Lung specialists step up calls for ban on ‘harmful’ e-cigarettes

DutchNews, October 7, 2019

Photo: Depositphotos.com

Dutch lung specialists have called for a total ban on e-cigarettes on the grounds that they cause lung disease and do nothing to prevent smoking. 

‘We want a complete ban on e-cigarettes in the Netherlands,  Leon van Toorn, of lung specialists’ association NVALT told AD. The association, which last month conducted a survey among its member to gauge the extent of the problem in the Netherlands, said the number of Dutch people reporting lung problems after vaping has risen from three to eight. 

One patient had to be admitted to intensive care because of the severity of his symptoms. None of the patients had had lung problems before. 

Van Toorn said he had attended a conference in Madrid last week which warned against vaping. ‘It showed convincingly that we can under no circumstances recommend the use of e-cigarettes,’ he said.

‘There is no scientific proof whatsoever for the claim that it is 95% less damaging that cigarettes and it looks as if only a very tiny number of people have stopped smoking by taking up vaping.’ 

Junior health minister Paul Blokhuis said in a response that the data the specialists have gathered will be included in the ongoing investigation into the safety of e-cigarettes. A total ban is not on the cards at the moment, Blokhuis said, because he is bound by European rules. 

The American Center for Disease Control and Prevention has recorded 1080 cases of lung disease and 21 deaths associated with vaping. It is not known which of the ingredients being inhaled is causing the disease, although in a number of cases THC, the psychoactive ingredient in cannabis, may have played a part. There have not been any incidences of disease on this scale in Europe so far, the paper said.

Medical industry again increases sponsorship of doctors, hospitals

Dutchnews, July 29, 2019

Pharmaceutical companies and medical aids makers have again handed over more ‘sponsorship’ money to Dutch healthcare institutions and patients organisations, according to new figures from a register set up to monitor transparency in the sector. 

In total, the industry paid €80m to healthcare groups, a rise of 12% on 2017, the register said on Tuesday. Some 152 companies signed the register, which was set up seven years ago. 

Some €71m of the money went to healthcare institutions such as hospitals and was largely spent on meetings and conferences. 

In total, nearly 3,700 healthcare professionals – mainly medical specialists – were given industry money, largely for presentations or membership of advisory boards. 

Companies are not required by law to include payments in the register. Nor does the register include industry funding for research. However, according to EU rules, drugs firms are required to state by law how much research funding they give on a country by country basis.

Drugs firms boost spending on hospital and specialist sponsorship

DutchNews, July 17, 2018

Drugs firms are spending more on sponsorship

Pharmaceutical companies and medical aids makers have again handed over more ‘sponsorship’ money to Dutch healthcare institutions and patients organisations, according to new figures from a register set up to monitor transparency in the sector. 

In total, the industry paid €71.5m to healthcare groups, a rise of 26% on 2016, the register said on Tuesday. The pharmaceuticals industry accounted for the bulk of the money – €59.1m, a rise of 6% on the previous year. 

Some 85% of the money went to healthcare institutions such as hospitals and was largely spent on meetings and conferences. 

In total, nearly 4,000 healthcare professionals – mainly medical specialists – were given industry money, largely for presentations or membership of advisory boards. 

Companies are not required by law to include payments in the register, which was established six years ago. 

Nor does the register include industry funding for research. However, according to EU rules, drugs firms are required to state by law how much research funding they give on a country by country basis. 

Frederik Schutte of the medicine advertising code agency SCG told the Volkskrant that based on the lists provided by 35 companies, that figure is likely to be around €100m in the Netherlands.

Children should be outside two hours a day to protect their eyes

DutchNews, December 13, 2017

Photo: Depositphotos.com

Dutch children have an increased risk of becoming short-sighted because they spend more time on computer screens and less time playing outdoors, ophthalmic professor Caroline Klaver says in Wednesday’s NRC. 

Half of the people in Europe in their 20s wear glasses or have contact lenses, Klaver says. And people who have glasses of -6 or more at a young age have a one in three risk of developing serious sight problems or even going blind, she told the paper. 

Myopia develops when the eyeball grows too long, relative to the focusing power of the cornea and lens of the eye. 

Klaver says short-sightedness is the biggest cause of blindness and that spending long times indoors reading or behind a screen increases the risk. 

‘We have to ensure that far fewer children develop short-sightedness by making sure they are outside for two hours a day,’ she said. ‘That exposes them to a substance [dopamine] which brakes the growth.’ Schools in particular should ensure children have an hour outdoors. 

Research by the Erasmus medical centre in Rotterdam shows that 2.4% of six-year-olds are short sighted. They were also more likely to have a shortage of vitamin D, to be overweight and not to play outside. 

