WHO Warns of Possible Dengue Outbreak Amid Jakarta Floods

The World Health Organization has advised the Jakarta administration to monitor cases of water-borne communicable diseases among flood-affected victims, warning that a delay in treatment could pose more serious health risks.

While the international health body praised the city’s quick reaction to set up more than 60 emergency health posts following the intense flooding on Thursday, the WHO reminded officials to ensure people had access to clean water and essential medicines to prevent any possible health outbreaks such as dengue fever.

“Floods do not necessarily lead to an immediate major increase in mosquito numbers, however it is important to track weekly case numbers and provide laboratory-based diagnosis to pick up the early stages of an epidemic,” WHO representative to Indonesia Khanchit Limpakarnjanarat told the Jakarta Globe on Saturday.

At least 17 people were reportedly killed during the floods, which displaced 18,000 people from their homes at its peak.

On Friday, the Jakarta Health Agency chief Dien Emawati said up to 8,000 flood victims in Jakarta had complained about a number of flood-related diseases, mainly coughs and colds, muscle aches and skin rashes.

The WHO, which cited diarrhea, skin infections, influenza, conjunctivitis and leptospirosis as common illnesses among flood victims, suggested the Jakarta administration distribute leaflets informing people about how to avoid these diseases.

“It is highly important to inform people that they have to seek medical help or go to the nearest clinic as soon as possible when they or someone around them develops any symptoms like a fever, cough, diarrhea, red eyes, or jaundice,” Limpakarnjanarat explained.

As of Sunday, floods receded in most areas, except for places such as Grogol in West Jakarta, Prapanca in South Jakarta and Pluit in North Jakarta.

The National Disaster Mitigation Agency (BNPB) has warned that flooding in the capital could continue until mid-February.

(source: www.thejakartaglobe.com)

Menkes Ajak Pejabat Kalbar Stop Merokok

Singkawang – Maksud hati hajatan berdialog masalah kesehatan dengan para pejabat Kota Singkawang. Ternyata Menteri Kesehatan Dokter Nafsiah Mboi SpA MPH lebih banyak bicara mengajak Gubernur Cornelis dan Walikota Awang Ishak beserta para perokok di Bumi Khatulistiwa ini untuk berhenti merokok.

“Hendaknya kita dapat membujuk orang lain untuk tidak merokok. Bagi yang sudah merokok untuk segera berhenti merokok,” kata Nafsiah dalam dialog mengisi kunjungan kerjanya di Hotel Mahkota Singkawang, Sabtu (19/1).

Bujukan itu disampaikan Menkes di hadapan Walikota Singkawang Drs H Awang Ishak MSi, beserta jajarannya, Gubernur Kalbar Drs Cornelis MH yang diwakili Kepala Dinas Kesehatan Kalbar dr Andi Jap, beserta para undangan yang menghadiri kegiatan bertajuk “Dialog Menkes RI bersama Pemkot Singkawang, Pemkab Bengkayang dan Sambas” itu.

Belum jelas apakah ajakan Menkes ini ada kaitannya dengan disahkannya Undang-Undang Cukai Tembakau atau dampak mantan Menkes Endang Rahayu mengidap kanker paru-paru akibat merokok pasif, maupun rencana kenaikan harga rokok.

Namun, baik Walikota Awang Ishak yang mengawali sambutan dalam kegiatan tersebut maupun Kadiskes Andi Jap yang membacakan sambutan Gubernur Cornelis, sama sekali tidak menyinggung permasalahan rokok.

Tetapi, Nafsiah dengan keras dan bersemangat menyampaikan kampanye anti rokoknya. Padahal kunjungannya yang tiba kesorean di Singkawang butuh masalah kesehatan dibahas lebih tuntas.

“Kalau tadinya penyebab kematian itu karena penyakit-penyakit infeksi, justru sekarang yang besar itu penyakit terkait rokok. Di antaranya stroke, jantung, tumor, kanker paru-paru dan sebagainya. Semua ini begitu menyedot dana pengobatan yang luar biasa,” kata Nafsiah.

Kalau masyarakat berani mengatakan menolak rokok, tegas Nafsiah, maka triliun rupiah bisa dipakai untuk meningkatkan mutu hidup dan kesehatan rakyat Indonesia. “Daripada dihabiskan di rokok yang menyebabkan penyakit,” katanya disambut tepuk tangan peserta dialog.

Menkes yang menggantikan posisi Endang Rahayu Sedyaningsih yang tutup usia karena kanker paru-paru ini juga menyampaikan kekagumannya kepada Provinsi Kalimantan Timur (Kaltim) yang berani mendeklarasikan Kawasan Tanpa Rokok.

Nafsiah menceritakan, dia diminta mendeklarasikan Kawasan Tanpa Rokok di Kaltim. Di provinsi tetangga Kalbar itu, gubernur beserta jajarannya, eksekutif dan legislatif, NGO, tokoh-tokoh agama betul-betul mempertahankan bahwa di sana terdapat Kawasan Tanpa Rokok.

