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

The Jakarta Post, Claudine Frederik, Sun, 11/30/2008 10:31 AM   

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. 

Meru Betiri Applies the Geographical Information System

Friday, 28 November, 2008 | 19:38 WIB

TEMPO Interactive, Jember:In order to list medicinal plants, the Meru Betiri National Park (TNMB) in Jember is now using a digital database with a geographical information system (SIG). The system was a result of a research carried out by three lecturers from Jember University's Technical Faculty.

The lecturers developed the SIG-based digital life which can integrate the entire medicinal plants data belonging to the TNMB forest areas so as to make it accessible to the public. "The TNMB is rich with unique, endemic, and powerful medicinal plants," said one of the lecturers, Maududie, yesterday.

Today, there are at least 101 species of herbal plants, shrubs, and trees which are categorized under 88 groups and 48 sub-species at the conservation forests managed by the TNMB in Jember. 

MAHBUB DJ

First aid needed: Doctors

Agnes Winarti, The Jakarta Post, Jakarta | Fri, 11/28/2008 10:49 AM  

Because many people injured in road accidents die on the way to the hospital, physicians have encouraged the public to learn how to administer basic first aid in emergency situations. 

"More victims of road accidents are brought to the morgue at Cipto Mangunkusumo General Hospital than to the hospital's care unit," said vascular surgeon Suhartono. 

"More people die on the way to the hospital." 

Suhartono was speaking at a seminar held by the University of Indonesia's School of Medicine in Central Jakarta last week. 

The seminar was promoting a safer community by encouraging the public to learn the correct way to apply first aid in cases of emergency. 

Suhartono said traffic accidents were the most common cause of injury in the capital, compared to workplace and domestic accidents and fires. 

"About 90 percent of traffic accident victims are of productive ages. It is such a waste. We must not ignore it." 

He said it was important for everyday citizens to learn how to be medical aids and first responders in emergency situations. 

Without knowing about trauma, which might be experienced by victims, people at accident scenes incorrectly administer first aid. 

For example, people have the tendency to move the injured before checking for bone fractures and dislocations. In some case this can worsen the victim's condition and may even cause death. 

The skills required by people first on the scene include knowledge of how to call rescue teams such ambulances, the police and firefighters, how to correctly lift and moved a patient, how to free the victim's airway and how to stop bleeding by pressing on the wound. 

All of these skills can be taught, Suhartono said. 

"It can be done without any special equipment because that is just how most common people go about their business. They don't walk around carrying medical equipment, right?" 

The Foundation of Emergency Ambulance 118 was established by the Association of Indonesian Surgeons in the 1970s. It has been providing companies, security guards, teachers, firefighters, police officers, pilots and stewardesses workshops on first aid. 

However, not enough people know how to administer first aid, Suhartono said. "The skills are rarely regarded as necessities." 

Most people are also unaware of ambulance services offered by hospitals, the police and the city health agency. 

Less than 30 percent of patients at Cipto Mangunkusumo hospital were brought to the hospital by ambulance, Suhartono said. Most patients arrive by private vehicles, taxis and bajaj, he added. 

"It also shows that the ambulance services offered by those institutions are not up to scratch. 

"There should be clearer regulations for an integrated ambulance system," he said, estimating that a total of around 300 ambulances belonged to 140 hospitals throughout Jakarta, the city health agency, community health centers and government institutions like the Indonesian Red Cross. 

"There is no ambulance network among the different institutions. Sometimes, ambulances belonging to community health centers, for example, are used for administrative work rather than responding to emergency calls." 

To learn first aid, contact Yayasan Ambulans Gawat Darurat 118 (Foundation of Emergency Ambulance 118) on 021-65303118, 64717089. The foundation's office is located at Jl. Letjen Suprapto, Ruko Mega Grosir Cempaka Mas Blok I/6, Central Jakarta.

Overseas demand for Indonesian workers stays high

Astrid Wijaya, The Jakarta Post, Jakarta | Wed, 11/26/2008 10:47 AM  

The ongoing global financial crisis will not reap havoc on the demand for Indonesian migrant workers, particularly in Kuwait, the United States and Canada, an official said. 

According to the promotion director of Manpower Replacement and Protection (BNP2TKI) Endang Sulistyaningsih, opportunity for Indonesian laborers to work abroad remains high, with the U.S. and Canada in need of about one million nurses and care-givers. 

"I just came back from the U.S., and they said they are seeking up to one million nurses before 2020," Endang told Antara. 

Endang added that the demand for care-givers in the U.S. and Canada was on the rise due to the huge population of elderly citizens. 

"Opportunities for our citizens to work abroad remain high, but the biggest challenge comes from language proficiency. We still lag behind the Philippines, India, and Bangladesh, but only because English is an official language in those countries," she said. 

On its official website (www.Bnptki2.go.id), BNP2TKI said that, through a private manpower recruitment company, Kuwait had requested 12,000 nurses from Indonesia for 2009. 

"This is a hard work to deal with in 2009," BNP2TKI head Muh. Jumhur Hidayat said, after a meeting with the company's chief executive in Kuwait on Monday. 

According to the latest data from the Central Statistics Bureau there are 5 million Indonesian migrant workers across the world. The bureau has predicted the number will grow by 700,000 to 1 million next year. 

