Elly Burhaini Faizal, Jakarta – Siti Chomsatun is one of the loudest critics of medical malpractice Indonesia – despite an allegedly botched operation that left her almost mute.

The 55-year-old woman, whose case was popularized in Ucu Agustin's new documentary Conspiracy of Silence, filed a lawsuit against the private hospital where she was treated.

Siti said she could not find a doctor when she went to an emergency room in Kramat, Central Jakarta, in the middle of the night after feeling short-winded after goiter surgery.

The doctor – who arrived only after he was called several times – only gave her sleeping pills despite her deteriorating condition, Siti alleged. "She almost died from such improper treatment," Siti's lawyer, Tommy AM Tobing, said.

Tommy, who works for the Jakarta Legal Aid Institute (LBH Jakarta) and Siti filed a malpractice complaint in August with the Indonesian Medical Disciplinary Council (MKDKI) and the Jakarta Police. No action has been taken by the MKDKI, according to Tommy.

LBH Jakarta received seven patient complaints in 2010, up from three complaints in 2009.

Of the seven complaints, public hospitals were involved in three claims related to allegations of poor access to medical care, socio-economic discrimination and medical malpractice.

Private hospitals were involved in two complaints that alleged malpractice and poor access to medical care.

In 2008, the institute received six medical malpractice complaints covering 135 victims, up from three cases in 2007.

Legal rights activists have warned that more people seeking medical help would become victims of malpractice unless the government ensured that bad hospitals and doctors were subject to penalties.

LBH Jakarta director Nurkholis Hidayat said on Monday that few doctors would speak out against their colleagues who faced malpractice allegations.

"They don't want to be involved in any legal case because they don't believe that they can get adequate legal protection in testifying against their own peers," Nurkholis told The Jakarta Post.

Doctors evinced a strong solidarity to protect each other stemming from their huge pride in the medical profession, Nurkholis said – the "conspiracy of silence" referred to by the documentary.

"It may be easier for them to give a sum of money than to acknowledge and make an apology for any mistake – even if there is strong evidence of their wrongdoings."

Complainants face a long struggle: the three people who lodged malpractice allegations in 2009 are still waiting to settle out of court. "Out-of-court settlements, including compensation payments, have emerged as the fairest solution for victims of medical malpractice due to difficulties in obtaining evidence," Tommy said.

It was difficult for laymen to assess malpractice, he added. "Most of patients do not have the knowledge or skills of medical practitioners. Therefore, it seems difficult for patients to consider whether doctors have properly diagnosed or treated their illnesses."

The government has given the MKDKI the sole authority to resolve malpractice complaints levied against doctors, hospitals or other medical providers.

Indonesian Consumer Protection Foundation (YLKI) chairman, Sudaryatmo said that medical malpractice would continue unless the government intervened to stop medical practitioners from acting with "impunity". "There should be more efforts to make the MKDKI an independent body," he told the Post.

Health Minister Endang Rahayu Sedyaningsih played down claims that the government refused to take action against medical malpractice. "We will levy sanctions, ranging from what is considered as 'light' punishment, such as warning letters and administrative sanctions, to the freezing of licenses as the 'heaviest' punishment," she said, referring to the law and Health Ministry regulations.