“Di mana kita bisa bernapas dengan bebas. Jangan kita bernapas dalam ruangan yang penuh dengan asap rokok yang merusak paru-paru dan tubuh kita,” katanya.

Dia menyatakan rasa bahagianya atas deklarasi Kawasan Tanpa Rokok di Kaltim itu. Menurutnya, hal itu merupakan suatu yang baru dan baik bagi dirinya dan rakyat Kaltim. “Mudah-mudahan di Kalbar juga nanti ya, Pak,” tegas Nafsiah.

Nafsiah betul juga, boleh jadi dia sudah menerima informasi sejumlah pejabat di Kalbar itu penggemar rokok. Sebut saja Awang Ishak paling doyan Gudang Garam Surya 16, Haji Dol sang wakil pengisap berat Sampoerna Mild dan Djie Sam Soe. Direktur RSU Abdul Azis malah mengisap rokok putih Lucky Strike.

Setelah panjang lebar membahas tentang rokok, Nafsiah hanya menyenggol beberapa permasalahan lain di dunia kesehatan. Dia lebih mengharapkan peserta dialog menyampaikan beberapa hal-hal yang menjadi permasalahan kesehatan di wilayah Singkawang, Bengkayang, dan Sambas (Singbebas). (dik)

(sumber: www.equator-news.com)

Setiap Orang Berhak Peroleh Layanan Kesehatan

BANDUNG, (PRLM).- Semangat Rancangan Peraturan Daerah (Raperda) Jaminan Pemeliharaan Kesehatan Masyarakat (JPKM) yang diusulkan Komisi E Dewan Perwakilan Rakyat Daerah (DPRD) Jawa Barat (Jabar) secara eksplisit sudah ada dalam Undang-Undang Dasar (UUD) 1945 pasal 28 H ayat 1. Di dalamnya dinyatakan setiap orang berhak hidup sejahtera lahir dan batin, bertempat tinggal, dan mendapat lingkungan yang baik dan sehat, serta berhak memperoleh pelayanan kesehatan.

“Tidak hanya itu, dalam UU No 11/2009 tentang Kesejahteraan Sosial juga dinyatakan hak warga Indonesia yaitu, hak atas jaminan sosial, termasuk asuransi sosial, hak atas standar kehidupan yang memadai, hak untuk menikmati standar kesehatan fisik dan mental yang tertinggi yang dapat dicapai,” kata Anggota Komisi E DPRD Jabar, Syarif Bastaman, terkait pengajuan Raperda JPKM.

Raperda JPKM ini terdiri dari 10 bab dan 23 pasal dengan ruang lingkup kepesertaan, hak dan kewajiban peserta, hak dan kewajiban pemberi layanan kesehatan, iuran biaya dan biaya pertanggungan, badan penyelenggara JPKM, pembinaan dan pengawasan, ketentuan penyidikan, ketentuan pidana, dan ketentuan penutup.

Dalam rancangannya, Komisi E menulis, kepesertaan JPKM adalah wajib bagi seluruh warga Jabar. Setiap peserta nantinya memiliki kartu peserta dan memberikan iuran setiap bulan sesuai ketentuan. Iuran masyarakat miskin akan ditanggung oleh pemerintah provinsi, pemerintah kab/kota serta sumber lain sesuai aturan. Sedangkan iuran kelompok informal tidak mampu akan ditanggung pemerintah daerah dan peserta.

Dengan begitu, setiap peserta akan berhak mendapat pelayanan kesehatan komprehensif sesuai paket manfaat yang ditetapkan dan mendapat pelayanan yang baik sesuai standar yang ditentukan UU dan peraturan. Pemberi pelayanan kesehatan (PPK) dalam raperda ini wajib mematuhi mekanisme rujukan berjenjang, memberi pelayanan kesehatan kelas tiga bagi peserta JPKM, dll.

(sumber: www.pikiran-rakyat.com)

Infectious diseases remain key agents of the debilitating poverty – WHO

The World Health Organization (WHO) 2012 Global Report for Research on Infectious Diseases of Poverty says infectious diseases remain key agents of the debilitating poverty afflicting so much of the world today.

The report, which was made available to the Ghana News Agency on Thursday says, each year these diseases kill almost nine million people, many of them children under five, and they also cause enormous burdens through life-long disability.

It notes that stepping up research into their causes and how to effectively treat them and prevent them from spreading can have an enormous impact on efforts to lift people out of poverty and to build a better world for future generations.

The report outlines ten areas where research on infectious diseases of poverty can make major improvements; these form the framework for the rest of the report.

It also focuses on specific themes: the environment, health systems, and innovation and technology.

Implementation of the actions proposed in this report should help improve current research prioritization processes, guide investment strategies and enhance commitment to using research to promote global health equity.

Like the Millennium Development Goals, these options for action are focused on by policy-makers, funders and researchers, they should lead to well-planned, effective, and powerful health interventions and have a real chance of saving millions of lives in years to come.

The global report for research on infectious diseases of poverty is an independent publication comprising different viewpoints written by expert authors.

