A Young Legislator’s Push for Health Care for the People

Jakarta Globe, Kennial Caroline Laia, Aug 18, 2014

Nova Riyanti Yusuf seeks to further make changes in
the health-care sector. (Antara Photo/Ujang Zaelani)

Jakarta. Becoming a politician was never part of Nova Riyanti Yusuf’s intention.

But Nova decided to enter Indonesia’s political arena in 2009 as a legislative candidate from the ruling Democratic Party. Her main goal, from the start, had been to fight for passage of the Mental Health Law, which was implemented in July.

“During [my electoral] campaign, I saw that nobody cared about mental illnesses. Most people even thought that the idea was bizarre,” the 36-year-old psychiatrist said in an interview with the Jakarta Globe last week. “Even though it hasn’t been entirely understood by everyone, mental health was severely marginalized back then. It was something unknown.”

Her empathy for mentally ill patients first came about while she was doing her residency in psychiatry, and she believes that mental health needs to be taken care of by the government.

She continued fighting for the law’s passage since the first draft bill was submitted to the House of Representatives five years ago.

Efforts by her and fellow mental health advocates came to fruition when the bill was passed into law last month. That marked Indonesia’s returning attention on mental health problems, after the 1966 law on mental health was scrapped and mental health issues were superseded in 1992 with the passage of a more general health law that was revised in 2009.

Nova says she and other Indonesian mental health champions are now working on spreading information concerning the new law to relevant stakeholders across the country.

They will also monitor the drafting process of derivative regulations to support their implementation.

She added that mental health was a critical issue, citing various medical reports that said that by 2020, depression would be the world’s number two cause of death, after coronary heart disease, and would correlate with an increase in suicide cases.

“To me, every single life is priceless. So, if someone ends their life because of a mental disorder, due to lack of attention from the government … it is time for us to begin preparing Indonesia to tackle this problem,” said the legislator.

Nova, who earned her medical degree from Trisakti University and a diploma in psychiatry from the University of Indonesia, says the country needs a health care system that covers every aspect of health — be it physical, mental, spiritual or social.

“It takes more than curative actions to cure health problems,” said the doctor, who is also known as Noriyu among her friends and colleagues. “Rather, we also need the psychological approach. Promotive, preventive and rehabilitative measures are very important to fix health problems in our country.”

AIDS

HIV/AIDS, according to Nova, is a severe illness that requires a psychological approach and serious attention from the government.

The 2014 Joint United Nations Program on HIV and AIDS (Unaids) Gap Report released last month put Indonesia among a group of six countries “left behind” in the push to ensure access to antiretroviral therapy for people living with HIV/AIDS.

Indonesia, the Central African Republic, Congo, Nigeria, Russia and South Sudan are facing “the triple threat of high HIV burden, low treatment coverage and no or little decline in new HIV infections,” the Geneva-based Unaids said.

In Asia-Pacific, meanwhile, Indonesia is among six countries — along with China, India, Myanmar, Thailand and Vietnam — that account for more than 90 percent of people living with HIV/AIDS in the region.

Nova said that “handling HIV/AIDS is like an effort in handling the human mind-set,” she said

“Indonesia is a ‘confused’ nation. We adhere to religious teachings [regarding homosexual relations forbidden by official religions in Indonesia], but a recent research by the Ministry of Health reveals that heterosexual couples who engage in unprotected sex are the most likely to be infected by HIV/AIDS,” she said

Meanwhile, research show that drugs are the second cause of HIV/AIDS exposure, the legislator added.

Nova said that the ministry needed to allocate more in its budget to tackle HIV/AIDS, including support of relevant research.

“Additionally, psychological approach is again the key. Giving people a complete understanding on HIV/AIDS and engaging religious figures [to support the cause] are in the must-list.”

Drugs

Nova, who delivered a keynote speech on “Youth at the Heart of Development” during a UN Population Fund (UNFPA) event at the UN headquarters in New York in April, says that another subject of her interest is narcotics.

She said in order to improve measures to tackle drug problems, the narcotics unit in the Health Ministry should be upgraded from a sub-directorate level to a higher division with broader powers.

“Currently the narcotics division is under the mental health unit. But we must know not every person who consumes addictive substances suffer from mental disorders,” she said. “Narcotics is an extremely difficult challenge. The unit in charge has to closely cooperate with the BNN [National Narcotics Agency] in handling such matters.”

She added that drug users should not be criminalized as they were basically victims of dangerous substances.

“Narcotics use is not always a legal problem. But it is also a health matter. That’s why the mental health law stipulates that every mental institution should allocate 10 percent of its beds for drug abuse victims,” Nova said.

Nova for minister?

Kartono Mohamad, former chairman of the Indonesian Doctors Association (IDI), says Nova can become a good candidate as health minister.

“Anyone is appropriate to be a health minister as long as they have the capability to hold the position, including Dr. Nova. She is capable in her field, as a politician and as a doctor,” Kartono told the Globe on Sunday.

Addressing Nova’s relatively short experience in the health sector, he said a long medical background wasn’t necessary for the ministerial post.

“Being a health minister is not limited to technocratic matters, although that’s also important,” he said. “He or she has to have good problem-solving management, integrity, mature thinking and vision.”

Still, Kartono said that it would be better if Nova trained herself further in the health sector. “Nova has the capability, but she has to gain more experience before assuming a ministerial post.”

Potential candidates eyed as the next health minister include Deputy Health Minister Ali Ghufron Mukti and Tjandra Yoga Aditama, the director-general for environmental health.

Prominent businessman Sandiaga Uno praised Nova’s performance in the House.

“I salute Dr. Nova’s performance, especially her commitment in fighting for mental health in Indonesia. She’s young, innovative and smart. I wish her success,” he said.

Despite her qualifications, she might face resistance in being a part of President-Elect Joko Widodo’s cabinet due to her being a politician from the Democratic Party, which supports Prabowo Subianto.

Yet, even before the presidential election Nova expressed her deviation from the party by expressing her support for Joko.

For this reason, she was allegedly relieved of her post as deputy head of the House’s Commission IX, which oversees health issues, in June.

“That’s part of the consequences I have to take,” said Nova, adding that it’s up to the president to decide whoever he trusted as his health minister.