Locita

Elizabeth Jane Soepardi, Kolam Ikan untuk Perbaikan Kesehatan di Asmat

PERMASALAHAN kesehatan khususnya gizi buruk di Asmat masih menjadi langkah panjang pemerintahan Indonesia, sekalipun status KLB campak telah dicabut oleh pemerintah Kabupaten Asmat, Selasa (6/2/2018).

Locita.co kemudian berkesempatan mewawancarai dr. Elizabeth Jane Soepardi, MPH, DSc di Direktorat Jendral Pencegahan dan Pengendalian Penyakit Kemenkes RI, Salemba. Dokter ini merupakan direktur Surveilans dan Karantina Kesehatan Kementerian Kesehatan.

Lulusan dari gelar Doktor Bidang Penelitian Pelayanan Kesehatan dari Erasmus University, Belanda ini sebelumnya menjabat sebagai Direktur Bina Kesehatan Anak, Ditjen Bina Gizi dan KIA sampai dengan tahun 2015 dan Kepala Pusat Data dan Informasi.

BACA juga:

Jabatan itu digelutinya sampai dengan tahun 2013. Dia turut ikut serta dalam rombongan turun langsung ke Asmat dan mengunjungi beberapa distrik dan desa mengarungi Sungai Pomats, akhir Januari kemarin.

Di dalam perjalanan itu, dia menceritakan mengenai jalan panjang meredakan permasalahan kesehatan di Asmat ini. Juga mendorong kesadaran masyarakat Asmat akan kesehatan dan kemandirian.

Sejauh ini bagaimana penanganan pasca KLB campak dan gizi buruk yang menimpa penduduk Asmat?

Mungkin sebagai latar belakang dulu jadi campak itu penyakit pada anak jadi sebelum imunisasi anak itu pasti semua sudah kena campak sebelum umur 15 tahun lah. Jadi kalau sebelum imunisasi anak itu pasti semua sudah kena campak.

Pengobatannya sebetulnya tidak ada jadi dia sangat limiting tergantung tubuh anak itu mampu bertahan lalu sembuh dan kemudian timbul kekebalan ilmiah nah sejak ada imunisasi campak tidak terkena campak lagi.

Yang kita takutkan dari campak itu dia major killer seperti di Afrika begitu ada gerakan imunisasi campak maka angka kematian anak itu drop berkat imunisasi maka angka kematian anak turun. Problemnya itu negara berkembang ialah untuk mencapai anak anak imunisasi itu termasuk kita di Jawa.

Jadi bukan susah mengakses tapi orang menolak karena tidak paham bahaya campak. Nah, kalau Papua lain lagi gak ada menolak imunisasi, problemnya adalah sulit mencapai sasaran vaksinnya gak ada masalah. Sesulit apapun nyampe di puskesmas.

Seperti contoh kemarin kita membawa tim di dalamnya ada dokter spesialis jadi diumumkan lah di gereja nanti sebentar siang ada imunisasi dan ada dokter itu penuh orang gak sakitpun minta diperiksa jadi dokter itu langka.

Kalau di Asmat saya liat cenderung dokter tinggal di kota, tapi ketika masuk ke kecamatan sudah gak ada sinyal, kalau dokter jaman dulu kan kita gak ada sinyal jadi gak masalah tapi kalau dokter muda jaman sekarang gak ada sinyal itu gak menarik bagi mereka jadi gak mau.

Nah sekarang kita ada program sama Menkominfo mereka ada program pemasangan bts di Indonesia Timur jadilah coba di setiap kecamatan ada puskemas itu pasti ada sinyal sehingga dokter guru mau tinggal.

Para keluarga penerima bantuan bahan makanan (foto: Halik Malik)

Soal kurang gizi sama juga?

Dulu Papua itu kan terkenal mereka makan sagu, mereka tebang lalu buat sagu sekarang begitu ada jadi ada bantuan besar, mereka kalau tidak membeli beras atau bantuan sekarang mereka sudah manja tidak lagi buat sagu mereka tunggu bantuan beras jadi kalau tidak ada makan seadanya.

