Arghea Desafti Hapsari, The Jakarta Post, Jakarta | Fri, 05/07/2010 9:38 AM
With most nurses providing treatment normally given by doctors, restrictions in the 2009 Health Law hamper health services in remote areas, the Constitutional Court was told Thursday.
Indonesia Nurses Association (PPNI) chairwoman Achiryani S. Hamid said the law was not suited to nurses in remote areas.
“Most community healthcare centers, especially in remote areas, are headed by nurses. In most cases, they are the only medical workers assigned to remote or border areas because the government cannot provide doctors or pharmacists.
“In emergency situations and when patients cannot be referred [to a hospital] due to geographical boundaries, nurses are required to give prescription drugs,” she said in her testimony at the first Constitutional Court hearing of a judicial review request of the health law.
Several nurses filed the request in March, contesting articles that prohibit nurses from prescribing patients with prescription only drugs, such as antibiotics and analgesics.
Among them is Misran, the head of a community healthcare center in Kutai Kartanegara, East Kalimantan, who was sentenced to three years in prison after unlicensed prescription drugs were found in his healthcare center last year.
On Wednesday, the court also heard testimony from the Indonesian Doctors Association (IDI).
IDI chairman Prijo Sidipratomo said the articles were needed as revoking them would be dangerous.
“Pharmacology should only be practiced by medical workers with the relevant authority and skill, otherwise it would be dangerous. The contested article protects society from misuse of drugs,” he said.
Kutai Kartanegara Health Agency official Emi Sukema said that there were only 75 doctors stationed in the regency.
“Most are assigned to community healthcare centers. Only 22 are in remote areas,” she added.
Pharmacists are even harder to find with only six serving the whole regency of almost 600,000 residents. The pharmacists and their eight assistants are assigned to 12 drugstores, all located in cities.
“We are short of doctors. That’s why our nurses double as doctors and even midwives. In one of the areas, we don’t even have a female midwife, so a male nurse has to [assist in childbirth],” she said, adding that the regency had 268 nurses.
“Since the Misran case, healthcare services in our regency became paralyzed because now healthcare workers are too scared to treat patients. There have been five deaths now, all because nurses are too afraid,” Emi told the hearing.
Constitutional Court justice Akil Mochtar asked the Health Ministry why it had not issued an implementing regulation as stipulated in the contested article.
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