PT-FI works closely with the local Mimika government to support the provision of health services in the region through capacity building, construction of clinics and malaria control programs. With the goal of achieving greater independency and sustainability of public healthcare, PT-FI is working to hand over PT-FI-run public health infrastructure and services and impart good healthcare practices to the local Mimika government.
Malaria, HIV/AIDS and tuberculosis (TB) remain the most common infectious diseases that not only afflict our neighboring communities but also our workforce and their dependents. Non-communicable diseases, principally cardiovascular diseases, diabetes, obesity, cancers and chronic respiratory diseases, are increasingly prevalent in our local communities. A combination of poor lifestyle (habitual risk factors including high, unbalanced nutritional intake, lack of exercise, smoking, etc.) together with a general increase in life spans due to factors contributing to better standards of living (e.g., employment opportunities, better housing and transportation, access to healthcare) have directly or indirectly contributed to an increase in chronic metabolic diseases and the likelihood of developing age-related aliments.
In coordination with the local government and non-governmental organizations (NGOs), the PT-FI Community Health Development department, assisted by the company’s medical services provider, International SOS, implements programs for education, prevention, counseling, diagnosis and treatment of diseases within and around the project area. This includes a comprehensive public health program addressing malaria, HIV/AIDS, TB, and mother and child health. PT-FI also provides significant funding for health activities via the Partnership Fund.
Papua province in general, and specifically the Mimika Regency where PT-FI operates, have the highest malaria prevalence rates in Indonesia. In almost every local community within our project area, malaria infection is the single greatest cause of morbidity and hospitalization. Coping with rapid population in-migration and growth is one of the biggest challenges for reducing the incidence of malaria in Mimika. Although declining, the health risks to PT-FI’s workforce and surrounding local communities remains a concern. In response, PT-FI continues to implement its integrated malaria control program focused specifically in the more urbanized areas of Timika.
Since 2013, PT-FI, the Amungme and Kamoro Community Development Organization (LPMAK) and in 2020 the YPMAK, in partnership with the local government, jointly have operated the Mimika Malaria Center and its Timika Malaria Control Program (TMCP). TMCP coordinates all malaria prevention activities, such as indoor residual spraying of insecticides in homes, and bed net distribution among the PT-FI workforce, their families and local communities. TMCP activities have resulted in reduced malaria incidence through significant expansion of coverage, improved coordination, surveillance and reporting of malaria data. In 2020, nearly 45,500 people in local communities were reached through malaria health promotion events. In addition, the malaria incident rate within the workforce stood at 83 per 1,000 people – a slight decrease from 2019. The number of detected cases of malaria at participating community clinics increased to 8,457 in 2020; however, all were effectively treated with first line ACT (artemisinin-based combination therapy). As multi-drug resistance in malaria parasites remains a significant challenge in Papua, detected malaria cases are effectively treated with ACT.
HIV/AIDS prevalence in Papua and Mimika Regency has the greatest impact on the Indigenous Papuan population. PT-FI continues to implement its HIV/AIDS prevention, outreach and treatment programs for its workforce and community members in collaboration with the local Mimika government health services. Results during 2020 were encouraging, with HIV/AIDS incidence in the workplace falling to 0.3 cases per 1,000 – a 77% decrease over 2019. Over 2,000 employees participated in HIV/AIDS-themed educational programs in 2020, and PT-PI’s education and outreach activities reached 2,701 individuals in local communities.
PT-FI continuously improves its HIV/AIDS Voluntary Counseling and Testing (VCT) service performance. In 2020, 6,400 PT-FI employees participated in VCT. This represents a reduction in the number of participants compared to 2019 since no annual medical checkups, usually integrated into the VCT, were undertaken in 2020.
Participants in VCT are being diagnosed with HIV cases at an early stage, before AIDS-related complications arise. Antiretroviral therapy is provided free of charge by the Indonesian government to HIV positive members of PT-FI’s workforce as well as among community members. Early diagnosis provides individuals an opportunity to receive proper treatment that leads to better long-term health outcomes, as well as helping to prevent HIV transmission to others.
PT-FI also provides confidential HIV/AIDS VCT services for community members at all three PT-FI-supported community clinics as well as at the Sexual Health and HIV Clinic in Timika operated by PT-FI in partnership with the local Mimika government and the YPMAK. In 2020, PT-FI provided VCT to 727 individuals from local communities.
The World Health Organization (WHO) ranks Indonesia, including Papua, as having the second largest number of TB cases in the world. PT-FI continues to implement its comprehensive TB program for both its workforce and surrounding communities. In 2020, PT-FI continued its intensive TB outreach efforts in response to high-prevalence rates in Mimika Regency. The company organized one-on-one and group sessions that reached more than 4,100 community members during the year. Through active case detection, PT-FI staff reached out to approximately 400 individuals who were in close contact with TB patients in the community, providing them with testing and educational information. TB outreach events, such as World TB Day, reached 4,131 community members and 2,000 in the PT-FI workforce.
The PT-FI TB Clinic located in Timika, which is operated in collaboration with the local Mimika government and the YPMAK, follows the WHO’s recommended Directly Observed Treatment Short-course (DOTs) approach for active case detection and treatment of new TB cases. Among the 593 people tested through PT-FI’s TB program in 2020, 121 new TB cases were detected in the community and 27 new TB cases were detected in the PT-FI workforce representing a 98% treatment success rate.
YPMAK Funded Health Programs
The YPMAK Foundation, the main recipient of financing from PTFI’s Partnership Fund, manages three main programs, namely health, education and community economic development. As such, YPMAK is designed to strengthen the long-term effectiveness of PT-FI’s social investments and works with the local Mimika government and selected partners to implement two main health programs - health services (prevention and promotion) in 16 target villages in six districts through the “Kampung Sehat” program, which focuses on mother and child health programs (MCH), malaria control, TB and HIV/AIDS control, eye health, sanitation and clean water. The second program is provision of health services through Mitra Masyarakat Hospital (RSMM). As of December 2020, RSMM has provided service for more than 96,500 inpatient and outpatient visits. The hospital, as a Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan partner (a Government social security program for health) expanded its services by building a new clinic within its complex. The clinic helps to register patients covered by the social security system before they are referred to a hospital as per BPJS procedure.
Health service through Waa Banti Hospital (RSWB) was stopped as a result of a security incident in early 2018. The hospital was set on fire and was no longer able to serve the community in the highlands. Guarantees and certainty of security in Banti is an essential factor to resuming health services for the community in that area. Currently health services for the Banti community are provided through a temporary facility managed by local paramedics. PT-FI continues to work with the Mimika Government and security officials to remedy the long-term sustainability problems of infrastructure and public health services in the area.
Total spending for the community health program as of December 2020 was $5.6 million or 76% of the total 2020 health budget.
PT-FI continues to focus on the existing health programs for communities while strengthening partnerships with other stakeholders, which is part of PT-FI’s mission to put Mimika Government in the frontline for health programs. Partnership with the Government on BPJS Kesehatan (social security program for health) will be a focus of Mitra Masyarakat Hospital service, while PT-FI will focus on improving the role and involvement of Government health officers in PT-FI-managed clinics. Strengthening partnership with the Government is a focus of these health programs.
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