RUNDOWN DELTA TALK SHOW
21 APRIL 2006 (47)
Topik: TENAGA KESEHATAN DAN AGENDA Hari Kesehatan Dunia tahun 2006
SESI 1. REKAP TBC - sehubungan Hari TBC Dunia 24.03.2006
SESI 2. WHD dan Permasalahan di Asia Tenggara
SESI 3. Tuntutan profesionalisme di bidang kesehatan
SESI 4. Peran dan agenda institusi pendidikan kedokteran di Indonesia
(sehubungan dengan WHD)
SESI 5. PENUTUP
Lesson learned buat pendengar
Ditutup cuplikan dari ... The Moral physician
SESI 1 (3 menit). (DELTA) Delta Medika, be smarter - be healthier ....
upaya mengajak kita semua agar menjadi konsumen yang cerdas dan BIJAK.
Seperti biasa ... ditemani Dr wati dan Tamu Istimewa kita yaitu Bapak
Dekan FKUI ... Dr Menaldi Rasmin, SpP
Tetapi sebelumnya kita rekap bincang2 dua minggu lalu perihal TBC
W: Sudah lebih dari 100 tahun setelah ditemukannya kuman M. TBC oleh R
Koch tetapi dunia masih dihadapkan pada banyak permasalahan TBC.
Sedihnya, lebih dari 50% kasus TBC di muka bumi ini terdapat di India,
Cina, dan INDONESIA.
Hari TBC dunia tg 24 Maret yl mengajak semua pihak untuk bekerja
bersama-sama menurunkan jumlah penderita TBC dan menurunkan angka
kematian akibat TBC ... Salah satu agenda pentingnya adalah TBC anak.
Mengapa? Ada banyak alasan, misalnya .. TBC pada orang dewasa sering
berawal dari TBC pada anak padahal... mendiagnosis TBC pada anak ...
bukan hal mudah. Di lain pihak, tidak sedikit misdiagnosis dan
mistreatment pada anak.
Mendiagnosis TBC pada anak ibarat menyusun kelopak bunga, tidak bisa
hanya atas dasar satu pemeriksaan saja. Dasar diagnosis harus terdiri
dari beberapa komponen yaitu adanya kontak dengan orang dewasa yang
menderita TBC aktif, keluhan/gejala, foto ronsen dada serta tes mantoux.
TBC dapat disembuhkan asalkan pengobatan dijalani dengan patuh.
DELTA: Kita masuk ke topik hari ini ... masih seputar Hari Kesehatan
Dunia yang temanya mengenai tenaga kesehatan. Seluruh dunia dilanda
krisis tenaga kesehatan. Krisis kuantitas (misalnya karena brain drain)
yang menyebabkan sarana kesehatan menjadi timpang. Bagaimana dengan
kualitas?
Mari kita ikuti sesi berikutnya
SESI 2 (6 menit). DELTA: Semua pihak ... termasuk institusi pendidikan
dan individu-individu .... diharapkan bekerja bersama-sama untuk
mengatasi permasalahan tenaga kesehatan. Apa sih isu utama di belahan
Asia Tenggara? Apa peran institusi dalam hal ini ... sekolah kedokteran
sehubungan dengan hari kesehatan dunia ini?
W: Ada masalah numerik dan ketimpangan distribusi tenaga kesehatan,
masalah manajemen serta kurangnya support, permasalahan lain yang
mencolok adalah:
- The poor training & technical skills dari para tenaga
kesehatan yang menyebabkan kurang efektifnya layanan yang disuguhkan
- Supervisi dan bimbingan yang kurang memadai
Oleh karena itu ... salah satu Action plan yang diajukan WHO mencakup
peran Institusi Pendidikan yaitu sebagai berikut:
* Meningkatkan kualitas pendidikan tenaga kesehatan dengan
mempersiapkan guru secara lebih baik.
* Melakukan pengujian dan juga melakukan perbandingan metode
pendidikan dan pelatihan di berbagai institusi
* Mengembangkan suatu benchmarks dan guidelines untuk akreditasi
insttusi pendidikan.
DELTA: Kalau melihat agenda WHO, hari kesehatan dunia ini juga merupakan
event untuk meningkatkan kualitas dokter. Apalagi salah satu tujuan
peringatan ini adalah memperkuat kepercayaan masyarakat terhadap sistem
kesehatan. Bagaimana kondisi di Indonesia?
