Life is Healthy

Antara News, Friday, May 7, 2010 13:44 WIB

Jakarta (ANTARA News) - Health Minister Endang Rahayu Sedyaningsih officially inaugurated a new building housing a world-class private health service unit at the Cipto Mangunkusumo General Hospital (RSCM) complex here Friday.

The new unit was named RSCM Kencana Integrated Service Unit.

"The management must make improvements in order to deliver effective and efficient services," said the minister when inaugurating the four-story building.

Improved health services in the country were expected to attract patients who had so far been seeking medical treatment abroad, she said.

"According to Singapore`s National Health Group survey, around 50 percent of foreign patients seeking medical services in Singapore, are Indonesians, or roughly 12,000 people annually," the minister said.

RSCM President Director Akmal Taher said the state-owned general hospital`s private services were targeting those so far seeking medical services abroad.

The new unit offers a number of health service clusters, among other things general medical checkups, in-vitro fertilization, tumor treatment, integrated breast clinic, aesthetic service, rehabilitation service, dental service, eye care center, and neuroscience.

"Services in all clusters are given in integrated ways by teams, and there is no departmental service," he said.

Several RSCM units, such as the Cardiology Unit, Perinatal Unit, and Radiotherapy Unit, have acquired ISO 9001 Certificates.

Radio Netherlands Worldwide, 3 April 2010 - 9:00am, by Zainab Hammoud

More than half of all girls and women do not bleed when they lose their virginity. However, this loss of blood is still important in cultures where women are supposed to preserve their virginity until marriage. So women have found ways of meeting their environment's expectations.

Karima, a Dutch/Moroccan woman in her early twenties, has a secret: she had hymenoplasty, or hymen reconstruction surgery, shortly before her marriage. The hymen is the membrane which encloses the vaginal area.

"In my culture you cannot tell your parents or your family that you were not a virgin when you married. My mother would not survive it," she says. She only allows herself to be interviewed with a distorted face and voice so that she cannot be recognised.

Gynaecologist Ineke van Seumeren has doubts about the procedure. "I have always found it a problem to do something that really isn't necessary. It is not a disease." A few years ago she thought up a different solution. She wants to inform people that the correlation between an intact hymen and virginity is a myth.

On the basis of his own research and that of many other investigators, he has become convinced that the phenomenon known as near-death experience (NDE) establishes the reality of an afterlife.

For more than 10 years, Dr. Long studied thousands of accounts of NDEs and created the Near Death Experience Research Foundation (NDERF), which has become the largest NDE research database in the world. Dr. Long's new book, Evidence of the Afterlife, which is based on more than 1300 accounts of NDEs that were shared with the NDERF, became a New York Times bestseller almost immediately after its release.

"People from all walks of life have had near-death experiences, and that even includes some physicians," Dr. Long told Medscape Oncology in an interview. "It shakes them up, and it makes it difficult because they are inclined not to let it be known publicly that they've had this experience."

Although there is some variation, NDEs can loosely be defined as mystical or transcendent experiences reported by individuals who are either dying or clinically dead. Common experiences reported to Dr. Long and other investigators are feelings of peacefulness, the sense of leaving one's body, the sense of moving through a dark tunnel toward a bright light, a review of one's life, and meeting up with other "spiritual" beings. Some people have even clearly described their own resuscitations with remarkable accuracy, down to conversations that occurred outside the room and beyond normal hearing range.

Dr. Long first became interested in NDEs in 1984, when he read an article on the subject that was published in a medical journal. Several years later, the wife of a college friend relayed her own experience with it, when she nearly died of an allergic reaction while under general anesthesia. A decade later, he started the NDERF to better study it.

In general, the subject is highly controversial, especially the conclusion that NDEs offer proof of an afterlife. However, Dr. Long pointed out that feedback from his medical colleagues has been positive for the most part. "Everyone respects the success of the book and many of them have thought and wondered about this on their own," he said. "All of my colleagues who read my book were impressed, as it was intended to be scholarly."

He acknowledged that not everyone agrees with his conclusions, but although "they may not agree, they feel that this is a significant point of view," he explained. "If they disagree, it may be due to factors such as their personal religious point of view or the scientific evidence. I can't blame them, because if someone had approached me 20 years ago, I would feel the same way."

