When Dr. Vina Wang first told her parents she would like to work for Alam Sehat Lestari (ASRI) in rural Borneo, they took some convincing.
“When I first wanted to go to ASRI, it was hard to ask for my father’s permission because my parents think Borneo is in the middle of nowhere. My mother was very supportive, but my dad was worried about his daughter in the middle of the jungle.” Vina told HIH’s executive director, Michelle Bussard, in a recent interview.
As an Indonesian of Chinese descent, it’s traditional for Dr. Vina to get her father’s permission before making important life decisions – and this would be a big change. Then a recent graduate from the prestigious Marantha Christian University in West Java, she was working for a clinic near her hometown, serving low-income communities. The job opening at ASRI sounded like an ideal opportunity: Dr. Vina was impressed by ASRI’s holistic approach to medicine and commitment to delivering high quality care to poor and distressed communities.
“I have a dream, “ she said, “to become a specialist in emergency medicine, and in Indonesia it’s a requirement to work for a year in an underserved community before applying to residency,” so after a long discussion, her father gave his permission for a year’s service.
One year later, Dr. Vina went back to him to ask to work for ASRI for another year -- and to travel to the US for a four month fellowship at Yale and Stanford that would lead to serving as ASRI’s Head of Clinic.
The ASRI clinic is a small, bright house set off one of the main thoroughfares of Sukadana – a narrow two-lane road that was paved only a few years ago. It’s easy to spot, especially during clinic hours: people come and go all day through the open door and entire families spill out of the waiting room onto the tiled porch as they wait for their loved ones to be seen by ASRI’s doctors. It may not seem like much at first glance, but this clinic is transforming the way medicine is practiced in rural Borneo – and creating new opportunities for both the patients and the doctors.
“Being a doctor in this very rural area with limited resources is very challenging, but at ASRI we’re having a good time learning.” Dr. Vina shared. “I’ll be very happy if I can help people and save their lives, because I learn to treat patients with everything we have.”
ASRI places a strong emphasis on constantly honing skills and sharing knowledge. Most of ASRI’s doctors are young, recent graduates coming to fulfill their year of service before applying for specialist residencies. ASRI’s volunteer program matches these talented young doctors with experienced medical practitioners from around the world, who share their varied expertise with ASRI’s doctors while learning about tropical medicine and providing care in a low resource setting. The free flow of knowledge ensures ASRI’s patients are always receiving the best possible care.
“Maybe these are things I can’t do in the city, because we’d have to refer patients to the higher facility or to a specialist. In Sukadana, ASRI is considered the highest level of care. We give our best efforts to save people’s lives.”
Dr. Vina’s best efforts got her noticed: when Dr. Nur, ASRI’s Head of Clinic, decided to return to school for his residency, Dr. Vina was tapped to be the next clinic leader. That was when she went back to her father.
“In the beginning, he said ‘no,’ because he was worried about me spending another year at ASRI. I explained how great an opportunity it was for me, and how much experience being head of clinic would give me. My mom helped me finally get his permission to stay at ASRI.”
But before becoming head of clinic, Dr. Vina had one more trip to make: to the United States.
Like Dr. Nur before her, Dr. Vina went to the United States for a four-month observership at Yale and Stanford Universities.
Before she left, Dr. Nur pulled her aside. “Please use this opportunity to learn as much as you can, because after you become head of clinic, you’ll be responsible for the decisions about patients and our clinic,” He told her. “Learn how Yale and Stanford do their education, so you can train and give teaching lectures to new doctors at ASRI.”
Dr. Vina took Dr. Nur’s words to heart: before she left, she made a wish list of the things she wanted to learn, which she sent to Health In Harmony supporters Drs. Kathleen White and Asghar Rastagar at Yale, and Drs. Ewen Wang and Michele Barry at Stanford. A schedule was made that would provide the most ASRI-specific learning possible.
Yale was a whirlwind of varied lessons. The days started with a morning meeting and rounds, where Dr. Vina saw all kinds of cases at an inpatient ward with a group of residents, pharmacists, and medical students. After rounds came a teaching lecture, followed by the noon conference. She studied reading x-ray film with an attending, a useful skill for the ASRI clinic, despite the clinic not having an x-ray machine: patients who can afford an x-ray at another facility often bring their films to ASRI for diagnosis and treatment. She spent her third week at the VA Hospital, doing a rotation at an outpatient clinic similar to ASRI and working with Dr. White’s team – a nurse practitioner, pharmacist, psychiatrist, and other doctors.
“I saw a lot of medical complications, especially in older patients with a lot of medical problems.” Dr. Vina shared. “It was a great learning experience.”
After two months at Yale, Dr. Vina joined Dr. Ewen Wang, a repeat ASRI volunteer and long-time supporter, at Stanford University. There, her observership was focused on shadowing an emergency services attending physician, and attending in-depth ultrasound classes with only four other students. To many American readers, ultrasound is only associated with pregnancy, but at the ASRI clinic, its uses are much more extensive.
“Sonogram is the only tool ASRI has for diagnostic imaging tests. The closest chest x-ray is in Ketapang, costs 8 to 10 dollars, and the transportation there is very expensive – often our patients can’t afford it. We use the ultrasound a lot for examinations: for example, if we have a trauma patient and are worried about internal bleeding, we’d use ultrasound to assess.” Dr. Vina said. “Ultrasound lets us make better, faster decisions for the patients – like sending them to Ketapang immediately for surgery if necessary.”
Chock-full of new techniques and skills for ASRI, Dr. Vina returned to Sukadana a few weeks ago as the Head of Clinic. Since returning, Dr. Vina shared that, “It’s been really busy, and we only have three rooms and three doctors!” She explained that the clinic was even more crowded than usual with five inpatients. “Right now we’re using one of our exam rooms for a TB room, which means that I’ve had to use the dental room sometimes.” Hence the great need for a new and larger Community Health and Training Center!
Despite the hectic pace, she’s settled back into work at ASRI and is enjoying working with the clinic’s newest doctors, Dr. Yuli and Dr. Nomi.
“I want to create good learning opportunities for Dr. Yuli and Dr. Nomi.” Dr. Vina said, ready to pass on all she has learned at ASRI and during her observership. “Dr. Ewen, who is here now, is a great helping me figure out how to approach different cases so I can tell Dr. Yuli it’s ok for her to take her time, and develop good diagnostic skills. Because Dr. Ewen understands our limited resources here, she’s a great teacher.”
She hopes to help make Dr. Nomi and Dr. Yuli’s ASRI experience as profound as it has been for her.
“Working at ASRI has been a life changing experience for me – it changed the way I think about patients. I’ve learned so much from Kinari, Nur, and the volunteers that have come here.”
And as for her father?
“He’s so proud of me.” And so are we!
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