Helping Children Get the Healthcare They NeedTo fulfil Begawan Foundation’s aims and create an environment that serves the needs of local people, the Gardners set up a health clinic at Begawan Giri Estate.Manned by a team of doctors and nurses, it provided free services to the Estate’s staff members and their immediate families. It also actively participated in the Estate’s training programmes by conducting first aid and emergency training for employees, with additional support provided by consultant doctors from Singapore. In addition, the clinic taught young pupils from the local kindergarten about the importance of caring for their health and personal hygiene. In fact, Begawan Foundation has always taken a special interest in child health, and its work in this area is not limited to youngsters in the immediate neighbourhood. Hirschsprung’s Disease The Gardners first became interested in the plight of children suffering from Hirschsprung’s Disease (HD) when the child of one of their staff was found to be seriously affected by this congenital disorder. HD was first described by a Dutch physician named Harold Hirschsprung in 1886. It is characterised by the absence of nerve cells in the large intestine, and it occurs in approximately 1 in 5,000 live births. Boys are more often affected by this disorder than girls. The outlook following successful surgical treatment for HD is very good, and such children can be expected to grow up and live normal lives. However, a good outcome depends on the availability of adequate facilities, so that the exact pathology can be accurately identified and the surgeon can plan the operative procedure precisely. The complications associated with unsuccessful surgery for HD are extremely serious and they pose very difficult problems for subsequent treatment. In such cases, the entire sequence of surgical treatment usually has to be repeated; and previous operations may make this a technically formidable procedure that requires tertiary institutional care. Originally, Indonesian children requiring this type of operation had to be taken to Singapore, although some Singaporean doctors have also been to Indonesia to train doctors there. However, the necessary medical equipment has to be purchased, and Indonesian doctors must be taught how to use it correctly. The importance of this is illustrated by the following case histories. Wayan Juliana Meganata, the oldest son of Remi and Wardana, had six unsuccessful operations for Hirschsprung’s Disease in Bali before he was brought to Singapore in 1998 for his first successful operation. Following a second operation in Singapore later in the same year, he now attends the hospital in Denpasar for regular checkups. Wayan Sudartana, a small boy from Ubud in Bali, had 12 unsuccessful operations for the same disease before going to Singapore in 1999 for his first and second operations. After three unsuccessful operations in Bali, Wayan Pantiaga was successfully treated under the watchful eyes of local doctors at the Sanglah Hospital in Denpasar, Bali, by Dr Joseph from the KK Women & Children’s Hospital in Singapore. Dr Joseph later returned to Bali to conduct a second operation, again observed by the local doctors. Another boy from Karangasem in Eastern Bali had four unsuccessful operations in Denpasar before he was successfully operated on by Dr Sukarena and his team at Sanglah Hospital, thus demonstrating that Bali’s doctors can successfully perform the procedure if they receive the right degree of support. Making medical care more accessible Unfortunately, many other children also suffer from this disease in Indonesia. Further work is needed to locate them and ensure they are operated on successfully. Hopefully, they will have access to the treatment they need in Indonesia. Taking a child to Singapore is very expensive. Passports have to be organised, and money has to be raised to pay for airfares and accommodation in Singapore for the child and an accompanying parent. The bill for their medical expenses needs to be covered as well. Ideally, it would be much better for these small children to get the treatment they need closer to their homes. But this can only be done successfully if the doctors who care for them have the right professional knowledge and equipment. The Foundation’s long-term aim is to enable the transfer of both medical expertise and technology to Indonesian doctors. |
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