Dr. Long believes that NDEs provide powerful scientific evidence that "makes it reasonable to accept the existence of an afterlife." Specifically, he cites "9 lines of evidence" that he has derived from his research.

"I find any 1 of them to be very strong evidence that there's an existence of life after death," Dr. Long explained. "But if you put all of them together, I think that the combination — in my opinion — becomes compelling."

The 9 Lines of Evidence From Evidence of the Afterlife

1. Crystal-clear consciousness. The level of consciousness and alertness during NDEs is usually greater than that experienced in everyday life, even though NDEs generally occur when a person is unconscious or clinically dead. In addition, the elements in NDEs generally follow the same consistent and logical order in all age groups and cultures.
   
   
2. Realistic out-of-body experiences. Out-of-body experiences are among the most common elements of NDEs, and what is seen or heard is almost always realistic. Even if out-of-body-experience observations include events that occur far from the physical body, and far from any possible sensory awareness of the patient, they are almost always confirmed to be completely accurate.
   
   
3. Heightened senses. Heightened senses are reported by most people who have experienced NDEs, and normal or supernormal vision has occurred in those with significantly impaired vision, and even legal blindness. Several people who have been totally blind since birth have reported highly visual NDEs.
   
   
4. Consciousness during anesthesia. Many NDEs occur while a person is under general anesthesia, at a time when any conscious experience should be impossible. Although there is speculation that these NDEs are the result of too little anesthesia, some result from anesthesia overdose.
   
   
5. Perfect playback. Life reviews in NDEs include real events that took place in the lives of those having the experience, even if the events were forgotten or happened before the person was old enough to remember.
   
   
6. Family reunions. During a NDE, the people encountered are virtually always deceased, and are usually relatives of the person having the NDE; sometimes they are even relatives who died before the patient was born.
   
   
7. Children's experiences. The NDEs of children, including children who are too young to have developed concepts of death, religion, or NDEs, are essentially identical to those of older children and adults.
   
   
8. Worldwide consistency. NDEs appear remarkably consistent around the world, and across many different religions and cultures. NDEs in non-Western countries are incredibly similar to those that occur in Western countries.
   
   
9. Aftereffects. It is common for people to experience major life changes after having NDEs. These aftereffects are often powerful, lasting, and life-enhancing, and the changes generally follow a consistent pattern.

Research and Different Viewpoints

The term "near-death experience" was coined by Ralph Moody, MD, PhD, in 1975 in his classic book Life After Life. Researchers have been studying NDEs for decades, and although most research has concluded that NDEs are real and unexplainable, the idea of consciousness beyond death has not been widely accepted.

"There have been over 20 different explanations of NDEs, and they cover any feasible physiological, biological, cultural, and psychological explanations you can think of," said Dr. Long. "But the truth is that not 1 of them makes any sense, even to skeptics, and that's why there are so many of them. None have been accepted as plausible, even by skeptics."

One proposed theory of the origin of NDEs is physiological changes in the brain, such as hallucinations caused by oxygen deprivation. Other theories are psychological, such as a reaction to approaching death, or are linked to a changing state of consciousness and cognitive functioning.

Kevin Nelson, MD, professor of neurology at the University of Kentucky in Lexington, has hypothesized that rapid eye movement (REM) intrusion contributes to NDEs. "The REM state of consciousness is, by its very nature and definition, activation of the visual system," he told Medscape Oncology. "The very first physiological sign of REM is pontogeniculoocciptal waves electrifying all levels of the visual system."

Because sleep-related hallucinations are most often visual, the REM system can account for the "heavenly" light so often reported in the NDE, he explained.

Dr. Nelson and colleagues investigated the lifetime prevalence of REM intrusion in 55 people who had experienced a NDE, and compared them with age- and sex-matched control subjects. They found that sleep paralysis and sleep-related visual and auditory hallucinations are substantially more common in people with a NDE. Although the results are preliminary, they suggest that REM intrusion could promote subjective aspects of NDEs and the often associated syncope (Neurology. 2006;66;1003-1009).

"The feeling of being in a tunnel and heading to the light can be explained by retinal ischemia, which causes blindness first in the periphery and preserves our central vision," said Dr. Nelson; "hence, the tunnel."

Dr. Nelson explained that the similarities between many NDE accounts exist because all people have similar brain biology. As for the feeling of leaving one's body, he pointed out that "out-of-body experiences are illusions that occur when our brain cannot integrate all of our sensations. They can be created by a trickle of electricity in the temporal-parietal region."

