Indonesia in Dire Need of Health Workers in Remote Areas

"Papua is one of 20 provinces in Indonesia that still has a high level of infant and maternal mortality."

Providing health care in remote and very remote areas has long been a major concern in Indonesia.

Papua is one of 20 provinces in Indonesia that still has a high level of infant and maternal mortality.

29-year-old John Gobay is lying in bed.

He has just been admitted to the community health centre in Skouw, on the border of Indonesia and Papua New Guinea.

He injured his right elbow in a car accident.

Nurse Amelia Womsior is the only health worker on call.

“Everything is still normal. Blood pressure and other vital organs are normal. He needs some rest. His elbow is still hurt, hard to move around. For now, we have to observe his vital organs for a while.”

She’s not a doctor, says Martha Retto, the head of the health centre, but local people are highly dependent on her.

“Local people here know her very well. They trust her.”

With a difficult geography, most health workers prefer to serve in urban areas.

As a result there’s an uneven distribution of health workers, and shortages in remote areas.

But Nurse Amelia has been working here for the last 8 years.

“I want to serve people, that’s my motivation. I feel that I belong to an institution that serves people. That’s what I want to do.”

The health centre is in Skuow, 60 kilometres from the capital of Jayapura.

It’s a 3-hour drive by car, on a long and winding road.

Some 30 patients come here every day... suffering from malaria, road accident injuries or for prenatal check-ups.

Amelia says it’s not easy working in remote areas like this.

“The main problem here is clean water. And health workers like me have to be on stand-by 24 hours a day. The official working hours are from 7 to 12, but for people here, we have to be ready anytime, even after working hours.”

38-year-old soldier Sahruddin often comes straight to Amelia’s house for a check-up.

He has been posted here for the last 5 years.

“I come here quite often. When she says its malaria and that I need an infusion, then I’ll have it. I hope I won’t get infected with malaria anymore. When I first came here, I got malaria almost every week.”

Last year, the Health Ministry launched an initiative to prioritize programs to reduce infant and maternal deaths in 20 provinces, including Papua.

Papua was chosen because of its lack of access to health care facilities due to the geographical challenges.

Sometimes Amelia has to walk for hours to reach her patients.

“I once helped a patient to give birth in the middle of the forest. It was quite far from home. At 5 in the morning the family picked me up, but when we got there, my patient was already in the forest. So I took all my equipment with me. But the baby was already out and the mother was in shock. She fainted.”

Jayapura’s Health Office has asked for more than 5000 health workers to be placed in remote areas across the island.

But many are worried about their safety.

In 2009, the Indonesia-PNG border at Skuow was closed because of the deteriorating security situation – several police officers were shot and a police station was bombed.

But there are also other issues: low salaries and a lack of facilities.

The head of the Jayapura Health Office, Dolarina de Breving, promises a raise, especially for those working along the border.

“I think the central government must give its share too... these people are working in a dangerous border area.”

Despite the challenges, Amelia has chosen to stay.

She receives around 200 US dollars a month but it’s not enough – the cost of living here is double that amount.

“We want the government to pay attention to us. We work full time here but we don’t get any support. We had a meeting with the government about this, but so far nothing has changed.”

• Indonesia
• nurse
• healthcare
• Skouw
• KBR68H