Abstract Ref Number = APCP181
A CONJOINED TWIN CASE: A PORTRAIT OF HEALTHCARE SERVICE AND WELLBEING OF CHILDREN IN RURAL KALIMANTAN
MozesThadeusDjaman General Hospital
Many studies have shown health disparities between urban and rural areas. Children are suspected to be more affected by these disparities.In 2000, the World Health Organization (WHO) shaped the eight Millennium Development Goals (MDGs). The under-five mortality rate in Indonesia has reduced by more than a half after MDGs implementation. In West Kalimantan, between 1994 and 2016, this rate had declined from 97 to 8 deaths per 1,000 live births.To support the success of Sustainable Development Goals (SDGs), the Indonesian Government made a new program called “WajibKerjaDokterSpesialis” (WKDS) which is a mandatory assignment for a new graduate medical specialists, to work in remote area. As an illustration of the obstacles of a young pediatrician in rural Kalimantan, I reported a case of conjoint twin newborns. Our hospital has very limited resources.We have incomplete neonate resuscitation equipments such as T-piece resuscitator, warm blanket, oxygen warmer and humidifier, and neonatal transport incubator. The NICU is not available too. Another problems are family financialand health insurance coverage.We referred the babies to Regional Hospital in Pontianak, which is about 183 km away with unfavorable geographical conditions.Some problems we have to deal in rural area in Kalimantan are poor health literacy; patient non-compliance and missed appointments; limited access to clean water, lack of health insurance coverage, socioeconomic problems, lack of public transportation, and geographical difficulties. To achieve the SDGs, beside the medical treatment, we are also trying to educate people and to give some training for healthcare providers. A collaboration between the stakeholders and the healtcare providers is needed to create a better health services, and the better access for people who live in rural area in Kalimantan.
Keywords: WKDS, health care service, rural area, young pediatrician