Indonesian Ostomate: A Collaboration
Challenge to Address Issues

By Ns. Pipit Lestari, S.Kep

Sunday 21st June, the Stoma Nurse Ostomy Support Group (SOS) held an online meeting between stoma nurses and ostomates in Indonesia, which was attended by representatives of the Asia Pacific Ostomy Association (ASPOA) to match ideas about stoma in Indonesia. This meeting identified several stoma challenges in Indonesia which has been exist for decades. Thousands of ostomates in Indonesia currently face various challenges. Lack of knowledge about stoma care, poor coordination between ostomate communities and the between the related health professionals, and affordable stoma bag supplies were some of the problems that are highlighted. This problem became a serious concern because it is directly related to ostomate quality of life.

There are currently huge number of ostomates in Indonesia, including old and new ostomates. Particularly in Bogor Area, there are at least more than 35 new ostomates recorded every month. However, despite this number of ostomate in Indonesia seemly to be huge, there is no exact data of ostomate recorded. We assume that the number recorded may be far less than the real number. This amount cannot be recorded properly due to lack of coordination between ostomate associations in Indonesia, as well as poor coordination between related parties such as stoma nurses, ostomate associations, surgeons, government and hospitals. The absence of a well-structured system that allows the regulation flow that supports the ostomate from pre-operative to rehabilitative is major cause of this circumstance.

Another Issue is the majority of new ostomates do not get good education about stoma care, ostomy supply (stoma pouches), and support groups. This issue are very significant because these uneducated ostomate would likely to be clueless how to live with stoma. Furthermore they would find difficulties to reach help and proper ostomy appliances. If this continues, there will be more ostomates whose quality of life is at stake to be poor. Ostomate which has optimal support from stoma nurses, doctors, and fellow ostomates has a much better quality of life than those who do not.

Stoma pouches are one of the primary needs for ostomates. Every month the ostomate needs at least 8 of it. The price of each brands of stoma pouches ranges from IDR 30k to 35k per bag for colostomy bags and IDR 50k-75k for urostomy bags. This price is certainly quite burdensome for ostomates, especially for middle to lower economic ostomates. Not to mention the stoma accessories, which can cost hundreds of thousands Rupiahs for ostomate with special needs such as hernia, and peristomal skin problem. Without the proper stoma pouches and knowledge of stoma care, the quality of life of ostomate is likely to be lower.

Nowadays, Stoma appliances assistance from ASPOA is always available. However, this donations and assistance could not be delivered due to constraints related to Indonesian ostomate data and the organizations that oversee the ostomate association are currently not well organized into one door system, because it will cause lack of liability to assure this donations to be properly stored and delivered. of this donationn. Other obstacles in receiving aid from abroad are shipping and taxing. Some assistance that has been sent by ASPOA is still not delivered to ostomate because it stuck in Customs and bureaucracy to collect the bags from Custom are difficult.

The main solution of this problem is to increase the collaborations between the parties concerned. WOcare and SOS Indonesia are willing to re-facilitate this joint work, so that support for ostomate can run optimally. Re-build a structured system to support the ostomate from the pre-operative process to rehabiliative until the ostomate is able to return to live its life as before is necessary. Back to work together to facilitate the supply of affordable bags for ostomate is very essential step to do. In the short term step We could raise awareness for the community and all related parties including surgeons, nurses, and government about stoma and the importance of meeting a stoma nurse so that more ostomates will

understand the proper stoma care and access to supply. In addition, the collaboration between all the parties including ostomate associations, health facilities, surgeons, stoma nurses, governemnment and community need to be facilitate soon. All the parties should Work together because Ostomate Quality of Life matters!