Mirna Nurasri Praptini, Jakarta
It is a well-known fact that many Indonesians seek medical help abroad. The fact that some 30-40 percent of foreign patients in Singapore at any one time are Indonesian is proof of this.
Mount Elizabeth hospital in Singapore is often referred to as the Indonesian Hospital due to the high number of Indonesian patients passing through its doors.
When asked why they seek medical treatment abroad, many Indonesians say the health care sector in Indonesia is poor and the price of medical help abroad is acceptable considering its quality.
Neighboring countries such as Singapore and Malaysia are now aggressively promoting their health care services in Indonesia, as can be seen in advertisements with attractive slogans such as ""affordable health check-ups"" or ""health tourism"".
Unfortunately, the government has paid little attention to this trend. Illegal alternative medicines and medical techniques also seem to go unnoticed in the country. All across the city banners are displayed advertising non-surgical cures for cataracts, medicines to treat cancer and programs that can make people lose a considerable amount of weight in a week.
When one types ""health tourism Indonesia"" into a search engine, a relatively small number of results are found. However, if this is substituted for ""health tourism Singapore"", the number of results is twice as many.
The skills and attitudes of health care professionals working in Indonesia adds to the dilemma. As patients tend to go directly to specialists, the treatment they receive is often not holistic.
For example, if an overweight person visited a nutritionist, they may be diagnosed with an eating disorder, while if the same patient visited a psychiatrist, they may be diagnosed with depression.
It would be best for such people to visit a general practitioner (GP) before they sought more specialized treatment. But in Indonesia, people do not seem to trust GPs and go directly to specialists.
Patients also often question the necessity of expensive examinations carried out by Indonesian doctors, who often fail to be communicative enough.
When patients seek a second opinion abroad, more often than not the same examinations and tests will be carried out, but will be explained to them first, enabling them to justify the expense.
Furthermore, a low standard of service tends to be offered in Indonesian hospitals and pharmacies. Patients are often forced to wait a long time to see a doctor. Consultations also often seem hurried due to the limited time doctors have.
Nurses seem just as busy, or unwilling to help, as doctors. In public hospitals, patients have to buy their own medicines or they will receive nothing and more often than not have to collect their own urine samples for testing.
In Singapore and the Netherlands, patients have scheduled appointments so they do not have to queue for too long. In England, doctors make house calls and often do not seek payment as they already receive salaries from the government. In Singapore and Malaysia, Indonesian patients are happy to pay for expensive examinations as their conditions are explained thoroughly and doctors rarely keep them waiting.
Many pharmacists in foreign hospitals text message patients when their medicines are ready so they can take a stroll while waiting. This level of service does not seem to be available in Indonesia.
We need to improve our health care sector because if people stay in Indonesia to receive medical treatment, there will be more money in the government's coffers to fund development.
We could improve the standard and skills of our health care workers by asking doctors and nurses to take competency tests.
Such tests will be carried out for the first time in Indonesia on Oct. 31. Doctors will also have to continually study, as their licenses will be canceled if they fail to meet minimum requirements, including participating in seminars, writing journal articles or joining discussion groups.
In public hospitals, the number of nurses is not adequate. For instance, many renal failure patients in need of emergency haemodialysis are not treated due to a lack of human resources. This is life-threatening.
Finally, the salaries of doctors and nurses need to be raised. We could learn from England, where doctors are given a certain area to work in and are paid monthly salaries.
While such salary hikes may not stop Indonesian citizens seeking treatment abroad, at least Indonesian health care workers would have increased pride and dignity.
In order to encourage patients to stay in Indonesia, we need to offer and promote good health care services. The government must help in this endeavor by nurturing an organized health tourism sector.
The writer is a student at the University of Indonesia's School of Medicine. She can be reached at riichan22@gmail.com.
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