Alumni of The Month: Nurhanita

When and what did you study in UK?

I studied the MSc. in Health Education and Health Promotion at King’s College, University of London in 2000 – 2001.

Can you please tell us the most memorable story from the time when you studied in UK?

The most memorable thing I treasured during my study in London was the genuine interaction with various people. I was the only Indonesian on the course, with a majority of British students and lecturers.  I lived in campus accommodation with other overseas students. Furthermore I volunteered with a charity in Hackney, supporting cancer clients and families. These unforgettable experiences truly reminds me of the universal virtue of human beings regardless of their race and ethnicity, religion, economic, social circumstances, and cultural backdrop.

We heard you are working in palliative care. It’s not really well known in Indonesia. Can you explain a bit about it?

The World Health Organization (WHO) defines palliative care as an approach that improves the quality of life of patients (adults and children) and their families who are facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and correct assessment and treatment of pain, and other problems, whether physical, psychosocial or spiritual. Palliative care also respects the choice of patients, and helps their families to deal with practical issues, including coping with loss and grief throughout the illness and in case of bereavement.

Despite the long existence of palliative care and inception of the modern hospice by Dame Cicely Saunders in 1967, the field is considered new in Indonesia. Some health professionals were exposed to it in the ‘90s.  But the policy makers and public hardly knew about it, and there was limited policy in support of palliative care and hospices. Only a few providers – hospital, ‘hospice’, charity, and community – served the ill or dying patients and families. Now I am beginning to observe, some progress. More health professionals, hospitals, charities and local government are showing interest and actions in providing support to the provision of palliative care on an in-patient, out-patient and home-visit basis.

Indonesia, however, still has some challenges to the implementation of good quality palliative care.  Not least its vast area, dense population, geography of rural, urban and islands.  Palliative care needs to be integrated with primary care support, including the provision of appropriate and accessible opioid-based pain killers as recommended by the World Health Organization.  It is vital, in the spirit of human rights and Universal Health Coverage, that an effective palliative care policy and practice is developed across the country for the benefit of all.

I am an optimist, despite the limited nature of the education measures and palliative care system currently in place.  Indonesia has a special culture with a long-held positive attitude and wisdom towards life, death, family, and community support. With this culture we should be more capable in ensuring a good quality of life for people living with life-threatening illness from diagnosis.  We should ensure a dignified quality of death – in their own preferred place: home, hospital, or hospice.  Finally we need to retain, nurture and support within the palliative care sector, Indonesia’s invaluable cultural and spiritual approach in support of the bereaved and family after death.

Please tell us about your current job role and the challenge in Indonesia?

To the best of my ability I keep supporting the impetus of palliative care in my hometown and throughout Indonesia, working with charities, individuals, community organizations, and policy makers who show an interest and willingness to participate in palliative care. I facilitate, advocate, educate, manage volunteers, liaise with individual donors, and keep befriending those in ill-health or dying.

I consider my work with palliative care a vocation.  It’s currently challenging to find formal full-time work within the sector, given my non-clinical background, and its current stage of development and limited funding.  I believe my skillset and background compliment the skills of clinicians:  It’s essential the profile of the palliative care sector and in particular the needs of the chronically ill, dying and bereaved continue to be raised.  In the meantime, I keep working in health promotion on a project or assignment basis.

Can you tell us the most memorable story during your career?

Each case offers its own individual journey. I personally love palliative care as it is a constant reminder of our wonderful life and imminent mortality.

Do you have any messages for Chevening alumni in health sector (maybe you can add your contact as well in case they want to get connected with you)?

Just to remember what we are here for.