The Indonesian government has tried to offer comprehensive health care with its National Health Insurance, or JKN, managed by state-run agency BPJS Kesehatan.
Signing up for the JKN is compulsory and relatively cheap, subsidized plans cost from around Rp 25,500 to Rp 81,000 ($2-$6) per month.
Sadly, administrative bungles have meant that in reality not every citizen has signed up for the JKN. And those who have sometimes still have difficulties getting medical treatment because of limited facilities or lack of doctors.
Many hospitals in rural areas do not have the equipment to treat chronic illnesses, so patients often need to be transferred to big-city hospitals – which are often located far away.
Transfer to bigger hospitals and the cost of treatment there will be sadly at the patients’ own expense. If they cannot afford the transfer, often all they can do is hope for a miracle.
Young Doctor With a Heart of Gold
This is the reality in many poorer parts of Indonesia and one that young doctor, harpist, and model Dwi Lestari Pramesti Ariotedjo, better known as Mesty Ariotedjo, witnessed on her own when she did her general practitioner internship Ruteng, a hilly district in the island of Flores in East Nusa Tenggara back in 2012-2013.
“In the end, many patients could not get treatment and had to die simply because they did not have the money to get transferred to better hospitals in big cities,” the 28-year-old doctor said.
Her harrowing experience in Ruteng inspired her and her colleague Gigih Septianto to establish WeCare.id, a crowdfunding site to raise money for patients who cannot afford the medical treatment they need.
Gigih was the winner of a Mandiri Young Technopreneur grant for his PhiRUNtrophy, a sports-tracking mobile app he invented that can convert one’s daily workout routine into donations.
He used the grant to found WeCare, which was launched in October 2015.
Two years after its inception, WeCare has managed to raise around Rp 2.5 billion from over 5,000 donors to pay for the treatment of more than 300 patients from all over Indonesia.
“Everybody deserves the best health care they can get. We’re doing our best to help all Indonesians,” said Mesty, who is currently training to become a pediatrician at Jakarta’s Cipto Mangunkusumo Hospital (RSCM).
Help for Everybody
Anyone can use WeCare’s services as long as they can produce the government-issued “poverty card” (SKTM) as proof that they cannot afford their medical treatment.
“We don’t just help patients from rural areas, but also those who need treatments that the JKN won’t pay for. These include anything from expensive medicines to rehabilitation therapy. Our focus is to help patients get the treatment they need,” Mesty said.
Applying for the crowdfunding can be done on the WeCare website by the patients themselves, their families or their doctors.
WeCare’s medical mediators, or “medicators,” will review each application and decide to accept or reject it based on the urgency of the case.
The medicators generally prioritize patients with serious prognosis and who need less than Rp 25 million to complete their treatment.
“But we look at every application on a case-by-case basis. We sometimes also select patients whose treatment will cost more than that. It depends on the urgency of the case and if we think it can easily attract donors,” Mesty said.
Once the crowdfunding proposal is accepted, a campaign to help the patient is set up. Each campaign is given two weeks to achieve its funding target, but there have been many occasions when donations came thick and fast and the campaign is over in a matter of days.
Mesty recalled a case involving a seller of gorengan (assorted fritters) in Jakarta, whose wife gave birth to a baby suffering from hydrocephalus.
The man had already gone into debt paying for the birth of his child, and had no money left to pay for his newborn’s treatment.
To make matters worse, the man was not signed up to the state-run JKN health care plan. Since there was never any drama with his wife’s previous pregnancies, he thought this one would not be any different.
“I told him we [WeCare] would try to help them as best we could. But in just one day, we were able to get the Rp 55 million the mother and baby needed,” Mesty said.
WeCare’s campaigns so far have an overall success rate of 90 percent. If a campaign fails to reach its funding goal after two weeks, WeCare will allocate it money from its “Donasi #UntukSemua” (Donation #ForAll) program – an always-available option for donors who want to give money without selecting a specific campaign.
But what happens if a patient dies? So far, around 5 percent of patients seeking help from WeCare died while still in treatment.
“If a patient dies, the money that hasn’t been used for treatment will be given to another patient. We make that deal with the patient’s family from the beginning,” Mesty said.
Paving Ways for Collaboration
WeCare has already received plenty of recognition for its efforts. In 2015, it won the Best Social Start-Up Idea at the Asian Social Innovation Award. It was also a finalist in the 2016 Bayer Aspirin Social Innovation Award, 2017 DBS-NUS Social Venture Challenges and 2017 Sankalp Southeast Asia Award.
