-rays, etc. Costs are now high. For example, the cost of an x-ray is Rp30,000 and the film cost Rp15,000. This cost is prohibitive for most of the patients who must use the hospital. Inpatient care costs Rp7,500, which includes 3 meals and "basic medical".

Large public hospitals are filled with patients who cannot obtain adequate basic healthcare at a primary level. They wind up at the public hospitals with severe complications of conditions that could have been easily treated earlier. Hospital budgets are severely constrained. Patients must buy the medical supplies used in the hospital. Neither patients nor public hospitals can pay for the supplies and medicines needed.
During our trips to Indonesia we have seen Indonesian mothers die after giving birth from such easily curable maladies as anemia. The effects of malnutrition on a generation of children will take its toll on the future of the country. DiIndo babygirl.GIF (19451 bytes)arrhea, Typhoid, Dengue Fever, Malaria, and other curable diseases continue to decimate the population. Funds for the medicines and supplies necessary to treat these maladies are not available. Hospital emergency rooms are filled with the victims of automobile and motor bike accidents. The economic crisis has taken its toll on budgets and x-ray film is a scarce commodity. A simple disposable syringe is so costly that it is reused a number of times before being discarded. Hospital budgets fall far short of the need.

The Uplift Indonesia program has been a stimulus for the infusion of additional humanitarian support for the people of Indonesia. Let’s keep the program alive. Let’s help sustain the lives of millions Indonesians, who, through no fault of their own, have nowhere else to turn.


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