Australian doctors transplant 'dead' hearts in surgical breakthrough

Yahoo – AFP, Madeleine Coorey, 24 Oct 2014

The revolutionary technique involves donor hearts being transferred to a portable 

machine where they are placed in a preservation solution, resuscitated and kept warm

(AFP Photo/Philippe Huguen)

Sydney (AFP) - Australian surgeons said Friday they have used hearts which had stopped beating in successful transplants, in what they said was a world first that could change the way organs are donated.

Until now, doctors have relied on using the still-beating hearts of donors who have been declared brain dead, often placing the recovered organs on ice and rushing them to their recipients.

But Sydney's St Vincent's Hospital and the Victor Chang Cardiac Research Institute have developed a technique which means hearts which had been still for 20 minutes can be resuscitated, kept beating and transplanted into a patient.

The first heart transplants were performed

 in the 1960s and used organs that had

stopped beating (AFP Photo/Brendan

Smialowski)

So far three people have received hearts in this way, with two recovering well and the third and most recent recipient still requiring intensive care.

"They are the only three in the world," surgeon Kumud Dhital, who is an associate professor at the University of New South Wales in Sydney, told AFP.

"We know that within a certain period of time the heart, like other organs, can be reanimated, restarted, and only now have we been able to do it in a fashion whereby a heart that has stopped somewhere can be retrieved by the transplant team, put on the machine... and then (surgeons can) transplant it."

The technique involves donor hearts being transferred to a portable machine known as a "heart in a box" in which they were placed in a preservation solution, resuscitated and kept warm.

All three patients have received hearts which came from different hospitals, with the organs kept beating during transport times of between five and eight hours.

Peter MacDonald, medical director of the St Vincent's Heart Transplant Unit, said it was likely that the first heart transplants ever performed in the 1960s used organs that had stopped beating. Three more had since been done with children.

"There have been no adult heart transplants from so-called DCD (Donated after Circulatory Death) donors since the very first ones done in the 1960s," he told AFP.

But in all previous cases, the donors and recipients had been in the same hospital.

"What we have done is developed a technique which enables us to firstly resuscitate hearts from a DCD donor and then have a capacity to transport that heart from the donor hospital wherever that donor hospital is ... to St Vincent's to enable it to be transplanted," he said.

"Where we will claim a world first is we have been able to do this in a remote hospital and transport it to St Vincent's.

"No one else has done that or attempted it. That's never even been contemplated before with a DCD heart."

'You see the heart starting to beat'

Executive director of the Victor Chang Institute Bob Graham said it was possible to watch the heart revive in the portable machine which involves connecting the donor heart to a sterile circuit where it is kept beating and warm.

"Absolutely, you see the heart starting to beat again," he told the Australian Broadcasting Corporation.

Graham said the preservation solution used in the console allowed the heart to be more resistant to the damage done to it when it had stopped beating and was deprived of oxygen.

He said the technique will mean that surgeons in Australia, where the definition of death is brain death, will be able to do 20 to 30 percent more transplants.

"In addition we'll be able to tell whether the heart is worth transplanting, because we can look at the function on the console before we transplant it," he said.

He said in countries where the definition of death is heart death, the implications could also be dramatic.

"This will potentially open up heart transplantation in countries like Japan, Vietnam and other places where the definition of death is heart death, not brain death," he said.

Michelle Gribilas, the first patient to receive one of the three hearts, said she was very sick before her operation but now felt like "a different person altogether".

The second recipient, Jan Damen, who had the surgery about two weeks ago, said he felt "amazing".

"I'm not religious or spiritual but it's a wild thing to get your head around," he said.

Dutch doctors devise monitor to spot who wakes up during surgery

DutchNews.nl, Monday 22 September 2014

(NOS/ANP)

Leiden University teaching hospital researchers are developing a new method to warn surgeons that a patient may be waking up during surgery, the AD reports on Monday.

Every one or two weeks, a patient wakes up on the operating table at a Dutch hospital although doctors often do not notice because the patient cannot move, the AD says.

However, the impact on the person concerned is traumatising. ‘The experience can be traumatic, even if the patient does not feel pain,' said professor Albert Dahan. ‘They have nightmares, concentration problems and suffer from anxiety.’

Sweat

The warning system consists of a monitor which measures if the patient is feeling pain – one of the signs that they are awake. ‘It is a sort of lie detector,’ says Dahan.

The monitor registers small changes in heart rhythms, brain capacity, blood pressure and sweat. ‘If a patient is awake, they will be in stress and may perspire. That can also be a sign they are awake,’ Dahan said.

