Thursday, July 3, 2008

Article on health issue

Posted by Journal Mommy Yenny at 7:56 AM

I've got below article from milis Sehat and posted the author's name, so I didn't plagiate it.

Some important points are:

* penyalahgunaan antibiotika di Indonesia adalah 87%!
* penggunaan puyer masih luas ditemukan
* 3 alasan dokter dengan mudah memberi resep antibiotika:
kurang keyakinan dari dokter untuk menyampaikan kepada pasien bahwa mereka tidak butuh
antibiotika untuk penyakitnya; sikap pasif dari pasien; pengaruh dari perusahaan obat.

happy reading !

Health services: Stools, fools and fungus

*Julia Suryakusuma* , Jakarta | Wed, 07/02/2008 10:53 AM | Opinion

Earlier this year I took myself and my nasty, persistent tummy problem to
the doctor. After listening distractedly to my symptoms for a few minutes,
he scribbled on his pad, prescribing antibiotics, without bothering to take
any stool samples. Desperate to get better, I didn't argue and just gulped
down the pills as quickly as I could. That night I felt even worse. I sms-ed
him to ask what was up? His answer: perhaps I needed psychoanalysis.

Hello? Where did that come from? I agree there was a need for analysis, but
at the other end of me, please!

Luckily, I got better on my own, but when my tummy started playing up again
recently, I made sure I tried out a new doctor. This one was a big
improvement. Much younger, he refused to prescribe antibiotics until all the
proper tests were done. In the meantime he gave me medication to alleviate
the symptoms and I struggled along until the next day, when the results of
the lab tests came back. Turned out the culprit was fungus, and if I had
been given antibiotics, it would have reduced the cash in my pocket, but not
the bug in my belly.

Later, talking to Dr. Wati from the YOP (Yayasan Orang Tua Peduli,
Foundation of Parents who Care -- **), an NGO dedicated
to building a better health community, I discovered that even a stool sample
may not have been necessary. Unless there's blood (a sign that there's an
amoebic infection), diarrhea is often a self-limiting disease, just like flu
and cough, sore throat and fever. That means the symptoms need to be
alleviated, yes, but the disease itself often doesn't need treatment. With
diarrhea, the most important thing is preventing the patient from becoming

But that doesn't stop doctors handing out antibiotics like candy, despite
effects that are much more dangerous than the original disease! Hadi, my
former driver, is a case in point. He regularly pops a few antibiotics
before staying up all night to watch a soccer match. This, he used to tell
me, was "as prevention, so I don't get sick".

I was horrified. I tried to tell him as calmly as I could how ABs should be
used, that they should be taken as a cure in fixed dosages over a prescribed
number of days, and only when you are already ill enough to need them. "If
you fail to do so, you build a resistance, Hadi", I said, "and then when you
really need it, it won't work for you anymore!"

The truly worrying thing is that there are many more Hadis out there, and
their cumulative drug-munching habits are building a community of
antibiotic-resistant people who cannot be easily treated when they fall
sick, because their bugs are super-resistant. That's why I called Hadi a *
krupuk* (shrimp or sago cracker): just like crispy, crunchy *krupuk* that
becomes limp when exposed to air and moisture, he wilts easily, falling sick
frequently and taking a long time to bounce back. Are we becoming a nation
of limp *krupuks* due to excessive and irresponsible drug-consumption?

Indonesia is now rife with IRUD: Irrational Use of Drugs. Unfortunately, the
inappropriate, ineffective and economically inefficient use of
pharmaceuticals is more common than not in the world, with between 52 and 62
percent of all antibiotics prescribed in developing countries being
unnecessary. And Indonesia is one of the worst culprits: here the percentage
is a staggering 87 percent, according to a YOP survey! Yes, 87 percent!

Hardly surprising, though. What, with increasing economic, social and even
environmental pressure and the hand-to-mouth existence of the majority of
Indonesians, it is little wonder that most resort to shortcuts and take
refuge in the belief that "there's a pill for every ill" so they can get on
with the daily business of survival.

Unfortunately, polypharmacy (prescribing several drugs at the same time for
conditions that don't require it) and over-prescribing are also very
widespread. One common problem is the practice of powdered drugs (drug
compounding) for children with minor health problems like, yes, fever, flu,
cough or diarrhea.

In most countries around the world, the administering of
poly-pharmacological drugs has been reduced to only 1 percent of all drugs,
but in Indonesia levels remain much higher. One example: there is a private
hospital in the city of Tangerang (20 kilometers west of Jakarta) that still
churns out 130 forms of compound drugs on a daily basis to feed the hungry
hordes of Hadis.

Doctors cite three main reasons for over-prescription of antibiotics, lack
of confidence being the first. Many doctors feel reluctant to tell a patient
that he or she doesn't need antibiotics, for example when their illness is
caused by a virus that antibiotics cannot treat, because most patients just
won't believe them.

The second reason is the passiveness of patients, many of whom
unquestioningly believe that the "doctor knows best". Indonesia is still a
largely patriarchal society, and so the "doctor is god" belief remains
deep-seated: There are not enough patients who are prepared to assess
whether the medication prescribed for them is really what they need.

The third reason is "company pressure", from pharmaceutical companies and
sales staff who ply the doctors with free samples which are then sometimes
dispensed to patients. The doctors also get perks in the form of business
trips, conferences and even cars from these drug companies! It's outright

It boils down to the market right? So, let's stop being fools about stools
and start making sensible decisions about our own health, rather than
allowing dopey doctors and money-mongering pharmaceutical companies to drug
us until we are sicker -- and poorer -- than before we went to the doctor!

*The writer is the author of *Sex, Power and Nation*. She can be contacted
at *



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