The Importance of Prehospital and Disaster Medicine in Rural Areas in Indonesia: A Viewpoint on Health Issues for Rural Societies

Abstract

Dear Editor,Regarding the recent article on the experiences of patients in rural areas of Australia, 1 it is a really timely subject for Indonesia now. Everyone, whether from the upper or lower middle class, regardless of religion, race, ethnicity, gender, young or old, everyone definitely wants a healthy body, both physically and mentally. Health is a healthy state physically, mentally, spiritually, and socially, which enables everyone to live a socially and economically productive life. 2 To meet the condition of a healthy body, several ways that can be done are by providing health workers who are qualified and able to properly handle initial problems in health, access to health services, availability of health insurance, and so on.With the ups and downs of health cases in Indonesia, the process of realizing health has its own obstacles and challenges for the Government of the Republic of Indonesia. What's more, Indonesia has just gone through the coronavirus disease 2019 (COVID-19) pandemic, which has caused changes in people's behavior, 3,4 especially in terms of health checks. Many people postpone having an examination, or even decide not to come to the health service at all, for fear of being exposed to COVID-19.The case had not yet been completed, another health issue related to nutrition emerged, namely stunting, which was found not only to be a problem in Indonesia, but also globally. 5 It later becomes one of the health issues that is still being carried out by the Government of Indonesia at this time. 6 But apart from these two issues, another issue that is no less important is the uneven availability of health workers and inadequate access to health, especially in remote areas in Indonesia.One concrete example can be proven by the number of health workers who are not evenly available in Sintang District. In the Serawai sub-district, although health workers were assigned to areas where they were needed, these officers were not found to be working actively. Often, health workers who have been assigned to rural areas choose to return to their place of origin or not be there for several reasons, namely the distance that is too far from the Puskesmas (Public Health Center), access that is not easy (can only use water transportation), salary that is not commensurate, and so forth. This certainly needs to be of particular concern and further explored by local governments in Indonesia.Often, the authors listen to complaints not only from the community, but also from health workers on duty in one of the rural villages in Sintang. Some of the complaints expressed were the difficulty of carrying out health checks at a low cost and the distance to the examination site requiring water vehicles (because land routes are difficult to pass); the difficulty of making referrals because it is not easy to access travel to referral points; the lack of assistance from the village to accommodate community needs to referral service places; salaries that are not commensurate with the risk; delays in referrals; and so on.Hearin...

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