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MOU Signing between the Provincial Health Department, the BRR and the University of Indonesia

Remarks by
Pieter Smidt
Head, Extended Mission in Sumatera (EMS)
Asian Development Bank

1 August 2007
Banda Aceh, Indonesia

Good morning and welcome to the Dean of the Faculty of Nursing, University of Indonesia, Professor Ellie and her colleagues. Welcome also to our colleagues from BRR and the Provincial Health Department , the Nursing and Midwifery Development Committee for Aceh, and, of course the nurses who will be heading for post graduate studies at the University of Indonesia in August.

In recognition of the fact that nurses and midwives make up the majority of the health staff in Aceh, it is vital that their skills and knowledge keep pace with the demands of good patient care and professional practice. ADB is only too painfully aware that many nurses and midwives lost their lives in the tsunami and those who remained struggled to come to terms with their loss, but many also courageously kept on coming to work to take care of others.

It is not possible to achieve the country’s health goals without improving the quality of care provided by nurses and midwives. As part of the objective to strengthen nursing and midwifery in Aceh, and to improve the quality of health care in its institutions, the Earthquake and Tsunami Emergency Support Project – ETESP as we call it – financed by Asian Development Bank has already sent nurses to Khon Kaen University in Thailand in May this year to pursue courses in several areas of nursing.

We are well aware that although it may be the doctor who saves lives, it is the nurse who keeps you alive. Without the care provided by nurses and midwives the mortality rate across many diseases would be far worse. In Aceh the maternal and child mortality rate is above that of the rest of Indonesia. The Aceh Strategic Plan of 2006 states that the infant mortality was estimated at 42 per 1000 compared to the national level of 35 per 1000, whereas the maternal mortality rate was 373 per 100,000 live births compared to the national figure of 304 per 100,000 live births. It was also mentioned that the reporting of child and infant deaths in Aceh was not yet routine, therefore we can expect the number of deaths to be higher than recorded.

The Strategic Plan also anticipates an increase in health problems for some years to come following the earthquake and tsunami such as:

(1) An increase in cases of communicable disease

(2) A fall in the nutritional status of susceptible community groups, including pregnant women and babies and children below age 5 years

(3) An increase in cases of mental health disturbance, due to the trauma experienced by the victims of disaster

Indeed, we recognize that nurses need to be equipped with the skills to diagnose and treat the higher incidence of these problems to help their communities to recover more fully.

A World Health Organization document entitled ‘Nursing and Midwifery Services: Strategic Directions 2002-2008’ makes it clear that education of health personnel for nursing and midwifery services needs to provide competent practitioners with appropriate skills that are available to deal effectively with the current and future challenges to practice. These challenges are being faced in Aceh as in other parts of the developing world.

In reviewing the status of Aceh since the tsunami, the World Bank has also noted that quote “Whereas the current focus is on the quantity of facilities and health providers, the focus should be improving the quality of health services…” This, we know, can only be achieved by improving the skills, knowledge and competencies of the health staff that work in health facilities. This is what we are seeking to do both within and outside of Indonesia.

Today we are therefore pleased to announce that BRR and ADB are sponsoring another group of nurses, 10 in total, to pursue their Masters training at the University of Indonesia. This is the culmination of activities which involved a public call for applicants in the local newspaper Serambi, followed by the initial selection of 25 candidates of the original 33 who applied. ETESP funds then paid for the tuition of the 25 candidates for 2 weeks preparation before their test and interview which decided the final outcome. We are hoping that the final 10 candidates will be the future leaders of nursing in Aceh and bring the benefit of their knowledge and expertise back to their institutions.

Finally, I like to wish the nurses all the best in their studies at the University of Indonesia and once again to thank our colleagues from the University of Indonesia for their collaboration. We see this as yet another step in supporting Aceh to care for its people.

Thank you.