Thank you Dr. Terawan!

My sincere thanks to His Excellency the Minister of Health, Bapak DR. Dr. Terawan Agus Putranto, Sp. Rad (K) and his ministerial staff. Healthy greetings to you and the Indonesian nation. How are you Sir? I hope this letter finds you and your staff in good health and that you are blessed in all that you do.

We have not met and you may not know of me, but it is my sincere hope that one day we can meet. I hope that day will come soon. If you are willing to grant me an invitation, I will gladly and quickly respond. My apologies for communicating with you through the web,  this is unusual and please accept my message of deep respect for you and your staff.

Allow me to introduce myself,  I am Doctor Nurlan Silitonga of the Angsamerah Clinic and Foundation. More information about my work and myself

I hope,  that as well as you and your staff, this letter will be read by non-government organizations, those interested in health issues, as well as the general public. It is my sincere hope that what I write here will assist the health sector in Indonesia to make  improvements.

Bapak Doctor Terawan, through this letter, my colleagues at Angsamerah and I would like to contribute some ideas with the aim of expanding health services and increasing access to these services for the people of Indonesia. The specific focus of these ideas is the delivery of  HIV-AIDS, reproductive and sexual health comprehensive services in private primary health care facilities.

By expanding health care services, we do not only refer to providing assistance to the community, but also establishing a healthy working environment for the staff of private primary health care facilities. This  ranges from medical doctors, paramedics, administrative staff, office assistants, and even health care volunteers and those concerned about health from various professions.

The Angsamerah team and I work as a private sector primary health care provider. Our health care service focuses on finding an optimal balance in clinical approaches to meeting the needs of the individual as well as the general public. We also implement collaborative and collective efforts to enable us to optimally utilize our limited resources.

Sir, we sincerely appreciate the breakthrough of your team in DKI Jakarta and at national level. A private clinic has been authorized as an independent provider of anti-retroviral (ARV) treatment. This signifies your trust in a private clinic to manage the distribution of government-subsidized ARV drugs.

That private clinic is Angsamerah, our workplace. The Angsamerah Clinic and Foundation is located in the center of Jakarta, at Jalan Johar 6A, Menteng, Central Jakarta. It is located near the Gondangdia Railway Station, providing easy access for patients from all over Jakarta, from the borders of the city as well as from nearby provinces. As well as our Menteng location, Angsamerah also has a clinic which serves as a ARV Satellite Clinic, on Jalan Fatmawati. We have high hopes that this clinic will soon become an ARV Referral Clinic, like our main center in Menteng.

Your excellency, you may perhaps wonder why Angsamerah Clinic was so eager to become an ARV Referral Clinic? The reason is simple – it’s part of growing up. Most importantly it was an opportunity for us to show that private clinics care and can be part of public-private partnerships that provide quality health care services to the public.

Your Excellency, this breakthrough was achieved through the integrated efforts of many parties. This means a lot to us and we feel it’s important that it is widely known.

Sine 2004, based on the regulations, the provision of ARV in Indonesia has flourished. Distribution was initially through designated hospitals (both public and private). Over time  more hospitals were added and then community health centers (Puskesmas). In this process, many private clinics served as extensions of ARV Referral Hospitals, enabling them to provide HIV testing services and ARV treatment. These clinics are referred to as ARV Referral Hospital Satellites. Private clinics receive the ARV from the Referral Hospital and reports on activity to Ministry of Health (MoH).

Your excellency, this breakthrough means a lot to us. Angsamerah, as an ARV Referral Satellite of the Sulianto Saroso Infectious Diseases Hospital (RSPI), has provided ARV for around 10 years. As of  May 2020, we are providing ARV to more than 800 patients monthly.

The RSPI team have been tremendously patient, guiding us to maximize the quality of our provision of ARV  treatment. The RSPI team led by dr. Adria Rusli, Sp.P. as the head of the hospital AIDS working group, has strived to make Angsamerah Clinic an ARV Referral Provider rather than a satellite.

In early June 2020, we gained recognition for our capacity to directly manage a government-subsidized ARV program with the guidance of the DKI Jakarta Health Provincial Office. We are very happy that our request, submitted to the Health Office, was granted.  After seven months, it became a reality.

Your Excellency, this breakthrough provides a great example of the benefits of public-private partnerships, in this case, increasing access to HIV testing , ARV treatment, and other health programs. These are so important for reducing and controlling the transmission of HIV. We hope that in future more private clinics will receive similar recognition and become involved in the expansion of public health programs run by the government.

Your Excellency, allow me to briefly share the Angsamerah Clinic mission. Besides maintaining and improving the quality of our clinic, we also aim to build partnerships with government programs as well as with other organizations. This is to expand services and  make diagnostic and treatment costs more affordable to the public.

Our third mission, equally important, is to keep striving to find more smart and economical ways to to maintain our quality and to improve the welfare of our staff. For us this is an important mission. As a private enterprise, we are able to manage our own resources, make savings, grow and remain alert in crisis situations, such as the Covid-19 pandemic.

Sir, this third mission is the most challenging. Why? We need a range of expertise, not only medical, but also with knowledge of entrepreneurship and financial support. Most health care colleagues know that running a clinic is costly. Both Angsamerah clinics are now well-developed, but were initially run using our own funds. We were also fortunate to have received financial assistance for capital funding and technical assistance from donor agencies.

The experience of Angsamerah over ten years  is very valuable. We did not retreat whenever we faced difficulties, in fact we have learned much and have directly seen the benefits of applying social entrepreneurship in the health sector. While running a business, our private primary healthcare services have also contributed to creating positive social impacts. We can foresee many opportunities for expansion of primary health care services in the private sector in the future.

Your Excellency, there are many mechanisms that can be used to allow health care providers run healthy,  independent practices and clinics.

Your Excellency, at Angsamerah we have dreams. We dare to imagine that soon Indonesia will soon have many independent practicing doctors, dentists, midwives and clinics providing a wide range of services that are user-friendly, affordable, and  located close to the community.

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