Students in Malang, East Java, collected garbage on Monday (20/2) during a garbage alms activity promoted by the Malang Environment Agency. The garbage was collected at a garbage insurance clinic in Bumiayu subdistrict, Kadungkandang district, Malang. The clinic receives garbage as payment for the premium of the city’s Health Care and Social Security Agency (BPJS Kesehatan).
Garbage is not always a disaster. In Malang, East Java, people collect garbage and take it to a clinic to use for the Healthcare and Social Security Agency (BPJS Kesehatan) premium. With this garbage, people can access essential health services.
At noon on Tuesday (21/2), Munah, 54, a resident of RT 001 RW 005 neighborhood in Bumiayu sub-district, Kedungkandang district, Malang, East Java, lined up to have a health checkup at Klinik Asuransi Sampah, a health clinic run on garbage, initiated by physician Gamal Albinsaid. The clinic was established in 2013.
Gamal was the recipient of the Kalpataru Award in 2016, as well as an award from Prince Charles for his idea to use garbage to pay the premium for health services.
Munah was excited because garbage could replace the fees to access doctors and medicine. Decades ago, she lost her first and second children to diarrhea. “I took my first child to a doctor. He told me to hospitalize my child. I was a domestic helper and had no money to pay the bill. So I took care of my child at home. But he did not survive,” she said.
The same happened to her second child, who became ill and died because his mother had no money to pay for medical treatment. This is tragic.
Now, Munah lives with her third child, husband and her parents. Every day, Munah collects plastic garbage, paper and bottles from her boss’ house. The garbage she collects is then picked up by a clinic employee every Wednesday. She doesn’t worry anymore. The waste now serves as her savings. “Had this model of health treatment existed long ago, my children might be still alive,” Munah said with teary eyes.
The family of Ponali, 65, Solfiah, 60, and their child Nurhamzah, 37, residents of Bumiayu subdistrict, have also received similar benefits. Using a walking cane, Ponali went to the clinic for a health checkup. Ponali’s family registered as a clinic member and joined BPJS Kesehatan.
“I have routinely received health checkups at the clinic for the last year. If I cannot go to the clinic, the doctor or nurse come to my home. Since getting treatment, I can get up and stand up,” said the man who suffered a stroke three years ago.
Ponali said before he had the stroke he worked as a farm laborer in the morning and sold fish at Gadang Market at night. He did this to make ends meet.
“I could not get treatment at the hospital because it was too expensive. Thank God, in the past year my health has improved and I can walk. I achieve this by collecting garbage,” Ponali said.
Since Ponali fell sick, his family got into financial trouble. Their child, Nurhamzah, worked as a construction worker and could only earn Rp 50,000 per day if there was an ongoing construction project. “We receive a lot of help with this health service model. Now, we have a way out if one of us falls sick,” Nurhamzah said.
The smiles of Munah, Ponali and Nurhamzah drive cooperation between Indonesia Medika (the health entity belonging to Gamal) and BPJS Kesehatan.
The cooperation was launched on Tuesday (21/2). The program, titled Garbage for the BPJS Kesehatan Premium was initiated by Indonesia Medika with BPJS Kesehatan Malang and the Malang Environment Agency.
More complete
The program is an upgrade to a previous model. The public not only receive essential health services at the clinic. As BPJS Kesehatan members, they are entitled to medical services in hospitals.
“Members of the garbage-run clinic used to only receive health services at the clinic. By registering as BPJS Kesehatan members, their health services also improve. By collecting garbage, if a patient has a heart attack, they can have surgery to implant a ring in their vein. Cancer patients can have chemotherapy,” Gamal said.
There are now 230 clinic members and 100 of them have registered as BPJS participants. The rest are still undertaking the verification process to prevent duplicate membership with the National Health Insurance-Healthy Indonesia Card (JKN-KIS).
The premium for BPJS Kesehatan’s third grade health service is Rp 25,500 per month per person. The value of the garbage collected is Rp 10,000 per month per person. That means there is a gap, which the clinic pays. “At the moment, we pay the gap using money from the corporate social responsibility [CSR] funds of some companies. In the future, we have options to maintain this model and to replicate it,” Gamal said.
Some of the options, Gamal said, were for the government to support the program by providing funds through the public service obligation (PSO) budget, continuing the use of company CSR funds and the garbage team managing garbage better so it was worth more. Under the last option, the public would pay Rp 15,500 to plug the monthly premium gap.
“We have to think about it all. We want to continue this program,” said Gamal, who also setup homedika.com (a website that connects medical workers and patients), ayotolong.com and siapapeduli.id (a crowd-funding site to help people access health services).
BPJS Kesehatan Malang health service management head Muji Hariyanti said BPJS Kesehatan accommodated any innovations that made it easier for people to access BPJS Kesehatan services.
