Emmy Fitri, The Jakarta Post, Jakarta
Treating an aging and ailing high-profile patient requires more than medical expertise.
The presidential medical team treating the late former president Soeharto was in the spotlight throughout his hospitalization, making the headlines with their daily updates on the condition of the former ruler.
What lessons can be learned from this 24-day medical ordeal?
Chairman of the Indonesian Doctors Association (IDI) Fahmi Idris said, as a fellow physician, he was proud of the dedication and teamwork of Soeharto's doctors.
"I think the (presidential) medical team showed to the public that doctors at home are able to demonstrate their competence. In a greater context, doctors are just human resources, part of the country's whole health service system," Fahmi said.
Wealthy Indonesians frequently travel to Singapore, Penang, Kuala Lumpur and Bangkok for medical treatment. Many others go the extra mile to Australia, the U.S. and Europe for medical help. The absence of public trust in local doctors is cited as the main reason for this.
"Hopefully, with what we've seen in the past few weeks, our people can be convinced that we have competent doctors and modern technology to treat them at home," Fahmi said.
The team, chaired by Army surgeon Mardjo Soebiandono, briefed the media on what medication was being given to Soeharto from day one -- Jan. 4 -- until the former ruler passed away on Jan. 27 as a result of multiple organ failure.
But Soeharto, Fahmi added, was a unique case for he was a former president and had an "unlimited budget" at its disposal for any treatment needed.
"What the government can learn from this is our doctors' competence must be supported with better macro health service management," he said.
"Good medical practices can only happen in a good health service system."
The government, he said, should be able to calculate the needs of general practitioners and specialists in different areas, referral mechanisms and the availability of reliable medical equipment.
"Medical equipment, which are also resources, will not be idle assets if hospitals network."
A better health service system would also see solid networking among doctors and hospitals, and a working insurance scheme, he said.
"A better health service system could therefore enable people, not only state officials or wealthy people, to get better services," Fahmi said.
Comprising 25 doctors, the presidential medical team can call in the top doctors in different fields if they need back-up or a certain expertise, and have privileged access to the latest medical equipment.
One cannot apply to be a presidential doctor, likewise one cannot refuse when appointed to the team," cardiologist Muhammad Munawar told Metro TV on the recruitment system for the presidential medical team.
Mardjo Soebiandono said overall, treating Soeharto was an extraordinary experience, not only in terms of the medical challenge but also the overwhelming media pressure.
"Geriatric patients like Pak Harto are more difficult compared to younger patients. On top of that, he also had a history of mild strokes, kidney stones, gastronomic and heart ailments. Decisions that we made had to be based on a comprehensive monitoring of his overall condition," he said.
"But with the help of colleagues, we were privileged to be able to use high-end medical equipment such as the Continuous Venovenous Haemodialysis (CVVHD), tissue doppler imaging and nuclear-powered thalium scan. I think it was a great experience for all of us on the team," said Mardjo, who also treated former vice president Sudharmono until his death in 2006.
Mardjo said doctors held meetings twice a day to review Soeharto's condition. In one of the meetings, usually the night meeting at around 9 p.m., family members were invited and briefed on Soeharto's condition.
"We were also challenged to communicate with the media. That's not part of the medical school curriculum," he said.
Three days before Soeharto's death, Mardjo said, doctors planned to perform a CRT (cardiac resynchronization therapy) to regulate Soeharto's cardiac muscles, but "God decided differently".