Jadi saya perhatikan di sana ini sakitnya ini makannya tiga sekali, jadi kita dikasi tahu orang papua mereka tidak kenal waktu, tiga kali sehari misal. Mereka ada makanan di makan, untuk besok makan gak tahu lagi, apalagi disuruh minum obat. Problematika utamanya pendidikan dan budaya, dan medan yang sulit karena itu rawa-rawa.

Semua rumah di sana, jalanan serta rumah panggung di atas rawa-rawa, ini rawa- rawa sarang malaria.Kita pernah melakukan tes dari sembilan dan delapan positif malaria.  Kita punya ide seperti di Timika.

Di Timika kan dulu juga rawa-rawa ada Freeport di sana, galian mereka itu mereka pakai untuk tutupi daerah rendah sehingga sekarang di sana sudah gak ada rawa-rawa sehingg malaria di Timika juga tidak ada.

Kita punya ide di situ, kita bikin kolam ikan jadi supaya galiannya ini dibawa ke tempat rendah tadi supaya tidak tergenang lagi, lalu piara iakan mujair yang pemakan jentik, lalu yang top itu nila merah, harga jualnya tinggi kepala puskemas punya kita bikin kolam dalamnya sejak dua hari jadi.

Lalu sama sumur gali, di sana itu 2,5 meter saja air sudah keluar bagusnya dan air tawar. Jadi semua mereka bergantung tadah hujan tapi kalau gak hujan kan percuma.

Jadi kalau di pedalaman solusinya adalah sumur gali, kemudian kolam ikan untuk menghilangkan rawa menghindari malaria dan juga sumber air minum dan gizi. Tapi kalau di Agats ibukota Asmat itu kan di muara sungai kalau kita bikin sumur gali airnya air payau jadi kita merencanakan karena di sana bakau kita idenya adalah bikin penangkaran kepiting.

Terus kita lakukan imunisasi di sana penuh sekali karena ada dokter kita imunisasi sampai habis vaksin kita kasih semua vitamin A dan obat cacing.

Sedangkan tenaga kontrak gak bisa kemana mana, di rumah dinas. Rapih sekali pekerjaan mereka, kalah kita di Jawa. Kita selalu ngomong rubah budayanya memang bagaimana cara ubah budaya, di sela-sela rumah itu tanam bakau kemudian di sela sela juga ada penangkaran kepiting kayunya itu bisa dipanen saya percaya dia kan kuat memang hidupnya di air.

Memang cakupan di sana rendah, Jadi rencananya Kemenkeskan menempatkan tim semua di puskesmas akan diisi tim kesehatan.

Peran dari lembaga non-pemerintah apakah cukup membantu?

Kami tidak mengelola langsung ya, di tempat kita ada pengadaan alat suntik jadi kita minta bantu dong kita mau ke Asmat dan sudah pastilah kita butuh dan mereka langsung ngasih, kayak menggali jadi memang harus seperti ini kemudian pemberi bantuan itu foto foto ini kita kasih. Itu kolam kepiting tiga hari ya, dalam waktu tiga hari sudah 37 kolam kepiting yang dibiayai 21, lainnya mandiri.

Kami sangat terbantu dengan hadirnya lembaga-lembaga non pemerintah di sektor pelayanan kesehatan. Intinya bisa bersinergis lah.

Bagaimana menurut Ibu tentang bantuan mi instan yang ditangkap Rebecca Alice Henschke?

Kalau untuk itu saya tidak tahu

Apa sampai saat ini Asmat masih membutuhkan relawan kesehatan medis?

Saya rasa masih karena itu namanya pegawai PTT bukan sekarang gak tahu kapan, untuk kondisi darurat ini masih dibutuhkan.

