Arga Reysamputra

Last updated: February 15, 2025 8:59 pm

Author: Theo Kelen

Editor: Zely Ariane

Jayapura, Jubi – The Papua Provincial Health Office stated that up to now there are 18,892 active HIV/AIDS patients, and those undergoing Antiretroviral or ARV treatment are 4,192 patients.

This was conveyed by the Head of the HIV/AIDS Section of the Papua Provincial Health Office, dr. Rindang Pribadi Marahaba in Jayapura City, Papua, on Friday (2/14/2025). “Those who routinely take ARV drugs are 4,192 patients,” he said.

Rindang said patients undergoing ARV treatment were spread across Jayapura City (1,741 people), Jayapura Regency (1,189 people), Biak Numfor Regency (470 people), Yapen Islands Regency (462 people). Patients undergoing ARV treatment were also in Keerom Regency (97 people), Waropen Regency (71 people), Supiori Regency (71 people), Sarmi Regency (63 people), and Mamberamo Raya Regency (28 people).

Rindang said that there are at least 144 ARV services spread across nine districts/cities in Papua Province. In addition, there are 59 HIV testing services. “Treatment services have reached the Health Centers,” he said.

However, according to him, few PLWHA are willing to undergo ARV treatment because of the stigma that PLWHA receive. In addition, many PLWHA cannot undergo ARV treatment because they are constrained by access and transportation costs to ARV treatment facilities.

“ARV [treatment] must be lifelong. If for example treatment is stopped, continue taking the same medicine but it is still reviewed. Usually it is reviewed for six months. If after six months the number of viruses is not detected, the drug is continued. But [if] the virus is high, it means one of the drugs is replaced. ARV has three types of drugs in one tablet. Take one tablet but inside there are three types of drugs,” he said.

Jayapura City is the highest

Acting Head of the Papua Provincial Health Office, dr. Arry Potingku MHM said that the highest number of HIV/AIDS sufferers in Papua is in Jayapura City. According to Potingku, the high number of HIV/AIDS cases is caused by several factors, including free sex.

“Free sex plays a major role in the spread of HIV/AIDS. [And] Jayapura City has the highest number of HIV/AIDS sufferers in Papua,” Potingku said last week.

Based on data from the Papua Provincial Health Office from 1993 to the end of 2024, there were 18,892 patients in Papua Province who were actively suffering from HIV/AIDS. The highest number of HIV/AIDS cases was in Jayapura City (8,487 people), followed by Jayapura Regency (4,746 people), Biak Numfor Regency (2,957 people), Yapen Islands Regency (1,599 people).

HIV/AIDS cases were also found in Keerom Regency (434 people), Supiori Regency (247 people), Waropen Regency (194 people), Sarmi Regency (166 people), and the fewest HIV/AIDS cases were in Mamberamo Raya Regency (62 people).

Arry Potingku asked the district/city health office to conduct HIV/AIDS screening. He said that during the free health check-up, HIV testing was also offered.

“Many have not been detected,” he said.

Dominated by OAP

The Person in Charge of HIV/AIDS at the Abepantai Health Center, Ruth Kristina Wabiser Amd Kep said that there were 75 HIV/AIDS patients undergoing Antiretroviral or ARV treatment at the Abepantai Health Center. According to him, the HIV/AIDS patients undergoing treatment were spread across Enggros Village, Nafri Village, Koya Koso Village and Abepantai Sub-district.

“There are 75 PLWHA patients served. Those who are patients undergoing ARV treatment. They are actively undergoing ARV treatment. This is a case from 2011 to the present,” Wabiser told Jubi, on Thursday (2/13/2025).

Wabiser said that HIV/AIDS patients were dominated by indigenous Papuans, namely 54 patients. Meanwhile, there are 21 non-native Papuans with HIV/AIDS. HIV/AIDS patients range from toddlers aged 2 years to 57 years.

“From 2 years old to 57 years old. The most OAP patients,” he said.

Wabiser also said that there were HIV/AIDS patients who were rejected by their families. He said that patients who were rejected by their families would stay at the Surya Kasih Hospice.

“There is still stigma and rejection from the family. If they experience rejection, we usually put them in the Surya Kasih Hospice, until their condition recovers well, then the family can accept them. That’s what we’ve found so far. In the hospice there is one patient [from the Abepantai Health Center] who has been there for almost three months,” he said.

The Person in Charge of HIV/AIDS at the Abepura Health Center, Iin Siti Rubiah SKep Ners said that as of January 2025, her party had served ARV treatment for 108 patients. Patients who received treatment were aged 20 to 62 years.

Siti said that HIV/AIDS patients were also dominated by indigenous Papuans. According to her, PLHIV patients were spread across Kota Baru Village, Awiyo Village, Yobe Village, and Asano Village.

“Mostly OAP. Some are routine, some are not. [But] we always provide [stock] of extra medicine for patients who leave the area [for] work, some work as far as Sarmi,” said Siti, on Thursday (2/13/2025).

Head of the HIV/AIDS Section of the Papua Provincial Health Office, dr. Rindang Pribadi Marahaba asked HIV/AIDS sufferers to routinely undergo Antiretroviral or ARV treatment. ARV treatment is important to reduce the risk of HIV transmission and prevent the worsening of opportunistic infections.

Rindang also asked families to provide support for their families who are undergoing ARV treatment. According to Rindang, support from the community is needed and especially for PLWHA patients.

“It is hoped that those who already know their HIV/AIDS status will immediately return to services to get ARV. Those who take ARV must do so routinely every day. For families, the community continues to support families infected with HIV/AIDS. So that they take their medication regularly,” he said. (*)

The nation’s physicians say proposal will prove expensive and undermine local expertise, but government says situation is critical.