MR:
DELTA: Kita sambung di sesi berikut
SESI 3: DELTA: Pak Dekan Yth, mungkin bapak bisa share sama kami semua
.. kenapa banyak orang Indonesia memilih berobat ke luar Indonesia?
Padahal DirJen WHO: Dr LEE Jong-wook mengajak semua pihak untuk sumbang
saran dan ide untuk membangun sistem yang memastikan agar para tenaga
kesehatan bisa dan mau bekerja di tempat dimana mereka dibutuhkan dengan
skill yang tepat dalam rangka memberikan layanan kesehatan berkualitas
bagi masayarakatnya. Menurut Bapak Dekan, good medical practice itu
seperti apa? Atau sederhananya ... dokter yang baik itu seperti apa?
MR:
DELTA: Di acara ini .... tidak sedikit keluhan perihal kesulitan
berkomunikasi. Padahal ... kurikulum komunikasi pasti ada.
Ada kesan, informasi (informasi yang obyektif maksudnya) sering menjadi
barang langka ... Padahal ... Informasi kan hak semua orang. Bagaimana
Pak Dekan?
MR:
DELTA: Saya pernah membaca di suatu booklet terbitan konsil kedokteran
Inggris, tertulis 7 prinsip seorang dokter yaitu:
- Tidak mendahulukan kepentingan pribadi,
- Memiliki integritas,
- Obyektif,
- akuntabel,
- terbuka,
- jujur,
- Memiliki sifat kepemimpinan
Nanti di sesi berikut kita sambung ...
SESI 4. DELTA: WHO dan Federasi Dunia untuk Pendidikan Kedokteran
mengajukan suatu strategi kemitraan ... dimana berbagai sekolah
kedokteran dan para pendidiknya berpartisipasi. Rupanya kualitas tenaga
kesehatan menjadi perhatian utama banyak pihak. Apa tantangan utama yang
dihadapi sekolah kedokteran di Indonesia khususnya FKUI?
MR:
DELTA: Rencana FKUI sendiri bagaimana terkait tenaga kesehatan baik
dalam hal kualitas pendidikannya maupun kualitas tenaga kesehatannya itu
sendiri.
MR:
DELTA: Butuh banyak inovasi strategi yang efektif untuk edukasi dan
pelatihan tenaga kesehatan.
Kita sambung di sesi berikut
SESI 5. DELTA: Bapak Dekan yth, dokter wati ... sebagai penutup, tolong
beri tips baik buat pendengar maupun buat tenaga kesehatan sehingga kita
benar-benar bisa WORKING TOGETHER FOR HEALTH, bisa mencapai taraf
kesehatan dan kesejahteraan yang lebih baik
MR:
Tentatif:
* Make the care of patients their first concern
* Treat every patients politely and considerately
* Respect patients' dignity and privacy
* Listen to patients and respect their views
* Give patients information in a way they can understand
* Respect the right of patients to be fully involved in decisions
about their care
* Keep their professional knowledge and skills up to date
* Recognize the limits of their professional competence
* Be honest and trustworthy
* Respect and protect confidential information
* Make sure that their personal beliefs do not prejudice their
patients' care
* Act quickly to protect patients from risk if they have good
reason to believe that they or a colleague may not be fit to practice
* Avoid abusing their position as a doctor; and
* Work with colleagues in the ways that best serve patients'
interests
In all these matters doctors must never discriminate unfairly against
their patients or colleagues. And they must always be prepared to
justify their actions to them
DELTA: Penutupan
Salam hormat buat semua tenaga kesehatan yang telah bekerja berdasarkan
prinsip Good Medical Practice . yang telah bekerja buat kesejahteraan
fisik dan jiwa bangsa Indonesia .
Catatan wati
The MORAL PHYSICIAN
The moral foundations of modern medicine have a dual ancestry: from the
Greeks, medicine has inherited the idea that the physician's primary
duty is to his patient; and from the Romans, that his primary duty is to
do no harm.
when a person is young, old, or sick, he is handicapped compared with
those who are mature and healthy; in the struggle for survival, he will
thus inevitably come to depend on his fellows who are relatively
unhandicapped.
