RSUP Fatmawati >> RSCM “Cipto” >> RSPP “Pertamina” >> RS Fatmawati >> RSKD Dharmais ??

The title of this post refers to string of Indonesian hospitals that my father-in-law has been treated at. What’s interesting is that these hospitals don’t cooperate with each other in any way. So in each case it has been the initiative of the patient’s family has been behind the move.

The result hasn’t been good. So how would be we do it  differently, the second time? Hopefully the answer will emerge over the lifespan of the blog.  For now, let’s assume we did everything right. Dharmais is not only the best cancer hospital in Indonesia, but they have official Indonesian national cancer center status. Which means the SKTM state-subsidized healthcare scheme  is in place and available to Pak Fadil who quit his work hawking chicken sate  from a mobile pushcart nearly two years ago.   At present the family has no source of income.

I’ve decided to take the day off tomorrow– half day anyway — and pay a visit with Mona and other family members. We’d like to know whether or not Pak. Fadil can get a tongue operation. It’s his only chance. RS Dharmais is a household name, although I suppose it’s a place most people would just as soon not too much about. Dharmais deals especially, perhaps exclusively, with cancer patients, including children. I’ve been there once.

We know Dharmais is well versed in attempts to cure oral cancer. As mentioned, we’re also interested to see if the Indonesian state-subsidized medical system will pay for it, as provided for by law.  Because otherwise, we’ll have to go back to RS Cipto.

Mona and Sema were at RS Cipto yesterday. And Pak. Fadil. Poor guy. Imagine dragging into an Indonesian state hospital as a Stage 4 oral cancer patient. He’s been there a million times. And the other state hospital on the other side of town — RS Fatmawati.

But they never seem to do anything. Almost as if they’d rather not, but that would be hard to prove. What they do — as we know very well by now — is give you a blood test. That takes a day, not including getting the results. And they’ll follow that up with a different type of test, for example heart function, lungs, liver, etc. You’d have to do about a week of tests (as an outpatient, coming to the hospital each day) to be ready for an MRI or CT scan. That’s not written anywhere, that’s what we learn from doing ethnography work. Participant observation. (I studied this in college, by the way).

So yesterday was Day 1, because Pak Fadil has been so sick he hasn’t been able to come to the hospital to do tests regularly. And then he was so sick at RS Fatmawati — when they put in the trach tube so he could keep breathing — that — well — that he couldn’t hardly pay regular visits to his docs at RS Cipto. And so, understandably, I guess, you have to start all over.

“We have protocol,” is what they told Sema.”And meetings.”

I wasn’t there but I know she wasn’t angry — well almost maybe — when she said, “yes, and as you meet my dad’s face is drying up. ”

And then she asked the young doc to examine the patient. And he did a double take. He wasn’t sure what to do. But then he did it.

Not uncommon. I’ve also had to tell an Indonesian doctor to do the very obvious.

So bit of a lack of faith, not so much on our part, as we can still conceive of how it would be to be a doc working in that hospital. But not Pak. Fadil. He can’t, for the life of him I”m sure, figure out why folks can get it together to remove his tongue. Of course there were opportunities before and he, I guess, turned them down. But that was back when his tongue, his mouth, his throat, everything was still working. Much less to lose now.

We’ll see what we learn at Dharmais.