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Healthcare stumbling in
RI’s Hepatitis fight

Poor access to healthcare means that most Indonesians infected with Hepatitis B do not get treatment — or even know they have the disease, one doctor says.

According to Ali Sulaiman, a hepatologist from the University of Indonesia’s medical school, the nation’s fight against hepatitis has been hindered by a lack of facilities and trained healthcare personnel.

“Many infected people — especially those who come from poor families — cannot afford access to the adequate medical services that are direly needed to diagnose their illnesses,” he said at a two-day symposium on viral hepatitis and liver diseases such as cirrhosis or cancer.

Many chronic cases of Hepatitis B, which he called a “silent killer”, were the result of incorrect diagnoses made by unskilled healthcare workers, according to Ali.

Hepatitis B has symptoms which resemble those of other diseases. Patients might report mild flu-like symptoms such as anorexia, myalgia, nausea, vomiting, fatigue, malaise and low-grade fevers, Ali said.

Jakarta Health Department chief Dien Emawati said on Wednesday that cases of viral hepatitis were often found at clinical practices, and especially at the nation’s Puskesmas community health centers.
Many health workers were unable to accurately diagnose the disease due to poor equipment,
Dien said.

“If we can diagnose Hepatitis B accurately, then we will be better able to anticipate the best treatment strategy and prevent the further spread of the disease,” Dien said.

According to the Health Ministry, about 12 million Indonesians suffered from Hepatitis B in 2010, the greatest number of Hepatitis B victims in the world after China with 120 million infected people and India with 40 million infected people.

About 2 billion people around the world have been infected by the virus, which is transmitted through contact with the blood or bodily fluids of an infected person, and from 350 to 400 million people live with a chronic Hepatitis B infection.

According to the World Health Organization, an estimated 600,000 people die every year due to the acute or chronic consequences of Hepatitis B.

“It is important for us to improve healthcare workers’ skills, especially those who work in health centers, to diagnose Hepatitis B accurately,” Ali said, adding that workers in Puskesmas community centers should be considered as the frontline troops of the nation’s healthcare system.

“We also need to make more serious efforts to provide better healthcare access to our people, especially those who come from the low-income bracket,” he added.

He said it would be more cost effective to prevent the disease with vaccinations, which would ensure early diagnosis and access to treatment.

According to Dien, 80 percent of Jakartans had adequate access to the Hepatitis B vaccine, while people living in rural areas had little access.

She added that the Jakarta administration has allocated Rp 513 billion in 2011 to improve healthcare by providing better access to vaccines and medicine at affordable prices and by improving healthcare workers’ skills and the medical referral system.

Ali said that improved healthcare services were vital to curbing both the health and economic impacts of the disease. (ebf)

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