My Visit to Indonesia -12th to 18th October 2015. I was invited to Indonesia in October 2015 soon after my visit to Singapore. This was for a training session to nurses doing an ETN course in a town of Bogor ( 100 kms from Jakarta ) conducted by WOCARE,seminar on Stoma Care in Jadwal (near Jakarta) for nurses & ostomates , Meeting with Dr Benny Philippi ( Senior Cancer surgeon & founder of Cancer Society of Indonesia as well as Indonesia Ostomy Association -InOA) meeting with directors of Cancer Society of Indonesia in Jakarta) and WOD celebration in Bali on 16th & 17th October 2015.

Back ground information:Indonesia is a largest island country of the world. There are 17000+ islands out of which 6000+ are not habited. They are situated on both sides of equator. The largest are Java, Sumatra, Borneo (shared with Brunei and Malaysia), New Guinea (shared with Papua New Guinea), and Sulawesi. Indonesia shares land borders with Malaysia on Borneo, Papua New Guinea on the island of New Guinea, and East Timor on the island of Timor. Its population is about 255 millions. It has multi religious country but approx.88% are Muslims.10% are Christians and very small persantage are Hindu, Buddhist etc. It is ethnically & linguistically very diverse country with around 300 distinct native ethnic groups, and 742 different languages and dialects. It became independent from Dutch colony in 1949 but fair & free democracy started only in 1999. Majority people are economically poor.

In the year 2000-2001 economic down turn occurred therefore ostomy products became very difficult to get in Indonesia. Therefore Dr Benny Philppi a senior cancer surgeon who had started a Cancer society of Indonesia , also formed a Indonesia Ostomy Association ( InOA) some time in 2001-02 to help the ostomates find ostomy products from different countries of the western world.

There are about 5000 ostomates in Indonesia & they have two ostomy support groups. Original InOA based & supported by Cancer Society of Indonesia in Jakarta and 2nd is SOS ( Stoma nurse Ostomy Support group based in Bogor about 100km away from Jakarta.The current president of InOA is Mr Muhammad Abduh & of SOS group is Mrs Yuliana Trihartati. SOS group is supported & affiliated by WOCARE in Bogor.

Both association have in their office stoma clinic. For InOA it is in the premises of Cancer Society of Indonesia & for SOS group it is in the premises of WOCARE in Bogor.

Even at present there are no major companies who sale ostomy products & ostomy products are very expensive to buy i.e. what is available at US $ 30-50 in India , the same product in Indonesia is available around US $ 200.So majority of ostomates are dependent on the ostomy products from donations from Australia, New Zealand or FOWs. Majority of ostomates are Colostomates as Cancer is the commonest indication for stoma creation. Yet they don’t have Irrigation sets available locally. Recently one multy national company has appointed a local distributor in Jakarta .

Indonesia has done extremely well in training nurses from different provinces & approximately about 200-250 fully trained ET nurses are present all over Indonesia.This is largely because of lot of hard work & vision of Mrs Widasari Sri Gitarja ( ETN & CEO of WOCARE ) of Indonesia based in Bogor. She conducts several ET nurse training programme through-out the year for last many years & gives excellent practical & hands on training in stoma, wound & continence care. She has excellent relations with ETNs from Australia as well as Malaysia who help her in their training program. She also helps ETNs to settle down in their home town & has excellent relationship with all her students. She has created many trainers as well from these ETNs. Indonesia is perhaps amongst very few countries of the world where ETN are in private practice. They provide home or community care to their patients as patients are not in position to come to their clinics.

Training Program in Bogor: During my stay in Jakarta/ Bogor I was privileged to teach few nurses who were doing their ETN course run by WOCARE. This course was for 8 weeks of theory & hands on training in their stoma clinic followed by exclusive practical training in the stoma clinic managed by WOCARE for next few weeks. Inclusive in the Course was a 8-10 days of training in UMMC stoma centre in KL, Malaysia under the guidance of Matron Mariam Mohd Nasir of UMMC.

I did speak on “ Digestive system & creation of digestive stomas” , “ Paediatric Stomas”, “Role of ASPOA in stoma Care in Asia”, “ Urinary Stomas”. Some time some points had to be translated in Bahasa Indonesia (Local language), a variant of Malay. I did visit their stoma clinic as well which is well equipped. I had opportunity to do a home visit to see & councell an ostomate as well one evening.

