Paediatrician Agnes Tri Harjaningrum is on the front lines in Indonesia in determining who will or will not be treated in suspected cases of coronavirus, in a country with a combined capacity of just 132 referral hospitals to combat the Covid-19 disease – a number seen as being far from adequate.
One of her patients in the Jakarta hospital she works in is a 3-month-old boy, who receives oxygen therapy and antibiotics or other medicines twice or more each day, depending on his condition. Harjaningrum said nurses would also give him milk through a feeding tube once his health improved.
Harjaningrum described her hospital, which she declined to identify, as a “level D” facility – the lowest in Indonesia’s hospital system, with most of its patients being referred by community health centres. Some of her patients have been admitted after failing to gain entry to higher-quality hospitals that are running at overcapacity.
The hospital is considered to have “limited facilities”, with an inadequate number of isolation rooms and no neonatal or paediatric intensive care units.
Although her hospital provides its medical personnel with personal protective equipment, she is concerned it could soon run out of stock as it becomes overwhelmed with patients. With a disposable medical hazmat suit costing about 500,000 rupiah (US$30), and frontline workers using at least four hazmat suits a day to treat just a single suspected coronavirus patient, costs are also piling up.
“It would be like suicide if we had to deal with a patient without wearing any personal protective equipment,” Harjaningrum said, noting that some of her friends in smaller regional hospitals use raincoats or take turns wearing the same medical hazmat suit when treating patients who may have Covid-19.
He said he had heard from frontline medical staff at his hospital and at other facilities that supplies of personal protective equipment were running short.
“The more that health workers are exposed, the more likely it is they will stop working,” said Riyanto, who is also the chairman of the Indonesian Emergency and Disaster Nurses Association. In recent weeks, social media has been alive with photographs of medical staff wearing cheap plastic raincoats in lieu of personal protective equipment. It is only through donations from surrounding countries and private individuals that now the situation is beginning to be somewhat relieved.