Ini Kesempatan! RSUD di Palangkaraya Ini Memerlukan Tenaga Dokter, Ayo Buruan Daftar!

BANJARMASINPOST.CO.ID, PALANGKARAYA - Direktur Rumah Sakit Umum Daerah (RSUD) Kalampangan, Palangkaraya, Kalimantan Tengah, dr Abram Sidi Winasis mengatakan, pihaknya terus berbenah.

Dia juga mengatakan, meskipun jumlah pasien yang menggunakan atau memanfaatkan RSUD Kalampangan hingga Selasa (19/9/2017) terus bertambah. Tetapi untuk ketersediaan sumber daya manusia khususnya dokter spesialis masih kurang,

"Sehingga perlu dilakukan penambahan," jelas Abram kepada BPost Online.

BANJARMASINPOST.CO.ID, PALANGKARAYA - Direktur Rumah Sakit Umum Daerah (RSUD) Kalampangan, Palangkaraya, Kalimantan Tengah, dr Abram Sidi Winasis mengatakan, pihaknya terus berbenah.

Dia juga mengatakan, meskipun jumlah pasien yang menggunakan atau memanfaatkan RSUD Kalampangan hingga Selasa (19/9/2017) terus bertambah. Tetapi untuk ketersediaan sumber daya manusia khususnya dokter spesialis masih kurang,

"Sehingga perlu dilakukan penambahan," jelas Abram kepada BPost Online.


No political party has answer for rural health crisis

None of the political parties have an answer to solve the growing rural health crisis, a leading rural health expert says.

Michelle Thompson, chief executive of the Rural Health Alliance of Aotearoa New Zealand (RHAANZ), says they surveyed all political parties asking what they will do to help rural health over the next three years.

"While all parties managed to respond, in the end, it was surprising that a week out from the election that none of them had clear information on how they would provide equitable rural health funding," Thompson says.

"This demonstrates the parties haven't really understood the specific challenges rural people face accessing health and social services due to factors such as low population density and/or isolation.

"There is the mentality that a single health policy fits all. Yet, we know that taking an urban policy and imposing it in a rural setting seldom works.

A new government needs to help remove barriers so rural people's health is considered just as important as those who live in cities.

"We don't even have a nationally agreed definition of what rural is, in terms of health services in New Zealand. This is shameful given our reliance on the rural economy.

"Having a fit for purpose definition of rurality was one of two key election asks we made to politicians yet there is no mention of this in their summaries.

"Nor is there mention of our second election priority which is the need to rural-proof government policy. The concept here is that our policy makers need to consult with rural communities and business when developing policy to make sure they have understood the rural reality so that their policies don't actually make health inequities worse.



Masih Butuh Tenaga Medis

BOLMUT—Tenaga medis di Bolmut masih minim. Sehingga dibutuhkan penambahan. Hal ini diungkapkan Siti Nurhidayah, Kasubag Umum dan Kepegawaian Dinas Kesehatan (Dinkes) Bolmut.

Menurutnya, yang paling kurang tenaga dokter. "Karena standarnya untuk puskesmas rawat inap butuh dua sampai tiga dokter. Namun yang ada hanya satu atau dua. Bahkan ada puskesmas yang tidak ada doker sama sekali," bebernya.

Lanjutnya, yang dibutuhkan saat ini yaitu tujuh dokter gigi dan delapan dokter umum. "Kalau perawat malah jumlahnya sudah lebih. Yang masih kurang juga adalah bidan. Karena total 106 desa di sini dan aturan harusnya satu desa satu bidan. Untuk puskesmas rata-rata harus dua sampai tiga bidan. Jadi jumlah bidan yang diperlukah harusnya ada sekira 130-an. Yang ada sekarang baru 72," jelasnya.

Kepala Puskesmas Boroko Juni Djenaan membenarkan hal itu. Menurutnya, ada 11 puskesmas di Bolmut. "Untuk Boroko Sendiri minimal tiga dokter di sini tapi hanya ada dua. Mudahan-mudahan kita bisa ketambahan dokter lagi," katanya.