The monitor may be put into use at all operations in two years time, the AD says.

Cipto Mangunkusumo hospital opens world-class private service unit

Antara News, Friday, May 7, 2010 13:44 WIB

Jakarta (ANTARA News) - Health Minister Endang Rahayu Sedyaningsih officially inaugurated a new building housing a world-class private health service unit at the Cipto Mangunkusumo General Hospital (RSCM) complex here Friday.

The new unit was named RSCM Kencana Integrated Service Unit.

"The management must make improvements in order to deliver effective and efficient services," said the minister when inaugurating the four-story building.

Improved health services in the country were expected to attract patients who had so far been seeking medical treatment abroad, she said.

"According to Singapore`s National Health Group survey, around 50 percent of foreign patients seeking medical services in Singapore, are Indonesians, or roughly 12,000 people annually," the minister said.

RSCM President Director Akmal Taher said the state-owned general hospital`s private services were targeting those so far seeking medical services abroad.

The new unit offers a number of health service clusters, among other things general medical checkups, in-vitro fertilization, tumor treatment, integrated breast clinic, aesthetic service, rehabilitation service, dental service, eye care center, and neuroscience.

"Services in all clusters are given in integrated ways by teams, and there is no departmental service," he said.

Several RSCM units, such as the Cardiology Unit, Perinatal Unit, and Radiotherapy Unit, have acquired ISO 9001 Certificates.

Myth of the virginal membrane still widespread

Radio Netherlands Worldwide, 3 April 2010 - 9:00am, by Zainab Hammoud

More than half of all girls and women do not bleed when they lose their virginity. However, this loss of blood is still important in cultures where women are supposed to preserve their virginity until marriage. So women have found ways of meeting their environment's expectations.

Karima, a Dutch/Moroccan woman in her early twenties, has a secret: she had hymenoplasty, or hymen reconstruction surgery, shortly before her marriage. The hymen is the membrane which encloses the vaginal area.

"In my culture you cannot tell your parents or your family that you were not a virgin when you married. My mother would not survive it," she says. She only allows herself to be interviewed with a distorted face and voice so that she cannot be recognised.

Gynaecologist Ineke van Seumeren has doubts about the procedure. "I have always found it a problem to do something that really isn't necessary. It is not a disease." A few years ago she thought up a different solution. She wants to inform people that the correlation between an intact hymen and virginity is a myth.

Evidence of Afterlife, Says Radiation Oncologist

Near-Death Experiences: Evidence of Afterlife, Says Radiation Oncologist

Medscape Medical News, Roxanne Nelson, February 25, 2010

What happens when a person dies?

It is a question that has been pondered since the beginning of the human race, and scientists, theologians, and everyone in between have offered their own beliefs and theories on the subject. But for Jeffrey Long, MD, a radiation oncologist in Houma, Louisiana, the answer to that question has become increasingly clear.

On the basis of his own research and that of many other investigators, he has become convinced that the phenomenon known as near-death experience (NDE) establishes the reality of an afterlife.

For more than 10 years, Dr. Long studied thousands of accounts of NDEs and created the Near Death Experience Research Foundation (NDERF), which has become the largest NDE research database in the world. Dr. Long's new book, Evidence of the Afterlife, which is based on more than 1300 accounts of NDEs that were shared with the NDERF, became a New York Times bestseller almost immediately after its release.

"People from all walks of life have had near-death experiences, and that even includes some physicians," Dr. Long told Medscape Oncology in an interview. "It shakes them up, and it makes it difficult because they are inclined not to let it be known publicly that they've had this experience."

Although there is some variation, NDEs can loosely be defined as mystical or transcendent experiences reported by individuals who are either dying or clinically dead. Common experiences reported to Dr. Long and other investigators are feelings of peacefulness, the sense of leaving one's body, the sense of moving through a dark tunnel toward a bright light, a review of one's life, and meeting up with other "spiritual" beings. Some people have even clearly described their own resuscitations with remarkable accuracy, down to conversations that occurred outside the room and beyond normal hearing range.

Dr. Long first became interested in NDEs in 1984, when he read an article on the subject that was published in a medical journal. Several years later, the wife of a college friend relayed her own experience with it, when she nearly died of an allergic reaction while under general anesthesia. A decade later, he started the NDERF to better study it.

In general, the subject is highly controversial, especially the conclusion that NDEs offer proof of an afterlife. However, Dr. Long pointed out that feedback from his medical colleagues has been positive for the most part. "Everyone respects the success of the book and many of them have thought and wondered about this on their own," he said. "All of my colleagues who read my book were impressed, as it was intended to be scholarly."

