SAMSURIDJAL DJAUZI: CARING ABOUT DRUG USERS, PEOPLE WITH HIV/AIDS

The owner of an Indonesian restaurant in Melbourne was a street child
who used to sing and play his guitar on public buses in Jakarta.

He is an elementary school dropout but his hard work has made him a
successful entrepreneur.

That story was told by Samsuridjal Djauzi, an internist and
immunologist, in his book titled Talks with Youths, which he
distributes to his young patients and participants in his life skill
training program.

Samsuridjal, 62, has great concern for the fate of the more than
500,000 young people in the country who are involved in drug use,
with many contracting HIV.

The friendly and kind man is chairman of the Indonesian Association
of Physicians in AIDS Care. He is active in the AIDS Working Group at
the School of Medicine, University of Indonesia/Cipto Mangunkusumo
Public Hospital, and chairs the National Movement on Improved Access
to HIV/AIDS Therapy, which he established several years ago. With his
colleague, Zubairi Djoerban, he founded Yayasan Pelita Ilmu, an AIDS
foundation, in 1989. The foundation also provides life skills
training for youths who drop out of school.

He received an award from the National Narcotics Agency in 2005 for
his hard work in fighting drug use.

A professor of internal disease at the university, he teaches in the
morning and has his practice at Dharmais National Cancer Hospital,
where he worked as the director from 2001 to 2005. He also has a
health column in the Sunday edition of Kompas daily, answering
various questions from readers.

Born in Bukittinggi, West Sumatra, Samsuridjal has two children from
his marriage to Siti Chamisa. Both children are physicians and each
is married to a medical doctor.

A fan of Pramoedya Ananta Toer's booksalthough he says it doesn't
mean that he agrees with all the writer's ideasand WS Rendra and
Taufik Ismail's poems talked to The Jakarta Post's T. Sima Gunawan in
his consultation room at Dharmais hospital recently.

What is your main concern in the health sector?

We still have high maternal mortality and child mortality rates,
which stand at 312 per 100,000 and 32 per 1,000, respectively. This
is much higher than other Asian countries. Wetalk about Malaysia or
Singapore. Even Sri Lanka has lower mortality rates.

There are a lot of things we should do to achieve the 2015 Millennium
Development Goals.

It should be noted that the cost of not doing something is higher
than the cost of doing it.

What do you mean?

For example, in the case of blood transfusion service. There are only
185 units throughout Indonesia while the country has 440
regencies/municipalities. Many women who bleed when delivering a baby
die due to the lack of blood supply. This happens to many victims of
traffic accidents, too. We could not save their lives because there
was no blood supply.

We have long gained our independence yet we do not have adequate
number of blood transfusion service units. Let's say we need Rp 1
billion (US$111,000) for a unit. Then it will cost Rp 260 billion to
meet the demand. This might be a lot of money but we suffer more with
the many deaths of these people, which will also result in economic loses.

Why do we have serious health problems?

Because of the small budget for health and education. WHO suggests at
least 5 percent of the national budget should go to the health
sector. But here, it is below that... maybe only about 3 percent.
Hopefully the government will allocate more funds for health and education.

It's necessary to boost people's participation in the health sector.
For instance, in the efforts to combat dengue fever, many people
still rely on health attendants who are expected to come for
fumigation, while actually it is the task of all of us to keep the
environment clean and healthy. Don't rely too much on the government.
We need people who can stimulate participation.

Health development is much related to many other factors such as
education and income. For instance, they know that they should boil
water before drinking it, but theyhave money to buy kerosene for the stove.

We need to do things so that people have enough income. That's why in
several places I provide life skills training: in my neighborhood, in
several prisons and in some other places targeting mostly youths.

How does the training program work?

People can be independent because of two skills. First are life
skills. People must have an ideal in their life. They must be able to
communicate, to look at the opportunities and to work, to manage time
and resources. Second is a special (vocational) skill that can help
them make money.

