TEMPO.CO, Jakarta,
Written by: Emma Stokwielder (Student of Journalism – Binus International University)
In April last year, an American journalist Jonathan Vit writes the article “Death by a thousand cars” for foreignpolicy.com. He discovers horrific numbers about the first response paramedics in the capital of Indonesia, Jakarta, and loses his hope for those who once will need urgent medical help. In 2015, only 12 patients arrived at the Cipto hospital, the rest were going straight to the morgue. One year later, Jonathan fell down with his motorcycle and he extremely injured. “The doctors told me I was two hours away from dying, if I didn’t were that close to a hospital, I might have died on the street.” However, in one year time, a lot has positively changed at the Ambulance Gawat Darurat Dinas Kesehatan DKI Jakarta (AGD) and faster medical help is on the way.
The traffic in Jakarta has been a problem for many years. In the city, you can see ambulances struggling their way through the traffic on a daily basis. On May 21 at 10 am, two Go-Jek (online ride-hailing company) drivers are escorting an ambulance through a congested street in Jakarta. The ambulance is on its way to a man who had a heart attack and is collapsed right on the street. Vegan Venjaya (20) see it is happening right behind the car he is in with his friends. “The traffic was really really bad that day” Vegan explains. He films the scenario with his phone and posts it online. The video is posted on the Instagram ‘gojek24jam’ and goes viral. In the comments section, people call the Go-Jek drivers hero and praise them for their action. Unfortunately, it still took too long for the ambulance to reach the victim and the family canceled the medical team. Instead of waiting for the paramedics, they drive their uncle in their own car to the nearest hospital. This happens frequently because the people in Jakarta have lost their hope in the AGD.
In April 2016, journalist Jonathan Vit gives a clear view on how bad the situation in Jakarta is around ambulances. His article shows that AGD (the biggest medical transport service from Jakarta) transports some 60 patients from city hospitals to their homes, outpatient centers, or specialists, but responds to at most an average of three emergency calls a day. At top of this, in 2015, only 12 patients arrived at Cipto hospital, the rest were going straight to the morgue. Vit ends the article with his experience with a dead body on the street. “The crowd was directing traffic around the body instead of offering any help,” he writes. A little less than a year later (end of January this year), Vit gets an accident himself. He falls down with his motorcycle and a car hits him. When the lady in the car yells at him for damaging her car, the bystanders help Jonathan to get back on his feet. “I didn’t really bother calling an ambulance, because they told me they often didn’t make it to the victim, so I just called a cab and luckily I was close to a hospital so I arrived there in 10 minutes.” Jonathan breaks almost every bone from his neck to his waist down and as a result his long collapse. “If I didn’t were that close to a hospital, I might have died right there on the street.” According to Vit, there is a solution for a part of the problem. The ambulance division told Vit the thing they were very adamant about: first responded paramedics at motorcycles instead of ambulances. “You at least can get a paramedic to the place of the accident and stabilize the patient.”
Now there has more than a year past. Kelvin Rupassa (36), the lady who Jonathan also interviewed, still works at the Ambulance Gawat Darurat Dinas Kesehatan DKI Jakarta. She has been working there for 6 years by now and has seen many changes, especially last year. Right now, the AGD has 60 ambulances of which 49 are available for emergencies and 11 are functioning more as a buffer. “Unfortunately, we have not enough employees to ride all our ambulances, so that’s why we call the remainders our buffer. When a disaster happens and we need as many ambulances as we have, we will deploy them,” Rupassa says. In one year, the number of the vehicles has grown with 17 and later this year, around October, they will get 30 more new ambulances. Rupassa hopes in 2018, they will receive another 80 new vehicles. This is necessary because the fact is that their response time is still 30 minutes, what has to be pushed back to 15 minutes. “To reach our goal of the response time of 15 minutes, we need to have one ambulance for every 5 KM of Jakarta. In total, this will come down at 169 ambulances”. March this year, AGD actually did got their own motorcycle unit Kelvin was hoping for. Right now the unit counts 13 motorcycles with paramedics. The best part is that motorcycle paramedics are way faster than ambulances and they can stabilize the patients while waiting for the ambulance to arrive. “One month ago, a man got a heart-attack in Ratu Plaza, Central Jakarta. We sent a motorcycle right away to stabilize the patient, we saved his life by giving him first aid on time,” Kelvin tells proudly.
Another positive change for the healthcare happened in April 2016. Governor Basuki Tjahaja Purnama or Ahok, together with the Ministry of Communication, introduced emergency line 112 to Jakarta. Previously, you had different numbers for every emergency service, now 112 will encompass them all together. “We have to make one standard across agencies. For example, what is the longest time taken for a fire truck or an ambulance to reach the area, and how can we improve that time frame?” Surya Putra (head of the Ministry of Communication) said to GovInsider. The AGD finds the implementing from 112 has been good for the emergency help, they are getting more calls and are working better together with the other emergency services like the police. Rupassa is not scared that there will be a negative change for them with new governor-elect Anies Baswedan. “Every government is worried about the health of the people and we are still with the same team, keeping on doing our thing.”
Still, there are some things that have to be improved in the near future. The hospitals in the city do have ambulances, but they are not yet available for emergency calls. The AGD hopes that next year the hospitals will be providing ambulances in case of emergencies because right now AGD is still the only one. The hospitals only need to provide their vehicles in case of a big emergency. “All the hospitals are connected with the 119 in case of a disaster. The government made a constitution so the hospitals have to obey and provide their ambulances when needed” Rupassa says. Next to the fact that Jakarta is short in ambulances, there is also a big problem around the education from Jakarta’s citizens. “The people think it is better to get the victim as soon as possible to the hospital, but that is not always the case. It is mostly better to wait for an ambulance so they can stabilize the patient first,” Kelvin says worriedly. “Even in the movies, made by Indonesian filmmakers, they never call an ambulance in case of emergency, but a taxi instead! We need to talk with the producers to make sure the people don’t pick up this wrong message and do call us in need for medical help.” Another dream of the AGD is to separate the units for emergency ambulances and the ones for transporting patients. In that way, it will be easier for the call center to have a good overview of how many ambulances are available for emergencies.
This month, the AGD moves to their new office in Central Jakarta where the 119 will join them. A 9-floor building with a call-center that has seats for 40 telephone operators and a fitness center. Kelvin has a positive view for the future of the health care in Jakarta. “With our new office, we can help more people in need because we have almost ten times the amount of telephone operators and we get more and more ambulances. The only thing that I’m worried about is that we don’t have enough paramedics. Most of the graduated nurses want to work in a hospital instead of by the AGD, that’s unfortunate because it only requires a training to become a paramedic.” The ambulance service keeps working hard to provide better and better urgent medical help to the citizens of Jakarta, but at the end of this long way they have to go, is a bright future.
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