He acknowledged that not everyone agrees with his conclusions, but although "they may not agree, they feel that this is a significant point of view," he explained. "If they disagree, it may be due to factors such as their personal religious point of view or the scientific evidence. I can't blame them, because if someone had approached me 20 years ago, I would feel the same way."

Dr. Long believes that NDEs provide powerful scientific evidence that "makes it reasonable to accept the existence of an afterlife." Specifically, he cites "9 lines of evidence" that he has derived from his research.

"I find any 1 of them to be very strong evidence that there's an existence of life after death," Dr. Long explained. "But if you put all of them together, I think that the combination — in my opinion — becomes compelling."

The 9 Lines of Evidence From Evidence of the Afterlife

1. Crystal-clear consciousness. The level of consciousness and alertness during NDEs is usually greater than that experienced in everyday life, even though NDEs generally occur when a person is unconscious or clinically dead. In addition, the elements in NDEs generally follow the same consistent and logical order in all age groups and cultures.
2. Realistic out-of-body experiences. Out-of-body experiences are among the most common elements of NDEs, and what is seen or heard is almost always realistic. Even if out-of-body-experience observations include events that occur far from the physical body, and far from any possible sensory awareness of the patient, they are almost always confirmed to be completely accurate.
3. Heightened senses. Heightened senses are reported by most people who have experienced NDEs, and normal or supernormal vision has occurred in those with significantly impaired vision, and even legal blindness. Several people who have been totally blind since birth have reported highly visual NDEs.
4. Consciousness during anesthesia. Many NDEs occur while a person is under general anesthesia, at a time when any conscious experience should be impossible. Although there is speculation that these NDEs are the result of too little anesthesia, some result from anesthesia overdose.
5. Perfect playback. Life reviews in NDEs include real events that took place in the lives of those having the experience, even if the events were forgotten or happened before the person was old enough to remember.
6. Family reunions. During a NDE, the people encountered are virtually always deceased, and are usually relatives of the person having the NDE; sometimes they are even relatives who died before the patient was born.
7. Children's experiences. The NDEs of children, including children who are too young to have developed concepts of death, religion, or NDEs, are essentially identical to those of older children and adults.
8. Worldwide consistency. NDEs appear remarkably consistent around the world, and across many different religions and cultures. NDEs in non-Western countries are incredibly similar to those that occur in Western countries.
9. Aftereffects. It is common for people to experience major life changes after having NDEs. These aftereffects are often powerful, lasting, and life-enhancing, and the changes generally follow a consistent pattern.

Research and Different Viewpoints

The term "near-death experience" was coined by Ralph Moody, MD, PhD, in 1975 in his classic book Life After Life. Researchers have been studying NDEs for decades, and although most research has concluded that NDEs are real and unexplainable, the idea of consciousness beyond death has not been widely accepted.

"There have been over 20 different explanations of NDEs, and they cover any feasible physiological, biological, cultural, and psychological explanations you can think of," said Dr. Long. "But the truth is that not 1 of them makes any sense, even to skeptics, and that's why there are so many of them. None have been accepted as plausible, even by skeptics."

One proposed theory of the origin of NDEs is physiological changes in the brain, such as hallucinations caused by oxygen deprivation. Other theories are psychological, such as a reaction to approaching death, or are linked to a changing state of consciousness and cognitive functioning.

Kevin Nelson, MD, professor of neurology at the University of Kentucky in Lexington, has hypothesized that rapid eye movement (REM) intrusion contributes to NDEs. "The REM state of consciousness is, by its very nature and definition, activation of the visual system," he told Medscape Oncology. "The very first physiological sign of REM is pontogeniculoocciptal waves electrifying all levels of the visual system."

Because sleep-related hallucinations are most often visual, the REM system can account for the "heavenly" light so often reported in the NDE, he explained.

Dr. Nelson and colleagues investigated the lifetime prevalence of REM intrusion in 55 people who had experienced a NDE, and compared them with age- and sex-matched control subjects. They found that sleep paralysis and sleep-related visual and auditory hallucinations are substantially more common in people with a NDE. Although the results are preliminary, they suggest that REM intrusion could promote subjective aspects of NDEs and the often associated syncope (Neurology. 2006;66;1003-1009).

"The feeling of being in a tunnel and heading to the light can be explained by retinal ischemia, which causes blindness first in the periphery and preserves our central vision," said Dr. Nelson; "hence, the tunnel."

Dr. Nelson explained that the similarities between many NDE accounts exist because all people have similar brain biology. As for the feeling of leaving one's body, he pointed out that "out-of-body experiences are illusions that occur when our brain cannot integrate all of our sensations. They can be created by a trickle of electricity in the temporal-parietal region."

