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In Search of Healthcare for All
Patients at Waiwadan Puskesmas, East Nusa Tenggara, accompanied by the midwife. Tempo/Amanda Siddharta
Thursday, 18 February, 2016 | 13:12 WIB
In Search of Healthcare for All

TEMPO.CO, Jakarta- Community health centers in four regencies in East Nusa Tenggara are upgrading their services. Standardization of care and a new referral system are driving the improvements.

The sound of a baby crying cuts through the Waiwadan community health center (Puskesmas) in Adonara, East Flores regency, East Nusa Tenggara. Teresia Bolina quickly picks up her one-month old daughter and unbuttons the top of her blouse to breastfeed her. The baby girl, who has yet to be named, begins nursing, and the shrill wailing stops.

Teresia has come to the Puskesmas for a routine checkup. Last December, she gave birth at the public hospital in Larantuka, the capital city of East Flores. She said she was referred to the hospital because it was too risky for her to deliver in the local Puskesmas, which lacks the necessary surgical equipment to handle problems that may arise. "A midwife from my village of Dusun Tiga accompanied me to the hospital," the 32-year-old woman said.

On the day of her delivery, she was picked up by an ambulance and taken to a boat for the 20-minute ride to the city. Teresia said she was already in the second stage of delivery and was worried she might have to give birth on the boat. Another ambulance was ready to take her to the hospital when she arrived at the port. At the hospital, rapid action on the part of health staff allowed her to deliver the baby safely.

Yustina Benga, Teresia's sister, was also referred to the public hospital after it became clear she would require Caesarean section. "I thought I could deliver normally, but on the day, my blood pressure spiked to 220. The midwife (at the Puskesmas) immediately referred me to the hospital," the 33-year-old woman said.

Six months later, she was back in the Larantuka hospital; her son had lost weight and was refusing breast milk. "I went back to the city and found out my son had an infection," she said. Yustina stayed in the hospital for another two weeks. 

Both Teresia and Yustina would not have received such service without the introduction of a new referral system that has created efficient communication between community health centers and the local hospital. Both women are participants of the free health care scheme run by the Social Security Management Agency (BPJS Kesehatan).

Teresia, who has three children, said the improvement in healthcare services was readily apparent. "Both the Puskesmas and the hospital closely monitor us to make sure my baby and I are healthy," she added. Before, there was no coordination between the health center on the island and the public hospital in the city.

Patients often had to find their own transportation, which is hazardous for mothers on the cusp of delivery. With accreditation standards, however, all staff at Waiwadan Puskesmas have clear guidelines for providing healthcare services for the patients, and ambulances are now on call. (*)


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