According to Dr. Nelson, brain physiology explains all the features of NDEs. "That is not to say that there isn't a reality beyond the brain," he said. "It's just that the brain is science, and anything beyond the brain is faith."

No Medically Explicable Explanation

In 2001, the Lancet published the results of a 13-year study of NDEs that was conducted in 10 different centers in the Netherlands (Lancet.2001;358:2039-2045). The study, one of the few to be conducted prospectively, tracked 344 cardiac patients who were successfully resuscitated after a cardiac arrest.

The researchers, led by Dutch cardiologist Pim van Lommel, MD, who was affiliated with Hospital Rijnstate in Arnhem at the time of the study, found that 62 patients (18%) reported NDEs. Of that group, 41 (12%) had what is referred to as core (or deep) NDEs.

At 2- and 8-year follow-ups, all surviving patients recalled their NDE experience almost exactly as they originally described it. The researchers found little difference between patients who had experienced a NDE and those who hadn't. They also noted that their findings failed to show any psychological, neurophysiological, or physiological factors that would have caused these experiences after cardiac arrest.

Even though the researchers were unable to uncover a medically explicable explanation for NDEs, they did acknowledge that neurophysiological processes must play some sort of role. But if NDEs are purely physiological — for example, caused by cerebral anoxia — then most patients who have been clinically dead should report one, they write.

Dr. van Lommel and colleagues note that there are similarities between NDEs and various other phenomena, such as electrical stimulation of the temporal lobe of the brain, but that those experiences usually consist of fragmented and random memories. In contrast, the recall after a NDE is clear and sequential.

"How could a clear consciousness outside one's body be experienced at the moment that the brain no longer functions during a period of clinical death with flat EEG?" the authors ask, adding that "NDE pushes at the limits of medical ideas about the range of human consciousness and the mind–brain relation."

For the past several years, Dr. van Lommel has been lecturing all over the world on NDEs and the relation between consciousness and the brain. "It is a challenge to explain to physicians and medical students, in the many lectures I give, why I came to the conclusion that consciousness can be experienced during a period of a nonfunctioning brain," Dr. van Lommel told Medscape Oncology.

"The hypothesis that consciousness is a product of brain function has never been proven whatsoever," he said. "Most physicians are not aware of the medical literature about what happens in the brain during cardiac arrest, and what exactly is really known about how the brain functions."

He explained that, in the Netherlands, more and more physicians seem to be "open to the possibility of a facilitating function of our brain to experience consciousness, and our consciousness being nonlocal — not cemented in place or time."

"But, of course, many neuroscientists have great difficulty in changing their basic concepts," Dr. van Lommel added.

On a personal level, Dr. van Lommel acknowledged that there is no hard scientific proof of an afterlife, and there will never be. "But for me, it seems very likely because it has been scientifically proven that patients experience, paradoxically, an enhanced consciousness during a cardiac arrest and during a period of a temporarily nonfunctioning brain."

Acknowledging NDEs

Physicians need to be aware of NDEs, contends Dr. Long, especially oncologists and others who care for patients with life-threatening illnesses. "I would advocate that if patients bring it up, physicians be ready to talk about it," he said. "But patients are often hesitant, so it's best to wait until they are ready to share [their experiences]."

Patients might just hint around about their experience; under those circumstances, doctors need to be ready to ask and need to know the right response. "These experiences are medically inexplicable, and they can be powerfully life-changing," said Dr. Long. "If physicians don't have the experience or feel uncomfortable discussing them, they need to refer patients to sources and organizations that can help them."

Dr. Long feels that increasing his understanding of NDEs has helped him to be a better physician for his cancer patients. Individuals who experience NDEs often become kinder, more loving, and more accepting of others, and he has begun to reflect those same effects in his own life. He explained that he now "faces life with more courage and confidence."

Dr. Long emphasizes that his years of research have culminated in his own personal conclusion that there is an afterlife, but not everyone is going to be convinced of that. Instead, he urges people to consider the evidence and "come to your own conclusions."

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The Jakarta Post, Jakarta | Sat, 03/13/2010 5:11 PM

The Ministry of Health has issued a regulation governing migration of foreign doctors in the country in the wake of the China-ASEAN free trade agreement, which includes proficiency in Indonesian language.

