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By The Way: Finding the silver lining -- in 16 cents of dental care

It recently occurred to me that our media has slowly but surely transformed itself in a doomsday information source

The Jakarta Post
Sun, November 30, 2008

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By The Way: Finding the silver lining -- in 16 cents of dental care

It recently occurred to me that our media has slowly but surely transformed itself in a doomsday information source.

The latest global developments have all but plunged it into a murky well of economical grief. Is there nothing but sadness to talk about, I wondered? Surely there must be a silver lining breaking through these ominous cloud banks. It cannot be all that bad I told myself. And eureka ... I found it in my own backyard, so to speak. There is, after all, a shaft of light feebly sending its groping rays into the monstrous, shadowy corners.

I am talking about the numerous public health centers (puskesmas) spread over the archipelago which in my opinion are doing a good job. At least on this level, we should give praise where praise is due.

Apart from the bird flu debacle which is not showing any signs of improvement, the government's poverty programs are truly extending a helping hand to an ever widening circle of patients with meager purses. With the present inflationary prices, I was not too surprised to find patients from the middle-income bracket also among the general fray.

In a nearby puskesmas -- packed daily with young mothers and children of all ages -- the day begins at 8 a.m. A majority of the patients suffer from flu-related problems.

Two doctors see patients twice weekly. Odd as it may seem, patients with teeth problems can be helped on a daily basis, except on Saturdays and Sundays.

It struck me how brave these young dental patients are. Many of us dread seeing the dentist. These youngsters did not make even the slightest fuss when the doctor sat them in the imposing dental seat.

A chat with the dentist revealed that anyone over 70 years old cannot have an extraction at the center. They are referred to the nearest hospital as they should be given a different anesthetic on account of their age which is not available at the center.

Any service at the public health center will cost the patient a minimum of Rp 2,000 (16 US cents). This includes generic medicines as well. One has to admit that this is practically nothing these days -- it won't even buy a proper bunch of chili.

There is a rule, however, which would-be patients cannot avoid. They have to be registered citizens -- in other words they must have valid identification cards.

The center goes further than just having low fees. Under the government's poverty program it also offers free six-month treatments to TB patients.

A good number of patients have been benefiting from this, said Penny, head nurse in charge of the program. Suspected TB patients first have to give a saliva sample at the center followed by having an x-ray of their lungs taken at the nearest hospital.

Alas, the nearest state hospital requires going on a trip to Depok which is, I think, about 10 kilometers from where I live. That's not too promising for emergency cases such as cardiac patients.

If the x-ray shows positive signs for the disease, the patient is put on a six-month treatment period. This consists of two months of intensive tablet consumption, followed by a milder dosage for four more months.

According to Penny who has extensive experience with this, an unsubsidized TB package would cost about Rp 2,000,000 ($166).

And that is for generic medicine, mind you. How much would imported drugs costs? Six-figure amounts just boggle the mind.

Another amazing fact is that not all people entitled to have this free treatment want to go to the public health center for a checkup.

Take my servant, for instance. She prefers to see a private doctor which she actually cannot afford and who prescribes medicine that does not really heal her runny nose and cough.

I suppose one cannot win them all. I just hope that the present economic situation will not force the government to skimp on the poverty programs' budgets.

-- Claudine Frederik

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