Striving to better rural healthcare

Start-up teams up with traditional care providers, uses digital tools to meet healthcare needs of the poor

Bishakha Devnath

Sixty-five-year-old Fatema Begum lives deep into Madan upazila of Netrakona, where formal healthcare is an inconceivable luxury. So, when an itch broke out all over her body, she ignored it at first. But things got severe; she found herself scratching her skin until it swelled and began aching.

The poor housewife then saw two "Palli Chikitshaks", meaning village doctors, and spent Tk 5,000 but in vain. When she stopped looking for relief, worrying about further expenses, she learnt from a neighbour about Projotno, a telemedicine service introduced by Jeeon.

A self-proclaimed "for impact" company, Jeeon bolsters healthcare providers already existing at union bazaars, instead of building new infrastructure like most other health organisations, so that they can provide better services to people living in remote areas at an affordable cost.

Indeed, Fatema had to pay only Tk 300 for consulting a doctor from Dhaka and Tk 500 for the medicines to become completely cured, and that was possible even without requiring her to travel miles of treacherous, village roads to places where formal health services are available.

To get the service, she only had to come to the nearest drug-shop-cum-Projotno-centre in Balali bazaar, less than 15 minutes from her home. Within minutes, she was connected to a dermatologist sitting in Dhaka, who after reviewing her symptoms and pictures of her skin, and talking to her, sent her a prescription over the internet. The prescription was printed out with the doctor's e-signature, and she could walk away with the required medicines within 30 minutes.

Not only that, her medical records would never be lost, and she could visit another Projotno centre after five years and the doctor would still be able to view her previous records.

This is how, Rubayat Khan, the startup's "Dreamer and Teambuilder", says, the organisation bridges the gap between rural patients and quality healthcare.

"I don't have any electronic medical record in Bangladesh. Yet, our patients in remote areas have their unique patient IDs and digitised records in the cloud," he says with pride.

Referring to the traditional practice popular at remotest corners of the country due to the unavailability of doctors, he says, "People often rely for their health completely on so-called village doctors who have no formal education in medicine, but know the names of drugs and how to provide first aid while running drug stores."

While some of them got a formal certification as Rural Health Practitioners (RMPs) in the 1980s, that certificate is no longer legally recognised; yet, there are 1.3 lakh RMPs practising across the country.

They are extremely hard to monitor and regulate because they are decentralised private sector providers.

Unaware of the health consequences, and encouraged and perversely incentivized by pharmaceutical companies, they regularly provide steroids and powerful antibiotics that bring quick relief to patients from sufferings from varied symptoms but at the same time leave irreversible impact on their health.

Giving an example at Jeeon's Lalmatia office in the capital, Dr Fahima Mumtaz showed pictures of a woman with inflammation on her cheeks. The patients had used an ointment with steroid on acne to see the problem reappear in a more severe form as fast as they were gone.

She has found such cases to be commonplace among rural patients.

Asked why Jeeon works with RMPs when they are the ones to be blamed for the misuse of drugs, Rubayat said they were living close to the patients targeted.

"RMPs have gained rural people's trust because they know them personally and they go to these health practitioners with their health complaints for decades or probably for generations. They charge nothing for anything other than medicines, offer credit when you don't have cash, and drink tea with you while inquiring about your ailing grandma.

"The formal healthcare system could learn a thing or two about personalised care from these guys!"

The team at Jeeon designed their operation around the RMPs, training them to put in necessary information and pictures of a patient into an Android application. A set of physicians in Dhaka would see them to suggest treatment, medical investigations, if needed, and even refer a patient to a specialised doctor in nearby facilities if the problem is complex and requires face-to-face consultation.

In doing so, Jeeon wants to be a partner for the government and the medical community to reign in malpractices in this sector, and sustainably improve the health outcomes for poor people in this country. The government has recognised Jeeon's efforts and awarded it as one of the top 10 startups in Bangladesh last year.

In its ongoing experimental phase at 32 Projotno centres in Kishoreganj, Netrakona and Sunamganj, Jeeon has provided treatment to some 7,500 patients already in nearly two years. The company has plans to expand its operation after concluding its pilot phase this September.