In October this year, WeCare was the only Indonesian representative invited to join the Start-Up Track session at the World Health Summit in Berlin.
These exposures have paved ways for WeCare to join hands with public and private sectors.
WeCare has six public and private hospital partners in Bandung, West Java, and two more in Jakarta. They include Hasan Sadikin Hospital, Al Islam Hospital, Atmajaya Hospital and the Jakarta branches of Lippo Group’s Siloam Hospitals.
In Bandung, WeCare signed an agreement with the city administration to promote WeCare to hospitals and convince them to partner with the startup.
Thanks to the partnership, hospital staff can now nominate patients that require WeCare’s help to raise money. This makes WeCare’s task easier because diagnosis and medical costs for the patients will already be verified by the hospital.
Bandung Mayor Ridwan Kamil has been known to promote WeCare on social media, attracting more donors to many of its crowdfunding campaigns.
WeCare has also worked with brands, for example with insurance provider Panin Dai-ichi Life for its #OrigamiHatiKami social media campaign.
The Instagram hashtag was used to encourage users to post photos of their origami creations, with each post matched with a Rp 10,000 donation. The campaign raked in a total of Rp 100 million for child cancer patients.
During the Islamic holy month of Ramadan this year, ride-hailing service Go-Jek also allowed its users to donate to WeCare using its ticketing feature, Go-Tix. A total of Rp 31,475,000 was raised and distributed to 15 child patients signed up with WeCare.
WeCare has also partnered with Uber, consulting firm Pricewaterhouse Coopers and received grants from beauty brand Wardah, state-run energy company Pertamina and watch store The Time Place, among others.
Despite its list of achievements, Mesty said progress at WeCare is still relatively slow.
Since her residency at RSCM consumes most of her time, Mesty barely has the energy to do anything else.
In the past, she also used to write articles on health for magazines and newspapers and academic papers – three of which had been published in the International Journal of Pediatric Endocrinology.
Now she only has two priorities: finishing her pediatrician training and developing more innovative crowdfunding strategies for WeCare.
“Gigih and I are still finding ways to make WeCare sustainable. I’m currently concentrating on finishing my degree but I do what I can to contribute [to WeCare], no matter how small,” said Mesty, who was in Forbes’s “30 Under 30 Asia: Healthcare & Science” list last year.
Mesty said she wants to ensure that WeCare not only survives but also remains committed to help people heal. The main challenge is how to help patients who need follow-up treatment or therapy.
WeCare so far are only able to help patients for up to six months. But Mesty said patients with immunity or nutrition problems, for instance, need special treatment for much longer, which is the reason why she is developing a membership program.
The program is scheduled to kick off in the first week of December even though it has not been officially launched. It works similarly to a health insurance plan, requiring patients to pay a fee of Rp 25,000-Rp 35,000 per month.
“One of the benefits of joining our membership program is the ability to consult our medicators through SMS, so you don’t need to chance it when you go to a hospital. A lot of hospitals like RSCM are packed with patients, but there’s simply not enough doctors. [Our SMS service] can inform patients if it would be better for them to go to a hospital, and which one, or Puskesmas [community health center],” Mesty said.
The membership is also expected to give more encouragement for patients to recover. According to Mesty, some patients take it for granted that WeCare will pay for more treatment as long as they sign up for their help and then slack off on their recovery routine.
The membership will also be made available to donors, allowing them to help individual patients until they recover completely.
Mesty, who was one of the recipients of BeritaSatu.com’s 2014 Inspiring Young Leaders Award – handed out by President Joko “Jokowi” Widodo – said she is also developing a new social enterprise in conjunction with WeCare.
She refused to reveal her plans for the new enterprise, but one thing she was certain was that WeCare will remain a nonprofit organization.
“We want to create a social enterprise, but as a separate entity. WeCare will not be turned into an enterprise,” she said.
Mesty and her team’s main focus now is to improve WeCare’s programs. The biggest challenge, according to Mesty, is not the the lack of doctors or nurses, but the lack of creative ideas.
On the other hand, entrepreneurs with good intentions to help medical practitioners have plenty of ideas but do not always know how to turn them into real projects.
“We have to come up with realistic ideas. Many health care startups had to fold because the organizers don’t know how to deal with specific medical issues. As long as they don’t have hands-on experience, it will remain difficult for them,” the recipient of Harvard School of Public Health’s Fellowship Award said.