Such a relationship of dependency is implicit in all situations where
clients and experts interact. Because in the case of illness the client
fears for his health and for his life, it is especially dramatic and
troublesome in medicine. In general, the more dependent a person is on
another, the greater will be his need to aggrandize his helper, and the
more he aggrandizes his helper, the more dependent he will be on him.
The result is that the weak person easily becomes doubly endangered:
first, by his weakness and, second, by his dependence on a protector who
may choose to harm him. These are the brutal but basic facts of human
relationships of which we must never lose sight in considering the
ethical problems of biology, medicine, and the healing professions. As
helplessness engenders belief in the goodness of the helper, and as
utter helplessness engenders belief in his unlimited goodness, those
thrust into the roles of helpers-- whether as deities or doctors, as
priests or politicians--have been only too willing to assent to these
characterizations of themselves. This imagery of total virtue and
impartial goodness serves not only to mitigate the helplessness of the
weak, but also to obscure the conflicts of loyalty to which the
protector is subject. Hence, the perennial appeal of the selfless,
disinterested helper professing to be the impartial servant of all
mankind's needs and interests.
The WHO/WFME work plan will benefit from the accumulated experience and
assets of each partner and will result in:
* A shared database that will include up-to-date experience in
implementing quality-improvement processes in medical schools
* Access, via the database, to information on specific schools and in
particular to a description of their approach to quality improvement
* Promoting twinning between schools and other institutions in
processes to foster innovative education
* Means to update the management of medical schools
* Identification and analysis, by WHO regions, of innovations in
medical education in order to help define appropriate lines of work for
each region
* Assistance to institutions or national/regional organizations and
agencies in developing and implementing reform programmes or
establishing recognition/accreditation systems
* A review of good practices in medical education that can serve as
examples and as a source for further innovation.
The strategic partnership will also address other crucial questions that
medical schools now face, such as improving their leadership function.
Through a systematic dialogue, the partners will pursue the work plan
and provide useful information to medical schools worldwide.
There is no single path towards improving the quality of medical
education. Each region and country features different approaches that
must be acknowledged, explored and brought to wider use. But to achieve
significant and lasting results, institutions must be committed to an
ongoing process of quality development. The WHO/WFME strategic
partnership aims to foster this commitment.
W:
DELTA:?
WHO works with Member States to strengthen their capacity to plan,
educate and manage their health workforce so that health services can
best meet health needs. WHO's activities cover a wide range:
Countries
* Supporting the development of health workforce policies within a
country's overall development policies
* Assessing the number and nature of health service providers
needed to address health priorities
* Exploring policy options for recruiting, managing and retaining
the health workforce in varied labour markets
* In particular, strengthening nursing and midwifery capacities to
attain the Millennium Development Goals.
Individuals
* The Health Leadership <http://www.who.int/health_leadership/en/>
Service is a two-year programme of training and WHO work experience for
young public health professionals from developing countries.
* The Fellowship Programme provides opportunities not usually
available in the Fellows' home countries for advanced study in
public-health fields and exchange of scientific knowledge and
techniques.
Close collaboration to accomplish this work occurs within WHO
headquarters and regions and with international, bilateral and NGO
partners.
DELTA: kita sudahi perjumpaan kita. Dan untuk selanjutnya Delta Medika
akan diselenggarakan 2 minggu sekali setiap jumat sore.
DELTA: Apa yang bisa kita lakukan sebagai individu? Sebagai anggauta
masyarakat?
All over the world, national health systems are finding it difficult to
train, sustain and retain their health workers. In developed countries,
as populations age and chronic conditions increase, there is an
ever-growing demand for health workers. That need is increasingly being
met by recruitment of trained workers from developing countries; a trend
which exacerbates the resource shortfall there.
Effective ways of preventing and treating disease require assessment,
delivery and monitoring by health workers. The capacity to respond to
the threat of pandemic human influenza, global efforts to reach the
Millennium Development Goals, and all our efforts to address priority
diseases are threatened by health workforce shortages. Poor distribution
of resources, wasted and unused skills, and migration of health workers
are making a bad situation worse.
Solutions do exist and new ones are being actively sought.
[Non-text portions of this message have been removed]
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"Morning greetings doesn't only mean saying 'Good Morning'.
It has silent message saying that I remember you when I wake up.
Wish you have a Great Day!" -- Ida Arimurti
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