Next day we had a meeting with nurses & ostomates (about 100 ) in Jadwal town near Jakarta. Many topics were discussed amongst which were “Role of Stoma Nurse as a ostomy coach” , “How I looked after my stoma and life- Personal experience of 40 years” ( By Dr Buch), “ Fund Raising” ,“Patients stories” followed by Q.& A.

Same afternoon Mrs Widasari, Mr Hamka ( ETNs) few others had a lunch meeting in Jakarta with Dr Benny Philippi. He is a very pleasant & friendly person who genuinely wants to improve QOL of ostomates in Indonesia. He has trained many surgeons in Indonesia.We had a good discussion about History of ostomy support group in Indonesia, How ASPOA/ IOA can help Indonesian ostomates, Customs duty exemption, Role of Cancer Society, Advocacy & help from ASPOA/ IOA etc. We became friends instantly. He also arranged my meeting with the directos/ Board members of Indonesian Cancer Society next morning to discuss about how to improve QOL of ostomates in Indonesia and various difficulties they have & their solutions.

I had three hours meeting with Director/ Board members of Cancer Society in Jakarta which included Dr Dieta,Mrs Widasari, myself, Dr Rebecca Angka of Cancer clinic, Dr Yumi Satria head of Training & information dept., Mr Muhammad Aduh ; President of InOA,& Mrs Yuliana Trihartati, President of SOS, Bogor & many others. They have excellent large premises & facilities including chemotherapy centre, Screening facilities for different cancers

like Lung, Prostate, Colon & Rectum, Cervix, Breasts etc. They also have accommodation for few patients who come for chemotherapy from faraway places. They get custom duty free donations of chemotherapy drugs for treating cancer patients.

We had very good discussion about how ASPOA/ IOA can help them to get free donation of ostomy products if they can get a letter for tax exemptions on donations from foreign countries & advocacy program. We also discussed “Visitor training Program” , Colon & Rectum cancer prevention program by organising Faecal occult Blood tests in large numbers in community just like Singapore Cancer Society has done. We discussed how to approach government through prominent doctors, Lions Clubs presidents, Rotary Clubs presidents & those who can influence law makers. They promised to do the work needed to get paper work sorted out to get tax free donations of products for ostomates.

Mrs Widasari & I flew to Bali for WOD celebrations in the same afternoon. We were received by local ET Mr Vijaya who is in private practice with a stoma clinic in Bali. We had early dinner on one of the finest Beach restaurant before we checked in to our hotel resort.

I visited some Hindu temples next morning before WOD celebrations starting in early afternoon. Bali is a very big island & has 90% of its populations as Hindu because in ancient time Hindu saints & Kings visited Bali.

I have attached a detailed WOD report written by Mr Vijaya ( ETN of Bali). There were a program of Traditional dance & music, Sharing of stories by ostomates, Lectures by health care professionals, Humour, Sharing of experience by different nurses from Bali & other parts of Indonesia & one who came from Australia ( City Near Melbourne) as well who is helping ostomates of Bali & ETNs of Bali to improve their skills & knowledge.

This was followed by nice gala dinner.

Next day they had organised watching of sunrise around 5-30am which was beautiful across the sea. This was followed by some games for all the ostomates which was quite fun. We had nice group photograph as well on the beach. After breakfast every one said goodbye to each other & departed for their destinations.

I stayed one extra day for some sight- seeing with Mr Vijaya. We went to a religious communal bathing & prayer place in Bali & a monkey forest near Vijaya’s in-laws town & in-fact visited them to see typical local house. It was a very nice heart full experience with excellent hospitality. I had a chance to visit Mr Vijaya’s private stoma clinic which is very spacious & well equipped to look after ostomy patients & look after various kinds of wounds of the patients as well. I had a chance before going to airport visit his elderly mother & his wife & two young sons as well in their home.

This was the most satisfying my first visit to Jakarta & Bali in Indonesia & I have made many friends there.

Dr Harikesh Buch, Mumbai.

