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Medical practice is not universal; medical customs, indications and procedures differ widely between countries and patients' expectations differ even more. If uncomfortable with this and seeking “the same as at home”, as in other aspects of expatriate life, you will be stressed, upset and sometimes angry. If prepared for these differences and having taken the necessary precautions, this situation need not remain the source of chronic complaint and anxiety that it is for some for the whole of any expatriate posting (usually their first and last!).

Before coming to Indonesia people should - as for any trip overseas - already have a sufficient supply of any prescription medicine needed until the next trip home. This is because while you may be able to continue that supply from a local facility, or you may find a local substitute acceptable to your original prescribing physician, this is not guaranteed; especially in the dire economic situation Indonesia finds itself in.

Early in your stay - before there is an emergency - identify the closest medical facility with English-speaking personnel or indeed with staff who speak the language of your preference. Ascertain its working hours and its reputation if possible. If in Indonesia for the first time, bring your overseas medical records with you to familiarize your new doctors with your past medical history and the results of your pre-deployment check-up (you did have one didn't you?).

Because the approach to the provision of medical care to both the population and the individual is quite different in Indonesia to what you may be used to, try and become a consumer of local health services to spot the differences BEFORE there is an emergency. Form a relationship with a doctor and clinic/hospital that you feel comfortable with.

Group practice medical clinics

The primary care medical facilities in Jakarta most utilized by expatriates are group practice medical clinics. They have a wide range of specialists and are quite capable of providing for most routine medical needs. As they cater to expatriates and middle-class Indonesians, they provide the best standard of medical care that can be given in Indonesia. In addition to a full range of specialists, facilities in the largest cities generally include laboratory, radiology, pharmacy, dental, physiotherapy, ambulance and emergency room services. The goal of these clinics is to provide comprehensive medical care. It is always best to check if they have staff continuously on duty even overnight, and that their ambulance is equipped and staffed to a standard you are comfortable with.

Cultural differences in medical care

However, certain cultural differences make clash with patients' expectations and is best to be informed about these in advance. While in most countries patients expect to be able to ask a doctor a wide range of fairly pointed questions, which may even include statements which imply that the doctor may not be sure of what she is treating or that his prescription will be effective, in Indonesian culture questioning the doctor is not the usual practice of patients. While doctors in the centers which cater to expatriates do expect to be questioned, and understand that foreigners may be more educated consumers of medical services than they are accustomed to seeing, it remains the case as in all societies that understanding the local practitioner's point of view and using politeness and patience rather than confrontation and aggression will lead to a more satisfactory consultation for both parties.

This is not to say that patients must accept a consultation where they feel frustrated about not knowing what is wrong or about not getting better. It is to say that patients are best to have in reserve access to a medical advisory service either onshore or offshore who they can contact 24 hours a day in an emergency and who they can call during working hours for routine independent medical advice.
Unless absolutely necessary as in a major medical emergency, it is suggested that you do not go to the local hospital on your own without first contacting your medical assistance company; if you must, at least ensure you have a fluent/native Bahasa Indonesia speaker to assist you, and enough money for the admission fees.

Many medications can be purchased over the counter that would only be available by prescription in your home country. However in most cases the manufacturer is different and therefore the drug is identified by a different brand name - know the generic (chemical) name of your medicines if you think you are going to need to restock locally. It pays to bring the package insert from your previous prescription with you. Fraudulent drugs are not a major problem, but be careful and check the dispensed drug before you pay for it.

You will need to pay cash at the completion of all medical consultations - and very few medical facilities in Indonesia outside the main centers accept credit cards. When they do, they often only accept VISA and Master Card.

Overseas treatment and medical evacuation

For serious injuries and illnesses, many expatriates and Indonesians alike choose to go overseas for treatment. The usual referral center is Singapore, as it is cheaper to fly there than to the two most common referral centers in Australia. However, the standard of care between the two countries is very little and some Westerners may be more comfortable with the medical approach in Australia. The cost of medical treatment in Singapore is often two to three times that in Australia, so for more extensive treatment this definitely offsets more expensive air fares.

