Building Resilience of Health System: the case of Nias Islands ASTRID KARTIKA
Indonesian Health System Is the current Indonesian health system responsive to the disaster?
Aceh Tsunami 2004 & Nias Earthquake 2005 – – the health of the survivors remained unanswered during the first week of the emergency phase and much depended on the humanitarian aids instead of government’s emergency health provision Puskesmas/primary level of health service provision collapsed Hospital damaged and still overloaded with victims Health workers shortage was exacerbated during emergency Existing health system could not cope with the disaster
Failed building effect Vertical collapse
World Health Organization (2008) • Government must ensure that health system itself is resilient to the impacts of emergencies and disasters and not only to respond to extraordinary situations of emergency and disasters. • It should be part of the so called ‘normal’ development plan both at the community level and nationwide. Emergencies should not merely be responded to quickly but their causes should also be analyzed and prevented. Mitigation and preparedness programs, together with response and recovery strategies, should also be developed and implemented accordingly (WHO, 2008)
The role of BRR in strengthening health system on Nias island – within the DRR scheme • • Health Facilities Improvement Human Resources Development Puskesmas Plus Development Legal Drafting of Nias Health System
Health Facilities Improvement • Reconstruction of earthquake resistance health facilities • Providing more spacious areas within the health centre to be used as the emergency space or disaster management zone
Human Resources Development to increase the quantity and to improve the capacity • In collaboration with UGM in Jogjakarta, BRR provided scholarships of 17 specialists, 18 General Practitioners (GPs) and 15 Master degrees 8 Nursing Degrees and 37 Nursing Diplomas. • Training Centre Development in Gunungsitoli Hospital
Intermediate Referral Health Services
Legal Drafting of Local Health System • One of the weaknesses of Indonesian Health System is its legal aspect. The current Indonesian system was issued by minister, not by law and this is challenged by weak health policy implementation. • BRR in corporation with UGM has been developing the Nias Health System which has incorporated the disaster preparedness scheme. In order to make it legal and sustainable beyond BRR’s term, a legal drafting is being developed. The legal drafting can be a long process but it is a good start for remote areas such as Nias in the future.
Lessons Learned: Keys to Resilience Health System • The need for incorporating DRR scheme into the National Health System • The need for binding the National Health System as a law • The need for public communication and awareness
Thank You …. . astrid_kartika@yahoo. com
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