It is also building partnerships to broaden the scope of its services, such as introducing an ECG machine built by an Italian startup at Projotno centres to screen and treat heart problems. Jeeon wants to build an all-in-one platform where people would get information about various low-cost and free health services provided by charitable doctors, hospitals and NGOs.

It seems Jeeon has a long journey to make, as it aims to reach all the remotest parts of the country. Luckily, Jeeon has a strong set of funders and supporters backing it. In addition to high net-worth private investors in the USA who provide 80% of its investment, Jeeon also received substantial support from the USAID and other foundations, and also a small grant from the government.

But in the long run, Jeeon expects the consultation fees and other revenues collected through its services to carry it to sustainability and self-sufficiency.

Based on Jeeon's inspiring vision for the future of healthcare in this country, that long-run could not come early enough.



Pemkab Minahasa Rekrut Dokter PTT Daerah

Tondano, ME
Guna memenuhi kebutuhan tenaga Dokter Kabupaten Minahasa melakukan rekrutmen Pegawai Tidak Tetap (PTT) daerah. Hal tersebut diungkapkan Asisten I Bidang Pemerintahan dan Kesejahteraan Rakyat, Dr Denny Mangala MSi

Menurutnya, perekrutan PTT daerah ini hanya untuk tenaga dokter. Hal ini diperlukan supaya semua Puskesmas yang ada di Kabupaten Minahasa memiliki dokter. "Beberapa waktu lalu kan kita telah menerima dokter PTT pusat, tapi kita masih kekurangan. Karena itu kita lakukan rekrutmen PTT daerah untuk tenaga dokter," ujar Mangala saat diwawancarai diruang kerjanya.

Lanjutnya, untuk gaji PTT dokter daerah ini dibebankan dalam Anggaran Pendapatan dan Belanja Daerah (APBD) Kabupaten Minahasa.

Dengan kehadiran para dokter PTT ini, diharapkan pelayanan kesehatan bagi masyarakat Tanah Toar-Lumimuut bisa semakin baik. "Ini juga adalah salah satu bentuk dukungan kita buat salah satu program pemerintah pusat terkait meningkatkan pelayanan kesehatan bagi masyarakat," jelasnya.

Terpisah, Hence, warga Kecamatan Kombi yang sempat berbincang dengan wartawan mengatakan bahwa dirinya sangat menantikan peningkatan pelayanan kesehatan bagi masyarakat. Terutama yang berada di wilayah pelosok yang jauh dari ibu kota dan fasilitas rumah sakit.

"Tentu kami menyambut baik hal-hal positif seperti ini. Karena bagi kami masyarakat yang berdomisili di wilayah pelosok, sangat membutuhkan kehadiran dokter spesialis di Puskesmas," ujarnya.

Selain itu ditambahkanya, fasilitas pendukung juga harus dipenuhi. apalagi saat ini rata-rata bangunan Puskesmas yang ada di Minahasa sudah direnovasi. Bahkan ada yan dibangun baru.

Namun sayang, pemetaan pesonil di Puskesmas belum merata. "Hal-hal pendukung seperti jumlah perawat harus juga diperhatikan. Begitu juga dengan peralatan-peralatan medik. Karena meskipun tersedia tenaga dokter tapi tenaga bidan dan perawat kurang, kan pelayanan kesehatan tidak akan maksimal," jelas lelaki berkacamata tersebut. (lucky kawengian)


Rural health: Two small hospitals learn how to survive

BIGFORK, Minn. – Small-town hospitals and clinics may not have all the bells and whistles of their big-city counterparts, but they offer something patients often cannot find in the cities: quarterbacks.

"You have a quarterback here," said Dr. Heidi Korstad, sitting in the cafeteria of Bigfork Valley, a sprawling medical complex of hospital, clinic, nursing home and other facilities in a town that falls short of 500 population.

The quarterback, Korstad said, is a small-town doctor who can supervise care for patients. "You have somebody that understands you, knows your medical problems ... knows your family, knows your economic situation."

With frustration, the doctor who has been at Scenic River Medical Service clinic in Bigfork 35 years said that does not always happen in bigger facilities. Too often, Korstad said, the patient "is a complaining widget."