The option to go overseas for treatment not only depends on whether you can afford it or whether your company will pay for it, because in some cases of injury and illness it is not possible to fly by normal commercial flight, or at the very least a doctor must accompany the patient. All medical evacuations are expensive, and if you do not have insurance coverage for medical evacuation few can afford to pay for it themselves.

Even if you do have insurance coverage for medical evacuation, many insurance companies, especially those in Europe and the United States, may not accept the necessity to go overseas for treatment. To avoid disillusionment and, frankly, fear in an emergency, it is strongly recommended that you check with your insurance company at the beginning of your stay in Indonesia on what conditions and situations they will accept as requiring treatment overseas.

If possible, before you come, be sure you understand EXACTLY what medical care and what evacuation services your employer is offering.

Medical advisory service

We noted earlier that patients are best to have in reserve access to a medical advisory service either onshore or offshore who they can contact in an emergency and for routine independent medical advice. International SOS is the premier provider of such services in Indonesia, and indeed is the largest provider worldwide. It may be useful to know how such a service operates. International SOS has three functions relevant to individual expatriates:

1. Emergency medical evacuation (and urgent medical referrals)
2. Medical oversight of the International SOS clinics in Jakarta
3. Medical advisory services for all International SOS members

Constraints (in other than medical emergencies):

1. For us to carry out a non-emergency response, authorization from your company is required (this is your employer's request) and for that we need your full name AND member number (again, this is your company's request).
2. Only Indonesian-trained doctors who hold Indonesian citizenship are able to get and hold medical registration in Indonesia; expatriate medical advisors can only provide technical assistance, i.e., a second opinion.
3. As is the case worldwide, a doctor not registered to practice in that country - and indeed a doctor not accredited to a particular institution - cannot enforce any standards of care on local colleagues.

Suggestions:

1. Know what you are looking for when you call your medical advisory service.
2. When you call for help, always have ready your name (or patient's FULL name if different), phone number (and membership number in calling International SOS) and short but succinct statement of what is wrong and what assistance you are seeking.
3. If it is a medical emergency, say so (i.e., is this what you would dial 911 or the equivalent for at home?)
4. If calling International SOS, expect to speak to a doctor as soon as possible if it is an emergency; otherwise expect a call back from us in a non-emergency situation in less than 2 hours.
5. If a clinical consultation is not to your satisfaction, do not engage in confrontation; complete it and then call your personal or company medical advisor.
6. Have elective medical tests and procedures done at home on your annual leave.

Blood Usage, Blood donations and Sourcing Rare Blood Types in Indonesia

You should contact International SOS or your medical assistance company if you or your family are admitted to any hospital in Indonesia and the medical team are proposing blood products. As per WHO, screening for HIV is not universal (97%) in Indonesia and the HIV testing across all of Indonesia is not to the level of international standards, although the Red Cross is currently gradually introducing the international standard HIV test for blood screening.

If you require an urgent blood transfusion in Indonesia, the hospital will arrange for the correct blood type to be ordered. Rh neg blood is very rare in Indonesians and as such there is a volunteer blood donor committee who works with the Red Cross and can assist to organize urgent donations from a registry of volunteer expatriates in the event RH Negative blood is limited or not available.

For further information, read Blood Donations in Indonesia - Rhesus Negative Blood.

Medical Care Across the Indonesian Archipelago

If you live outside Jakarta, or are planning to travel outside Jakarta, please see International SOS's Medical Clinics and Assistance Centres listing.

For information on medical insurance, see the Medical Insurance page.

International SOS medical staff have agreed to answer medical questions related to living in Indonesia for the Ask the Experts forum. Please send your questions to us.

We trust this information will assist you in making correct choices regarding your health and welfare. However, it is not intended to be a substitute for personalized advice from your medical advisor.

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