BNP2TKI data showed that the total combined remittance of migrant workers increased from US$3.42 billion in 2006 to $5.84 billion last year. In the first four months of 2008, the figure already stood at $2.23 billion. 

Canada is deemed the best potential market for Indonesian workers. Yonas Karyanto, the general manager of labor supplier PT Yonasindo Intra Pratama, said Tuesday that, at the end of the year, the North American country had requested 500 skilled Indonesian workers. The company has managed to send just 15 people so far, as the rest failed to meet the Canadian Embassy's qualifications. 

Yonas said Canadian employers would pay their Indonesian employees salary equal to that given to local workers. (iwp)

The Most Lethal Dengue Fever Virus Found in Jember

Wednesday, 26 November, 2008 | 19:50 WIB 

TEMPO Interactive, JEMBER:The dengue hemorrhagic fever (DHF) found in Jember seems to be the most aggressive, and as such, is the most lethal virus of its kind in East Java. “The gene’s mutation process is also more rapid than similar viruses in other areas,” said Fedik A. Rantam, the Institute of Tropical Disease’s (ITD) virologist from Airlangga University in Surabaya, yesterday. 

An ITD study conducted since 2000 showed that the dengue family flaviviridae in Jember was more aggressive compared to samples of similar viruses taken from a other areas in East Java. The virus has a pathogenic character which is now used as a sample to make a DNA vaccine against dengue fever. This comes at a time when for the last two years, there have been changes in the patterns of the DB virus attack. 

Normally, when people catch the DB virus, the symptoms would be red spots, high fever or a bleeding nose, ear or mouth. Now, the symptom could manifest itself in the form of diarrhea, fever, and temporary blindness. Some virus, which may emanate in more subtle ways, normally attacks adults and over-weight people. 

MAHBUB DJUNAIDY

Iris Detection Without Flashlight

Wednesday, 26 November, 2008 | 20:09 WIB 

TEMPO Interactive, Bandung:The Indonesian Institute of Sciences’ (LIPI) Informatics Centre is launching software that would enable the process of detecting the health status of the body’s organs and the body system, by use of an iridology examination. “The system is to detect the body’s condition through the eyes’ iris which is digitally photographed,” said Wawan Wardiana, Lipirisma Researchers Team chief during the first software launch at the LIPI office in Bandung, last Monday. 

The software can aid doctors in looking at the patient’s condition before diagnosing his disease. Doctors can see through the iris from a digital photograph through Lipirisma. “We will no longer need a flashlight to check on the patient anymore,” Wawan said. 

The team is also developing home-based software which people can use before going to the doctor. The home edition is a simpler tool than the ones designed for professionals. 

The software is an improvement over the previous eye iris monitoring software, first developed in 2006. A student at the Surabaya’s Tenth November University has also created his version of the eye iris software. “We guarantee that this software is safe and has a high accuracy rate,” Wawan said. 

Many features come with the Lipirisma software, for instance, a special camera, storing a picture file in a JPEG format, facilitating the analysis function because it provides a Jensen-Chart circle whose area shows information on the related organ. Lipirisma also has database to record the result of the patient’s iris analysis, the iris diagnostic history and a photograph of the patient. The offered retail price is Rp 1,5 million. 

Doctor Farida Megadini from the An Nabwah Clinic in Surabaya has been testing the system for three weeks and said its accuracy rate was 80 percent. “This tool will help doctors in analyzing their patients’ organ’s condition and system by looking at the seven circle zones in the eyes iris in line with Dr Ignatz van Peczely’s projection,” said Farida, who was also involved in the study. 

The tool can be used to treat cataract patients, but it will be difficult for patients suffering total trauma. Many requirements must be met in order to use the tools. For instance, the need for suitable lighting when taking the photograph and using at least a three-pixel camera. “This is to allow a diagnosis of the organs’ health and body system,” he concluded. 

ALWAN RIDHA RAMDANI

Indonesia gets tough with foreign drug companies

Jakarta  (ANTARA News)  -  Foreign drug companies can quit Indonesia if they do not like new rules requiring them to have local production facilities, Health Minister Siti Fadilah Supari said Monday.

Rules introduced earlier this month are designed to encourage foreign companies to transfer technologies to Indonesia and boost investment to create jobs, she said. 

"If they want to get licences (to sell their products) they have to invest here also, not just take advantage of the Indonesian market," Supari was quoted by AFP as telling  Dow Jones Newswires. 

"They can't just operate like a retailer here, with an office size that's three metres (yards) by three and make billions of rupiah. That is not fair."  

The decree, which has drawn protests from the US Chamber of Commerce, will affect 13 international pharmaceutical companies that currently sell their drugs in Indonesia but do not have production facilities here. 

The affected companies include Wyeth, Eli Lilly and Merck Sharp & Dohme Corp. of the United States, Switzerland's Roche, France's Servier, Denmark's Novo Nordisk, AstraZeneca of Britain and Astellas Pharma of Japan. 

Under the new rules, foreign companies have a two-year grace period in which to set up production facilities. 

Supari said she believes Indonesia's big drugs market -- worth around two billion dollars a year -- would persuade the companies that building production facilities is worthwhile. 

Those who fail to do so would be banned from selling their products or distributing them through companies that do have plants in Indonesia. 

"If they want to go away, go ahead," she said. She added that India and China had already enacted such requirements. 

