Andreas Harsono, Banda Aceh – The Indonesian Red Crescent – claiming there is an oversupply of "do-gooders" who "do not speak the language" – has said it wants all foreign doctors helping the Indian Ocean tsunami survivors in Aceh to leave and hand over their emergency medical functions to local doctors instead.
Gunawan, the spokesman for the Indonesian Red Crescent, said in a press briefing on Monday, "It is better if the international community helps us with medicines rather than sending human resources here." Although there is now a surplus of foreign doctors, more medicines are needed as ailments such as malaria and dengue begin to break out.
Gunawan said the large number of foreign doctors was "counter-productive" as "there are language and cultural barriers with regard to the presence of foreign doctors" that prevent them from making a worthwhile contribution to medical relief work.
But Acehnese such as Ismet Nur, the co-coordinator of a grassroots relief service in Ulle Kareng – a crowded neighborhood in Banda Aceh – sees it another way. "We have cases where Indonesian doctors are perceived to be not as professional as their international colleagues," he told Inter Press Service.
Gunawan said the Indonesian Red Crescent arrived in Aceh on December 27 – a day after killer waves lashed the province killing at least 220,000 – and set up two field hospitals in Lambaro and Pidie districts, as well as a mobile medical facility.
The Red Crescent spokesman said there are more than enough local medical staff on the ground. "Altogether more than 390 [local] volunteers are involved in our work," said Gunawan.
At the present moment, the local relief agency also works with volunteers from Germany, Turkey, Malaysia, Pakistan, India, Belgium and the United States.
There are at least 100 aid organizations – plus UN agencies – operating in Aceh. Aid agencies have provided emergency food, water and shelter to about 330,000 people, according to the UN Office for the Coordination of Humanitarian Affairs. The agency says the next step is to construct temporary settlements for 150,000 families.
Because the tsunami destroyed hospitals and medical clinics, killing doctors and nurses, access to quality health care has been severely restricted. Drinking water is still in short supply and this keeps the risk of some sort of epidemic high.
World Health Organization (WHO) officials are worried about an outbreak of measles as well as the risk of malaria, which is spread by mosquitoes. The United Nations Children's Fund (UNICEF) reports that measles still kill more children than any other disease that is preventable by vaccine.
Measles can lead to brain damage, deafness, blindness and mental disorders. To help prevent an outbreak of measles, WHO has set up a program to vaccinate as many children as possible – up to 65,000.
Currently, refugees in Aceh seem to be suffering from diarrhea, respiratory problems and skin infections. While these diseases are not considered life threatening, they can lead to more serious illnesses. Sanitation is still lacking, and that alone can pose health risks.
To make matters worse, last week Australian doctors reported treating a case of Mucormycosis, a deadly fungus that attacks the brain, lungs, skin, kidneys and sinuses.
It is still not clear how many doctors, anesthetists, surgeons, dentists and nurses work in Aceh now. Bernt Apeland of the International Committee of the Red Cross said Aceh used to have 700 doctors and nurses. They mostly "disappeared" during the tsunami, he told IPS.
Commenting on the Indonesian Red Crescent's statements, Apeland said: "I do agree that in the long run the health service should be ran by Indonesians. But it is an emergency situation here.
"We were asked by the Indonesian authorities to set up a field hospital. We always have 10 doctors – five Indonesians working side-by-side with five internationals," he added.
Relief worker Ismet wants the foreign doctors to stay. He says he is skeptical of the local medical services – and he has every reason to be.
His son, Mahdi Anzala, a 23-year-old college student, had a bad cut in his foot as a result of injuries sustained when he tried to flee the killer waves. The festering sore, because it was untreated, later developed into a tumor. Ismet first took his son to an Indonesian clinic to seek medical help.
"They asked me to register first, then to show documents from my district officials – you know, typical Indonesian bureaucracy. Later a doctor checked Mahdi and said he should be transferred to a bigger hospital," Ismet told IPS.
It is a common practice among Indonesian doctors to ask their Acehnese patients to produce their red-and-white identity cards. Red and white are the colors of Indonesia's national flag. The cards were specifically designed for the Acehnese after the Indonesian government declared martial law in Aceh in May 2003, in its fight against separatist rebels.
Before the December 26 tsunami struck, Aceh was almost entirely closed to any international presence due to military operations there against the Free Aceh Movement (GAM), which has been fighting for independence since 1976. More than 10,000 people, mostly civilians, have been killed since then.
Ismet said he had to thank a foreign doctor – who happened to visit the relief camp where he is currently seeking shelter – for saving his son's leg.
"This Brazilian doctor saw Mahdi's wound and decided on the spot to perform surgery on a bench, using local anesthesia, to remove the tumor," he said. "No questions asked, he just [did] what he thought was best. "When the tumor was out, it was the size of my thumb," added Ismet. Ismet said his son started walking after the Brazilian doctor came back to the camp again to remove the bandages.
Murizal Hamzah, an Acehnese journalist who works for the Jakarta-based Sinar Harapan daily, also considered the Indonesian Red Crescent's request "a bit odd".
"I have traveled and visited many hospitals throughout Aceh. Indeed, the foreign doctors are more popular than local ones because the bureaucracy of the Indonesian medical services is really notorious," he said. (Inter Press Service)