It was initiated and facilitated by the Special Programme for Research and Training in Tropical Diseases, supported by the European Commission, and based on wide contributions from stakeholders at various stages of the work.

It offers new ways of improving public health in low and middle income countries, with research as the compelling foundation and driver for policies. GNA

(source: vibeghana.com)

WHO sees major progress in battling neglected tropical diseases

Jan 16, 2013 (CIDRAP News) – The world has made “unprecedented” progress in the last few years in the battle against neglected tropical diseases (NTDs), with two maladies targeted for eradication within the next 7 years, the World Health Organization (WHO) said in a report released today.

The WHO has set its sights on eradicating guinea-worm disease (dracunculiasis) in 2015 and doing the same to yaws by 2020, according to the report. Five other diseases are targeted for elimination—stopping transmission in a defined region—in 2015.

The diseases are two of 17 NTDs on the WHO list, all of them infections that are or were common in tropical regions where poverty is widespread.

The campaign against the diseases has gained momentum since the WHO issued its first report on the topic in 2010 and especially since the “London declaration” on NTDs was signed a year ago, the agency said. The declaration spurred commitments by affected countries, global health initiatives, funding agencies, philanthropists, drug companies, and the scientific community.

“The prospects for success have never been so strong,” WHO Director-General Margaret Chan, MD, said in a foreword to the report. “Many millions of people are being freed from the misery and disability that have kept populations mired in poverty, generation after generation, for centuries.

“We are moving ahead towards achieving universal health coverage with essential health interventions for neglected tropical diseases, the ultimate expression of fairness. This will be a powerful equalizer that abolishes distinctions between the rich and the poor, the privileged and the marginalized, the young and the old, ethnic groups, and women and men.”

The NTDs include nine diseases caused by microbial pathogens such as bacteria, viruses, and protozoans; examples are Chagas disease, dengue, leishmaniasis, leprosy, rabies, and trachoma.

Another nine diseases on the WHO list are caused by “macroparasitic” pathogens, mostly worms. They include dracunculiasis, cystercicosis, echinococcosis, schistosomiasis, and soil-borne helminthiases, among others.

“Eradication of guinea worm is in sight,” the WHO said in a press release. The infection is a crippling disease caused by a long, thread-like worm that people contract by drinking water contaminated with infected water fleas. Only 521 cases were reported from January through September of 2012, compared with 1,006 cases for the same period in 2011, the agency said.

In the 1980s guinea-worm disease was endemic in 20 countries, but by 2011 it was confined to four: South Sudan, Chad, Ethiopia, and Mali. No medicine or vaccine is effective against the disease, but the WHO believes it can be eradicated through a set of public health measures.

Yaws, the most common of three diseases caused by Treponema bacteria, was greatly reduced in the 1950s and 1960s, but it resurged in the 1970s after efforts flagged, the report says. The disease mainly afflicts children and is not fatal but can cause crippling and disfiguring deformities.

The disease can be effectively treated with a single oral dose of azithromycin or, if that’s not available, a single injection of long-acting benzathine benzylpenicillin, the report says. “Consequently, yaws has been targeted for eradication by 2020.”

The agency plans to launch the eradication drive with large-scale treatment drives in parts of Cameroon, Ghana, Indonesia, Papua New Guinea, the Solomon Islands, and Vanuatu. The experience gained in those efforts will guide further steps.

In other observations, the report says rabies has been eliminated in several countries through dog vaccination campaigns, and the WHO is “eyeing” regional elimination by 2020.

Chan commented that many of the diseases persist in the same countries, which “emphasizes the need to deliver preventive chemotherapy as an integrated package.” She said funding is increasingly designated for programs involving integrated delivery of drugs for multiple NTDs.

In 2010, 711 million people received treatment for at least one of four diseases (lymphatic filiariasis, onchocerciasis, schistosomiasis, and soil-borne helminthiases) that are marked for preventive chemotherapy with single-dose medicines, according to the WHO press release.

One disease that is a long way from elimination or control is dengue, caused by a mosquito-borne virus. In 2012 it ranked as the fastest-spreading vector-borne viral disease, with a 30-fold increase in the past 50 years, the report notes. More than 125 countries reported dengue cases last year, and in 2011 there were more than 2 million cases, with 4,248 deaths.

The WHO’s dengue goals include reducing deaths by 50% and cases by 25% by 2020, using 2010 numbers as the baseline, the report says. There is no specific treatment and no vaccine for the disease, although vaccines are in development.

“The world needs to change its reactive approach and implement sustainable preventive measures” for dengue, such as surveillance and outbreak response, mosquito control, and future vaccine implementation, the agency said.

(source: www.cidrap.umn.edu)

Mendesak, Reformasi Sistem Kesehatan

JAKARTA – Masih adanya kasus kelalaian medik membuat penataan sistem kesehatan yang mengutamakan keselamatan pasien perlu segera dilakukan. Dugaan kelalaian medik bisa dipicu kurangnya komunikasi, rendahnya kompetensi tenaga kesehatan, buruknya manajemen fasilitas layanan kesehatan, hingga lemahnya pengawasan.

