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Nurses at a Covid-19 vaccination booster program in Yogyakarta , Indonesia . Photo : Krishna Tedjo
A different perspective
Virtual tour gives unique insight into Indonesia ’ s healthcare system .
By Elise Hartevelt
Third-year nursing student Shamsiya Hassam Mooradun recently attended a virtual Public Health Study Tour ( PHST ) program about Indonesia ’ s public health sector to help develop her nursing career .
The two-week intensive program is intended to equip students with practical in-depth knowledge and was the result of a partnership between Charles Darwin University ( CDU ) and the University of Indonesia ( UI ).
Described as “ an eye opener ”, Shamsiya said that it had improved her understanding of health challenges faced in a different country .
“ It was quite interesting , not as boring as watching lectures , and it was broken into different segments where we could visit different places virtually ,” she said .
“ We had seminars from different people from universities , hospitals and organisations that came to introduce different parts of the health care and public health .
“ You were also able to interact with Indonesian students who were taking part in the course .”
Indonesia ’ s healthcare system is facing numerous challenges , including diseases like malaria that affect 1.32 million citizens every year .
Moreover , the country has experienced a surge in HIV cases and is still ranked third in the global prevalence of leprosy .
“ In Australia , you would not really hear about neglected diseases like malaria , leprosy , stunting or HIV ,” Shamsiya said .
“[ The course ] helped me to gain a better understanding of different issues of public health .”
Other challenges are related to Indonesia ’ s geography and complicate the extension of healthcare services to remote areas .
On average , people living in rural areas have access to one doctor for every 16,792 inhabitants compared to a ratio of one doctor to 2,763 citizens in urban areas .
“ One nurse would be placed in a remote community , and she ’ ll be responsible for that community by herself , and that ’ s one of the challenges .
“ In Australia , you would specialise in different types of nursing , but over there , they get trained to go on field and look after the community .”
Poverty in rural areas also increases the risk of crippling health-related costs when an epidemic strikes .
While Indonesia offers a similar healthcare plan as Medicare , it doesn ’ t cover the expenses as effectively .
Research suggests that only half of the fees are covered by the government , leaving Indonesians to cover most of the costs by themselves and through insurance schemes .
“ If you work and you can afford it , you can have private health cover and then you get better care and go into private hospitals ,” Shamsiya said .
“ For those who cannot afford to have this , you would still have out-of-pocket expenses .”
The virtual study program also addresses cultural differences and how they influence health care systems .
Cultural beliefs impact how people seek care , perceive their health and how they would like to be treated medically .
“ You learn how to interact in a different culture , communication wise , and gain a bit of understanding of how health is also related to culture ,” she said .
“[ With ] some diseases they look at it from a different perspective , like black magic or that a person is possessed .
“ You need to promote health but understand the patient as well .”
The importance of personalised care is emphasised by Australia ’ s high immigration numbers .
In 2020 , over 7.6 million people living in our country were born overseas , while one-third of Australia ’ s nurses are foreign-born .
“ Australia is a multicultural country , so you meet lots of people , including Indonesians ,” Shamsiya said .
“ If you happen to be nursing someone from Indonesia , you have a bit of understanding of what they ’ ve been through in their country public health wise .”
Though cultural competence training is often included in educating nurses , the program has an added benefit because of its practical nature .
Shamsiya said that it can help nurses in the future and would encourage any nurse to join the program .
“ Overall , the program was an eye opener to the Indonesian public health system and the various challenges associated .”
CDU Associate Lecturer in Nursing Donna Diffley , who coordinates the Nursing Practice Project ( NPP ), said that it is crucial for nursing students to gain experience beyond the classroom .
“ The program connects our students with leading health professionals , policy makers and community health workers in Indonesia to discuss approaches to health issues with their Indonesian counterparts .” ■
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