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Published: November 11th 2008
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High Five
Daily ritual of buying bananas Blog 0 - July 2008
Our travels in 2008 have brought us to a noisy, busy seemingly chaotic town Kupang on the dry dusty island of West Timor at the eastern end of Indonesia. The nearest town you’ve probably heard of will be Darwin, Australia, approximately 1000 miles SE of us.
Colin and I are here, in Indonesia with Voluntary Service Overseas (VSO) to help install a hospital information system in the town’s public hospital. The project was initiated by the German Overseas Development agency (GTZ) and Colin worked with them last year for 6 month doing the systems analysis and strategic plan. This project is the follow up to that work.
It may seem strange to you (it did to me) that money is being spent on ICT Training (my job) and installing hospital information systems (Colin’s job) when the hospital desperately need more expert clinicians and medical equipment. But it seems the need for one type of expertise should not prohibit the use of another. We have seen a throughput of doctors and midwives working here on secondment from Bali, Java the other richer islands but few want to stay they see it as penal service.
Admin block
Colin on way to work . Training room on top floor to the left I know little about aid work but it appears to me that the feeling now amongst government and non-government (NGOs) aid agencies is to stop fire fighting and put in systems that enable communities to manage their processes better and hence make more effective long term use of the aid money they are given. This is not just in health care but in water supply, land management, waste disposal and so on. Hence even the volunteer midwives, nurses, nutrionists, doctors out here with VSO concentrate on putting in long term programs that are self-sustaining than actually working with patients.
So our remit is to create a useful patient record system that will enable the hospital to keep patient information in one place so they can co-ordinate lab tests, recall patients, give follow up care, manage the supply of medicines - ultimately provide better and more cost effective treatment. I was told by a volunteer midwife that in her health center patient details are recorded in a series of ledgers - blood group in one book, next of kin in another, known medical ailments another, each medical episode is recorded chronologically in a ledger, previous births and complications well
Village folk
The hospital is for these people as well but can they afford to get into town? If they do the whole family comes and camps in the ground until the patient is well enough to be taken home again. somewhere perhaps - so the concept of a patient record and cross referencing is just not there.
Also to make billing more effective. Hospital fees have to be paid either by the individual or if they have no work then by another government department - the billing to the appropriate departments is fraught with problems.
The hospital staff we are working with are educated well qualified and committed to the public health services (they do all run private practice as well but that is OK). The problem lies with the administration and management at hospital, local, regional and national level - it is inefficient, corrupt (by our standard), and inept.
So there are anomalies like the ENT department (where due to an awful ear infection I have spent a long time) is clean, well run with quite modern equipment but outside the entrance to the ENT is a, pile of medical rubbish, a stagnant pond harboring gawd know what collapsed step leading to a rubbish strewn walkway to the next unit - no-one seems to care about the site.
So this is where we are.
I was not going to write a blog for this
Records 3
stacked up in every space.The major employer in Kupang is the civil service â“people work hard to become a civil servant and cherish the job.
The job is record keeping.
Without this work the unemployment amongst eth aspiring, educated population would be very high.
It is this salaried group provide income for the mass unemployed from whom they buy services as needed â“ cut out the record keeping and there will be crippling poverty for the town folk as well as the village people.
trip because I expected it to be fairly uneventful - I was wrong - so if you are interested read on!!!!
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Bob
non-member comment
Bumphopolis.
Enough bumph to build a city ! I wish you luck sorting it. Great blog and pics, as always. Looking forward to seeing you both IN ONE PIECE (each) back in Oxford.