حصريا، شريف فض الله: الممرضات في المقدمة، يجب أن يكون هناك أقصى قدر من الحماية

Nurses, like other health workers (Nakes); doctors and midwives, are at the forefront of all situations. Especially during the current COVID-19 pandemic which is still not gone. According to the General Chairperson of the PPNI DPP (Indonesian National Nurses Association) Dr. Harif Fadhillah, SKp., SH., M.Kep., MH., nurses should receive maximum protection.

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Dr's statement Harif Fadhillah, SKp., SH., M.Kep., MH., not without reason. So far, as chairman of the PPNI, he has often visited nurses on duty throughout the country, even in border areas and conflict areas such as Papua. During the visit, he still found that in some places the nurses' work facilities were not up to standard and there were nurses who were targeted by conflict. Even though this is vital, because health workers are like nurses, doctors and midwives, they are at the forefront of treating patients. Especially during this pandemic. What happens if the issue of work safety that should be without tolerance becomes neglected?

During this pandemic, he said, 671 nurses had died in their duties. "According to the report I received, there were 671 nurses who died during the pandemic," said Harif who had served as Secretary General of PPNI in 2010-2015, before he was finally elected to the PPN Congress in Palembang, which appointed him as the General Chair of the DPP. PPNI for the 2015-2020 period.

The data is indeed no more than doctors who also have to return to the fellowship of the Almighty during the COVID-19 pandemic. As reported by Antara, the Mitigation Team for the Indonesian Doctors Association (PB IDI) recorded 730 doctors who died due to COVID-19. The highest death rate was in July, as many as 261, while in August 72 doctors were infected with SARS-CoV-2.

"The most general practitioners are 385 people, followed by obstetrics and gynecology specialists, internal medicine specialists, and pediatricians," said the Head of the Mitigation Team for PB IDI Doctors, Adib Khumaidi in a webinar that took place last Thursday 9 September.

It's not only a matter of life safety, because the health workers are accidentally exposed to COVID-19. According to Harif, the issue of incentives is also crucial. "We note that there are still many nurses and like other health workers whose incentives have not been paid during this pandemic. Even though they have worked optimally. Usually cases like this occur in hospitals managed by local governments. Hopefully this problem can be resolved soon," he said to Iqbal Irsyad, Edy Suherli, Savic Rabos and Rifai who met him at the PPNI DPP office, Jalan Lenteng Agung, Pasar Minggu, South Jakarta, recently. Here is the full excerpt.

What will happen to nurses during this COVID-19 pandemic?

If we talk about nurses during this pandemic, we really see it from an aspect of humanitarian duty, for example. So these nurses are on the front line, the WHO (World Health Organization) also reminds world leaders about the importance of nurses as a front-line during this pandemic. Then when viewed from the aspect of the risk of work is also extraordinary. The risks they face when carrying out their duties are not inferior to those faced by doctors and midwives. When ordinary people are prohibited from leaving their homes, they have to go out and accompany patients.

This is what happened to them. And the workload which is quite high during this pandemic occurs during busy times when the number of patients increases both in hospitals and at the Puskesmas. They get an additional burden not only physically but also mentally. For example, when the ER queues are extraordinary, and when the hospital opens a tent as an emergency room or additional treatment room. When I asked them, they said it didn't matter if there were a lot of patients. But what makes it sad is that they can't do anything because; no place, and less oxygen. That adds to the psychological burden.

How are nurses treated compared to other health workers such as doctors and midwives?

If the treatment is in accordance with the roles and functions of each. Doctors are the main goal of treating from the aspect of disorders of the human body. Meanwhile the nurse saw the response of the disturbed body. So that the nurse is caring. Although in the past people considered nurses to be doctors' assistants. But today is not like that. We have different goals and tasks, but both are to improve the patient's condition. Even though there are still some differences in policy, yes. For example, in terms of incentives, there are gradations, there are 15 million specialists, 10 million for general practitioners and 7.5 million for care and midwives. And 5 million for the other Nakes.

If you look at this incentive, there is a difference. From what perspective, what are the responsibilities? Or educational background? Or what? It should be that during this pandemic the amount depends on the risks faced. But the nurse didn't mind that.

How many victims of PPNI members during this pandemic?

Until 3 days ago we had a tiered report regarding the data on nurses who died. The last number I got was 671 people. This number is large even though more doctors have died.

In terms of incentives, is there still a problem?

