First week in Mlonggo puskesmas (regional health-centre), originally made as a kind of GGD it now serves the community more as a small hospital.

Straight away this already shows the biggest problem in indonesia concerning public health, and our goal evaluating the public health in indonesia. The centres made for public health do not fill that purpose well anymore, only a minority of its activities.

The last week we went visiting patienthomes in the small villages of the Mlonggo area, the first day we implanted some Norplant’s, anti-conception implants. The 2^nd day we went to check for wound-infections at the house of the patients.

Ofcourse this is way too fast to check for this, as this should be done at aproximately 3 days. The real reason we checked the patients was to check if the patients themselves removed the implants because apparently sometimes the patient only takes the implant because of pressure from for instance, her husband. Luckily this was not the case in our patients.

The remainer of the week we visitted some patients who were treated at the hospital for, for instance diarhoa or tyfus and checked their home-situation on signs where they could have gotten the infection. Mostly this did not yield clear results but sometimes the cause was all too obvious, with drinking water not properly cleaned, or other bad hygiene habits.

For instance: everyone seems to boil the water they drink, but seem to forget to boil or clean the water for washing, tooth-brushing and doing the dishes. Mostly this water looks more or less as something out of a horror story. (brown, dirty, probably some movable organisms going about) One guess where they had the infection from.

When visitting we often had neighbours asking to check on their sick child or person or ask for advice, this yielded some extra help from the home-visits as we diagnosed a few patients which would otherwise have been missed. The sad part was though that some already saw a dokter, but since you only have a few minutes per patient here in indonesia, they disease was missed or niglected. Be happy with our 10-20mins at the general physician in the netherlands, here it can be as less as 1.

Saturday the senior doktor of the puskesmas invited us to have a tour around the villages visitting the other co-ass, which turned out to be a nice trip inspecting all the different puskesmas and winded us up with the doktor checking on the peanut-fields and the cow-pulled plows. Good that work and pleasure can be combined in indonesia :D.

This weekend we will be spending our time in the beach resort, taking some rest. Next week we will visit a international congress in Semarang together with the organising doktor of the rotation here, doktor Hussein, who invited us there. Should be good!

Concerning my computer and internet acces, my laptop is still dead, so it is quite a problem staying in contact. Sorry for that, I still read the comments on the blog though, I just have little time to respond.

Thank you all, take care.