ETN training , BOGOR, Indonesia, October-2015

ETN training in Bogor, Indonesia Oct.2015

Innovative teaching tools,Bogor October 2015

Outside WOCARE Office, BOGOR, October 2015

With Prof. Benny Philippi (In the middle), Jakarta,October 2015

With Members of Indonesian Cancer Society, October2015

Members of Indonesia Cancer Society, Jakarta, October 2015

WOD October 2015 Bali, Indonesia

WOD, 2015, Bali, Indonesia

REPORT  OF  WOW  OMG:  AN  EVENT  TO  SUPPORT  EACH  OTHER  OCTOBER  2015  FROM  BALI-­‐  ETN  Mr.  VIJAYA  

Participants in WOD-2015, Bali, Indonesia

WOW  OMG:  AN  EVENT  TO  SUPPORT  EACH  OTHER    

World  Ostomy  Worldwide  Ostomy  Meeting  and  Gathering  or  WOW  OMG  is  a  term  that  is  used   for   an   event   meeting   of   ostomate   for   celebration   world   ostomy   day   in   October   2015.   This  event   has   been   held   two   days   on   Friday   16th   until   Saturday   17th  October   2015   at  Grand   Inna   Bali  Beach   Sanur,   Denpasar,   Bali,   Indonesia.   WOW   OMG   was   organized   by   Dharma   Mulia   Husada  Foundation   (Dhalia   Care)   Bali   and  Wocare  Centre  Bogor.   This  meeting  has   the   theme   “share   your  great   experience   and   compassion”.   This  meeting  was   the   first   time   that  we   held   in   Indonesia   for  celebrating  world  ostomy  day  in  October.                                  

Yogyakarta  Surabaya  

Manado  

INDONESIA  

Participant  Region  in  WOW  OMG    

This  event  was  attended  by  50  people  who  consist  of  ostomate  and  family  in  various  regions  Indonesia   including   stoma  nurses  and  general  nurses  also   joined   to   support   the  ostomate.  Almost  fifth  teen  ostomate  with  one  of  their  family  came  to  this  event  from  Lampung,  Jakarta,  Yogyakarta,  and  Surabaya  and   for   the   stoma  nurse  also  general  nurse   from   Jakarta,  Bali   and  Manado.  We  are  very  pleased  and  appreciate   to  our   friend   from  Malaysia   and  Australia   two  people  were   joined   in  celebrating   in   World   Ostomy   Day.   Some   nursing   students   from   Nursing   Academy   also   came   as  committee  and  enjoy  together  celebration  of  World  Ostomy  Day.    

 Participant   Region   Number  Ostomate   Lampung   1  

Jakarta   6  Yogyakarta   2  Surabaya   5  

Bali   1  

Ostomate  Family     8  Stoma  Nurse   Semarang   2  

Jakarta   2  Bali   1  

Malaysia   2  General  Nurse   Jakarta   5  

Bali   7  Manado   1  Australia   2  

Nurses  Student   Bali   5  TOTAL   50  

 

Table  of  Participants  WOW  OMG    

We  have  two  keynote  speakers   in  this  event.  First  keynote  speaker   in  this  meeting  was  dr.  Harikesh  Buch  from  India  as  president  of  International  Ostomy  Association  (IOA).  He  is  a  doctor  also  ostomate  that  gave  information  about  developing  ostomate  organization  around  the  world.    He  also  gave  us   solution   to  make  one  group  or  organization   in   Indonesia   so   that   the   government  will   see  how     is   ostomate   and   they   can   support   .The   second   speaker   was   Puan  Mariam  Mohd   Nasir   and  Rahime  from  Malaysia  as  Stoma  Nurse  that  gave  ostomate  how  to  keep  spirit  and  improve  quality  of  life.  Ners  Widasari  Sri  Gitarja  from  Wocare  Centre  Bogor  and  Ners  I  Made  Sukma  Wijaya  from  Dhalia  Care  also  share  their  experience  in  this  meeting  to  raise  the  spirit  of  all  participants.

All   participants   enjoyed  WOW  OMG   for  World   Ostomy   Day   celebration   in   two   days.   This  event  was  held  at  Grand  Inna  Bali  Beach  adjacent  to  Sanur  Beach,  Bali  so  all  ostomates  can  enjoy  the  beautiful   scenery   of   the   famous   beach   with   white   sand   and   fantastic   sunrise.   In   the   first   day   all  participant  have  got  information  and  sharing  their  experiences  from  two  speakers  in  talk  show  and  then  continue  with  dinner  and  entertainment  with  Balinese  dancing  and  instrumental  music.  In  the  second  day  all  participant  saw   fantastic   sunrise  and  game   for  exercise.  Then  we  close  WOW  OMG  event  with  engaging  all  participants  to  souvenir  shop  and  lunch  at  Oleh  Oleh  Krisna.  

   

 

 

 

 

 

   

 

 

 

 

 

 

   

From ETN Mr Vijaya : Dhalia Care Clinic, Nursing Practice in Wound, Ostomy &Continence Care,Jl.Buluh Indah No. 38,Denpasar-Bali, Phone ; +62 85 100 657778 , Email: dharmamuliahusada@gmail.com