On the wall just above her was a broken clock, being correct twice a day. On her sparse desk lies her own stethoscope and an old, mercury filled sphygmomanometer. Those are her only tools here. And her ears, listening patiently to every little detail. And her eyes, watching and observing. And her touch, compassionate to every symptom.
Perhaps the broken clock signifies more than just lack of maintenance. The speed with which she must attend to hundreds of patients each day contrasts with the stillness of the clock's unmoving hands. But each second she spends with the patient is more than just a diagnosis. She connects with them, jokes with them, and make them feel heard and at ease. All this she does within an amazingly short time.
8 hours of work, 3-400 patients from Monday to Friday and 200+ on the weekends (and shorter hours). Yes, less than 1 minute per person is her average time. Most of the ailments she sees stems from lack of basic hygiene, especially clean water to wash.
Skin rash and postules, as well as infections on minor cuts are common. Diarrhea and other digestive problems are also common. And the third common issue is respiratory. Those three accounts for most of the ailments she sees. So much so that within the 1 minute or less, she already knows what to prescribe. The onsite pharmacy stocks these items like candy, prepackaged with the maximum number of pills each person may receive (less than what is required in most places).
Occasionally, there are more serious symptoms such as fever from infections, or bronchitis. Some of these she is prepared to handle and the medicine is available at the pharmacy. But anything beyond that, especially if it requires a night's stay, will be handled by the larger hospital, about 15km away. About an hour's trip each way.
The sign outside is old, the paint peeling and rust spots peeks through from behind. It is still legible, and everyone knows it is the local free clinic. Well free if you have your national ID card signifying you live in the area and to ensure you're not double dipping on your medicine allowance. If you don't have your card, the charge will be Rp 3000, or about US$0.33.
Funny, there's another sign that lists the different medical services available at the clinic. And it is shiny, it looks like new. It also has a large advertisement from a particular over the counter headache medicine.
Despite the steep dirt driveway that turns into a mud pit when it rains, and the less than sterile image, everyone still knows that it is the clinic. A place to go for ANY medical issue, large or small. It does have a dentist on site, a small lab and a midwife. But being in front of the major thoroughfare in the area, often they have to deal with victims of car accidents. While they're ill-equipped to care for the wounded, they're well equipped to stitch up the wounded and prepare them for a longer transport to the nearest hospital.
Often, on her 90 minute daily commute to work, she has to stop at the accident site. Either stop and treat them now so the victims can be sent to the hospital (or home). Or she can wait until they're brought to her clinic much later.
All this for a monthly salary of Rp 1.8 juta, about US$200.
PS: sorry for any spelling or grammatical errors. First draft, uncorrected. These days I just don't have time to write properly. But I don't want to not write either.
PPS: while I was in Kalimantan, it was a lot more remote (check out where Muarateweh is, and if you can find it the village of Luwe Hulu). And the doctors there make the rounds to each home.
1 comment:
really?
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