At the outset, let me put the disclaimer: A) I do not claim to know about healthcare in entire Jakarta or Indonesia B) This post is related to just my own experiences.
Over the last 7 years, I have concluded that the healthcare options available to us where we live in central Jakarta are at best dubious, despite having 2 very well known state of art hospitals nearby. As an expat, the first problem that one comes across is to find a doctor, a GP, that is reliable. Usually, there are references, but everyone’s perspective and experience are different. Also, it’s not easy to find a doctor whose approach matches with your beliefs.
In Indian context usually, the approach/line of belief is ‘minimum intervention’ – that maximum healing should be done with minimum possible intervention in the body’s natural rhythm and healing process. Treatment only if necessary. Body is a natural healer. We need to allow it enough chances to heal itself. Antibiotics are used at a later stage in the healing process – usually only after determining that other medicines are not working. There is something called drug resistance which develops on account of constant, unnecessary and incomplete drug intake. Thus my first preference would be to find such a doctor who believes less is more.
As an expat, very first difficulty is finding a good GP, especially the one that confirms with your own approach of health care. Yes. the doctors KNOW what is right, however, over the years, we laypeople do develop a valid perspective in my opinion, which is in other words known as ‘informed choices’. This became more critical to me after my son’s birth. All the ensuing reading and discussion with his Indian pediatrician led me to be fixated with minimum intervention philosophy. One of my closest friends happens to be a practicing pediatric cardiologist, presently in Germany but who has also worked in India and thus contributed to my education on the subject substantially. I think of her as my lifeline!
The problem might also be because as expats we receive references of doctors who are good with English as well as only state of art clinics/hospitals, which might not necessarily lead to effective treatment. Finding the right medical care is like finding a needle in the haystack. That’s what my experience says.
Urgent need for today’s post came from yesterday’s visit to the nearest GP’s clinic. I had been having fever since early morning and it seemed to increase gradually, so I went to the clinic at my husband’s insistence. It was just the first day of fever. Since I don’t work, I do not have the pressing need to feed myself antibiotics or cure myself immediately. But I do have a 3-year-old at home who is absolutely attached to me and from whom its difficult to quarantine myself. We had been hearing about dengue since last week in Jakarta so we thought better be safe. As my GP measured the temperature, it was 38 degrees (100 F). He asked me certain questions about fever, phlegm etc the usual. Then he immediately offered injection – anti-inflammatory he said. It will also break my fever. I asked him why was he offering injection when it was just 100 degrees. He replied because my throat was extremely inflamed. I said I would not like to take an injection. Then he gave me a total of 6 medicines including antibiotic, anti-allergen, something to manage my stomach acid, a syrup to alleviate sore throat, a flu-related tablet and one more tablet. The syrup was a concoction of some powdered medicines+syrup – what they call ‘Racikan’ here and you don’t know what it includes. I asked him why was he giving antibiotics – he replied because he was sure I had bacterial flu and not viral flu and that it needed antibiotics. I didn’t argue. I am not a medico. But I have enough experience of falling sick on account of flu and it getting cured by itself with no medication. I was only relieved that it wasn’t much serious.
I came home and messaged my dearest pediatric cardiologist, who despite handling close to 100 patients for the day on account of winter-related sicknesses, replied back saying all I needed to do was just to take a paracetamol and lie down for as long as my son lets me, drink lots of fluids and repeat this for the next few days till I feel better. She was shocked that I was offered injection as well as antibiotic and then an anti-allergy to counter the effects of antibiotic if any. I followed her advice and my fever has broken immediately and not returned so far as I type.
This, however, is not a sole example. Over the last 7 years, we have always been given antibiotics for flu every single time we saw a doctor from the nearby clinic/hospitals. We being expats are not covered by the national healthcare program and hence our bills for simple flu visits can range up to 700,000 IDR which is near about USD 50 / INR 3500. We do not have health insurance too. Which of course is our own laziness but in any case I don’t think coverage will include flu visits.
I was chatting with few friends on this and they were in fact in favor of a treatment containing antibiotics though aware of drug resistance etc. They were working individuals and felt they didn’t have enough time for the flu to naturally subside. However such strategy is harmful in the long term and someone badly needs to educate the public at large. Some of them were indeed shocked at the total bill amount I mentioned because larger clinics and hospitals are probably charging a lot more due to their infrastructure and their names. There could be the whole shebang of corporate sales/ profit targets at hospitals behind this for all I know.
When I was in India, the very first pediatrician I consulted, who was attached to the maternity ward where I gave birth, was big on medicines. Which is exactly why I looked up, researched and found the right doctor for my son in India. Here so far despite living for 7 years, I have been unable to.