Desakan itu muncul dalam rapat dengar pendapat (RDP) Komisi IX Dewan Perwakilan Rakyat dengan Direktorat Jenderal Bina Upaya Kesehatan Kementerian Kesehatan, juga RDP Umum dengan Ikatan Dokter Indonesia (IDI), Konsil Kedokteran Indonesia (KKI), Majelis Kehormatan Disiplin Kedokteran Indonesia (MKDKI), keluarga korban, dan pengelola rumah sakit (RS) tempat dugaan kelalaian medik terjadi, Selasa (15/1).

Dugaan kelalaian medik yang dibahas dalam RDP dan RDP Umum adalah kasus RAP (10) di RS Medika Permata Hijau, Jakarta. Setelah menjalani operasi usus buntu yang dilakukan secara mendadak tanpa pendapat kedua (second opinion) dari dokter lain, 22 September 2012, pasien kini tak bisa melihat, bicara, mendengar, ataupun merespons. Pengelola RS mengatakan, pasien mengalami alergi obat sehingga denyut jantung sempat terhenti.

Kasus lain menimpa EMD (10 bulan) di RS Ibu dan Anak Dedari, Kupang, Nusa Tenggara Timur (NTT). Setelah operasi kasus invaginasi usus (masuknya bagian pangkal usus ke ujung usus), korban mendapat transfusi darah langsung ke vena. Setelah itu, fungsi napas pasien turun dan akhirnya meninggal akibat perdarahan di seluruh organ tubuh.

Kasus lain terjadi pada MS (52) di RS Santa Elisabeth, Medan, Sumatera Utara. Setelah dikuret karena pendarahan di luar menstruasi dan dugaan adanya kista, kandung kemih pasien tersayat hingga kencing tak bisa dikontrol. Setelah dirawat di RS lain, kini pasien harus kencing melalui kateter yang dipasang permanen di ginjal. MKDKI memutuskan ada kelalaian medik dan KKI sudah mencabut surat tanda registrasi (STR) dokter yang pertama melakukan operasi selama dua bulan.

Tempat mengadu

Wakil Ketua Komisi IX DPR yang memimpin sidang, Nova Riyanti Yusuf (Partai Demokrat/ DKI Jakarta II), mengatakan, kasus kelalaian medik yang terungkap umumnya melibatkan pasien dari kelompok ekonomi menengah atas. Pasien miskin lebih banyak pasrah.

Jika ada dugaan kelalaian medik, kata Ketua Divisi Pembinaan Konsil Kedokteran KKI M Toyibi, masyarakat dapat mengadu ke MKDKI-KKI atau ke Majelis Kehormatan Etik Kedokteran (MKEK)-IDI. Pelanggaran yang ditangani MKDKI menyangkut disiplin. Sanksi berupa peringatan tertulis hingga pencabutan STR sementara yang membuat dokter tak bisa praktik.

Pelanggaran yang ditangani MKEK terkait etika. Selain ke MKDKI dan MKEK, korban juga dapat mengadu ke polisi/pengadilan secara pidana atau perdata. Ketiga proses dapat berjalan simultan di ketiga lembaga.

Ketua MKDKI-KKI Ali Baziad mengatakan, pada 2006-2012 ada 183 pengaduan dugaan kelalaian medik. Namun, hanya 88 pengaduan yang dapat diproses dan melibatkan 121 dokter. “Kurangnya komunikasi dokter dan pasien memunculkan banyak ketidakpuasan layanan,” katanya.

Dari 121 dokter itu, hanya 57 orang yang terbukti melanggar disiplin. Dari jumlah itu, hanya 26 dokter yang dicabut sementara STR-nya. Jika tak kompeten, dokter sebaiknya merujuk.

Ketua Yayasan Lembaga Konsumen Indonesia NTT Marthen L Mullik mengatakan, kelalaian yang dilakukan tenaga kesehatan dipicu buruknya manajemen RS. Karena itu, RS tempat terjadinya pelanggaran juga perlu mendapat sanksi dan pembinaan.

Anggota Komisi IX DPR Endang Agustini Syarwan Hamid (Partai Golongan Karya/Jawa Timur V) menambahkan perlunya dokter dan RS mengedepankan empati pada pasien korban dugaan kelalaian medik. Pasien datang untuk mencari kesembuhan dan dokter adalah manusia biasa yang bisa salah.