The president and chief executive of the US Chamber of Commerce, Thomas J.   Donohue, last week sent a letter to President Susilo Bambang Yudhoyono, urging the president to "consider revising the decree." 

There are 29 international pharmaceutical companies marketing their products in Indonesia, with total market share of 25 percent. 

The minister said the new rules will give "fair treatment" to pharmaceutical companies that have already invested in drug production facilities in Indonesia.

Microchips for AIDS patients in eastern Indonesia

The Jakarta Post

Niniek Karmini, The Associated Press, Jakarta | Mon, 11/24/2008 7:25 PM  

Lawmakers in Indonesia's remote province of Papua have thrown their support behind a controversial bill requiring some HIV/AIDS patients to be implanted with microchips - part of extreme efforts to monitor the disease. Health workers and rights activists sharply criticized the plan Monday. 

But legislator John Manangsang said by implanting small computer chips beneath the skin of "sexually aggressive" patients, authorities would be in a better position to identify, track and ultimately punish those who deliberately infect others with up to six months in jail or a $5,000 fine. 

The technical and practical details still need to be hammered out, but the proposed legislation has received full backing from the provincial parliament and, if it gets a majority vote as expected, will be enacted next month, he and others said. 

Indonesia is the world's fourth most populous country and has one of Asia's fastest growing HIV rates, with up to 290,000 infections out of 235 million people, fueled mainly by intravenous drug users and prostitution. 

But Papua, the country's easternmost and poorest province, has been hardest hit. Its case rate of almost 61 per 100,000 is 15 times the national average, according to internationally funded research, which blames lack of knowledge about sexually transmitted diseases. 

"The health situation is extraordinary, so we have to take extraordinary action," said another lawmaker, Weynand Watari, who envisions radio frequency identification tags like those used to track everything from cattle to luggage. 

A committee would be created to determine who should be fitted with chips and to monitor patients' behavior, but it remains unclear who would be on it and how they would carry out their work, lawmakers said Monday. 

Nancy Fee, the UNAIDS country coordinator, said the global body was not aware of any laws or initiatives elsewhere involving HIV/AIDS patients and microchips. 

Though she has yet to see a copy of the bill, she said she had "grave concerns" about the effect it would have on human rights and public health. 

"No one should be subject to unlawful or unnecessary interference of privacy," Fee said, adding that while other countries have been known to be oppressive in trying to tackle AIDS, such policies don't work. 

They make people afraid and push the problem further underground, she said. 

Local health workers and AIDS activists called the plan "abhorrent." 

"People with AIDS aren't animals; we have to respect their rights," said Tahi Ganyang Butarbutar, a prominent Papuan activist.

He said the best way to tackle the epidemic was through increased spending on sexual education and condom use.

Woman found dead after alternative medication

The Jakarta Post | Sat, 11/22/2008 8:24 PM  

A woman has been found dead after being treated by a so called traditional medication in Cipancur village, Sukabumi, West Java Province. 

The husband of the 50 year-old Komariah, Dayat, told kompas.com Saturday that bruises were found all over her corpse, but the cause of death had not been clarified by an autopsy. 

Dayat said Komariah, who had been suffering from a nerve dysfunction for two years, was admitted to the care of an alternative medication practitioner near his village on Thursday. She died the following day. 

“I was forbidden to see her when I went there to visit and give her fruits. The practitioner said that she was resting. 

“On Friday night, my wife’s body was delivered to our house, fully covered by white sheets. Due to curiosity of the cause of the death, my family opened the sheets and found bruises all over her body,” Dayat said. 

The family reported the incident to a local police office, which then sent officers to question the alternative medication practitioner and took Komariah’s body to Syamsudin Hospital in Cisaat city for autopsy. 

Heryanto, a physician in charge of the autopsy, said that he need more time to examine the body before deciding the cause of death. 

“An initial examination to the corpse indicates that the bruises were caused by a hammering of a blunt object,” Heryanto said. (and)

Australia, Indonesia to join forces

The Sydney Morning Herald

Australia and Indonesia will join forces to help the region cope better with extreme weather being wrought by climate change and other natural disasters. 

Australia will spend $67 million over five years to help establish a Jakarta-based centre, aimed at reducing the impact of disasters through training in areas of better risk assessment, identifying new threats and improving relief capabilities. 

Prime Minister Kevin Rudd and Indonesian President Susilo Bambang Yudhoyono unveiled the joint strategy on the sidelines of the Asia Pacific Economic Cooperation (APEC) leaders' summit in Lima on Saturday. 

Since the Boxing Day 2004 tsunami, which killed more than 200,000 people in nations ringing the Indian Ocean, Australia and Indonesia have been working together on ways to better deal with the increasing number and severity of disasters. 

In past week alone, Australia has dealt with severe floods and storms in Queensland and the Indonesian island of Sulawesi has been hit by a major earthquake. 

"Not only only do disasters take lives, they take away the livelihoods of survivors," Dr Yudhoyono told reporters. 

"Just this week both Indonesia and Australia experienced devastating calamities." 

The centre is expected to be up and running by April 2009, and will be prepared to deal with the several regional disasters that kill around 10,000 people annually. 

A study by Australia and Indonesia found that half the world's megacities are in locations vulnerable to earthquakes, and issues like climate change, urbanisation and poor land use were exacerbating the impact of other natural disasters. 

"Also our region is subject to intense volcanic activity and now we see the consequence increase storm activity and with greater intensity," Mr Rudd told reporters. 