Artinya temporary. Bayangkan itu ada tujuh belas puskesmas yang ada dokternya tujuh di puskesmas agats dokternya tiga kumpul di situ ada puskesmas pegawainya cuma satu sementara di Agats kota jumlahnya 47.

Soal gizi buruk?

Itu memang agak berat kita harus mengubah budayanya itu, kita yang dikirim mau masyarakat tidak cuma berharap, tapi juga menghasilkan (bekerja) contohnya kepiting tadi minimal punya pekerjaan dan penghasilan selama ini ekonominya tidak berjalan. Telur gak ada loh datang dari Timika.

Kalau begini kan Kementerian Peternakan bisa masuk tidak ada peternakan ayam sama sekali. Dan ini gak cuma di situ. Mereka dikasih uang untuk dihabiskan, gak bisa manage, maka itu dengan pendampingan bisa dicegah.

Saya yakin nanti dengan adanya sinyal dokter dokter juga bisa masuk. Jadi artinya kita orang pusat ini sudah keenakan ada SOP tapi di sana gak bisa apa-apa, gak ada, kita jadi mikir.

Kasihan asmat itu kalau gak ada kejadian ini.  Gak ada yang tahu loh, padahal ini sudah sejak dulu loh, berarti ini kan ada pembiaran, yang saya heran orang pusat yang sudah pernah masuk ke Asmat kok cuma diam saja.

Ini kan di sana tim ketiga berikutnya tim keempat nanti fokus air minum di Agats akan dibuat sumur-sumur besar dengan teknologi air payau akan diubah air tawar.

Ada informasi perubahan pangan?

Jangankan mereka kita di perkotaan itu tiga kali sehari makan mi instan, enak dan murah kan? Kalau mereka disuruh nanam mendingan beli, gak mikir kan dia gizi. Ini kita berharap dengan rawa rawa dipadatkan harus ada pertaniaan tanam ubi, ini saya gak tahu karena di Asmat rawa. Gak bisa.

Sagu mereka malas karena sudah ada bantuan beras, nah kita harap mereka mau bertanam ubi, karena itu lebih bagus dari beras. Inikan kita punya ilmu yah, semua yang tumbuh ke atas padi, gandum, jagung itu kalu kita makan selesai kenyang ngantuk dan gak bisa pikir.

Itu sebabnya dulu belanda dulu kan orang Indonesia itu makannya ketela, nah pas beras masuk dari China, Belanda biarkan saja. Sementara yang tumbuh ke bawah kentang ubi, talas tu kita kalau makan gak jadi ngantuk itu sebabnya belanda tetap makan ketela.

Baiknya itu kita membuat gerakan kembali lagi ke ketela. Itu kemarin kan menpan menyerukan makan singkong, harusnya diceritain apa bagusnya makan singkong itu.

Penyuluhan kesehatan kepada anak-anak Asmat (sumber foto: Halik Malik)

Sejauh ini apa lagi upaya dari Kementerian untuk menangani KLB ini agar tidak terulang kembali?

Untuk infrastruktur kebutuhan untuk pelayanan kesehatan akan ada penempatan tim di puskesmas di kabupaten nanti akan ada pendampingan dari pusat, modelnya di dampingin saja karena dalam bekerja.

Terus soal ini kan saya pernah baca statemnet bahwa KLB ini akan terjadi juga di daerah lain misal Yahukimo? Kita sudah merencanakan memetakan cakupan yang rendah itu akan turun tim lagi seperti ini. Memang sudah dikerjasamakan dengan TNI ini nanti ditempatkan setelah Asmat dan TNI merencakan 17 kabupaten selama 9 bulan berarti akan ada simultan.

Kabupaten lain tidak terjadi KLB kan. Cuma kalau dibiarkan akan terjadi ini kan Asmat itu jadi pengalaman kok rendah dibiarkan, kita dulu alasannya tidak ada sinyal padahal belum tentu, ini berarti kan harus ngecek dikunjungi.

Dhihram Tenrisau

Dokter gigi di klinik BPJS

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