Senin, 14 Maret 2011

Artikel di Buletin 118 Medicus Mundi Ch

Health and Healing: Experience from Indonesia

Right to explore the mystery beyond the suffering of sickness

The medical high technology care neglects that the people suffering of a sickness are looking for a much broader dimension of healing. For this it is necessary to shift from the paradigm of sickness to a paradigm of wellbeing.
By Emmy Sahertian * (mission 21 - christian awareness in partnership)


It has been a long time struggle to understand the mystery behind the concept of health, since it was a part of services movement which focused on hospital based approach. The modern people believe that technology of diagnostic and pharmacology, medical knowledge specialization, professionalization of nursery care and treatment were the great development to solve the suffering of sickness and diseases, playing the role of people believe in effort to maintain their health. The key word is “technology” behind the basic need to ease the suffering of sickness. Health as the state of holistic wellbeing (WHO), on one side, could gain hope to overcome suffering of sickness through high technology exploring, but on the other side people face the fact that developing an industry of services needs a lot of money and creates another problem which is called “sickness paradigm” of solving health problem. It is another term of curative hospital orientation in health services, when people always depend on modern medicine and technology of diagnostic with sophisticated knowledge and skill of medical provider. It is like an empire of health system which tends to neglect the right of the community to maintain its wellbeing through health services.

Sickness paradigm in health

In development countries like Indonesia, people spend more time and resources to solve their health problem because of the rapid development of new strain virus like HIV which increased opportunistic diseases as TBC, Hepatitis A,B, C, etc; new strain virus like H5N1 (bird flu) and H1N1 (swine flu), etc. Through sickness paradigm approach, people always spend a lot of life resources to cure their illness in hospitals. This creates the next critical problem of social injustice, increased gap between “the haves” and “the have not” or under-privileged community in getting access of proper medical services behind the hospital’s door. The current issue of health that publish in National Newspaper (Kompas Newspaper, Monday, 22 Nov.2010) reports about the emerging situation in health system, when “the have not” people must spend money to solve their suffering of sickness, decreased income generating and trapped them into poverty. Even though they could access the social scheme insurance for needy people, but it is a small grant from State. It is not enough to fulfill their holistic wellbeing, except only decrease the illness effect.

Healing is a dynamic process to explore the mystery of sickness

Since “Alma Ata” declaration launched in Kazakhstan, 6-12 September 1978, about primary health care approach, it was like a solution with efficient and cost-effective way to organize a health system, where the open space of community participation in determining their health gained the right solution to explore the mystery of sickness. Beginning with planning of health prevention, exploring the access of healing and evaluating the results, motivated people traced the access beyond the existing modern healing, as a way to overcome problem of “sickness paradigm”. It was called “health paradigm”. Focused on community participation to compose their holistic wellbeing, inventing their traditional wisdom and sustain the social health scheme of community based health.
Exploring the community struggle to face the mystery of sickness, many people seek beyond the sign of a suffering body, a transcendental believe. It is not to escape from unfinished problem of physical suffer but it is based on their experience. Healing is a dynamic process to seek beyond the suffering body from diseases. It is a transformation of human wellbeing which have connected with the transcendental world, it was “opus divinum est” (God’s work - Motto of “Cikini” National Council of Churches hospital in Indonesia). From this side they believe that there is another field to explore and that there is a wider space to explore, not stopping behind the hospital’s door. For them “home base” service is the basic hospital of life connecting with natural wisdom of health. In Indonesia we inherit various natural wisdom to solve health problems, for example herbal treatment of pandanus conoideus (red fruit) for anti oxidant and increasing CD4 to support Anti Retrovirus Therapy for People Living with HIV and AIDS in West Papua, and another herbal plant that had recognized by community to maintain their health, which already pass the academic examination and that is still neglected in treatment calculations. But now, it gets gradually stronger to reach the community believe. It is their right to explore the mystery beyond suffering of sickness, not only the right of medical practitioners.

*Emmy Sahertian is from Timor. She is a pastor and has worked for several years in the field of pastoral care in hospital, and now as the program advisor of M21