"With natural disasters, none of us can predict who will be the next victim, who will be hit next and often there is so little notice when they come." 

Mr Rudd said the centre would organise joint exercises to improve operational capabilities between nations and would develop the use of realistic disaster management scenarios. 

It will also aim to better integrate military assets in disaster relief exercises and planning.

 

Nutrition awareness pilot project succeed in educating the poor

The Jakarta Post, Jakarta | Sat, 11/22/2008 12:55 PM  

Residents in Kalibaru, North Jakarta, said a pilot nutrition and health awareness project aimed at abolishing malnutrition helped them understand how to live healthier lifestyles. 

"My family always washes their hands before eating, and I also learned to allocate my money to buy nutritious ingredients rather than spending it on snacks," a housewife, Uus, told The Jakarta Post Friday. 

She was one of the 2,500 Kalibaru residents taking part in the pilot project organized by the Indonesian Poor People's Union (SRMI) and the Directorate of Community Nutrition at The Health Ministry. They launched the project on Oct. 24. 

The pilot project ended Friday in Kalibaru with an event attended by Health Minister Siti Fadilah Supari. 

SRMI executive Marlo Sitompul said the Rp 1 billion (US$83,000) pilot project targeted over 16,000 people in Jakarta's slum areas in 52 subdistricts.

The fund is being used to build communication posts to distribute free nutritious meals every Friday. The fund is also being used to administer one-day intensive training programs to canteen owners at the project's locations on how to properly prepare and cook nutritious meals. 

The trainers are all nutrition experts appointed by the Health Ministry. 

"After the training, I know how to prepare nutritious foods for my family and customers," a canteen owner, Sumini, said. 

Sumini said she learned the proper cooking and food processing methods, including how to make sure the water she used to steam rice was properly boiled. She also learned about balanced diets. 

Despite the positive impacts to the residents' lifestyles, the project experienced some setbacks. Some residents claimed that although their names were on the list of people eligible for free meals, they never received the promised packages. 

"My family never received a free meal, despite the fact that my kids were the first on the list," a resident, Dodo, said. 

She said she expected the project to implement a better distribution system in the future. They really should prioritize the poorer residents, she added. 

Other residents said they also needed free multi-vitamins, especially for babies, the elderly and pregnant women. 

Marlo said the SRMI had done its best to ensure that all listed residents received their free meals, but the project had a limited budget and supply. 

"In some cases, some five-member families only received two boxes of free meals. In such cases, we encouraged the parents to prioritize their children," he said. 

Despite the setbacks, SRMI coordinator Dika M.N. said he hoped that with the pilot project's current success, the Health Ministry would consider putting the project on its agenda and launch it not only in Jakarta, but also in other provinces. 

Five severe malnutrition cases are listed in Kalibaru, according to SRMI. Just last week, 400 toddlers were reported as severely malnourished in Depok, Greater Jakarta. 

In Indonesia, it is calculated that over 4 million children under the age of five were malnourished in 2007. Most malnutrition cases are caused by poverty and the families' inability to provide nutritious food for their children. 

The government has yet to list the actual number of malnourished children in 2008, but according to Ina Hernawati from the Health Ministry, approximately 4 to 5 percent of children under five are malnourished. (hdt)

Half traditional markets prone to bird flu: Commission

The Jakarta Post, Jakarta | Fri, 11/21/2008 6:48 PM  

The National Commission on Bird Flu has revealed that 50 percent of traditional markets that slaughter and sell chickens are highly prone to outbreaks of bird flu virus. 

Head of the commission, Bayu Khrisnamurti, told tempointeraktif.com on Friday there were many such vulnerable markets in Jakarta. 

Bayu said bird flu could spread easily because the markets did not set special zones for slaughtering, selling and accommodating live chickens. 

Between 2002 and 2008, the Agriculture Ministry reported 13 million poultry had been culled in 31 provinces. Only two provinces -- Maluku Utara and Gorontalo --- were apparently free of the disease. 

The ministry's director general of husbandry, Tjeppy D.Soedjana,said, in controlling the spread of the virus the ministry needed to focus on Banten, Jakarta, Bali, West Java, East Java, Central

Java, Yogyakarta, South Sulawesi, Kalimantan, Maluku, Papua and Nusa Tenggara. (ewd)

BPOM seizes illegal medicines in Surabaya

The Jakarta Post, Surabaya, East Java  |  Tue, 11/18/2008 9:32 PM  

Surabaya's food and drug monitoring agency (BPOM) reported on Tuesday it had seized around 100,000 packages containing hazardous medicines and food supplements that were being sold in the city. 

The agency seized 35,230 packages of traditional remedies, and 65,910 capsules of imported traditional medicine, BPOM examinations and investigations head Harlina Samadi said on Tuesday. 

The agency deployed two teams and collected all illegal medicines from shops along Jl. Bratang and Jl. Kapas in the Hoky shopping complex in the Bintaro area. 

"We have pulled the products because they contain hazardous chemical substances, including Sildenafil citrate (sold as Viagra) and Tadalafil (Cialis)," she said. 

Sildenafil citrate could cause dizziness and stomach aches, Harlina said, while Tadalafil could lead to chest pains and strokes. (ewd)

Meat imports may be contaminated: Consumer group

The Jakarta Post, Jakarta | Tue, 11/18/2008 8:06 PM  

Responding to a recent government decision to allow meat imports from Brazil, the Indonesian Consumers Foundation (YLKI) on Tuesday warned Indonesian consumers of serious health risks these imports may pose. 

