Doctors are rightly treated with respect. We turn to them for any health-related questions, to treat our illnesses, and in some cases they are literal lifesavers.

But becoming a doctor also means contributing a great deal of time – at least 10 years – for medical school and residency, all the while absorbing lessons, knowledge and skills to improve oneself. So it’s perfectly normal for students of medical school to feel inadequate or exhausted at times, as mentioned in the “Meet and Greet: Sharing Knowledge & Journey to Become a Doctor”.

Hosted by the Tanoto Foundation Alumni Association (PANUTAN), the online event took place on July 31, 2021 and invited six Tanoto Foundation alumni from Indonesia and Singapore to share their journey in becoming doctors. Tanoto Scholar Debora Widawati served as moderator while fellow Tanoto Scholar Monica Agnes Sylvia served as host.

Introduced by Tanoto Foundation’s Global CEO, Dr J. Satrijo Tanudjojo, dr. Ng Choon Ta, Member of the Board of Trustees at Tanoto Foundation, opened the session by giving a keynote speech. dr. Choon Ta is also a Consultant for the Department of Cardiology at the National Heart Centre Singapore and a Clinical Assistant Professor at Duke-NUS Medical School.

“Medicine has always been a calling – one that requires dedication and hard work,” he said. “When we graduate from medical school, we start a lifelong journey of service to our patients, and on our mission to advance medical science by finding cures and new care paradigms.”

All six speakers acknowledged the arduous journey to become a doctor, one that required calling, motivation, focus, commitment and dedication. They noted the struggle to balance work and life, and some recommended having other interests as something to look forward to alongside work.

“Medical school is quite demanding: the amount of content we have to do is quite crazy and the speed with which we have to do it is even crazier,” said dr. Shannon Lee, an alumnus of National University of Singapore’s Yong Loo Lin School of Medicine in 2020. “But I think what I learned from it after a while is to not be so afraid of falling behind and learn at our own pace. Better to do it with confidence.”

Fellow 2020 alumnus dr. Summer Zhang Linyi shared the sentiment. “In medical school, I was surprised of how hard it is no matter how much we studied during junior college,” she said. “It’s [also] very hard to balance your life and be who you are and be competent and be a good doctor that you wanted and what the society wants. I feel like one of the things we feel everyday is an impostor syndrome, having the feeling of incompetency and not being who you are despite putting all in the hours you have in your hands.” Nevertheless, she also shared that eventually she found that she was able to adapt and find that balance between work and life.

Stressing the importance of time management in the matter of work and life balance, dr. Surya Atmaja who currently works at a regional public hospital in Jambi credited the soft skill workshops provided by Tanoto Foundation. “Thanks to those, I could manage [my time] smoothly,” he said.

Speakers also recognized the role that Tanoto Foundation played in enriching their journeys in becoming doctors, such as Project Sukacita, the annual community service project for underserved communities in Riau’s Pangkalan Kerinci. Initiated by Tanoto Scholars at Singapore Management University in 2012, the program also saw participants from the National University of Singapore and Nanyang Technological University in recent years. Activities include giving guidance to children on how to lead clean and healthy lifestyles as well as health screenings for children and their parents.

“[The project taught us] to analyze the strengths and shortcomings of each member, the importance of effective leadership as well as teamwork,” shared dr. Woo Shi Min, who is currently in pediatric residency program at the National University Hospital in Singapore. “[These] valuable lessons hopefully prepare us for our work situation and in the future as well.”

Working in the area most affected by the Covid-19 pandemic, the doctors acknowledged how the health crisis has affected their lives. dr. Anton Sony Wibowo, a fellow in the Southern Tohoku General Hospital, Japan, had to leave the country and continue his education online from Indonesia. dr. Summer had the experience of changing personal protective equipment (PPE) up to 30 times a day. There was also the lack of standard of procedure and PPE, especially in the beginning of the pandemic, as shared by dr. Shannon.

When asked about the most rewarding thing about being a doctor, all speakers acknowledged that ultimately it’s about the patients’ lives, especially as they can become part of the patients’ journey in overcoming their illnesses. “Seeing our patients get better and seeing the smiles on their faces is the most rewarding thing,” said dr. Woo Shi Min.

Dr. Marcherly Wardi, who is studying a physical medicine and rehabilitation specialist program at the University of Indonesia, said that she can fulfill her passion of dedicating her life to helping others by being a doctor. While dr. Anton said that doctors attend to human needs, which are quite unique. “There are ethical and cultural matters, which set the profession apart from others,” he said.

To aspiring doctors, dr. Ng Choon Ta shared his words of wisdom, “I wish to assure you that you are not alone in this journey. The career can be demanding, and there are times that one may feel like giving up. You have the privilege as well as the opportunity to tap on our network of healthcare and medical professionals across the Tanoto Foundation. More importantly, we hope that via the sharing of experiences, we will gain insights which can positively impact our lives and those around us.”

Tanoto Foundation donated 200 tons of rice to help people in West Java who have seen their livelihoods disrupted by the pandemic.