According to Dr. Nelson, brain physiology explains all the features of NDEs. "That is not to say that there isn't a reality beyond the brain," he said. "It's just that the brain is science, and anything beyond the brain is faith."

No Medically Explicable Explanation

In 2001, the Lancet published the results of a 13-year study of NDEs that was conducted in 10 different centers in the Netherlands (Lancet.2001;358:2039-2045). The study, one of the few to be conducted prospectively, tracked 344 cardiac patients who were successfully resuscitated after a cardiac arrest.

The researchers, led by Dutch cardiologist Pim van Lommel, MD, who was affiliated with Hospital Rijnstate in Arnhem at the time of the study, found that 62 patients (18%) reported NDEs. Of that group, 41 (12%) had what is referred to as core (or deep) NDEs.

At 2- and 8-year follow-ups, all surviving patients recalled their NDE experience almost exactly as they originally described it. The researchers found little difference between patients who had experienced a NDE and those who hadn't. They also noted that their findings failed to show any psychological, neurophysiological, or physiological factors that would have caused these experiences after cardiac arrest.

Even though the researchers were unable to uncover a medically explicable explanation for NDEs, they did acknowledge that neurophysiological processes must play some sort of role. But if NDEs are purely physiological — for example, caused by cerebral anoxia — then most patients who have been clinically dead should report one, they write.

Dr. van Lommel and colleagues note that there are similarities between NDEs and various other phenomena, such as electrical stimulation of the temporal lobe of the brain, but that those experiences usually consist of fragmented and random memories. In contrast, the recall after a NDE is clear and sequential.

"How could a clear consciousness outside one's body be experienced at the moment that the brain no longer functions during a period of clinical death with flat EEG?" the authors ask, adding that "NDE pushes at the limits of medical ideas about the range of human consciousness and the mind–brain relation."

For the past several years, Dr. van Lommel has been lecturing all over the world on NDEs and the relation between consciousness and the brain. "It is a challenge to explain to physicians and medical students, in the many lectures I give, why I came to the conclusion that consciousness can be experienced during a period of a nonfunctioning brain," Dr. van Lommel told Medscape Oncology.

"The hypothesis that consciousness is a product of brain function has never been proven whatsoever," he said. "Most physicians are not aware of the medical literature about what happens in the brain during cardiac arrest, and what exactly is really known about how the brain functions."

He explained that, in the Netherlands, more and more physicians seem to be "open to the possibility of a facilitating function of our brain to experience consciousness, and our consciousness being nonlocal — not cemented in place or time."

"But, of course, many neuroscientists have great difficulty in changing their basic concepts," Dr. van Lommel added.

On a personal level, Dr. van Lommel acknowledged that there is no hard scientific proof of an afterlife, and there will never be. "But for me, it seems very likely because it has been scientifically proven that patients experience, paradoxically, an enhanced consciousness during a cardiac arrest and during a period of a temporarily nonfunctioning brain."

Acknowledging NDEs

Physicians need to be aware of NDEs, contends Dr. Long, especially oncologists and others who care for patients with life-threatening illnesses. "I would advocate that if patients bring it up, physicians be ready to talk about it," he said. "But patients are often hesitant, so it's best to wait until they are ready to share [their experiences]."

Patients might just hint around about their experience; under those circumstances, doctors need to be ready to ask and need to know the right response. "These experiences are medically inexplicable, and they can be powerfully life-changing," said Dr. Long. "If physicians don't have the experience or feel uncomfortable discussing them, they need to refer patients to sources and organizations that can help them."

Dr. Long feels that increasing his understanding of NDEs has helped him to be a better physician for his cancer patients. Individuals who experience NDEs often become kinder, more loving, and more accepting of others, and he has begun to reflect those same effects in his own life. He explained that he now "faces life with more courage and confidence."

Dr. Long emphasizes that his years of research have culminated in his own personal conclusion that there is an afterlife, but not everyone is going to be convinced of that. Instead, he urges people to consider the evidence and "come to your own conclusions."