YLKI board member Indah Suksmaningsih said meat products from Brazil were not completely free of foot and mouth disease. 

"There is only one state in Brazil that is free from foot and mouth disease," Indah said. 

Due to rising prices of meat from Indonesia's traditional meat import sources, such as Australia, New Zealand and the United States, the government decided recently to open up a new channel of meat imports from Brazil. 

While infections of foot and mouth disease are rare in humans, Indah argued that risks would be higher for Indonesian consumersbecause they often consume cow bones and entrails. 

Symptoms of the disease in humans include malaise, fever, vomiting and sometimes small blisters of the skin. 

"It is easier to catch the disease from cow bones and entrails," she said, adding that cow bones and entrails were favored not because of taste and texture but for price. 

To minimize risks, Indah said, the government must at least ban imports of cow bones and entrails, and establish a special task force to scrutinize imports for potential foot and mouth contamination.(anb)

Hospitals take part in effort to reduce waste, emissions

Agnes Winarti and Triwik Kurniasari, The Jakarta Post, Jakarta | Mon, 11/17/2008 10:46 AM  

Green movements, which have sprouted up over the last few years, have encouraged hospitals in the capital to adopt environmentally friendly habits. 

State-own cancer hospital Dharmais in West Jakarta has been reducing its electricity and water usage, reusing paper and producing compost out of its organic waste for years, said head of public relations and domestic affairs at Dharmais, Bambang Purwanto, in a recent interview. 

Dharmais has been encouraging staff members to reuse administration papers and recycle organic waste as compost fertilizer for the past five years, Bambang said. 

"We can reduce up to one third of our monthly paper use, for instance, by using both sides of the paper for administration," Bambang told The Jakarta Post. 

He said the hospital produced up to a ton of compost every month, mostly used as fertilizer for plants on the hospital grounds. Dharmais stands on a 38,920-square-meter plot of land. 

"Several months ago, we began recycling our paper waste. We then use the recycled products as scrap paper," he said, hinting at a plan to go commercial with their recycled paper products some time in the future. 

Eight-story Dharmais has also reduced its use electricity and water usage over the last 10 years. 

"We have managed to cut some 20 percent off our monthly electricity and water expenses. So, we save hundreds of millions off monthly utility spending and use it for improving our employee's welfare," he said. 

"It is not an easy task raising people's awareness and changing their bad habits. They need to be constantly reminded. We make an effort even with the smallest of things." 

Bambang said the simplest yet strongest thing the hospital could do was put stickers on all electricity buttons and water taps reminding staff and patients to reduce their utilities usage when applicable. 

A banner placed in the hospital area encourages staff to set air conditioners at 25 degrees Celsius. 

After years, Dharmais has finally received public recognition for their environmentally friendly efforts. 

It was recently chosen as the first winner among nine other finalists in the Jakarta Green Office Competition co-sponsored by several NGOs and companies, including World Wide Fund for Nature (WWF) Indonesia, and the Jakarta Environmental Management Board (BPLHD). 

"We are very proud to win the award, especially because we are the only hospital participating in the event among dozens of other commercial companies," Bambang said. 

Over the past 10 years, the hospital has established a special team called the Energy Saving Team, which monitors excessive energy use. Any unit reported for failing to save energy will be reprimanded." 

The hospital recently does not only encourage electricity, paper and water savings, but also fuel consumption reductions by encouraging staff members to use public transportation, carpool, or cycle or walk to and from the hospital. 

Since it was established in 1993, Bambang said, Dharmais had its own waste management system for liquids as well as an incinerator to burn body parts taken during surgery and used-medical equipments, such as needles. 

Besides Dharmais, Persahabatan Hospital in Rawamangun, East Jakarta, is also promoting green habits. 

It has provided vast green areas in a bid to increase air quality around the hospital, said the hospital's director Agung P. Sutiyoso. 

"Providing a green and healthy environment is a part of our service to patients, so they will feel safe and comfortable," Agung said. 

"We believe good air quality at the hospital will fasten the patients' recovery," he said. 

He said Persahabatan had a 96,717-square-meter green area, more than 70 percent of its 134,521-square-meter plot of land. 

The hospital has its own water waste treatment plant, two incinerator machines and an environmental laboratory, he added. 

"In the near future, the hospital management will install a non-Freon air conditioner to curb green house emissions. We will also open a special clinic for smokers who want to quit smoking because smoking contributes to air pollution," he said. 

Persahabatan management also encourages their employees to adopt eco-friendly habits, such as using both sides of the paper and using water and electricity efficiently, said Oni Konsa, the hospital's gynecologist.

Tangerang regent, deputy hospitalized with dengue

Multa Fidrus, The Jakarta Post, Tangerang | Mon, 11/17/2008 7:33 PM  

Both Tangerang regent Ismet Iskandar and his deputy Rano Karno were hospitalized with dengue fever, which they allegedly contracted during a visit to Sukadiri district last week. 

Ismet's eldest son, Ahmed Zaki Iskandar, said on Monday his father was admitted at Omni Hospital two days ago. 

Separately, Rano's youngest sister, Suti Karno, confirmed Rano was being treated at Cinere Hospital in South Jakarta for dengue fever since two days ago. 