Menyikapi terus adanya kasus kelalaian medik, Ketua Umum IDI Zaenal Abidin mengatakan pentingnya pembinaan tenaga kesehatan oleh setiap organisasi profesi dan pemerintah, baik dalam persoalan etika, disiplin, maupun kompetensi. “Dokter juga dilindungi hukum saat bekerja sesuai standar profesi,” katanya.(MZW)

(sumber: health.kompas.com)

Komisi IX: Tak ada Data Komprehensif Terkait Malpraktik

Metrotvnews.com, Jakarta: Komisi IX sebagai komisi yang membidangi masalah kesehatan, sering kali mendapat surat pengaduan dari masyarakat terkait masalah kasus medis. Pada hari ini, Selasa (15/1), Komisi IX mengadakan rapat dengar pendapat (RDP) dengan mengundang Direktur Jenderal Bina Upaya Kesehatan (BUK), Ketua Umum Ikatan Dokter Indonesia, Ketua Konsil Kedokteran Indonesia, dan beberapa korban kasus dugaan malpraktik yaitu kasus SS di Rumah Sakit Es Medan, kasus MR di RS MPH Jakarta, dan kasus ED di RS Ddr Kupang.

Nova Riyanto Yusuf, Wakil Ketua Komisi IX dari Fraksi Partai Demokrat, pimpinan RDP, menyadari bahwa tidak ada data komprehensif mengenai kasus dugaan kelalaian medik di Indonesia. Kalaupun ada data tersebut, menurutnya seperti fenomena gunung es. Hal tersebut masih sebatas kasus yang terdokumentasikan, masih banyak kasus lain yang tidak terdokumentasikan, baik karena keluarga korban tidak mau melaporkan kasus yang dialami kepada pihak yang berwenang maupun keluarga korban tidak tahu harus melapor kemana.

Komisi IX menurut Nova Riyanto Yusuf sepakat diperlukannya suatu reformasi di bidang pelayanan kesehatan. “Saya sangat memahami harapan tinggi masyarakat terhadap dokter. Bagi sebagian masyarakat, seorang dokter bahkan dianggap seperti setengah dewa yang akan menyembuhkan penyakit,” ujar Nova yang juga berprofesi sebagai seorang dokter.

Namun, di sisi lain, saat ini masyarakat sudah semakin pintar dan kritis. Berbagai peraturan perundang-undangan yang mengatur masalah kedokteran dapat dengan mudah diunduh dari internet. Untuk itu Nova mengajak para teman sejawat untuk terus berusaha meningkatkan kualitas pelayanan, juga tidak lupa mempelajari regulasi yang berlaku agar tidak terjeblos dalam potensi kelalaian medik.

Komisi IX berharap tidak ada lagi martir sebelum berbenah untuk meningkatkan kualitas pelayanan kesehatan di Indonesia.

Setelah mendengarkan keterangan dari berbagai narasumber, termasuk orang tua korban MS dan ED, Komisi IX mendorong pihak Kementerian Kesehatan RI dan Konsil Kedokteran Indonesia, melalui Majelis Kehormatan Disiplin Kedokteran Indonesia, untuk segera memutuskan berbagai kasus dugaan kelalaian medik yang terjadi dengan seobyektif mungkin dan menjatuhkan sanksi kepada rumah sakit dan tenaga kesehatan sesuai dengan peraturan perundang-undangan yang berlaku.

Selain itu, Komisi IX DPR RI juga mendesak Kementerian Kesehatan untuk meningkatkan pengawasan terhadap rumah sakit, sesuai dengan amanat UU Praktik Kedokteran, UU Kesehatan, dan UU Rumah Sakit, sehingga kasus dugaan kelalaian medik di kemudian hari dapat diminimalisir. Komisi IX DPR RI juga meminta laporan tertulis dari Kementerian Kesehatan RI terhadap proses penyelesaian kasus MS di RS Es Medan paling lambat 22 Januari 2013 dan kasus ED di RSIA Ddr Kupang paling lambat 22 Mei 2013.

Lebih lanjut, Komisi IX DPR RI juga mendesak Kemenkes melakukan sosialisasi terhadap prosedur apabila ada masyarakat yang ingin mengadukan kasus dugaan malpraktik yang dialaminya, termasuk juga memberikan fasilitas yang mempermudah proses tersebut, seperti nomor telepon yang mudah dihubungi atau alamat yang jelas.

Nova sangat menyayangkan karena ketika mencoba nomor telepon Majelis Kehormatan Disiplin Kedokteran Indonesia (MKDKI) yang diklaim sebagai nomor untuk pengaduan kasus malpraktik di nomor 021-31923199, ternyata tidak ada yang mengangkat.

Terakhir, Komisi IX meminta Kementerian Kesehatan RI, IDI, dan KKI untuk merumuskan strategi agar kualitas tenaga kesehatan, infrastruktur, dan manajemen fasilitas pelayanan kesehatan dapat ditingkatkan dalam rangka reformasi pelayanan kesehatan.

Terkait kasus MR dan MS, Komisi IX menyampaikan simpati yang sangat mendalam dan senantiasa berdoa agar mereka berdua segera diberikan kesembuhan oleh Tuhan YME. Khusus orang tua dari bayi ED, Komisi IX menyampaikan rasa duka yang sedalam-dalamnya.

(source: www.metrotvnews.com)

Chinese government transparent about smoggy air

One of Beijing’s worst rounds of air pollution kept schoolchildren indoors and sent coughing residents to hospitals, but this time something was different about the murky haze: the government’s transparency in talking about it.