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What the near-death experience reveals about consciousness

"Perceptions of God" – June 6, 2010 (Kryon channeled by Lee Carroll) (Subjects: Quantum Teaching, The Fear of God, Near-death Experience, God Becomes Mythology, Worship, Mastery, Intelligent Design, Benevolent Creator,Global Unity.... etc.) (Text version)

“… When a Human almost dies, they get close to the veil, very close. They are ever so close to the creator's energy and just barely touched by it. When their heart was stopping and their breathing was almost gone, before they were brought back to life with science, they got to touch the hand of God for just an instant. What they saw was magnificent! The energy before them was filled with love and light, filled with family, filled with beauty. There was no strife there. There was no punishment there or even the hint of it. And when they came back from that experience, listen to what they told you. It changed their lives, didn't it? Listen to each one talk about it, for they continued to say, "There is nothing to fear and death is something you experience as a normal transition." Blessed is the Human Being who experiences both death and birth and has the wisdom to report, "Oh, it's uncomfortable, but I'll get through it, because I've done it before." The person who has experienced a near-death experience is no longer afraid to die! What does that tell you? They have seen what is there and they embrace it! …”

Foreign doctors must master Indonesian: Minister

The Jakarta Post, Jakarta | Sat, 03/13/2010 5:11 PM

The Ministry of Health has issued a regulation governing migration of foreign doctors in the country in the wake of the China-ASEAN free trade agreement, which includes proficiency in Indonesian language.

Health Minister Endang Rahayu Sedyaningsih said on Saturday the government imposed strict requirements on foreign doctors who wished to operate in the country that she had no worry about the impacts of the free trade regime on health sector.

“The impacts of the CAFTA on health sector are not that serious, but visible, such as migration of foreign doctors to the country,” she told Antara during a visit to Semarang.

The regulation requires the foreign doctors to master Indonesian and register themselves with the Health Ministry. It also says the foreign doctors can work only at institutions appointed by the government, but are prohibited from running private health clinics.

The work permit for the foreign doctors ranges from two years to five years.

Tangerang Hospital Receives Warning For Hiring Unlicensed Foreign Doctors

Jakarta Globe, February 17, 2010

The Health Ministry has issued a warning to Mayapada Hospital in Tangerang, Banten, for hiring foreign unregistered oncology consultants who did not have a practice license.

“The doctors at Mayapada Hospital did not have any permits. We don’t forbid people from working in Indonesia, but they must follow the rules, so we gave them a warning,” Farid W Husein, the director general of the ministry’s Medical Service Department, told Metro TV on Wednesday.

Farid said that the government had also asked the hospital to announce to the public that they had terminated the service. Previously, Mayapada had placed an advertisement in a national newspaper about the foreign oncologists. The hospital had confirmed they would remove the advertisement and publish an apology.

Farid said the government prevents health institutions from hiring foreign medical workers without official permission from the Health Ministry and Director General of Medical Service. Permission is given based on a recommendation from the local health office and professional organizations.

The Ministry’s legal adviser Faiq Bahfen said that the government would apply penalties to foreign doctors who practiced in Indonesia without registration and a practice permit. The penalty would also apply to the institution that hired them.

“We will look at the regulation and determine the proper penalties,” he said.

Aceh Hopes Modern Hospital Will Prevent Medical Tourism Among Indonesians

Jakarta Globe, Nurdin Hasan, January 24, 2010

German Ambassador to Indonesia Norbert Baas visiting a ward for premature babies at Zainoel Abidin Hospital in Banda Aceh. The German-aided hospital cost Rp 418 billion and is meant to provide top-of-the-line care for Acehnese. It was officially inaugurated on Saturday. (JG Photo/Suparta)

Banda Aceh. Aceh Governor Irwandi Yusuf and German Ambassador to Indonesia Norbert Baas officially inaugurated on Saturday what they said was the “most advanced hospital in the country.”

Zainoel Abidin State Hospital (RSUZA), which is equipped with several state-of-the-art medical instruments, including a CT Scan, MRI machine and radio-diagnostic devices, was rebuilt with aid from the German government. The facility has been receiving patients since last August.

“We say that RSUZA is the most advanced hospital in Indonesia, and its facilities can match prominent hospitals in Penang and Singapore,” Irwandi Yusuf said during the inauguration ceremony

He added that he hoped the new hospital would put an end to the practice of thousands of Acehnese going to Penang, Malaysia, or Singapore each month for medical treatment.

“Including myself, who has to opt for Singapore as a place to have medical treatment because the facilities at the neighboring country’s hospitals are far more advanced than what we have had in Banda Aceh,” the governor said. “But, considering the development, I am certain that the equipment we have now can rival hospitals abroad.”

He also encouraged the staff to prove to the public that the hospital personnel could master the hospital’s advanced machines. “A strong building and advanced equipment are not enough to make RSUZA the best hospital in terms of services for the people of Aceh,” he said.

Baas said that RSUZA was equipped with advanced infrastructure and utilized eco-friendly integrated waste management technology.

“The employees of RSUZA have been intensively trained to ensure the patients and staff can reap maximum benefits from its new facilities and equipment,” he said, adding that the hospital was also designed to weather flooding and earthquakes.

