Oral Cavity Cancer in Orang Rimba

Nyesep (60), the wife of Sahar, one of the Orang Rimba members of Roni Group was laid down and hospitalized in Raden Mattaher Hospital in Jambi Province. Sore and swollen in her lower lip were characterized and diagnosed as oral cancer, also known as the oral cavity cancer by the doctor. The mother with four children of hers was apparently aware of any changes on her down lips last year. It was only a small bump like an ulcer, but developed bigger time by time. Health facilitators of Indonesian Conservation Community – WARSI visit this target male several times yet was rejected as she did not want to receive any medical treatment. Instead, she preferred traditional treatment to medical treatment while living under the palm plantation belongs to Kembang Ujo Villagers, Pamenang, Merangin District.

Nevertheless, on Tuesday (9/10) Nyesap finally gave up on her condition and asked for medical treatment in the hospital as her lower lip is worse and more swollen influencing her appetite. She was sent to Pamenang Puskesmas while directly proposed to Abunjani Hospital in Bangko in the afternoon. It is in line with the system of patient treatment in Local Health Insurance (Jamkesda), Merangin District. On Thursday, she was further sent to Raden Mattaher Hospital in Jambi Province.

“Now, we are still waiting for a complete medical checkup by the doctor to decide what’s next, early diagnosis of the oral cancer was conducted and the doctor committed to have a surgery,” said Kristiawan, The Coordinator of Tribes Program of Indonesian Conservation Community in Jambi Province.

According to Kris, the local government is still in charge of all expenses spent during the treatment for the Orang Rimba by the local health Insurance program. “One thing we are worried about is that the treatment of Nyesep required her to go to bigger and better hospital while there will be numerous registration system and requirements that the Orang Rimba would find them hard to fulfill without any facilitation, thus, the problem arose either in terms of service provider or facilitator of the Orang Rimba,” said Kris.

This matters as the local health insurance program for the Orang Rimba has not integrated yet to the National Health Insurance (JKN) Program held by BPJS. “our JKN program is based on NIK (identity number), yet, the Orang Rimba apparently, up to now, have not had any identity card yet, only few of them have. Meanwhile, Nyesep and other eight family members living in the sesudungon (traditional house of the Orang Rimba made of plastic) have no identity cards at all, thus, they can not access the JKN-BPJS,” said Kristiawan.

Eventually, this issue is not a new thing as it has already been carried out in several discussions with policy makers. “We were collaborating with the social office, health office, and Population and Civil Registration Agency to discuss this issue in the last September, there were many issues exposed by multi parties to help improve the health service for the Orang Rimba,” Said Kris.

In addition to not being registered in the population and registration system, a number of regions have already policies regarding the health services for the Orang Rimba by Community Health Insurance (Jamkesmas). However, the Jamkesmas has limited quota, so not all Orang Rimba can be served, another obstacle is that Jamkesda and Jamkesmas only entered into force in Jambi Province, thus, if the Orang Rimba or several men have to leave Jambi Province, then another problem would arise.

On the other hand, the hospital officials do not know with whom they should ask for the expenses spent for the Orang Rimba by Jamkesda Program. “Therefore, the Orang Rimba somehow should have been registered in the population and registration system for at least the identity numbers (NIK), thus, the BPJS could take their health fee into account,” Kris added.

Today, there are 5,235 people of the Orang Rimba scattered throughout five districts, namely Bungo, Merangin, Sarolangun, Batanghari and Tebo Districts. They are living in the forest and while most are under the rubber and palm plantation owned by the big companies and villagers. The commitment and awareness of all parties are very crucial for the Orang Rimba, so they could have a fair and same right as other people.

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