While welcomed by residents and environmentalists, Beijing’s new openness about smog also put more pressure on the government to address underlying causes, including a lag in efforts to expand Western-style emissions limits to all of the vehicles in Beijing’s notoriously thick traffic.

“Really awful. Extremely awful,” Beijing office worker Cindy Lu said of Monday’s haze as she walked along a downtown sidewalk. But she added: “Now that we have better information, we know how bad things really are and can protect ourselves and decide whether we want to go out.”

“Before, you just saw the air was bad but didn’t know how bad it really was,” she said.

Even state-run media gave the smog remarkably critical and prominent play. “More suffocating than the haze is the weakness in response,” read the headline of a front-page commentary by the Communist Party-run China Youth Daily.

Government officials — who have played down past periods of heavy smog — held news conferences and posted messages on microblogs discussing the pollution.

Severest smog since figures released

The wave of pollution peaked Saturday with off-the-charts levels that shrouded Beijing’s skyscrapers in thick grey haze. Expected to last through Tuesday, it was the severest smog since the government began releasing figures on PM2.5 particles — among the worst pollutants — early last year in response to a public outcry.

A teacher and her students exercised during class break in Jinan on Monday, as city residents were advised to stay indoors. (China Daily/Reuters)

A growing Chinese middle class has become increasingly vocal about the quality of the environment, and the public demands for more air quality information were prompted in part by a Twitter feed from the U.S. Embassy that gave hourly PM2.5 readings from the building’s roof.

The Chinese government now issues hourly air quality updates online for more than 70 cities.

“I think there’s been a very big change,” prominent Beijing environmental campaigner Ma Jun said, adding that the government knows it no longer has a monopoly on information about the environment. “Given the public’s ability to spread this information, especially on social media, the government itself has to make adjustments.”

Air pollution is a major problem in China due to the country’s rapid pace of industrialization, reliance on coal power, explosive growth in vehicle ownership and disregard for environmental laws, with development often taking priority over health. The pollution typically gets worse in the winter because of an increase in coal burning.

“The pollution has affected large areas, lasted for a long time and is of great density. This is rare for Beijing in recent years,” Zhang Dawei, director of Beijing’s environment monitoring centre, told a news conference Monday.

According to the government monitoring, levels of PM2.5 particles were above 700 micrograms per cubic meter on Saturday, and declined by Monday to levels around 350 micrograms — but still way above the World Health Organization’s safety levels of 25.

In separate monitoring by the U.S. Embassy, levels peaked Saturday at 886 micrograms — and the air quality was labeled as “beyond index.”

Factories order to scale back emissions

City authorities ordered many factories to scale back emissions and were spraying water at building sites to try to tamp down dust and dirt that worsen the noxious haze.

Schools in several districts were ordered to cancel outdoor flag-raisings and sports classes, and in an unusual public announcement, Beijing authorities advised all residents to “take measures to protect their health.”

Vehicles drive on a very hazy winter day in Beijing. (Jason Lee/Reuters)

The Beijing Shijitan Hospital received 20 per cent more patients than usual at its respiratory health department, most of them coughing and seeking treatment for bronchitis, asthma and other respiratory ailments, Dr. Huang Aiben said.

PM2.5 are tiny particulate matter less than 2.5 micrometers in size, or about 1/30th the average width of a human hair. They can penetrate deep into the lungs, and measuring them is considered a more accurate reflection of air quality than other methods.

“Because these dust particles are relatively fine, they can be directly absorbed by the lung’s tiny air sacs,” Huang said. “The airway’s ability to block the fine dust is relatively weak, and so bacteria and viruses carried by the dust can directly enter the airway.”

Tumour risk

Prolonged exposure could result in tumours, he added.

Demand spiked for face masks, with a half dozen drugstores in Beijing reached by phone reporting they had sold out. A woman surnamed Pang working at a Golden Elephant pharmacy said buyers were mainly the elderly and students, and that the store had sold 60 masks daily over the past few days.

The bulk of the smog choking Chinese cities is belched out by commercial trucks, but authorities have put off enforcing tougher emissions standards to spare small businesses the burden of paying for cleaner engines.

“It is not a problem of technology. It’s more about consumer affordability. Increasing the emissions standard greatly increases the cost,” said John Zeng, Asia-Pacific director for LMC Automotive Ltd., a research firm. “Most buyers are small business owners, and they are very price-sensitive.”

Upgrading to cleaner engines would cost about 20,000 yuan ($3,150 Cdn), adding about eight per cent to a typical sticker price of a vehicle, according to Zeng.

The haze even inspired a song parody, widely circulated online. “Thick haze permeates every street in Beijing, the pollutant index is worse than the charts can read. I’m surrounded by buildings in a fairyland and I see people wearing masks all over the city,” go the lyrics. “Who is travelling in fog and who is crying in fog? Who is struggling in fog and who is suffocating in fog?”

