...profit the professor naught

Returning to Michael's article in Inside Indonesia. I'm sure that anyone who is involved with HIV in Indonesia has identified 'Professor Setiawan'. I fully understand the frustration of 'Nuraini' and Michael, and there's no point in me trying to defend the doctor. Nuraini's report is unfortunately by no means unique. We have frequently suggested ways that doctors could spend more time with their patients, in particular those recently diagnosed - and their families. The situation in this case is exacerbated by the fact that the doctor concerned has a high reputation - in many ways justified. So many patients, or more often their families, insist on being treated by the 'Prof'. The result? The sixty patients at every surgery that Michael referred to.

What saddens me more (and makes it more difficult for me to be balanced) is that I have known this doctor for more than 18 years. I first met him on the night my partner was diagnosed with HIV, and I immediately felt we were in good hands. My partner appeared very comfortable with him. As the end came, the doctor on a couple of occasions visited my partner at home, and he took the time to attend the 40-day 'selamatan' following his death.

In the following year, I volunteered with the AIDS service organization the doctor had co-founded, and he mentored me as we developed the program to support people living with HIV in Jakarta. He greatly encouraged me in my efforts to offer information in the vernacular on care, support and treatment for people with HIV. Although I left the organization after a couple of years, we continued (and continue) to meet, and I think our mutual respect remains.

However, the relationship did start to suffer as we tried to encourage people with HIV to develop more empowered relationships with their doctors. Sometimes his patients would contact me with concerns, and I would try to provide them with informed advice. On their next visit to the doctor, some of them would begin with 'Babé says...', clearly not an ideal way to start a discussion. I know this doctor is very concerned about interfering between other specialists and their patients, even when the patient concerned is also is also one of his - I sometimes think this is taken to the extreme, particularly where the other specialist has limited experience treating people with HIV. But given this, I can understand that he doesn't appreciate me 'interfering' in his relationship with his patients. This is not, of course, my intent, and generally I am only attempting to provide the most up-to-date information, and always tell them to discuss this with their doctors before making any decision.

What can and should be done by us 'bulé' (foreigners) to address these problems? Sometimes I feel I'm on the horns of a dilemma. Has Michael's action helped? I'll return to this subject later...

Babé