There are too many youths who do not know what their life is for;
they do not know how to spend their time. They do not know that there
is funding at the subdistrict office for them. The government has
funds for small and medium enterprises but this is not used properly.
Karang Taruna (local youth organizations), youths of churches and
mosques, should help promote the proper use of the funds.

We need to stimulate young people's motivation, So, through
activities we want to become a bridge for these youths.

It seems that the condition of our youths is not that pleasant.

Don't weep over your fate. There is more than enough discussion about
the youths' weaknesses and badness.

It's better to see the potential. Many of them want to improve their
lives. There are still many people who will work voluntarily to help
those youths. We still have social solidarity. Unfortunately, we lack
leaders at the grassroots level as many just want to become
president, a minister, a governor, only a few want to live in the
village or to lead a small group.

How about the drug problem in the country today? Has it become more serious?

Yes. In 1990s it was found that many of them (drug users) were using
needles, which can spread viruses. After five or 10 years they
started to suffer diseases such as hepatitis C, and many were
detected to have HIV.

Here, in this hospital, every afternoon we deal with about 50 young
people who are infected with HIV.

Drugs and HIV/AIDS are related. Sixty percent of injecting drug users
get HIV. In the past most HIV cases were due to unsafe sex, but now
it is because of drugs. Of course there are still HIV cases as a
result of unsafe sex as the use of condom only reaches 20 percent.

In 2005 the National Drugs Agency estimated that there were 575,000
injecting drug users in the country. Do you have the figures of
HIV/AIDS cases and drug cases in the country?

In 2002 the estimated number of HIV/AIDS cases was between 90,000 and
130,000. Last year it was between 180,000 and 210,000. But this is
too conservative because there is also another estimation that puts
the number at between 500,000 and 600,000. The trend is increasing
and it is a sharp increase.

As for the number of youths involved in drug cases, it has reached
more than 500,000. They must be trained about life skills. Most of
them have dropped out of school because most schools won't accept
them and it is quite difficult for them to work in the formal sector.

They must get help. Otherwise, this will become a time bomb of
unemployment, crime. Anyone who is able should contribute, not only
for the youths but also for security (in general).

Where do you provide the training?

Besides in prisons, Yayasan Pelita Ilmu also provides training in 11
places, mostly in Jakarta like Kampung Bali, Bukit Duri and
Cengkareng. The other places include Karawang and Indramayu (both in
West Java), where we also give training in working in beauty salons
for some 100 HIV-positive women.

In the past, some hospitals refused to treat people with HIV/AIDS.
How about today?

Hospitals now accept them even though they might still discriminate
against the patients, such as sending them to a special room.

Was becoming a doctor your childhood dream?

My parents were very modest. My father was a teacher who also had a
small trade while my mother was a housewife. We lived in a small
kampong at the foot of a mountain which was quite far from the city.
I was very close to my mother as father traveled a lot. One day a
tree fell over and hit her in the head and it was bleeding.
Traditional herbs made of leaves were put on the wound, but it became
worse and she got a fever. I took care of her. We were so poor that
we did not have any toilet, so she defecated in a bowl and in the
morning I had to throw it away into a pond near the house. At that
time I was five years old and I remembered mother praying so that I
could became a doctor.

Many patients complain about doctors who are arrogant and are
reluctant to give sufficient information. As they are not satisfied
with the medical service here, many Indonesians prefer to see a
doctor abroad, particularly in Singapore. What is your comment?

Nurses often depend on the doctors when it comes to information, even
basic information. Actually, nurses can give basic information to patients.

This happens because of two things. First, there is a lack of comfort
and friendliness in the medical service here. Second, Singapore is
aggressive with their promotion. Actually we also have many good
qualified doctors with the same education standards.

But many doctors have a practice in many hospitals. There are also
many doctors who are arrogant because they have the feeling that they
are important and that the people need them. If they are not
friendly, theybe able to compete with doctors from abroad.