(source: www.cbc.ca)

Komitmen Pemerintah Terhadap Kesehatan Dinilai Masih Lemah

[JAKARTA] Sejumlah kalangan menilai komitmen pemerintah terhadap masalah kesehatan di Indonesia masih sangat lemah. Hal ini terlihat baik dari sisi politik anggaran maupun regulasi yang belum pro terhadap kesehatan masyarakat.

Ketua Yayasan Lembaga Konsumen Indonesia (YLKI) Sudaryatmo,pakar kesehatan dari Universitas Hassanudin Prof Razak Thaha dan Ketua Umum Ikatan Dokter Indonesia (IDI) Zainal Abidin dan pendiri Maarif Institute Ahmad Safii Maarif menilai pergantian pimpinan/penguasa terus terjadi,namun masalah kesehatan tetap berjalan di tempat.

Pertanyannya,setahun menjelang pemilu 2014,masihkah kesehatan rakyat mendapatkan perhatian. Mereka mengimbau maraknya politik nasional menjelang pemilu 2014 tidak boleh mempengaruhi berbagai program pembangunan kesehatan yang telah dicanangkan.

Sudaryatmo,mengatakan, dari sisi politik anggaran kesehatan dan pendidikan,komitmen pemerintah Indonesia dibanding negara lain masih ketinggalan. Ini terlihat dari alokasi untuk pendidikan dan kesehatan dari total Produk Domestik Bruto (GDP),Indonesia paling rendah dari negara lain yaitu 2%. Sedangkan Kamboja 4%,Laos mendekati 5%,Malaysia 10%,Philipina 15% dan Thailand hampir 7%.

“Jadi dari sisi politik anggaran pemerintah memang belum berpihak pada isu kesehatan dan pendidikan. Minimnya anggaran kesehatan menimbulkan banyak persoalan seperti kematian ibu dan balita karena kurang mendapatkan dukungan memadai,” kata Sudaryatmo pada acara refleksi setahun menjelang Pilpres 2014 yang digalar IDI di Jakarta, Senin (14/1). Hadir pula Wakil Menteri Kesehatan Ali Ghufron Mukti.

Menurut Sudaryatmo,dibanding kesehatan,pemerintah lebih komitmen dan disiplin untuk membayar hutang. Untuk pendidikan dan kesehatan hanya 2% dari GDP, tetapi untuk bayar hutang mencapai 10%. Lebih tinggi dari negara lain, seperti Kamboja kurang dari 1%,Laos 3%,Malaysia 8%. Walaupun Philipina juga cukup tinggi yakni 12% dan Taiwan 15%, namun rasio antara anggaran kesehatan dengan membayar hutang seimbang, sedangkan di Indonesia sangat jomplang.

Ketidakberpihakan pemerintah terhadap isu kesehatan dan pendidikan juga terlihat dari struktur APBN 2013. Mengutip data Kementerian Keuangan,menurut Sudaryatmo,dari total APBN sebesar Rp 1,683 triliun,dialokasikan dominan ke sejumlah sektor. Di antaranya infrastruktur Rp 201,3 triliun (11,96),pertahanan negara Rp118,3 triliun (7,02%),subsidi Rp317,2 triliun (18,84%),transfer ke daerah Rp 526,6 triliun (31,4%).

Struktur anggaran ini menunjukkan sebagian besar untuk subsidi,bahkan lebih besar dari pembangunan infrastruktur. Padahal, kata dia,sebagian besar subsidi tidak jelas sasaran dan implikasinya terhadap perbaikan masalah di masyarakat.

Subsidi BBM misalnya mencapai Rp 193,8 triliun (61,2%) dari total anggaran subsidi. Dibanding subsidi listrik yang sebesar Rp 80,9

triliun (25,51%), subsidi BBM bermasalah karena pemerintah tidak memiliki data dan pertanggungjawaban soal penerima maupun besarannya. Menurutnya, misteri subsidi BBM akan menjadi catatan hitam sejarah ekonomi kontemporer Indonesia.

“Padahal untuk mengatasi masalah kesehatan,menurut para pakar tidak sampai membutuhkan anggaran sebesar subsidi BBM,” katanya.

Razak Thaha mengatakan,meskipun Indonesia selalu bangga memiliki pendapatan perkapita atau pertumbuhan ekonomi lebih dari negara tetangga,tetapi dalam masalah kesehatan tidak lebih baik.

Masalah gizi di Indonesia misalnya belum mengalami penurunan signifikan. Di antaranya Indonesia merupakan negara kelima dengan

jumlah orang pendek (stunting) paling banyak di dunia, selain Tiongkok,India,Pakistan,Nigeria dan bahkan di atas Vietnam. WHO

mencatat 90% anak pendek ada di 36 negara berkembang,termasuk Indonesia.

Menurutnya, orang pendek merupakan representasi dari kemiskinan di setiap provinsi. Di mana ada lumbung kemiskinan di situ orang pendek lebih banyak, seperti di NTT,Papua Barat dan NTB. Mereka terlahir dari ibu-ibu yang juga miskin dan kekurangan gizi.