Health Minister Endang Rahayu Sedyaningsih said on Saturday the government imposed strict requirements on foreign doctors who wished to operate in the country that she had no worry about the impacts of the free trade regime on health sector.

“The impacts of the CAFTA on health sector are not that serious, but visible, such as migration of foreign doctors to the country,” she told Antara during a visit to Semarang.

The regulation requires the foreign doctors to master Indonesian and register themselves with the Health Ministry. It also says the foreign doctors can work only at institutions appointed by the government, but are prohibited from running private health clinics.

The work permit for the foreign doctors ranges from two years to five years.

Jakarta Globe, February 17, 2010

The Health Ministry has issued a warning to Mayapada Hospital in Tangerang, Banten, for hiring foreign unregistered oncology consultants who did not have a practice license.

“The doctors at Mayapada Hospital did not have any permits. We don’t forbid people from working in Indonesia, but they must follow the rules, so we gave them a warning,” Farid W Husein, the director general of the ministry’s Medical Service Department, told Metro TV on Wednesday.

Farid said that the government had also asked the hospital to announce to the public that they had terminated the service. Previously, Mayapada had placed an advertisement in a national newspaper about the foreign oncologists. The hospital had confirmed they would remove the advertisement and publish an apology.

Farid said the government prevents health institutions from hiring foreign medical workers without official permission from the Health Ministry and Director General of Medical Service. Permission is given based on a recommendation from the local health office and professional organizations.

The Ministry’s legal adviser Faiq Bahfen said that the government would apply penalties to foreign doctors who practiced in Indonesia without registration and a practice permit. The penalty would also apply to the institution that hired them.

“We will look at the regulation and determine the proper penalties,” he said.

German Ambassador to Indonesia Norbert Baas visiting a ward for premature babies at Zainoel Abidin Hospital in Banda Aceh. The German-aided hospital cost Rp 418 billion and is meant to provide top-of-the-line care for Acehnese. It was officially inaugurated on Saturday. (JG Photo/Suparta)

Banda Aceh. Aceh Governor Irwandi Yusuf and German Ambassador to Indonesia Norbert Baas officially inaugurated on Saturday what they said was the “most advanced hospital in the country.”

Zainoel Abidin State Hospital (RSUZA), which is equipped with several state-of-the-art medical instruments, including a CT Scan, MRI machine and radio-diagnostic devices, was rebuilt with aid from the German government. The facility has been receiving patients since last August.

“We say that RSUZA is the most advanced hospital in Indonesia, and its facilities can match prominent hospitals in Penang and Singapore,” Irwandi Yusuf said during the inauguration ceremony

He added that he hoped the new hospital would put an end to the practice of thousands of Acehnese going to Penang, Malaysia, or Singapore each month for medical treatment.

“Including myself, who has to opt for Singapore as a place to have medical treatment because the facilities at the neighboring country’s hospitals are far more advanced than what we have had in Banda Aceh,” the governor said. “But, considering the development, I am certain that the equipment we have now can rival hospitals abroad.”

He also encouraged the staff to prove to the public that the hospital personnel could master the hospital’s advanced machines. “A strong building and advanced equipment are not enough to make RSUZA the best hospital in terms of services for the people of Aceh,” he said.

Baas said that RSUZA was equipped with advanced infrastructure and utilized eco-friendly integrated waste management technology.

“The employees of RSUZA have been intensively trained to ensure the patients and staff can reap maximum benefits from its new facilities and equipment,” he said, adding that the hospital was also designed to weather flooding and earthquakes.

The hospital’s reconstruction was part of German aid for Indonesia, which was augmented after the 2004 tsunami in Aceh that killed 170,000 people, Baas said. During five years of reconstruction in the region, the German government has disbursed a total of 178 million euros ($251.6 million).

The development of the two-story hospital, which sits on 42,946 square meters of land, started in March 2006, funded by a 31 million euro grant from the German government through state-owned bank KfW. The German Agency for Technical Cooperation provided an additional 10.2 million euros worth of technical assistance.

Uwe Ohls, KfW’s first senior vice president of for Asia and Europe, said that the bank would continue to guide the hospital management for the next two years and would facilitate collaborations between the hospital and several universities in Germany for paramedic training courses.

The director of the hospital, Taufik Mahdi, said the facility had 350 beds, and would add 150 more this year. Since the hospital opened, an average of 600 people a day have come to receive medical treatment.