The hospital’s reconstruction was part of German aid for Indonesia, which was augmented after the 2004 tsunami in Aceh that killed 170,000 people, Baas said. During five years of reconstruction in the region, the German government has disbursed a total of 178 million euros ($251.6 million).

The development of the two-story hospital, which sits on 42,946 square meters of land, started in March 2006, funded by a 31 million euro grant from the German government through state-owned bank KfW. The German Agency for Technical Cooperation provided an additional 10.2 million euros worth of technical assistance.

Uwe Ohls, KfW’s first senior vice president of for Asia and Europe, said that the bank would continue to guide the hospital management for the next two years and would facilitate collaborations between the hospital and several universities in Germany for paramedic training courses.

The director of the hospital, Taufik Mahdi, said the facility had 350 beds, and would add 150 more this year. Since the hospital opened, an average of 600 people a day have come to receive medical treatment.

Govt drafting bill on health workers

The Jakarta Post, Jakarta | Sun, 11/29/2009 12:08 PM

A Must for Indonesian Doctors to Work in Remote Areas (KOMPAS/LUCKY PRANSISKA)

The government is drafting a bill that will help address shortage of health workers in remote areas, a minister says.

Health Minister Endang Rahayu Sedyaningsih told Antara on Saturday the bill on health workers would offer special facilities to doctors, specialists and other medical workers who are willing to serve in remote and disadvantaged regions.

The special treatment includes extra allowance, facilities to pursue further study and admission to the civil servants corps.

Endang said the bill, if passed into law, would solve the long-standing problem of poor access to health care facing people in less developed areas.

In the short run, the government will send 130 reinforcement health workers to a number of remote areas across the country, Endang said. The government will also assign senior resident doctors who are at the final stage of their specialist education to serve in hospitals in isolated regions.

Related Article:

A Must for Indonesian Doctors to Work in Remote Areas

National Symposium Held on Brain and Heart

Friday, 27 March, 2009 | 17:40 WIB

TEMPO Interactive, Jakarta:The Indonesian Cardiocerebrovascular Association’s board, supported by the Indonesian Doctors Association is holding the Brain and Heart Symposium IX on March 26 – 27 in Batam. The event is expected to improve knowledge and capacity as well as health services, particularly for heart disease and stroke.

The event held at the Planet Holiday Hotel, Batam, is being attended by doctors who are the front runners for health services in remote areas. The event is also to publish ways to prevent heart disease and stroke for the public.

HERU TRIYONO

Snoring no laughing matter: Specialists

Prodita Sabarini, The Jakarta Post, Jakarta | Mon, 03/02/2009 2:13 PM  

Many Jakartans are unaware of the health and social risks that come with sleeping disorders, seeing insomnia as a regular part of urban life or assuming that snoring as a sign of deep sleep, a sleep specialist says. 

Dr. Andreas Prasadja, a sleep physician at the Mitra Kemayoran Sleep Laboratory, pointed out a lack of sleep poses health risks and contributes to the number of traffic accidents in the city. 

"We've heard about so many traffic accidents being caused by drivers falling asleep at the wheel," he said Friday at a seminar on sleeping disorders. 

Andreas said he hoped to dispel two commonly believed false notions: Sleep as a sign for laziness and snoring was a sign of deep, restful slumber. 

He said our urban lifestyle, which hails productivity and runs by the motto "work hard, play hard", has contributed to people's sleep problems. 

For productivity's sake people force themselves to work long hours using stimulants which then keep users awake when it was time to rest. Light sleeping is not the only consequence: overuse of stimulants can lead to kidney failure. 

He also said exercising just before going to bed can disrupt sleep as well as a brightly lit room, or snuggling up with our digital sidekicks, laptops and cell phones, before snoozing. 

He said people should avoid taking stimulants - including caffeine, nicotine, and chocolate - nine hours before going to sleep, replacing them with relaxing drinks such as camomile tea. 

He also encouraged people to finish their exercise regimes three hours before going to bed and to stop all work-related activities an hour before. 

"When you feel really sleepy, then go to bed. Do not do anything in bed except sleep and have sex," he said. 

Another sleep disorder which is the most common and the most dangerous but also the most ignored is snoring. 

"Snoring is not a laughing matter. It's serious. If untreated it can cause hypertension, heart failure, diabetes or stroke," he said. 

He said that hypersomnia, a condition where people feel excessive daytime sleepiness despite long nighttime sleep might be caused by sleep apnea, a sleep disorder characterized by pauses in breathing during sleep, common among people who snore. 

