http://www.atimes.com/atimes/Southeast_Asia/GB03Ae05.html
Southeast Asia
Feb 3, 2005

Indonesia targets foreign doctors
By Andreas Harsono

BANDA ACEH, Indonesia - The Indonesian Red Crescent - claiming there is an 
oversupply of "do-gooders" who "do not speak the language" - has said it 
wants all foreign doctors helping the Indian Ocean tsunami survivors in Aceh 
to leave and hand over their emergency medical functions to local doctors 
instead.

Gunawan, the spokesman for the Indonesian Red Crescent, said in a press 
briefing on Monday, "It is better if the international community helps us 
with medicines rather than sending human resources here." Although there is 
now a surplus of foreign doctors, more medicines are needed as ailments such 
as malaria and dengue begin to break out.

Gunawan said the large number of foreign doctors was "counter-productive" as 
"there are language and cultural barriers with regard to the presence of 
foreign doctors" that prevent them from making a worthwhile contribution to 
medical relief work.

But Acehnese such as Ismet Nur, the co-coordinator of a grassroots relief 
service in Ulle Kareng - a crowded neighborhood in Banda Aceh - sees it 
another way.

"We have cases where Indonesian doctors are perceived to be not as 
professional as their international colleagues," he told Inter Press 
Service.

Gunawan said the Indonesian Red Crescent arrived in Aceh on December 27 - a 
day after killer waves lashed the province killing at least 220,000 - and 
set up two field hospitals in Lambaro and Pidie districts, as well as a 
mobile medical facility.

The Red Crescent spokesman said there are more than enough local medical 
staff on the ground. "Altogether more than 390 [local] volunteers are 
involved in our work," said Gunawan.

At the present moment, the local relief agency also works with volunteers 
from Germany, Turkey, Malaysia, Pakistan, India, Belgium and the United 
States.

There are at least 100 aid organizations - plus UN agencies - operating in 
Aceh. Aid agencies have provided emergency food, water and shelter to about 
330,000 people, according to the UN Office for the Coordination of 
Humanitarian Affairs. The agency says the next step is to construct 
temporary settlements for 150,000 families.

Because the tsunami destroyed hospitals and medical clinics, killing doctors 
and nurses, access to quality health care has been severely restricted. 
Drinking water is still in short supply and this keeps the risk of some sort 
of epidemic high.

World Health Organization (WHO) officials are worried about an outbreak of 
measles as well as the risk of malaria, which is spread by mosquitoes. The 
United Nations Children's Fund (UNICEF) reports that measles still kill more 
children than any other disease that is preventable by vaccine.

Measles can lead to brain damage, deafness, blindness and mental disorders. 
To help prevent an outbreak of measles, WHO has set up a program to 
vaccinate as many children as possible - up to 65,000.

Currently, refugees in Aceh seem to be suffering from diarrhea, respiratory 
problems and skin infections. While these diseases are not considered life 
threatening, they can lead to more serious illnesses. Sanitation is still 
lacking, and that alone can pose health risks.

To make matters worse, last week Australian doctors reported treating a case 
of Mucormycosis, a deadly fungus that attacks the brain, lungs, skin, 
kidneys and sinuses.

It is still not clear how many doctors, anesthetists, surgeons, dentists and 
nurses work in Aceh now. Bernt Apeland of the International Committee of the 
Red Cross said Aceh used to have 700 doctors and nurses. They mostly 
"disappeared" during the tsunami, he told IPS.

Commenting on the Indonesian Red Crescent's statements, Apeland said: "I do 
agree that in the long run the health service should be ran by Indonesians. 
But it is an emergency situation here.

"We were asked by the Indonesian authorities to set up a field hospital. We 
always have 10 doctors - five Indonesians working side-by-side with five 
internationals," he added.

Relief worker Ismet wants the foreign doctors to stay. He says he is 
skeptical of the local medical services - and he has every reason to be.

His son, Mahdi Anzala, a 23-year-old college student, had a bad cut in his 
foot as a result of injuries sustained when he tried to flee the killer 
waves. The festering sore, because it was untreated, later developed into a 
tumor. Ismet first took his son to an Indonesian clinic to seek medical 
help.

"They asked me to register first, then to show documents from my district 
officials - you know, typical Indonesian bureaucracy. Later a doctor checked 
Mahdi and said he should be transferred to a bigger hospital," Ismet told 
IPS.

It is a common practice among Indonesian doctors to ask their Acehnese 
patients to produce their red-and-white identity cards. Red and white are 
the colors of Indonesia's national flag. The cards were specifically 
designed for the Acehnese after the Indonesian government declared martial 
law in Aceh in May 2003, in its fight against separatist rebels.

Before the December 26 tsunami struck, Aceh was almost entirely closed to 
any international presence due to military operations there against the Free 
Aceh Movement (GAM), which has been fighting for independence since 1976. 
More than 10,000 people, mostly civilians, have been killed since then.

Ismet said he had to thank a foreign doctor - who happened to visit the 
relief camp where he is currently seeking shelter - for saving his son's 
leg.

"This Brazilian doctor saw Mahdi's wound and decided on the spot to perform 
surgery on a bench, using local anesthesia, to remove the tumor," he said. 
"No questions asked, he just [did] what he thought was best.

"When the tumor was out, it was the size of my thumb," added Ismet.

Ismet said his son started walking after the Brazilian doctor came back to 
the camp again to remove the bandages.

Murizal Hamzah, an Acehnese journalist who works for the Jakarta-based Sinar 
Harapan daily, also considered the Indonesian Red Crescent's request "a bit 
odd".

"I have traveled and visited many hospitals throughout Aceh. Indeed, the 
foreign doctors are more popular than local ones because the bureaucracy of 
the Indonesian medical services is really notorious," he said.

(Inter Press Service) 



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