Yusuf Nugraha, Treating Others without Causing Distress
Healthcare is more than just administering medicines. It is a devotion to ensuring public health. Yusuf Nugraha, 37, is a medical doctor who cares for all his patients equally. With 10 used plastic bottles, he serves his patients with all his heart.
The sky was already turning red as afternoon turned into dusk on Monday (16/7/2018) and yet the Harapan Sehat Clinic in Sukasari village, Cilaku, Cianjur, was still filled with patients. Some were queueing for physical examination and others were waiting for their medicines. More than half of the patients were wearing simple clothes with disheveled flip-flops and without any jewelry. Some of them were middle-aged. They were all waiting patiently.
On one corner of the physical examination desk, there was a list of medical service costs. Different from other clinics, the Harapan Sehat Clinic gives several options of payment amounts, between free-of-charge and hundreds of thousands of rupiah. Patients are free to choose. There are even unique ways to pay for medical service at the clinic, including by reciting one juz (section) of the Quran or giving 10 used plastic bottles.
Payment with used plastic bottles is unusual. Their financial value does not even cover the costs of physical examinations and medicines.
Harapan Sehat Clinic director Yusuf Nugraha, who opens practice at the clinic, provides the payment amount options to alleviate poor patients from the burden of medical costs. The clinic cooperates with companies in using their corporate social responsibility (CSR) schemes to cover the medical costs.
That afternoon, Yusuf was explaining the plastic bottle exchange payment option to several queueing patients. Wearing a neat white coat, Yusuf spoke in polite Sundanese to his patients, some of whom were elderlies.
Yusuf blended easily with his patients in the waiting room. He often joked and laughed together with them. Just in front of him, an elderly woman was sitting calmly with a smile on her face.
“I don’t want you to be afraid of coming here just because you don’t have any money. Whenever you feel unwell, just come. Don’t think about the payment,” Yusuf said while gently massaging the woman’s shoulder, as if he was massaging his own mother.
Yusuf said that good communication made patients comfortable and led them to trust him in providing treatment suggestions. The positive energy induced by the trust enables doctors to find out patients’ illnesses easily as the patients will be more open with their conditions.
For Yusuf, gaining patients’ trust was not only about good communication but also about freeing them of medical costs. He said that poor people sometimes avoid going to doctors as they could not pay. This is especially if they have illnesses that require costly treatments.
“They choose to hide their illnesses as they are afraid to go to the doctor and have no money. This is despite doctors are trained to cure people and to ensure public health. We are sworn to serve the people,” he said.
Afraid of getting sick
Yusuf’s motivation of helping poor and sick people to get health was nurtured since he was a small boy. Yusuf said that he was not as lucky as other kids. When he was just five years old, the youngest of five siblings were forced to endure a separation in his family.
Through shaky voice, Yusuf told about his life difficulties in his youth. He lived a modest life with his mother and four siblings. As an elementary school teachers, Yusuf’s mother worked hard to earn money for the family. The life made him afraid of getting sick and going to the doctor.
“Once I was so afraid when I got sick because I know that it would be costly. Even for daily needs, we had to share whatever we had, no matter how small, with one another. I don’t want others to experience that,” said.
Costly medical costs affirmed Yusuf’s pledge of helping others as a medical doctor. With permission and help from his family, Yusuf enrolled at the Jenderal Achmad Yani University’s School of Medicine.
During his education, Yusuf spoke to many doctors and found that many saw doctors as a highly-paid profession. He said that this was unfortunate as doctors should serve the people.
“Health belongs to everyone and is a human right. It is unfortunate if people see doctors merely in financial terms and not as a devotion. For me, becoming a doctor is my way of humanizing people by providing them with affordable healthcare,” he said.
Unique ways
In order to truly serve his hometown of Cianjur, Yusuf deliberately does not set any fee for his poor patients. Since the Harapan Sehat Clinic was established in 2008, he has always provided several options of payment amounts. This way, he hopes the poor locals are willing to seek medical treatment.
At first, Yusuf did not provide the payment option with used bottles. Then, one time, he received a patient wearing simple clothing. After the medical check, the middle-aged man gave him Rp 10,000 (US$0.69). Yusuf tried to reject the money as he offered free services for the poor.
“However, the old man did not want me to take pity on him. I forgot when this was but I never forget the man’s face. He said that he had saved the money to come to me. I was so touched and could not reject the money. In the end, I accepted it,” he said.
He then told his wife Dwi Kartikasari, 32, about it. Dewi, who is an environmentalist, proposed that he set up a payment option with used bottles. In the scheme, patients can obtain a coupon for free healthcare service by handing in 10 used bottles.
“Not everyone accepted the option willingly. There is an art to giving and to help others without offending them. We set up the used bottles payment scheme to avoid people from being reluctant to come here. The payment option with one juz of the Quran was set up as the people here is predominantly Muslims,” Yusuf explained.
The scheme was not always smooth. The cross-subsidy system would affect the clinic’s income when regular patients are fewer than the poor ones. Yusuf said that he once had to use hundreds of millions of rupiah of his own money to cover operational costs.
However, Yusuf remains firm with his principle. Currently, he has 46 employees, including four doctors and one dentist. Every month, the clinic serves 200-300 patients, comprising 40 percent of general patients, 30 percent of healthcare social security agency (BPJS Kesehatan) beneficiaries and 30 percent of social program beneficiaries.