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The Jakarta Post
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A few good reasons to choose foreign hospitals and doctors

  • T. Sima Gunawan

Jakarta | Sat, October 3 2009 | 02:04 pm

Good news for Indonesian hospital patients. We now have a new law on hospitals which provides us better legal protection.

The House of Representatives passed the hospital bill into a law at the end of September, a few months before the Prita Mulyasari case hit the mass media.

Prita was a patient at Omni International Hospital in Serpong, about an hour's drive from Jakarta. She was detained and tried on libel charges. Being dissatisfied with the hospital's poor service regarding the results of her blood test, she had spread her complaints via email, which were soon circulated nationwide.

Such a complaint is actually not rare. We have heard many patients talking about various problems ranging from poor services to malpractice. Yet, little has been done to deal with the issues raised.

As a result, a large number of patients seek medical healthcare abroad, including in China, Malaysia and Singapore. I am one of them.

After I was diagnosed with breast cancer in 2004, I saw several doctors in two different hospitals in Jakarta and underwent a mastectomy and six chemotherapy sessions.

During the chemotherapy, I had a bad experience. It was not only about suffering from severe mouth ulcers and hair falling out. I was cheated by a nurse.

At that time I bought the medicine from the Indonesian Cancer Foundation to save money, but the nurse told me that the drug (dosage) was not enough. Therefore I agreed when she said that she would buy some more from the hospital's pharmacy.

It turned out that she lied. When I found out about this scam and told the doctor about it, he only shrugged. "Maybe she was confused," he said.

After the chemotherapy, I had to regularly see my doctor - the one who performed the mastectomy. At the beginning he was nice. But I was frustrated because later he became really rude. I had been determined to see another doctor when I learned that he died from complications. I am not quite sure about his diseases but this apparently explained about his recent attitudes.

My next doctor was nice and friendly. In 2007 he told me to have a bone scan after I complained that my ribs hurt a bit.

The scan results showed that cancer had spread to my bones. He said that I had to wear a brace to support my back because my backbone had been affected.

Another doctor in the medical rehabilitation unit told me to wear the brace for three months all the time, except when I was having a shower or in bed. She also said that I should not move a lot.

Wearing the brace was really painful. After a few days, I could not stand it and decided to fly to Singapore.

My Singaporean doctor shook her head when I told her about the brace. Unlike the doctor in Jakarta, she told me to have a brisk walk or another suitable exercise about 40 minutes a day.

For some reason, I later saw another Singaporean doctor in a public hospital. She was very nice and patient. She answered all of my questions and explained things in detail, sketching on a piece of paper, when necessary.

The soft-spoken doctor also told me that I was on stage 4 because the cancer had spread to my bones.

In August, as she found that my tumor marker was soaring much higher than normal, she told me to have a CT scan. I did it in a private hospital in North Jakarta, which claimed to have a sophisticated 128-slice CT scanner.

I also brought the results of the CT scan that was done in March in another Jakarta hospital for comparison.

When I read the radiologist's conclusion, I was shocked. It said that there was thickening at the wall of the lung, which indicated early metastasis. In other words, the radiologist suspected that cancer had spread to my lung.

I immediately informed my doctor in Singapore, who then asked me to come soon.

She said she wanted to see the CT scan results from the latest examination and the previous one.

Upon my arrival to the hospital last month, I gave all of the results to the receptionist. I did not see my oncologist immediately as she needed to discuss the CT scan results with her colleague.

A few hours later, she told me that there was no such metastasis on my lung.

She showed me the results of the CT scan taken in late August and the one taken in early March.

"Look, the same spots were already there. Actually they look lighter in the new results, which indicate that the results of the recent CT scan are better than those of the previous one," she said.

I was relieved the cancer did not spread to the lung. On the other hand, I was really upset with the radiologist in Jakarta.

"You could sue the hospital," my friend commented.

"Yes, ask for compensation and *if you win* you can use it to buy medicine," another friend added.

Bringing the case to court might draw public attention and this could be a wake-up call for hospitals, radiologists and other doctors to improve their services. But it is also a tiring process, which takes a lot of time and energy. The lack of legal certainty could pose other problems.

The new hospital law, according to a legislator, would provide legal certainty for both patients and the hospital. It also lays down requirements about regular medical and performance audits, which would guarantee the quality of hospital services.

If it is properly enforced, both the patients and the hospitals will enjoy great benefits. The patients would not have to spend extra money to travel abroad for medical treatment and local hospitals would earn more.

There is no doubt that the law is really good on paper. It is the enforcement which remains to be assessed in practice.

The writer is a journalist and cancer survivor.

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