"Bang Doel has been at the hospital since Sunday night," she said, using Rano's nickname made famous in his Si Doel Anak Betawi TV series appearances.Both Ismet and Rano attended a campaign to plant rice in Sukadiri district last week in an attempt to boost Tangerang regency's rice production.

Tuberculosis: A new pandemic?

By Patrice Poltzer, For CNN

LONDON, England -- Many people think of tuberculosis as being a disease from the past. The truth is far from it: Tuberculosis is mutating into dangerous new strains for which there is no known cure.

One of the most frightening strains is XDR-TB, which stands for extensively drug-resistant TB.

Unlike less virulent strains, XDR-TB does not respond to the antibiotics that are usually used to treat TB. The disease is virtually incurable and threatens to become a pandemic.

About 40,000 new cases of XDR-TB emerge every year, the World Health Organization estimates.

Award-winning photojournalist James Nachtwey, who has chronicled the death and devastation the disease is bringing to many countries around the world, describes XDR-TB as "a merciless, man-eating predator lurking in the shadows."

He warns: "If it's not contained, the consequences could be dire."

Nachtwey, who has been covering humanitarian crises for more than 30 years, was awarded a TED prize in 2007 which gave him $100,000 and one wish to change the world.

His wish centered on spreading awareness of this deadly form of TB and the images are borne out of Nachtwey's frustrations with the underreporting of what is potentially a global health crisis.

His photos tell the grim stories of impending death. In one, a man's suffering is so palpable that it is almost impossible to tear your eyes away from him. See Nachtwey's arresting photos »

Another image shows a woman in a Thai hospital staring vacantly, as if resigned to the fact that death is soon approaching.

Yet another shows the look of helplessness on a mother's face faintly reflected in the terrified eyes of her ailing child. And so the images continue, revealing with each click of the mouse a photo that is more haunting than the last.

Nachtwey traveled to seven different countries, including Cambodia, South Africa, Swaziland and Siberia, and used his photography to tell the story of a disease that primarily afflicts developing nations, but has been found elsewhere worldwide.

His work is documented at XDR-TB.org, a Web site solely dedicated to telling the story of the disease through his powerful images.

Health experts say that the tragic thing about XDR-TB is that it should not exist. TB in itself is curable. But if anti-TB drugs are not properly administered or used, the disease can mutate into deadlier strands such as XDR.

And the life-saving drugs used to treat regular TB only cost $20 per patient in the developing world, according to the WHO.

But there haven't been enough funds raised to combat the disease, which is strongly linked to poverty.

Furthermore, according to Louise Holly from Action, a group aimed at controlling the spread of TB, no new scientific developments to combat TB have been made in more than 40 years.

Holly told CNN that people have many misconceptions about TB.

"The drug resistant strand is a highly contagious airborne disease. With increased travel and globalization, it is possible for anyone to pick up the disease, even in developed countries like the U.S. and UK," she said.

Holly said that TB can be transmitted in overly populated areas, which include poor villages and prisons, but also in cosmopolitan places, such as London or New York, where people work closely together and ride crowded public transportation.

Currently, treatment options for XDR are virtually non-existent. Those most susceptible to it are people with weakened immune systems, such as those with HIV.

Holly told CNN that as serious as the XDR strand is, it could serve as a wake-up call to the public that the disease still exists and that people should view tuberculosis as a modern-day ailment.

Decentralization helps Bali improve healthcare services

Hyginus Hardoyo, The Jakarta Post, Sanur  Sat, 11/15/2008 11:03 AM  

Amid the many failures and deviations when it comes to implementing autonomy in regions throughout Indonesia, Bali has managed to take advantage of the opportunities, a lecturer of state-run Udayana University says. 

The ability to make the most of opportunities, which were made possible after the downfall of the authoritarian New Order administration in the late 1990s, has enabled the local administration to reach their potential in nearly all sectors of development, A.A Gde Muninjaya said Thursday. 

Muninjaya spoke at a panel discussion entitled "Decentralization and Autonomy in Bali: Challenges and Opportunities for Community Health", which was part of a three-day conference being held until Saturday by the East-West Center in Sanur, Bali. 

Muninjaya said decentralization in response to the passage and implementation of the Autonomy Law in 1999 and 2001, followed by health sector reform, facilitated greater community participation after being dominantly governed by Jakarta. 

"Decentralization has encouraged intersectoral cooperation while improving the quality of health services management up to the regency levels," he said. 

Muninjaya told The Jakarta Post about two regencies in Bali -- Jembrana and Tabanan -- which were able to take advantage of the decentralized system to provide qualified and affordable health services to locals. 

"The Jembrana regency administration, for example, has been able to create a health insurance system, which no longer uses assistance from the central government, but from its own regency budget," he said. 

Under the new system the regency administration guarantees all residents, including the poor, access to health services, he said. 

Muninjaya said Tabanan regency administration had also been successful in changing the image of state-run hospitals, which used to be shunned by patients due to their dirty and dismal conditions, into convenient hospitals by using money from its own budget. 

Muninjaya said the breakthrough was only possible through the work of visionary leaders, who worked to improve people's welfare, and not those who only thought about their own coffers. 

Thanks to decentralization, he said, Bali currently enjoyed better health services, with its development indexes being higher on average than the national figures. 

