As Indonesia failed to contain COVID-19 and is now one of the pandemic’s epicentres, it’s taking a huge toll on Indonesia’s medical profession. Over 600 physicians have died. More than 500 nurses, 300 midwives and dozens of pharmacists, dentists and laboratory workers have died. Health workers work very long hours while being sleep-deprived and exhausted.
Amid this mounting challenge, professors at the Medical School at the University of Indonesia last month called on all health professionals, the government and the general public to unite to fight the COVID emergency.
I’m a historian of science and have been studying the history of medicine in the Dutch East Indies. The professors’ appeal reminded me of the language used by Indonesian physicians and medical students during the colonial era.
Today’s physicians and other health professionals’ dedication to fight COVID-19 and protect the nation’s health reflects the commitments of Indonesian physicians and medical students in colonial times.
Fighting COVID-19 against all odds
Indonesia’s health system is overwhelmed and in many places beyond breaking point. Oxygen and personal protective equipment are in short supply. For some time now, trainee physicians and recent graduates have been recruited to work at the front lines, initially without pay.
Many people isolating at home receive no medical attention. Some die in solitude.
By now, we are all familiar with the images that appear almost daily in the newspapers: improvised cemeteries where deceased individuals are hastily buried, overcrowded hospitals enlarged with tents to provide more beds, and overworked, tired and burnt-out health workers. The number of individual tragedies is endless. An unending stream of death notices appears on social media.
Against all odds, Indonesian physicians and medical students show commitment and dedication to the health of the nation.
They do this despite insufficient supplies of protective gear, medications and medical equipment from the government.
They also have to operate amid the swirling of rumours and hoaxes that create public fear, anxiety, mistrust and suspicion. Several social media posts claim that people are infected with COVID-19 in hospitals. Health workers are regularly chased out of villages. People are afraid that their sick family members are taken away and that they will not be allowed to conduct customary rituals when they die.
Indonesian physicians have not always been held in high esteem. People who can afford it prefer to receive medical care in Singapore or Malaysia. Indonesians often complain about the high cost of medical care, the high fees physicians in private practice charge, and the lack of respect they have received in public hospitals.
But through their dedication and commitment, Indonesian doctors today display the same spirit of devotion that motivated their colleagues during colonial times.
It is said Indonesia’s national awakening started with the founding of the youth association Budi Utomo on May 20 1908. Since then, physicians and medical students have participated in the Indonesian nationalist movement, often occupying leadership positions. They played a significant role in bringing about independence.
Legacy of Indonesian physicians
In my book Nurturing Indonesia: Medicine and Decolonisation in the Dutch East Indies, I argue that Indonesian physicians and medical students were motivated by a desire to care for the nation, apart from their dedication to care for their patients.
The founders of Budi Utomo believed that medical care would lead to improvements, as would education and a rising standard of living. They urged Indonesian students and educated Indonesians (a tiny group at the time) to unite irrespective of ethnic differences to improve everyday life for all Indonesians.
Several Indonesian physicians and medical students joined the Indonesian nationalist movement between 1908 and 1942. The movement had various goals, from providing disaster relief and establishing schools and clinics to forming political parties and advocating independence. The participants in the Indonesian nationalist movement realised they needed to unite to achieve them.
All need to come on board
According to World Health Organization data, Indonesia has only 4.65 doctors per 10,000 people. As a comparison, in Australia this number is 37.6.
But as Ova Emilia, dean of the Faculty of Medicine, Public Health and Nursing at Gadjah Mada University, has argued, the low number of physicians is not the main problem to overcome in winning the fight against COVID-19. A crisis like the COVID-19 pandemic needs to be countered by a determined and co-operative approach that includes governments (local and central), educational institutions, infrastructure, logistics and local communities. The political, economic and cultural sectors all need to come on board.
Today, leading Indonesian physicians are calling on all Indonesians to be part of a universal movement. During this COVID emergency, health must become a national priority.