Westerners think we’re the same as 20 years ago but things have changed a lot

Big Plans: Sanglah chief Dr Wayan Sutarga.

With a rabies toll of 26 since the outbreak began on the island last year and dengue fever on the rise, many westerners are hesitant to get treatment in local hospitals. Dr I Wayan Sutarga, the new head of Sanglah Hospital, spoke with Carla Albertí de la Rosa about the hospital’s plans to meet international standards.

Sanglah authorities said last year the hospital was going to be renamed. Is it?
I don’t think so. Sanglah is good enough and everyone around the world knows us as Sanglah Hospital.

How has Australian funding affected the running of the hospital, in particular the new international wing, and the eye unit?
The Australian government works very closely with us and supports us very much to help us develop this hospital.
They developed the Integrated Intensive Care building. It’s composed of the cardiac intensive care unit and the burn unit. They also support us with training.  They have given scholarships for staff at Sanglah Hospital to do master degrees. Seven of our staff have already joined a master degree programme in Australia. Shortly they will come back and help us develop this hospital.
The Australians have also given funds to the Bali government to develop the Australia Bali Memorial Eye Centre (AMEC) and Sanglah will be part of the programme. In the last meeting, AMEC and Sanglah agreed to develop a system where AMEC will be the secondary hospital and Sanglah will be a tertiary hospital. The budget will be distributed depending on what area of services to develop in AMEC and what area of services to develop at Sanglah Hospital. AMEC and Sanglah will work very closely to improve the quality of services.

Is there ongoing cooperation between the Australian government and Sanglah Hospital? And if so, what?
I really want this to happen. But the regulation is only between Canberra and Jakarta. But personally, we have very close contacts with people in Australia who give us advice and ideas. Most tourists in Bali are Australian and Sanglah Hospital wants to be a good hospital to support tourism.
We want to make sure Bali’s tourists are safe. We already work with the Australian hyperbaric association for our services to meet international standards. I will promote cooperation in Jakarta.

Sanglah celebrated its 50th anniversary last December. What have been the milestones in that time?
We launched the Cochlear Implant program. The cochlear bone is in the ear. We’ve found about 24 babies in Bali that did not have a good cochlear bone, so they were deaf. We replace the bone with an artificial bone so the baby can hear again.
Another highlight has been the integration between education and medical services. A teaching hospital is the best type of hospital. But in Indonesia, some teaching hospitals are not as good as non-teaching ones. So there’s something wrong. Teaching and medical services should be integrated, because good services will lead to a good teaching process and a good teaching process will also affect the medical services.
We are a teaching hospital and we will be the best one in Bali.

What are the main health issues affecting Bali now?
We’re still struggling with infectious diseases. Dengue is still a problem as well as some new emerging disease such as swine flu, bird flu, and since last year we’ve been fighting against rabies. Bali never had rabies, but in the last year it’s already infected [nearly] all of Bali.

An island-wide alert has just been issued over dengue fever. How many cases has Sanglah had recently?
Around 20 cases. They will increase with the rainy season.

What is the best way to wipe out rabies in Bali?
It’s very simple: control the dogs. Also, if someone is bitten they must be vaccinated.

Aren’t people controlling their dogs?
Balinese people love dogs very much. They are part of our lives. But if you love someone you should be responsible and look after them. They should give them vaccinations and have them under control so they don’t bite anyone. If a dog bites someone, the owner should be held responsible for it. But many people don’t see it like that.
I understand that it’s the first time this (a major rabies outbreak) has happened in Bali and we need time to make people respond.

As a regional government-funded hospital, Sanglah accepts patients from as far as the outlying islands in East Nusa Tenggara province. What percentage of your in- and out-patients are people not living in Bali? And what are they suffering from?
About 10 percent. They suffer from very serious conditions such as cancer or heart attacks.

Many Westerners living in Bali are fearful of being treated in local hospitals and either attend international clinics here or go abroad, to Singapore for example. Are their fears of lack of medical expertise and equipment at local hospitals justified? How does Sanglah measure up internationally?
Some of our areas don’t meet Westerners’ standards. But even though customer service is not as good as in the West and needs to be improved, just like our teamwork still needs to be strengthened, some areas are above the standards or at least meet them. The international wing or our surgery and nursing meet these standards.
The image of our hospital also plays its part. Westerners think we’re the same as 20 years ago, but things have changed a lot. That’s why we need to work on our website, to show how good we are.

As the new head of Sanglah Hospital, what are your aims? What do you hope to have achieved during your time at the helm?
Our aims, not just mine. We want this hospital to have fully attained international standards in the next five years.
I personally want everybody in the hospital to work hard and to contribute with a maximum performance to achieve our dreams.
In five years, Sanglah won’t be as sophisticated as the Mayo clinic or some other sophisticated clinics in America or Europe. We want to meet international standards, but Sanglah will still be a Balinese hospital.
To make that happen we will strengthen our internal business process. All the procedures and management in the hospital will be improved as much as possible.
We also want to improve the medical and nursing education in the hospital and reorganise our research. We have done so much research, but it hasn’t been properly organised or published. We want to publish our research through our website for the world to see. We hope scientists from abroad will join us in our research and that we can join the international research effort.

The Bali government’s newly launched free Mendara healthcare programme doesn’t cover people with HIV because they have to take anti-retroviral drugs throughout their lives and it’s too expensive. What are you going to do to improve the lives of the 2,400 reported citizens that are affected by the disease?
The scheme doesn’t cover antiretroviral drugs but they still cover the disease. People with HIV can have tuberculosis; it still takes care of that.
Antiretroviral drugs will be donated by the Jakarta government.

Many parts of Indonesia are risk areas for malaria. However, because of its sea breezes Bali is said to be free of the disease. Is this true?
I don’t want to comment on that. I can just say that I hope so.

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