"Due to steady health development, life expectancy rate in Bali reached an average of 70.4 years, slightly higher that the national rate of 68.1 years," he said. 

Despite the many successes, however, Muninjaya said there were still a number of shortcomings, including the high prevalence of communicable diseases, like dengue fever, HIV/AIDS, TB, tetanus and gastroenteritis.

Regulator bans 22 performance-enchancing drugs

Triwik Kurniasari, The Jakarta Post, Jakarta | Sat, 11/15/2008 10:54 AM   

The national food and drugs regulator has released a list of 22 performance-enhancing drugs and supplements banned because of their alleged side effects. 

A series of tests found the products contained chemical substances and should be categorized as prescription drugs, not as jamu (herbal medicine) or food supplements, head of the Food and Drugs Monitoring Agency (BPOM), Husniah Rubiana Thamrin Akib, said Friday. 

"The producers claimed and registered those products as purely herbal medicines, while in fact the items were mixed with prescription drugs. It is very dangerous," Husniah said. 

"All products contain sildenafil citrate, which can cause headache, nausea and even death, and tadalafil, which can cause stroke." 

Among the banned products are six imported items -- five herbal medicine products and a food supplement -- and four products with fake registry numbers. The imported items are from China. 

Blue Moon and Tripoten are two of the banned products. 

As of today, the agency has found more than 208,000 boxes and 1,095 packs of various listed products in 16 provinces across the country. More than 157,000 boxes were found in Jakarta, Husniah said. 

"It is just a provisional number because we are still conducting inspections in some parts of the capital and many other cities across the country," she said. 

"We found many of those products in Jakarta because the city is the biggest market for the drug and supplement producers. 

"Besides that, the performance-enhancing drugs and supplements are more affordable for Jakartans than for people who live in villages, for instance." 

In a drug store in Jakarta, a box of a performance-enhancing drugs sells for more than Rp 25,000 (US$2). 

Husniah warned producers, distributors and retailers to stop producing and selling the items, adding that those failing to comply with the ban could face up to five years' imprisonment and Rp 100 million (US$) to Rp 2 billion in fines. 

If members of the public find these products for sale, they can report them to BPOM by phone (021) 4263333 or to their nearest provincial food and monitoring agency. 

Meanwhile, Thomas Darmawan, chairman of the Indonesian Food and Beverages Producers Association, said the products should have been subject to laboratory tests by the National Committee of Accreditation before the list was made public. 

"Although BPOM is an institution owned by the government and it can conduct research, it actually only has authority to monitor and educate producers about making good products," Thomas said. 

He said the committee had higher authority than BPOM. 

"If producers claim they are not breaking the law, they should have a chance to prove that. But if they are proved wrong, they should face penalties," he said.

OUTBREAK VILLAGE

The Jakarta Post, Fri, 11/14/2008 5:12 PM 

 

 

 A team from the Makassar health and public safety agencies exterminate poultry suspected to be infected with avian influenza in Sudiang village, Bringkanaya Regency, on Friday. Seventeen people from Sudiang have been admitted into the Wahidin Sudirohusodo Hospital for treatment. (JP/Andi Ajramurni)

17 treated in Makassar for suspected bird flu

Andi Hajramuni, The Jakarta Post, Makassar |Thu, 11/13/2008 8:23 PM  

Wahidin Sudirohusodo Hospital in Makassar, South Sulawesi, has been treating 17 patients since Wednesday for suspected bird flu. 

The suspects, 13 of them children, are residents of Sudiang subdistrict. Seven were admitted to the hospital Wednesday, the rest arrived Thursday. 

Hospital spokesperson Andi Kurnia Bintang said the patients were suffering from high fever, coughing and breathing difficulty, all symptoms closely associated with bird flu. 

"Rapid tests showed they may be infected with the H5N1 avian influenza virus, but we are waiting for blood test results to come back from the Hasanuddin University lab," Kurnia said. 

Kurnia said 31 chickens had died in the subdistrict in the past week before three toddlers started to show symptoms Monday. 

Separately, head of Makassar's husbandry office, Sulistiawati, said that his office had found several chickens which tested positive in the bird-flu quick test. 

She said she had sent officers to cull 20 birds and spray disinfectant at chicken farms in the area. (dre)

Bird flu awareness campaign to target early learners

Erwida Maulia, The Jakarta Post, Jakarta | Thu, 11/13/2008 10:34 AM  

The government will kick off a new round of avian influenza awareness and prevention campaigns in elementary schools to help the country with the largest death toll from the virus to consolidate its progress in defeating the largely fatal disease. 

Younger primary school students will learn of the threat of bird flu through a government awareness campaign, while older students will be taught about the disease as part of their natural science curriculum, said Mudjito, director for kindergartens and elementary schools at the Education Ministry. 

He said students would be encouraged to adopt healthy habits as measures to avoid infection. Younger students will learn how the virus is transmitted and about ways to recognize infected poultry, he said. 

"We are preparing three modules to help teachers deliver the campaign messages to students. First, on the importance of community awareness to tackle bird flu. Second, on what the H5N1 virus is; And, third, on how to tackle the virus," Mudjito told reporters on the sidelines of an Education Ministry seminar entitled The Improvement of Awareness on the Danger of Bird Flu in Elementary Schools 

About 300 principals, elementary school teachers, school supervisors and representatives of local education agencies in Greater Jakarta attended the event. 

