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The Indonesian Doctors Association has long lamented the fact that the nation has far too few physicians for the size of its population, and that it would take decades to get the right ratio.

As Fachmi Idris, the chairman of the association, known as the IDI, says, the ratio between the size of Indonesia’s population (about 235 million) and the number of general physicians (50,000) is far from ideal. The figures produce a ratio of one physician for every 4,700 people, about the same as Thailand’s but lower than Malaysia’s. While hardly relevant, it is perhaps constructive to know that the United States has one physician for every 360 people, while in Africa it is one doctor per 40,000 people.

Indonesia needs 80,000 general practitioners, about 30,000 more than currently available, according to Fachmi. On another level, he adds, it would take 40 years to meet the required number of surgeons.

At present, the total number of physicians in the country is about 70,000, comprising 50,000 general practitioners and 20,000 specialists. Graduates of medical schools number only 5,000 annually, of which only 50 percent actually continue on to practice medicine, while the remaining choose other professions.

The situation is worse concerning specialists: 50,000 surgeons are needed, but only 5,000 are on hand. And while some 200 gynecologists and obstetricians enter the medical profession each year, most of them choose to stay in large cities because that’s where the money is.

Against the backdrop of those figures, it comes as a surprise that when the Indonesian Internists Association held a workshop, titled “The Presence of Foreign Doctors in Indonesia,” in Jakarta last week, participants lambasted the fact that many foreign physicians had opened practices in Indonesia, especially in Jakarta and Bali.

One would think that with the dire situation Indonesia faces in the field of health care, additional medical personnel, even though foreign, would be welcomed with open arms. While they may lack familiarity with local diseases at first, in most cases these foreign doctors would have local partners to guide them during the initial period.

To be sure, the medical profession and government officials are not against the presence of foreign doctors as such, and would actually allow them here as long as they meet certain requirements in order “to protect Indonesian society and to uphold the integrity of Indonesian physicians.”

In any case, the prevailing regulation says foreign medical personnel can only be here on a professional basis in the context of “transfer of technology in A and B-class hospitals only,” according to a legal officer at the Ministry of Health.

In contrast, foreign pilots are still allowed to work for domestic airlines as instructors, flight officers and co-pilots. Hery Bhakti, the director general of air transportation at the Ministry of Transportation, said last week said that as the domestic airline industry was projected to grow by 10 percent annually, the country would require 400 to 500 more pilots a year. That figure cannot be met domestically as national flight schools can only churn out at the most 150 pilots a year.

As Hery rightly pointed out, failure to adopt the foreign pilot policy would stall the growth of the domestic airline industry and open the field for foreign operators to enter the market.

Both fields, health care and air transportation, have much to do with human lives and the trained people entrusted to handle them. In the end, it doesn’t really matter if the trained people in question are locals or foreigners as long as they can deliver the goods. It would be ideal if Indonesia could enjoy these services without narrow chauvinism or feelings of insecurity getting in the way.

Official data show that 41 foreign physicians applied for a license to practice in the country last year, but as of this writing not one has been approved. One can only speculate on the reason their licenses have not been issued — bureaucratic snags, refusal to pay bribes — but what needs no further explanation is that Indonesian medical people may feel threatened by the presence of their foreign counterparts.

What is also clear is that the non-presence of foreign doctors has delayed, if not deprived, many patients from getting medical care.

Perhaps many of us may have to be reminded that when Hippocrates, the Greek father of medicine, said that the goal of the physician was the care and cure of the patient, he never made any distinction between Indonesian and non-Indonesian doctors.

 

Taufik Darusman is a veteran Jakarta-based journalist.