The case of faltering incentives is especially for nurses who work in hospitals managed by local governments. For hospitals or agencies that are managed by the central government, such complaints are a little heard. There were 368 regencies/cities that received warnings for being late in providing incentives to health workers.

What PPNI measures for the safety and welfare of nurses?

Internally we made a work guideline for nurses when handling this pandemic. This matter continues to be socialized to PPNI members through webinars which are attended by more than 1000 people every day. Then our Youtube channel is also visited by 25 thousand per impression. At that time we also urged them to carefully adhere to health standards and protocols.

To get out, we advocate to various parties, such as the Hospital Association and the Ministry of Health, to pay attention to the condition of nurses, such as the provision of sufficient PPE, the hotel or what kind of stay. Then what is the food like? And so forth. We also proposed to BNPB and finally formed an Agency or Division under the Task Force. Their job is to protect health workers. Now there are policies that we propose so that if health workers get sick or are exposed to COVID-19. For health workers who are exposed they are immediately treated. We also created a special line of 117 ex 3 for people who have been exposed to COVID-19 and want to get help from the health workers. There is also a Ministry of Health policy that prioritizes health workers who are exposed to the drugs they need.

For those who have died in the line of duty, we DPP PPMI also help fight for the rights of health workers. In the form of compensation of 300 million rupiah and received appreciation, namely a sign of service and honor from the president. We also help find scholarships for children who have died, both from the government and private institutions.

Regarding the case of health workers being persecuted, what is the role of PPNI?

Our protection is directed at the threat of being infected, if this is with the right PPE. Next is the matter of setting the guard from the hospital, it is not allowed to double shift. In the past, before the pandemic, it was still there, but now it shouldn't exist. If you only use PPE for 4 hours, it can't be up to 7 hours. Lately, there is no problem with PPE. The time at the beginning of the pandemic does exist. The next protection is for nurses who carry out their duties. The problem is that there are several cases of nurses being abused by the patient's family. There were 13 cases of violence against nurses. We all follow up legally.

What about the case of health workers being persecuted in Papua?

For Papua, this is not only during the pandemic, our records have been 2 times. The nurse who was affected, although the latter was not a victim, but a laboratory analyst. But there were 4 nurses there, one of whom was also seriously injured. Two years earlier it was in which area I forgot if I'm not mistaken Wamena, there was also a nurse who died from being shot. We condemn this brutality. The nurse who is carrying out her duties should be protected by the two disputing parties. We ask the government to investigate thoroughly and create a security system.

Internationally we have also said that this should not be done even in conditions of war. But how come this is not war, but KKB (Armed Criminal Group). In the end, we complained to Komnas HAM. We discussed at IDI (Indonesian Doctors Association) to bring this issue to the world level.

How many PPNI members are there now?

There are 694,644 registered members, out of about 1 million existing members. This number will continue to grow as the number of people registering increases. Nurses take care of the community with their competence, the community takes care of nurses with their motivation, hopefully the performance of nurses can be even better.

Are there any PPNI members working abroad?

There are nurses who are currently working in 4 countries. So there are 4 overseas PPNI branches in the Kingdom of Saudi Arabia, Qatar, Kuwait and the United Arab Emirates. Almost all of those who work there are already PPNI members

Is the welfare of nurses in Indonesia good?

We are still on par with Laos and Cambodia. When compared with Malaysia and Singapore, it is still far away. In the future, hopefully it will be better. Moreover, private hospitals still respect nurses with UMR standards, even though they have special competencies. Especially in the private sector. In ASN, there are rules. This is our next fight.

Although her initial profession was a nurse, in the course of her career, Dr. Harif Fadhillah, SKp., SH., M.Kep., MH., who is currently still the General Chairperson of the PPNI (Indonesian National Nurses Association) DPP, is pursuing a variety of professions. Apart from being a nurse, she is also a lecturer at the Faculty of Nursing, University of Muhammadiyah Jakarta (UMJ). And he is also listed as an advocate or lawyer at a law firm in Jakarta. However, due to his busy schedule as the Head of PPNI, he is not active as an advocate.

Being a nurse for Harif, is filial piety to his parents. His initial dream was to become an agricultural engineer. Because of that he had participated in Sipenmaru (New Student Admission Selection) in his day. He has graduated from the Faculty of Agriculture, University of Lampung. But while he was waiting for college, his parents had an accident. Harif is taking care of the hospital.

That's when he saw how diligently the nurses cared for his parents who had broken bones, bruised faces and other injuries. "At that time I was amazed to see the dedication of the nurses who were so patient in caring for my sick parents," continued this alumni of SMAN 1 Terbanggi Besar, Central Lampung (1988).

