Insight: In memory of Ari Wanandi: Healthcare reform overdue

Today, June 21, our family commemorates the 40th day of the passing of Ari, my second son.

Ari succumbed to a malignant cancer that first affected the back of his tongue, and eventually spread to the lymph nodes and other organs. His courageous fight against the cancer lasted about a year, seven months of which he spent at Gleneagles Hospital in Singapore.

During that time, Ari and our family had a few hopeful months thanks to the expertise of and special care given by the team of doctors. Ari did not survive because of the severity of his illness, but our family has no regrets knowing that the doctors made all possible efforts to save him. We witnessed their dedication to their profession and personal care toward patients.

All the months our family spent at Gleneagles gave us an opportunity to get to know other Indonesian families whose loved ones were also patients there. We commiserated with each other and shared many stories of difficulties dealing with healthcare and medical treatments in Indonesia. I have no intention to expose our dirty linen in public, but wish to show the problems we face because they are the main reason why so many Indonesians choose to take their family members to Singapore for medical treatment.

I believe that in Indonesia we have an abundance of good and capable specialists, some of whom are considered brilliant. However, they are too preoccupied with their private practices and have too many patients to deal with. The evening practices of popular specialists in some cases run into the wee hours. By regulation, active duty doctors are obligated to teach at medical schools or practice at designated hospitals in the morning, and so must do their private practice in the evening.

Former vice president Jusuf Kalla, now the president of the Indonesian Red Cross, proposed a new regulation to limit the number of patients a doctor sees to 20 per day. Wisely, he understands that overburdened doctors can never live up to the physicians’ oath that expects them to help patients regain health. Treating patients in haste and with less personal care can lead to the wrong diagnoses being given, which often happens in Indonesia, and sometimes leads to death. This policy would be a good way to provide equal opportunities to doctors to help patients better, and to make sure patients get quality medical treatment.

For common people, the Soeharto administration’s policy to provide public health centers at village and subdistrict levels (Puskesmas) should be applauded and sustained. Unfortunately, this policy has not been well maintained, and doctors and subsidized medicines are becoming increasingly scarce.

As part of a good healthcare policy, the government should do more to promote the availability and use of generic medicines so more people can afford them.

Another problem with the Indonesian healthcare policy is the absence of good legal protection for patients against malpractice by doctors. Cases abound but the available laws and regulations are not adequate to address them, which is a reflection of problems within the judiciary.

One possible policy that both the government and Indonesian Doctors Association (IDI) might consider is cooperation with foreign medical centers, including in Singapore, to help improve public medical services in Indonesia in the spirit of health for all. Indonesia should improve the provision of healthcare services for the general public. Education and healthcare are keys to enabling our people to compete in the globalized world. Our people must be competitive, and for that they must be adequately educated and trained to boost their productivity, while also healthy enough to sustain their workload. Constitutionally, we now have a bigger budget for education, but in implementation there is a lack of vision and strategy related to manpower planning and the future economy we would like to live in.

When I expressed my gratitude to the doctors at Gleneagles Hospital in Singapore, for taking care of my son so wonderfully during the most difficult part of his illness, it did not mean I am ignorant of Singapore’s deficiencies in healthcare. A doctor friend at the Singapore General Hospital observed that while Singapore is so proud to have achieved a First-World level in economic development, in healthcare it is still not on a par with other First World countries. Many more improvements and a bigger budget are needed. The cost of treatment in Singapore is also quite high, especially for foreigners, but in general one can depend on its quality and professionalism, which are so necessary in maintaining or regaining our health.

If some of the problems I mention can be addressed seriously by the Indonesian government by improving the policies and services for the general public then Ari’s pain and passing will not have been in vain. When that happens, I will be the first to thank the government.

Ari, may your departure serve as a lead for the betterment of others.

The writer is vice chair of the board of trustees for the Centre for Strategic and International Studies (CSIS) Foundation.