"During sleep the muscles of the body relax, including the soft tissue around the air way in the throat area. These tissues can collapse and obstruct breathing during sleep, causing people to stop breathing until they gasp for air," he said. 

To take in air, sufferers must wake over and over so they are never fully rested and can wind up with chronic, life-threatening consequences of extended sleep deprivation. 

The importance of sleep, however, has yet to be fully understood by the public, including doctors, Andreas said. 

"In Indonesia doctors diagnosing patients with hypertension or diabetes still rarely ask how well their patient is sleeping at night. In developed countries, that question is one the first questions the doctors ask a patient," he said. 

Lalaine Gedal, a Singapore-based sleep physician, said the prevalence of sleep apnea among 35-year-olds is 20 percent among men, and 5 percent among women. Among the elderly, 60 percent of men have sleep apnea and 40 percent of women. 

A patient of Andreas said he had not realized he had been suffering from sleep apnea until he became very tired every day, dozing off during meetings and even while driving. 

For those who dread surgical interventions, an effective and noninvasive method for stopping snoring involves a machine. Andreas' patient now uses a Continuous Positive Airway Pressure device known as a CPAP. 

The CPAP includes a mask with air tubes and a fan. It uses air pressure to push the user's tongue forward and keep the throat open. This allows air to pass through the airway consistently. It reduces snoring and prevents apnea wake-ups. 

There are only two sleep specialists in Indonesia, both based in Jakarta. Andreas and Rimawati Tedjasukmana founded Thursday the Indonesian Society of Sleep Medicine, or INA Sleep. 

Andreas said he hoped to educate people about sleeping disorders, through the organization.

Symptoms likely rare disease

The Jakarta Post, DEPOK | Mon, 02/23/2009 11:45 AM  

A girl who was hospitalized a few days ago after receiving a diphtheria, pertussis, and tetanus (DPT) vaccine in Depok has been diagnosed as having Stephen Johnson syndrome, according to the hospital’s paediatrician. 

“The syndrome occurred after the girl was treated with some medicines to cure the side effects that come naturally after an immunization, such as fever,” Dr. Indra Sugiarno said Saturday during a press conference in Depok’s Sentra Medika hospital. 

The syndrome was not related directly to the immunization and giving medication for fever after a an immunization is normal, Dr. Indra said. 

Head of the Depok administration’s health agency explained the chronology of the case. 

The seven-year-old elementary school student had an immunization of a 0.5 cc DPT at her school on Feb. 4. The next day she felt pain in her upper arm and shoulder. On the fourth day, Feb. 7, the pain had spread to her neck as bumps began to appear on her skin. 

By Monday, Feb. 9, the girl became weak and had a fever. The next day she was given two kinds of medicine for her fever at a health clinic, but her condition continued to deteriorate as the lumps spread across her upper body. 

The lumps continued to appear and, after being prescribed five kinds of medicine by a doctor on Feb. 13, her condition continued to worsen; her lips turned dark blue. On Feb. 14, after being taken to another health clinic, she was referred to the hospital. 

“The Depok administration will cover all expenses for the care of the child, even if the conditions were not caused directly by the immunization,” he said. 

The immunization was part of a national program from the ministry of health. 

“An immunization of DPT bears no absolute contraindication,” Indra said. “It means there is no specific condition that can prevent a child from being immunized.” 

He said the little girl needed to be hospitalized because the syndrome could lead to infection, which can be fatal on open skin. The danger level of the disease greatly depends on how large the area of the open skin is. 

Stephen Johnson syndrome is caused by hypersensitivity to medicines, viruses, or infection Dr. Indra explained. The real cause of the little girl’s case is yet to be determined by the experts studying her case, he said. 

“The disease has genetical susceptibility. The case rate is one in a million people a year,” he said. 

The syndrome is mostly seen in forms of defiant reactions on skin and mucus membrane.

Dr. Hapsari, the dermatologist assigned to care for the girl said, “The condition of the girl is now getting better.” 

Prasetyo, the father of the girl, said his daughter can again eat soft food after only being able to take nutrition intravenously. 

As of Saturday morning the lumps had disappeared, but her neck, upper arm, and chest were blackened. 

Early symptoms of Stephen Johnson disease include reddening of the skin, which later turns to necrosis, causing the skin to blacken, Dr. Hapsari said. 

She said the condition of the skin might return to normal in a few weeks. “It all depends on the treatment.” The color of the skin, he said, might not return to its original shade. 

Dr. Indra stressed that for the interest of the patient the condition of the patient should be kept discreet, but the public’s right to be informed — as the case was related to the national program of immunization — led to the disclosure of the case, with the consent of the patient’s parents. (iwp)