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Indonesia deploying medical interns to Covid-19 front lines

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The Indonesian government pays interns assigned to the western part of the country 3.15 million rupiah ($214) per month and those in the eastern part 3.6 million rupiah per month. AFP

Indonesia deploying medical interns to Covid-19 front lines

Indonesian Minister of Health Terawan Agus Putranto is in hot water because of a recent comment about having deployed thousands of medical interns to the front lines of the nation’s Covid-19 treatment efforts.

He said last week: “We still have 3,500 interns and 800 Nusantara Sehat [Archipelago Health programme] workers – In addition to 685 volunteers such as lung specialists, anaesthetists, internists, general practitioners and nurses – who are ready to be deployed and to help if a larger workforce is needed.”

He said 16,286 medical interns and volunteers had already been deployed to Covid-19 referral hospitals and labs.

His statement, the latest of his comments to attract public criticism, followed reports that more than 100 doctors had died of Covid-19 and growing concerns that the nation’s healthcare system was facing collapse.

In the Indonesian system, recent medical graduates must sign up for a one-year internship after passing a national competency exam. The internship is split between a hospital and a community health centre (Puskesmas), and each segment is six months long.

This period of hands-on study is required to obtain a medical licence and to be eligible for subsequent specialisation residencies.

In response to the pandemic, the government has shortened the internship period to nine months, decreasing the length of time spent at hospitals in an attempt to minimise interns’ exposure to Covid-19.

In the programme, interns treat patients under the supervision of doctors. The government pays interns assigned to the western part of the country 3.15 million rupiah ($214) per month and those in the eastern part 3.6 million rupiah per month.

But facing the uncertainty of the pandemic, many young doctors-to-be have decided to put off their internships. In addition, graduates who have tested positive for Covid-19, are pregnant or have comorbidities are currently prohibited from taking part in the programme.

Only about 60 per cent of the quota was filled for the first 2020 internship cohort, which began in May, two months after Indonesia reported its first Covid-19 cases, said the Indonesian Doctor Internship Committee (KIDI), a team appointed by the ministry to oversee the programme.

However, the numbers improved in August and September. Some 3,100 people enrolled out of the 3,400-intern quota, KIDI chairman Robby Pattiselanno said.

A 25-year-old doctor-to-be who started her internship last month at a Covid-19 referral hospital in East Java, a hotbed of contagion in the country, said she could have started the internship in May but had decided to postpone.

The intern, who wished to remain anonymous, said she put the programme off after learning that it required doctors to be relocated if necessary.

The intern said that at her hospital, confirmed Covid-19 patients had to be attended to exclusively by staff doctors. But as the interns were assigned to the emergency room, they would have little idea whether the patients they were treating had the virus until the patients were tested.

Even though the nation’s emergency rooms have been divided into two sections – one for patients with apparent Covid-19 symptoms and one for patients without – symptomatic patients do not always end up in the right place, said the intern, who was assigned to the non-Covid-19 section.

She said she saw about three suspected or probable Covid-19 cases each shift and that many patients who visited the non-Covid-19 section of the emergency room complained of breathing difficulties.

Hera Afidjati, 24, who is set to start her internship later this month at another Covid-19 referral hospital in East Java, said that with no certainty about when the pandemic would abate, she had decided to take the risk.

Hera felt it was her duty to help address the outbreak, but she hoped the government would come up with better solutions, including by identifying the root causes of medical workers’ deaths.

“One specialist doctor can’t be replaced by a number of general practitioners. It takes many more years to study the field, and the competencies are different,” she said.



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