The campaigns will reach a number of schools in eight provinces hit hardest by the virus: Jakarta, Banten, West Java, Yogyakarta, Bali, East Nusa Tenggara, North Sumatra and Gorontalo. 

Mudjito said the Education Ministry had conducted the campaigns in tandem with, among others, the Health Ministry, the National Committee for Bird Flu Control and Pandemic Awareness and the German government's Deutsche Gesellschaft fur Technische Zusammenarbeit (GTZ). 

The Health Ministry will prepare materials for the modules, and the GTZ will distribute them to elementary schools throughout the country, Mudjito said. 

Deputy head of the national bird flu committee Emil Agustiono told the seminar the campaigns were crucial to preventing an avian influenza pandemic, which could potentially claim a significant number of lives and cause short-term economic losses of up to Rp 48 trillion. 

"Economic activities would be paralyzed as people become sick or afraid of becoming sick. The long-term losses will be even bigger," said Emil, also deputy for the coordination of health and environment education at the Coordinating Ministry for People's Welfare. 

The first case of human infection was recorded in Indonesia in 2005. As of October 2008, the number of cases had reached 137, including 112 fatalities. 

The infection and fatality rates have fallen since 2007. 

The committee's head Bayu Krisnamurti has claimed the declines were the result of successful prevention campaigns, including those targeting students. 

The campaigns implored students to wash their hands before eating, ensure their parents thoroughly cooked poultry before serving it and to keep away from live poultry. 

 

Prosthesis helps man stay true to profession

Agnes Winarti, The Jakarta Post, Jakarta  | Thu, 11/13/2008 10:31 AM 

 LIFE IS GOOD AGAIN: Motorcycle taxi ojek driver Karma with his wife and three-year-old daughter. For the past four years Karma has been able to work again, thanks to his artificial leg. (JP/Agnes Winarti)

"Sorry, I think my leg is coming loose," said Karma, a motorcycle taxi ojek driver, one evening during a downpour. 

"I am sorry, what did you say?" said his passenger on the back of the motorcycle. 

Apologizing, Karma asked her to switch to another ojek driver. 

"My artificial leg was getting wet and heavy. I could not continue driving. We always laugh when recalling that incident," Karma told The Jakarta Post recently with his wife. They live together near Darul Mustaqiem, opposite Manggarai train station in South Jakarta. 

Forty-something Karma and wife Erni never imagined they could laugh at such an experience, or even dream he would ride his ojek again. 

Six years ago Karma was hit by a motorcycle while heading home from his ojek shift at Manggarai train station. 

Instead of going straight to hospital, he followed relatives' advice and sought treatment from a traditional healer specializing in broken bones in Cimande, West Java. 

The six-month treatment turned out to be a disaster. The healer could not fix his broken right leg, and it developed rot. Karma was rushed to the nearest Red Cross Hospital in Bogor, but his right leg had to be amputated below the knee. 

After the surgery, he did not work for two years and relied on his wife for support. She worked as a mobile salesperson traveling to housing complexes to sell cooking utensils. 

"I was frustrated," said the father of four. "I had no other skills which I could use to earn some money. Opening a business was not an option, since I required large start-up capital." 

In 2004 Karma met a man who required a polio brace to assist him in walking, despite having both his legs intact. The man worked at a specialist store for prosthetic devices. 

The man suggested Karma try a device from the store to see if it assisted him in day-to-day living. 

After submitting his identity card, profile photograph and evidence of his low socio-economic status, Karma, like hundreds before him, was given a free prosthetic leg from the store. The device was provided to Karma if he agreed to participate in the Peduli Kasih program, a charity organized by TV station Indosiar. 

Through the program, Karma learnt to walk again and even managed to overcome his doubts and attempt to ride a motorcycle. 

"I can ride a motorcycle again and even take a passenger on the back. So, I decided to return to my ojek post." 

Erni, despite her concerns, let him become an ojek driver again. 

"At first I was worried, but then I realized it was the only way he could feed the family. So I could not say no," she said. 

He earns Rp 600,000 a month from his ojek work, while his wife works periodically as a masseuse. 

"This artificial leg has been incredibly useful. Not only can I ride the ojek again, but more importantly I am the breadwinner in my family once more," Karma said. 

The hardest aspect of being an ojek driver with a prosthetic leg, Karma said, was combating the rainy season. 

"It is difficult to ride a motorcycle when it is raining, and it is impossible to prevent my leg from becoming wet. Once it is soaked, it becomes loose and heavy. If it rains, I have to head home." 

Karma said despite this difficultly, he would continue his work as an ojek driver. He said no other work suited him, and he would not be able to obtain a different license because of his physical condition. 

"Nobody notices my defect, except my regular customers, who are fine with it."

Public health centers get high-tech beds

The Jakarta Post, Thu, 11/13/2008 10:29 AM  

JAKARTA: Kemang Medical Care Hospital in South Jakarta donated 38 electronic beds to 21 public health centers and clinics around Greater Jakarta and Cikarang on Wednesday. 

The donation was part of one of the hospital's charity programs, which include education for the public on proper healthcare, especially for mothers and children. The hospital was opened last October. 

"We want to keep people healthy, not just cure them when they fall ill. That's why even after a patient is healed, we will maintain a relationship by following up and giving proper health information," the hospital's managing director Purnawan Junadi said. -- JP