Di satu sisi jumlah anak gemuk juga semakin bertambah. Anak gemuk adalah calon-calon penderita penyakit tidak menular di kemudian hari,seperti hipertensi,stroke,jantung dan diabetes.

“Padahal anggaran untuk gizi melalui pagu kesehatan terus meningkat, bahkan saat puncak resesi ekonomi. Tahun 2000 anggarannya baru sekitar Rp 21 miliar,tetapi naik tujuh kali lipat atau Rp 700 miliar di tahun 2007. Tetapi status gizi malah tambah jelek,lalu kemana anggaran itu,” katanya.

Ali Ghufron Mukti,mengatakan, pemerintah sudah cukup memberikan perhatian serius pada masalah kesehatan. Buktinya, hampir tidak ada negara di dunia ini yang menjamin 86,4 juta warganya untuk berobat gratis seperti yang dilaksanakan oleh Indonesia. Selain itu, progam Jampersal menjamin persalinan gratis untuk semua ibu hamil.

“Dari sisi anggaran memang dari persentase masih di bawah 2,1% dari total APBN, tetapi nominal-nya terus meningkat setiap tahun. Tahun ini sebesar Rp 32 triliun, dan 2014 diperkirakan mencapai sekitar Rp 40 triliun,” katanya.

Zainal Abidin,mengatakan,anggaran kesehatan setiap tahun hanya berkisar di 2% dari total APBN. Karena itu IDI mengimbau pemerintah untuk menaikannya sesuai dengan UU Kesehatan 36/2009,yakni minimal 5% di luar gaji pegawai. Secara politis,kata dia,pemerintah memiliki tanggung jawab konstitusi untuk menjalankan Sistem Jaminan Sosial Nasional (SJSN) dengan baik. [D-13]

(source: www.suarapembaruan.com)

Who Will Pay More For Health Insurance Under Obamacare?

As a consequence of some Obamacare requirements — such as the requirement that health insurers accept everyone who applies, never charge more based on serious medical conditions (modified community rating), and/or start paying for many often-uncovered medical conditions — health-insurance premiums have been going up. But not everyone is equally affected by the increase in premiums. According to Institute for Policy Innovation’s Merrill Matthews and past chairman of the Social Insurance Public Finance Section of the Society of Actuaries Mark Litow, the market that’s likely to be hit the hardest is the the individual market (more than the small-employers market and much more than the large-employers one). Their piece in this morning’s Wall Street Journal is also interesting in that it lists the states that will see the largest and smallest increase in insurance premiums. They write:

We compared the average premiums in states that already have ObamaCare-like provisions in their laws and found that consumers in New Jersey, New York and Vermont already pay well over twice what citizens in many other states pay. Consumers in Maine and Massachusetts aren’t far behind. Those states will likely see a small increase.

By contrast, Arizona, Arkansas, Georgia, Idaho, Iowa, Kentucky, Missouri, Ohio, Oklahoma, Tennessee, Utah, Wyoming and Virginia will likely see the largest increases—somewhere between 65% and 100%. Another 18 states, including Texas and Michigan, could see their rates rise between 35% and 65%.

They explain that “ironically citizens in states that have acted responsibly over the years by adhering to standard actuarial principles and limiting the (often politically motivated) mandates will see the biggest increases, because their premiums have typically been the lowest.” We also know that a vast majority of young Americans will see their cost go up under the new law. On Saturday, Avik Roy of the Manhattan Institute reported on a new study by Kurt Giesa and Chris Carlson in the latest issue of Contingencies, the American Academy of Actuaries’ bimonthly magazine, which shows that 80 percent of Americans in their twenties will face higher costs under the law, even after taking under consideration the premium-assistance subsidies. He wrote:

Obamacare’s insurance exchanges were originally designed to subsidize the purchase of regulated, private-sector insurance for those with incomes between 138 percent and 400 percent of the federal poverty level: based on 2012 guidelines, that amounts to between $31,809 to $92,200 for a family of four.

But Giesa and Carlson estimate that 80 percent of Americans below the age of thirty in the individual market will face higher premiums, despite subsidies. “Our core finding is that young, single adults aged 21 to 29 and with incomes beginning at about 225 percent of the FPL, or roughly $25,000, can expect to see higher premiums than would be the case absent the ACA, even after accounting for the presence of the premium assistance.” Fully 80 percent of these twenty-somethings have income above $25,000.

What’s interesting is that, according to Roy, about two-thirds of the uninsured population is under the age of 40. In other words, we are starting to see how the law may be hurting the most those “uninsured” Americans that it claimed it would help. He adds:

Overall, the authors found that “premiums for younger, healthier individuals could increase by more than 40 percent” in the non-group insurance market due to Obamacare’s community rating provision. (A handful of states that already mandate community rating, like Massachusetts and New York, were excluded from the Giesa-Carlson analysis.)

There is plenty more information about the study and what it means here.

Finally, if you aren’t depressed enough, I would recommend reading this piece by Reason’s Peter Suderman about why Obamacare won’t control health-care costs.

 

(source: www.nationalreview.com)