At the same time, his parents also whispered to him. "You just become a nurse," he said imitating the request of his parents who were still lying sick. Driven by a sense of devotion to his parents, he finally left his status as a student of the Faculty of Agriculture.

He started as a student at the D3 Akper (Nurse Academy) program at the Jakarta Islamic Hospital and finished in 1991. And he worked at the Jakarta Islamic Hospital. After working for several years, he then submitted a scholarship proposal at his place of work, and his proposal was approved. Harif then continued his undergraduate studies at the Faculty of Nursing, University of Indonesia and finished 1998.

Still not satisfied with studying nursing, he continued his study at the Masters of Nursing at Muhammadiyah University of Jakarta and finished 2017. Is that enough? Turns out not yet. Harif is still continuing his study at the Doctoral Program in Nursing Universitas Airlangga Surabaya. And he also won a doctorate in January 2021.

How about a lawyer? His interest in law began when he enrolled at the Faculty of Law, Ibnu Chaldun University, Jakarta in 2007. After that he was advised by his colleagues to take an advocate course, and after joining he graduated and continued his profession as an advocate. Not enough at the S1 level, Harif also continued his law studies at the Sugijapranata Catholic University Masters of Law, Semarang and finished in 2018. With a hard struggle, he was able to complete his studies even though it took 8 years. "I almost dropped out (drop-out), but finally I was able to complete my master's degree in law," he admitted.

Having a lot of busyness makes Harif have to be smart about maintaining health and fitness. “Health is very important and must be maintained. Especially during a pandemic like now. Prokes and vaccinations are non-negotiable. I'm the only one who has been fully vaccinated and still exposed to COVID-19. But thank God, now he has recovered and can return to his normal activities,” said the man who was born in Curup, Bengkulu, August 3, 1969.

As the head of PPNI, he diligently visited nurses who served in remote parts of the country. They are fighting against the ferocity of the COVID-19 pandemic in the midst of limited health facilities. “Yesterday at a very high time of the pandemic, we visited and encouraged friends in the field. They work hard and are full of risks,” Harif said.

What he supervises, among others, is the working facilities of the nurses, and the working hours and rest areas for nurses. “When resting, it must be of quality, not the amount, if possible, don't be disturbed when the nurses get rest. And no less important is the work equipment because they have to deal with COVID-19 sufferers as well," he said.

As for personal health, Harif really has to take care of the chronic ulcer disease that he has been suffering from for so long. “Because I have chronic gastritis, I have to maintain the quality of the food. The frequency of food intake is also the same. And I have to avoid certain foods that can be triggers such as durian,” he said.

In addition, he took the time to exercise. Even though he is aware that his current age is no longer young, he cannot force his body to do strenuous exercise. “I regularly play table tennis. Table tennis doesn't require too much energy. I did it just to sweat, just enough. I do it two or three times a week," he continued.

In terms of art, Harif likes to sing melancholy songs by Rinto Harahap, Rano Karno and Tommy J. Pisa. However, he admits that he is still within the scope of karaoke at home or in a limited environment. “When I'm at home to unwind with my wife and children, I sing. Incidentally, I like melancholic songs that used to be hits. Its creators are Rinto Harahap, Rano Karno and Tommy J. Pisa. Another song, which is at the same time as the creators," he said.

Harif realizes that his time to meet with family is very limited due to his busy schedule in the organization, as a lecturer and also an advocate even though he is now inactive. Therefore he will make the most of the time available to meet his family. When there is a marathon working visit from one area to another he will try to stop for a moment at home. After that, he continued his work visit or carried out his activities as a lecturer.

"It just so happens that my first child has finished college. The second child is still studying in Bandung. And another is studying at a boarding school. For a child who is studying in Bandung, we just have to make an appointment when he comes home on holiday. As for my son, who is at the Islamic boarding school, it is a little difficult because during this pandemic, physical gatherings are limited by the pesantren," said Dr. Harif Fadhillah, SKp., SH., M.Kep., MH., to overcome the difficulties of meeting their children at Islamic boarding schools, online methods were also used, such as video calls.

"Internationally we have also said that this should not be done even in conditions of war. But how come this is not war, but KKB (Armed Criminal Group). In the end, we complained to Komnas HAM. We discussed with IDI (Indonesian Doctors Association) to bring this issue to the world level,"

Dr. Harif Fadhillah, SKp., SH., M.Kep., MH.