Tria Dianti
2024.07.19
Jakarta

Doctors and medical personnel at work in the respiratory disease department, which treats patients suffering from illnesses caused by air pollution, at Persahabatan Hospital in Jakarta, Aug. 24, 2023.

[Bay Ismoyo/AFP]

A government plan to alleviate a critical doctor shortage by hiring foreign ones is facing a backlash from critics who say it will undermine local expertise, cause communication issues and drain funds that could be used to enhance education and training at home.

The government has said the shortage needs an immediate solution. 

Indonesia has 160,000 practicing doctors but needs 275,000, according to its Health Ministry. 

And most doctors in the sprawling archipelago of nearly 280 million people are concentrated on the densely populated islands of Java and Bali.

However, not everyone trusts those numbers.

The issue of foreign hires has become so contentious in the medical community that the rector of Airlangga University, a state institution, fired the dean of the faculty of medicine, Budi Santoso, in the first week of July after he criticized the government plan for foreign hires.

That dismissal was reversed less than a week later after a fusillade of protests from his colleagues on the faculty and the wider medical community. Many faculty members at Budi’s university threatened to strike if he was not reinstated.

Budi had argued that Indonesia’s schools produce doctors of international caliber. 

Indonesia’s health minister said this month the issue of allowing foreign doctors to practice in Indonesia had been settled with the passage of the health law last year.

“There should be no more debate. Legally, the Indonesian people’s representatives and the government have agreed,” said Health Minister Budi Gunadi Sadikin, although he did not specify where the government plans to hire doctors from.

“If some members of the public disagree, it’s like saying ‘I don’t agree with the election results,’ even though it’s already been decided.”

The World Health Organization (WHO) recommends a standard of one doctor for every 1,000 people. Indonesia falls significantly short of this benchmark, with a ratio of about 0.47 doctors per 1,000 people, according to government data. 

At a recent parliamentary hearing, the health minister said that heart disease and strokes caused the deaths of 250,000 and more than 300,000 Indonesians every year, respectively. He attributed these fatalities to limited access to healthcare, including a scarcity of specialists. 

He said that increasing the medical workforce in Indonesia could potentially reduce the number of deaths from heart disease to 150,000.

“This is not a competition between foreign and local doctors. They are [sought] here because we want to prevent the 250,000 deaths from heart disease,” the minister said.

Any worries about cultural or communication gaps have been addressed in the health law, government officials say. 

Foreign doctors must pass a competence evaluation and undergo an adaptation process at a local health facility, the law stipulates. Those foreign doctors with at least five years of experience outside their countries, or who are widely recognized experts in their fields, would be exempt from these requirements. 

But one Indonesian who goes by the name @Ikhmart- on X, formerly Twitter, wrote on the platform about the perils of language barriers.

“One key to successful diagnosis and therapy is the patient’s history, known as anamnesis. Imagine if a foreign doctor treats patients who only speak local languages; the likelihood of misdiagnosis and incorrect treatment increases,” @Ikhmart-  wrote.

“Even local doctors sometimes struggle to communicate with local communities.”

‘What about financing?’

The chairman of the Indonesian International Association of Doctors and Health Scientists questioned the feasibility of recruiting thousands of foreign doctors.

Iqbal Mochtar said foreign doctors typically seek better salaries than what physicians make in Indonesian public hospitals.

In the United States, a cardiologist typically earns $40,000-$60,000 monthly, enough to pay 3-4 Indonesian cardiologists, he said.

“Hiring foreign doctors is not cost-effective. If they’re paid Indonesian rates, it’s unlikely high-quality doctors will come,” he said.

He also said the government’s claim of a massive doctor shortage needs to be investigated.

“A thorough mapping is needed to determine the actual need: general practitioners or specialists, in which regions, what specialties, how many doctors, and who will pay their salaries?” Mochtar said.

The head of the country’s main medical association concurred.

Mohammad Adib Khumaidi,  of the Indonesian Medical Association, called for transparent national regulations and a comprehensive analysis of doctor distribution.

“The problem now is that 70% of doctors are concentrated in Java and other major cities. The capacity for specialist services is also uneven,” Khumaidi said during an online discussion on July 9.  

“And what about financing? Should the government pay for it? If so, there are still many local specialists whose livelihoods need to be considered.”

Khumaidi said many local doctors were willing to serve across Indonesia, provided there are clear career paths, welfare, incentives, and security. 

“Rest assured, Indonesian doctors are no less competent than foreign ones,” he noted.

Aside from addressing the shortage of medical personnel, the move is also seen as a step to prevent affluent Indonesians from seeking treatment overseas.

The Indonesian government estimates that Indonesians spend between 100-150 trillion rupiah (U.S. $7-9 billion) annually on medical treatment and services overseas. Some reports estimate that 600,000 to 1 million Indonesians seek medical treatment abroad. 

‘Ticking time bomb’

Meanwhile an academic said Indonesia needs more doctors as its population ages. 

Ascobat Gani, a public health professor at the University of Indonesia, said the current senior population of 29 million is projected to rise to 42 million by 2029 and 68 million by 2045.

“This exponential growth will undoubtedly require neurologists, neurosurgeons, and rheumatologists. Compared to our current production [of graduating doctors], we will not be able to keep up,” he told BenarNews.

This could create a dangerous situation, Gani warned.

“We can no longer contain this and must innovate. It’s a ticking time bomb,” he said.

Ascobat doesn’t believe foreign doctors would encroach on the job market for local doctors, because Indonesia is vast in size and diverse. 

“Our production capacity has never met the rapid increase in demand. The easiest solution might be to import doctors from countries like India,” he said.

“For a long-term solution, the government needs to empower and increase the number of medical faculties. But this process is not easy and takes a long time.”