Korstad and other small-town health professionals say that besides providing quality medical care, they offer personal attention that cannot be obtained in bigger facilities.

"It is the people you live with," said CEO Nathan Blad of Renville County Hospital and Clinics, based in Olivia.

The Bigfork and Olivia facilities sit 261 miles apart in far different country (timber and lakes versus farming), but they are two examples of how some small Minnesota hospitals have bucked the trend of financial problems and even closure.

"A great number of rural hospitals face an uncertain financial future," said Terry Hill, a Duluth-based leader of Minnesota and national rural health organizations.

The biggest challenges come in the most-remote hospitals, said Mark Schoenbaum of the Minnesota Health Department. Bigfork, Hill said, is the most remote Minnesota hospital.

Bigfork is north of Grand Rapids in north-central Minnesota. It is surrounded by forests, with numerous lakes amid the trees. Residents call their area the "edge of the wilderness."

The Renville hospital, meanwhile, is on the open west-central Minnesota plains surrounded by farm fields in the 2,400-population Olivia. The city promotes itself as the "Corn Capital."

The Olivia facility is two years old and packed with modern technology, including a robotic surgery system, the first in the state for a hospital its size.

The robotic system, which went active in August, can be used for a variety of surgeries, with a surgeon controlling it nearby. The $1.4 million system can give a surgeon a three-dimensional view inside a patient's body and allows a doctor's hand movement to be translated into a more precise movement than a human can accomplish.

The hospital and clinic are owned by the county and under one roof, a roof built in 2015 when Blad and other hospital leaders looked at financial information and determined they could replace an antiquated facility without tax money.

The Olivia hospital and clinic have connections with specialists who visit the hospital and provide audio-video connections to doctors from St. Cloud and the Twin Cities to remotely deal with patients who suffer from stroke, cancer and other issues.

Like throughout rural America, finding doctors willing to move to Olivia sometimes is a problem.

"Oh, you don't have a Target?" is a common question early in the recruiting process, Blad said.

Bigfork, meanwhile, attracts health care professionals who like the outdoors life.

"I specially came here because I wanted to live in the woods," Korstad said.

Travis Luedke, human resources director for the Scenic Rivers Health System clinics that work with Bigfork, recruits for six medical and four dental clinics. He said many health care professionals are tough to find, but doctors are the worst.

"They are locked in the metro area," he said about medical students.

But there are medical provider shortages, too.

Three years ago, he hired a dentist from Egypt. "That was the closest dentist I could find."

One major issue is housing, he said. "I can't tell you how many I have lost because I can't find a home for them."

Retired Dr. George Rounds, now Bigfork board chairman, grew up in the large suburban city of Richfield, but moved to Bigfork because "I wanted to go to a place where I was needed." He practiced in Bigfork his entire career.

After all these years, Rounds said he still is not sure if he is optimistic about rural medicine's future. Federal programs can make or break the hospital, he said, and the political climate for continuing such programs is uncertain.

Bigfork CEO Aaron Saude said that not being in a big health care system means specialists sometimes are more difficult to schedule for visits to his community, which is 40 miles from any other hospital.

Telehealth, the audio-video connection to specialists located far away, has been difficult for Bigfork because of slow internet connections, The hospital and clinic soon likely will have a higher speed broadband access, which may allow for more telehealth work, Saude said.

Rounds, on the other hand, said he is not sure telehealth is the answer anyway. "It is hard to beat a face-to-face encounter with a person."

What it's all about

Regardless of where a doctor works, big hospital or small, there are some successes he or she will remember.

"Yesterday, somebody died and didn't stay dead and left laughing," Dr. Heidi Korstad of Scenic Rivers Health Services in Bigfork said. "That was fun."

She explained: A patient came in with a sore leg, but while at the facility suffered cardiac arrest. After CPR revived the patient, he left in a helicopter for further treatment elsewhere, and was laughing as he was leaving.

"People trust us," Korstad said. "It is really stressful because you know they are really counting on you."

But when a patient leaves laughing, it reliefs that stress a bit.


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