Let Them Shine

Let them shine

If you are an expatriate who recently unloaded your luggage and are trying to settle in, you might find yourself trapped in traffic-jam and feeling the heat of Jakarta.

Soon, you will be familiar with the scene of  sad faces of children with dirty hands knocking at your car window, mumbling something that you don’t understand.  But you know straight away that they are asking for your help. When you see their dirty faces and you remember the happy faces of your children, suddenly you feel the urge to help them. Within seconds you draw out a coin and hand it to them with smile. You feel much better after they said: “thank you mister..thank you ma’am”.

Often we are oblivious that by giving them our coins, we are teaching them that begging is the easiest way to gain material benefits, rather than striving and working for achievements.   But I know your good intention.   You simply like to help the community.  You feel the need to do something to help the children, but you are not sure how…

If you ever stop by the Child Health Department of Cipto Mangunkusumo Hospital, you will see disadvantaged children who deserve our empathy.  Despite 5-stars restaurants and over-booming of foreign food chains in the metropolitan city of Jakarta, you will be surprised to see the face of malnourished children in one corner of the hospital, which you probably have seen on NGO postcards.  In a different corner, you would see children with cancer  who received delayed treatment simply because the parents could not afford treatment earlier.

As a national hospital, patients are referred from all over  Indonesia. We receive cases as far  west as Aceh and as far east as Papua.  Parents come with the high hopes of better treatment for their children.  Yet, their hopes turn once again to despair when they see the  medical bills.  The government provides some health care assistance program, but certainly to deal with the governmental insurance one would need to provide legal documents, which means only the children whose parents own ID cards and other legal documents can fulfill the criteria for these assistance programs.  Many children in the hospital are not covered by specific health-care insurance because the parents failed to show the paperwork for many reasons.  Some of these classic reasons are, the child is born out of the wedlock or simply because the parents could not afford to get married or pay legal paper for the marriage certificates. Thus a paper called ‘kartu keluarga’, (household registration card) could not be issued.  Consequently, the family does not qualify to apply for  health insurance or any assistance programs..

Two amongst some possible assistance programs available for poor family are: “Jaminan kesehatan daerah/Jamkesmas” (regional health insurance), which would cover 100% of medical treatment, but they are only provided for those underprivileged children who lives outside of Jakarta. The other is “ Surat keterangan tidak mampu/SKTM”  (insurance for the underprivileged family).

The second one mentioned, SKTM is only  limited to  families who own Jakarta ID and are proven by the local authorities to be economically poor.  However,  Jakarta consists of migrants from nearby cities and different islands who are trying to make a living in Jakarta.  This explains why many sick children have no access to appropriate medical care  The SKTM only provide 50% coverage, the family is still required to pay 50% of the medical fee.  All these schemes have been found very helpful and they have helped to alleviate the burdens, yet there are still many families who are not covered by health scheme.

When a family applies for any of medical assistance when they arrived at the hospital, the Health Department will initially need to check their eligibility and review their required documents.  After completion of paper submission, there would be a visit by a governmental officer to their house for the final proof that the family really lives in poverty.  The process requires some period of time, yet sometime there is urgency in health management. The insurance and the type given will then be granted based on their eligibility.

I would like to share three stories of children whom I have encountered.   The photographs may be disturbing and it’s not all happy endings. However, the reality is, there are many children who do not have access to proper medical care.

The first girl is a three years-old girl (picture 1) who began her treatment in our hospital half a year ago. She suffers from neuroblastoma, a malignant tumor that derives from nerve tissue. She arrived in our hospital with terminal stage cancer simply because the parents could not afford the treatment and was oblivious that the abdominal enlargement was something serious. The parents are both jobless.  Although they are finally granted the SKTM assistance program, still they can not afford half of the medical fees that’s not covered by SKTM.  One set of neuroblastoma chemotherapy treatments could easily cost US$100, which is a lot of  money in our currency, and she needs more than one set  of chemotherapy treatments, not to mention the operation and hospital costs. With the help of generous donations, she was able to continue her  chemotherapy. Sadly after battling with end-stage of neuroblastoma, she passed away on September 2011.


Picture 1
Picture 2

The second story is about a 14 years-old girl who was referred from their regional hospital. She suffered from osteosarcoma, a bone malignancy.   In addition to  intense chemotherapy,  CT scans and bone scan were needed at the time.       She was orphaned and was raised by her poor retired uncle and aunty who had no Jakarta ID.The family was discouraged with unaffordable treatments, but they then learnt about possible the health care assistance programs.  While the insurance was being processed in ‘kampung’ (village), she was able to receive further treatment with the help of donations.  Unfortunately, the cancer had progressed too far.  She passed away around 5 months ago because of the severity of the cancer.

The third story is about a small boy (as seen carried by his sister in picture 3).  This malnourished boy  HIV positive and is raised by his grandmother. His parents have long passed away, and he badly needs support for treatment. Through the generosity of anonymous  donors, these disadvantaged children finally received access to appropriate medical treatment.

Picture 3


These children’s stories are few of the many sad realities you would find in our corridors. If you have a big heart, you could drop by and see the real face of these poor children who really needs our support. You can check by yourself what you would like to do to help them and get the feeling of helping out local community.

As this note was being written, a TV channel showed a group of children who sang happily a classic children song, “This Little Light of Mine” by Harry Dixon Loes.  Somehow the lyrics spoke out loud to me as I encounter sudden writing block.  I’m not a fund-raiser, neither have I worked for any NGO’s. I am just a doctor who has been given the  opportunity to see from upclose, where help-at-hand is needed. A Teddy bear was the last wish of the girl who suffered from osteosarcoma.  I will never forget her smile as I handed her the soft toy few days before she passed away.   She smile as if singing out ‘This little light of mine…I’m going to let it shine”.  Despite the pain she endured, her smile was priceless.  Since I learnt about the donation program, I no longer feel guilty every time I shake my head in traffic lights when children put their pity face on for me.     No matter how hard they bang at the window and beg: ‘eat..eat..i want to eat’, I will not budge because I’ve found a way to help those who can’t even voice out their real needs and now I am passing it to you.

Let them shine…