Province suffers acute doctor shortage, governor blames 'greedy' staff and hospital managers for high rate of patient deaths
A health worker examines a patient at Kampung Harapan clinic, about 26 kilometers from Jayapura in Papua. (Photo by Benny Mawel/ucanews.com)
Benjamin Lagowan will forever be haunted by the death of his cousin, who was misdiagnosed with an intestinal infection and ultimately died due to a lack of adequate health care in his hometown in Indonesia's Papua highlands.
Alex Molama, 27, was rushed by stretcher to a hospital in Wamena, the capital of Jayawijaya Regency, in August after complaining of stomach cramps.
The family got him there as best they could in lieu of any other available form of transport in this remote corner of the world where ambulances are considered a rare luxury.
The doctor told the family Molama appeared to have an intestinal infection and referred him to a specialist.
However, as the specialist was out of town at the time, nurses with limited training and resources struggled to treat him, and his relatives had to sit by and watch as the young man's condition deteriorated from bad to worse.
"His belly was swelling and bile was pouring out of his mouth," Lagowan told ucanews.com.
On Aug. 24 Molama was sent to another hospital in Jayapura, the capital of Papua province, equipped with better facilities.
"The doctors there told us he wasn't suffering from an intestinal infection but acute kidney failure," Lagowan said. Molama died five days later.
The agony did not end there, however.
As the family attempted to take his body home they encountered frustrating and painful delays, as there were no medical staff on duty to sign his release papers.
Marcelina Matuan has a similar story to share.
Her sister in-law, Yuliana Lagowan, 37, was forced to try traditional herbs and medicines after feeling pain in her head, because there were no specialists available at the same hospital in Wamena to help identify what was wrong.
Lagowan (no relation to the other deceased patient) was rushed to another hospital in the town a few days later after she fainted one day.
Once there, the doctor informed her family that she had suffered a brain hemorrhage and had to be treated at the Jayapura hospital or she most likely would not survive.
"The problem is that it took us a week to get the referral letter so we could send her there," Matuan recalls.
When the family finally arrived in Jayapura, the doctors were unable to perform surgery immediately despite the urgent nature of her condition because they had to wait for a chief surgeon to arrive from Jakarta.
Due to a shortage of doctors, the surgeon was only available at that hospital on Fridays and Saturday.
"They asked us to be patient," Matuan said.
Lagowan died before the surgeon showed up.
Sepit Boma, 18, joined this chorus of despairing, bereaved relatives after watching his elder brother perish due to a shortfall in state funding for public health.
Simon Boma, 23, was taken to a local hospital in Abepura on Sept. 24 after he complained of chest pains and difficulty passing urine. The doctor suggested he be hospitalized to receive better treatment.
"But no one tended to him properly. The doctor just gave him some Paracetamol for the pain, and his condition never improved," Sepit said.
Realizing they could provide just as much if not better care at home, the family took him back to their village, where he died on Oct. 1.
A health worker tends to a patient at Kampung Harapan clinic. (Photo by Benny Mawel/ucanews.com)
There are thousands more examples of Papuans who have died due to poor health care services in the region. Tragically, many die in government-owned hospitals, which are considered to be the best in the province.
Three months ago a document on patients who have passed away at Jayapura Public Hospital was circulated among journalists in Papua.
It recorded 1,275 deaths from 2008 to 2012.
A similar survey published in Tempo, a weekly magazine, in February reported that from 2013 to 2017, 2,393 patients died at the same hospital — close to double the number of the previous four-year period.
Dr. Aloysisus Giyai, head of the Papua health department, said the number of patient deaths at the hospital was the highest in Indonesia.
"These numbers are very worrying. The average number of patient deaths at hospitals nationwide is 120 a year," Giyai told ucanews.com.
He said there are many contributing factors but the main cause was the limited number of trained personnel.
Papua has about 12,000 medical workers but pundits say it needs three times as many to provide an adequate level of service to the general population.
Another factor cited by Giyai is the widespread belief by people, especially those living in rural or isolated communities, in black magic, shamans, and other health healers usually considered "quacks" in the West.
"When a person gets sick, it is often assumed that someone has put a curse on them, or that some other form of sorcery is at play," he said.
"As such, the patient is taken to see the village shaman rather than a trained doctor at a proper hospital."
In too many cases, he said, the patient is only rushed to a legitimate medical facility when they are at death's doorstep and there is little doctors or nurses can do to save them.
Papua governor Lukas Enembe has blamed the unacceptably high number of casualties in Papua on a lack of genuine dedication on the part of medical staff and hospital administrators, many of whom are imported from other regions.
He said that in too many cases their chief concern is enriching themselves not ensuring the sick and wounded get the best possible treatment.
"Running a hospital is big business. There is a lot of money to be made. Too many people lack the heart to serve the people of Papua," said Enembe, who was re-elected as governor in June.
He said many health care facilities in the region are being mismanaged.
One of his top priorities is fixing the problems with the Papua Health Card (KPS), he said.
While the system was designed to help impoverished Papuans who are unable to afford their own medicine, surgery, or other health services, it is open to abuse by unscrupulous medical practitioners, he added.
"We need to employ people who genuinely care about Papuans," he said, adding he plans to build more hospitals that will be staffed exclusively by local doctors and nurses.
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