How Indonesian Healthcare Workers Survived Their Posts

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1500 Singaporean healthcare workers resigned from their jobs eaelier this month, as widely reported by news agents around the world.

Resignation rates among healthcare workers are going up, said the Singaporean Senior Minister of State for Health Janil Puthucheary on Monday (Nov 1).

Around 1,500 healthcare workers resigned in the first half of this year, compared with 2,000 annually pre-pandemic, he said.

So far, close to 500 foreign doctors and nurses have resigned in the first half of this year, compared with around 500 in the whole of 2020 and about 600 in 2019.

“These resignations were mostly tendered for personal reasons, for migration, or moving back to their home countries,” he said in a ministerial statement in Parliament on Monday.

Dr Janil noted that for healthcare workers, it has been over 20 months of continuous daily battles against the pandemic, with a large proportion of them unable to take leave since last year.

As told by a colleague sent in the following message: “It feels like what started as a 2.4km run became a marathon, and just as we are reaching the finishing line, we have to run a second marathon. Our people are exhausted physically, mentally, emotionally – whether they will admit it or not.”

With healthcare workers being continuously overstretched, it is “not surprising” to find resignation rates going up this year.

Meanwhile, Indonesian health workers are also hanging by thread during the prolonged pandemic. Aside from losing 1,967 healthcare workers to Covid-19, the already struggling rest of the workers are forced to stand their posts even more now.

According to data alerted by the Head of the Personnel and General Division of the Directorate General of Pharmacy and Medical Devices of the Ministry of Health (Ditjen Farmalkes) of the Indonesian Ministry of Health, Indonesia still had a deficit of various types of health workers.

Standards for the needs of Indonesian health workers have been set in Permenkes 75 of 2014 and Permenkes of 9 of 2014.

According to these standards, Indonesia has a need for dentists as many as 9,825 people for Inpatient and Non-Ranap Health Centers.

However, Indonesia only has 7,127 dentists for Puskesmas. This means that there is still a deficit of 2,698 people.

Pharmacists have an important role in the delivery of health services; their duties include drug distribution, maintaining the quality of drug storage, to selecting expired medicines.

Ideally, the RAP and Non-RAP Puskesmas need 13,279 pharmacists. However, the real human resources are only 12,155 people. This means that Indonesia still lacks 1,124 pharmacists.

Nutritionists are experts in the field of nutritionists and dietitians. This type of health worker can handle setting nutritional standards for individuals, the general public, or hospital patients.

According to the standards regulated in the Minister of Health Regulation, Indonesian Health Centers require 13,279 nutrition workers.

However, there are only 10,697 real human resources, so that Indonesia still has a nutritional deficit of 2,582 people.

Blood transfusion is classified as a medical procedure that is very risky and can be fatal. Therefore, Indonesian health services require Blood Service Technicians.

According to the Directorate General of Pharmacy, Puskesmas and clinics throughout Indonesia need 9,825 Blood Service Technicians.

However, the real human resources are only 8,124, so that Indonesia still has a deficit of 1,701 Blood Service Technicians.

With so much deficit in healthcare workers faced by the country, we can only imagine how hard they have to work during the pandemic. If they are still standing now, it shows just how loyal and strong they are.

The COVID-19 pandemic in Indonesia has resulted in a very heavy burden on the health care system in the country, including health workers. The most visible risk is the safety aspect of health workers, especially those on the front lines, who are very vulnerable to being exposed to COVID-19 and are at risk of life threatening.

It has been recorded that more than 100 doctors and hundreds of other medical personnel have died from being infected with COVID-19 while carrying out health service duties.

In addition to the aspect of safety and protection from infection, another risk that has the potential to affect the quality of life and productivity of our medical services is the mental health aspect, including the risk of burnout syndrome or mental fatigue. Health workers are potentially exposed to very high levels of stress, but there are no rules or policies that can protect them from a mental health perspective.

Research conducted by a research team from the Master of Occupational Medicine Study Program, Faculty of Medicine, University of Indonesia (MKK FKUI) shows the fact that as many as 83% of health workers in Indonesia have experienced moderate and severe burnout syndrome, which is psychologically at risk of disrupting quality of life and work productivity in services. health.

According to the Head of the Research Team, Dr. dr. Dewi Soemarko, MS, SpOK, this study also found the fact that General Practitioners in Indonesia who carry out medical service duties at the forefront during the COVID-19 Pandemic have a 2 times greater risk of experiencing burnout syndrome.

“The high risk of suffering from burnout syndrome due to exposure to unusually severe stress in health facilities during this pandemic can have long-term effects on the quality of medical services because these health workers can feel depressed, extreme fatigue and even feel less competent in carrying out their duties, and this is certainly have a negative impact on our efforts to fight COVID-19,” said dr. Dewi in a virtual media meeting on Friday, September 4, 2020.

The Research Team from the Master of Occupational Medicine Study Program consisting of Dr. dr. Ray W Basrowi, MKK; dr. Levina Chandra Khoe, MPH; and dr. Marsen Isbayuputra, SpOK, found another fact that is also very worrying, such as:

-83% of health workers experience moderate and severe burnout syndrome.

-41% of health workers experienced moderate and severe emotional exhaustion, 22% experienced moderate and severe loss of empathy, and 52% experienced moderate and severe lack of confidence.

-Doctors who treat COVID-19 patients, both general practitioners and specialists, are twice as likely to experience emotional exhaustion and loss of empathy as those who do not treat COVID-19 patients.

-Midwives who treat COVID-19 patients are twice as likely to experience emotional exhaustion as those who do not treat COVID-19 patients

-There are still health workers (2%) who do not get personal protective equipment (PPE) from their health facilities.

-Around 75% of health facilities do not carry out routine swab checks and 59% do not carry out routine rapid tests for their health workers.

Dean of the Faculty of Medicine, University of Indonesia, Prof. Dr. dr. Ari Fahrial Syam, SpPD-KGEH, MMB stated that this research is a form of contribution from FKUI to the government in terms of helping identify potential risks of health problems for medical personnel in Indonesia during the pandemic. According to Prof Ari, “various findings from this study can be a source of recommendations for protection intervention strategies and improving the health quality of Indonesian medical personnel so that they are maximal in carrying out their medical service duties but also remain healthy.”

The results of this study recommend that in addition to aspects of physical health and safety protection, hospital management, health facilities and the government should begin to prioritize aspects of mental health interventions such as psychological assistance and counseling for health workers, especially those on duty during the pandemic.

Another aspect that must also be done is to create a safe and comfortable atmosphere for health workers in carrying out medical functions by applying the principles of comprehensive occupational medicine.

Are you a healthcare worker too? What is your opinion on this matter? What can we do to release you from such a burden? Let us know in the comment, and we’ll see you on our next article. Stay safe, stay healthy!