The donation was handed over symbolically by External Affairs Director at Tanoto Foundation, Ari Gudadi, to the representative of West Java Police, Sr. Comr. M. Syahduddi, and the Commander of the Military Area Command (Pangdam) III/Siliwangi, Maj. Gen. TNI Nugroho Budi Wiryanto.

(From left to right, External Affairs Director at Tanoto Foundation, Ari Gudadi, and the representative of West Java Police, Sr. Comr. M. Syahduddi)

Sr. Comr. M. Syahduddi stated that the implementation of restrictions in West Java, known as the PPKM Darurat, had been successful in reducing the transmission of Covid-19 in the province, as evidenced in the decreasing number of confirmed cases and bed occupancy rate. According to Syahduddi, the rice donation from Tanoto Foundation will further support the implementation of PPKM Darurat.

“However, we are also balancing this [restrictions] with donations from West Java Police and other police stations under our jurisdiction, and so far, this has been effective in supporting the implementation of PPKM Darurat. Hence, I would like to express my upmost gratitude to Tanoto Foundation for this rice donation,” said Sr. Comr. Syahduddi.

Pangdam III/Siliwangi, Maj. Gen. TNI Nugroho Budi Wiryanto, emphasized that the pandemic had been declared as a non-natural disaster, and that it could not be resolved by one institution alone.

(From left to right, External Affairs Director at Tanoto Foundation, Ari Gudadi, and Pangdam III/Siliwangi, Maj. Gen. TNI Nugroho Budi Wiryanto)

“Once again, I would like to thank Tanoto Foundation for this donation. Rice is a staple food among our people. We would like to make sure that it is distributed rightly to poor people and those who are affected by the Covid-19 pandemic,” said Maj. Gen. Nugroho.

Tanoto Foundation is committed to supporting the government of Indonesia in the fight against Covid-19, from providing oxygen to hospitals and patients to donating basic staples. Stay safe and let’s do what we can so we can all get through this together.

Proper care during pregnancy is important for both the expectant mother and the unborn baby, but the awareness of antenatal care in some communities may be less than ideal.

The reasons for not getting pregnancy care vary from hesitancy to lack of access, and it can impact the physical and mental health of pregnant women and their babies.

In the sixth episode of Selalu SIGAP, our host Andrea Lee chats with dr. Ardiansjah Dara Sjahruddin, Sp.OG., M.Kes, or dr. Dara, an obstetrician-gynecologist, about the importance of antenatal care and the things you need to know about it.

This episode covers:
   a. What is antenatal care
   b. Why it is important for expectant mothers and their babies
   c. What you need to remember

Pregnancy Care

Antenatal care is a pregnancy examination to ensure the optimal health of an expectant mother and her unborn baby. It should be initiated at the onset of pregnancy to identify any potential risk so that it can be prevented or reduced.

According to dr. Dara, the first examination always includes a check-up with ultrasonography (USG) to ensure that the expectant mother’s uterus contains a gestational sac. A large cavity of fluid surrounding the embryo, it is evident by around day 30 of pregnancy.

A normal pregnancy occurs when an embryo is seen within the gestational sac. But when a fertilized egg grows outside a woman’s uterus, called ectopic pregnancy, it can cause life-threatening loss of blood. This is an example of how antenatal care plays a critical role in preventing any risks to an expectant mother and the baby.

Ideally, an expectant mother should have her pregnancy checked by a doctor once every month to make sure that she and the baby receive the best care possible. But Dr Dara acknowledged that doing so might be a privilege for some people who lack access to such services. For them, he suggested that at least check-ups are done twice in the first trimester, once in the second trimester and once or twice in the third trimester.

Along with a USG examination, antenatal care would also include monitoring the pregnancy progress, identifying any pregnancy complication, providing mothers with vitamin supplementation and discussions about the mother’s medical history and general health.

Doctors will also consult with expectant mothers about the delivery process, ensure their mental wellness and prepare them for taking the baby home.

The Essential Matters

With antenatal check-ups, abnormalities in pregnancy and preventable illnesses can be detected. These include early complications such as hypertension and diabetes in pregnancy that can seriously affect an expectant mother and the baby. Gestational diabetes may increase the risk of high blood pressure for the mother, while the baby may be at risk of excessive birth weight and breathing difficulties.

“Hypertension and diabetes are illnesses that can occur during a pregnancy, even though an expectant mother has no medical history of such illnesses,” said dr. Dara.

“During pregnancy, one might have cravings for sweet foods such as chocolate and ice cream, because those foods provide a feeling of comfort and happiness,” he added. “Pregnant women can go through so many mixed and confusing feelings, and sweet foods can be there as a friend. But too much consumption of sweet foods can lead to diabetes when it is not controlled. And that is one thing that can be prevented with antenatal care.”

For monitoring the fetus’ development in the womb, doctors rely on the use of USG. “With USG, we can minimize any risk of death for the mother and the baby through careful observation,” said dr. Dara.

For example, late in pregnancy a baby might be in a breech position. It is when the baby’s buttocks or feet lie bottom first in the uterus instead of the usual head-first position. With a pregnancy examination, a doctor can provide advice and techniques to move the baby in the uterus. That way, an expectant mother can give birth through a vaginal delivery instead of a cesarean delivery that might pose more risks.

Research showed that having antenatal care visits reduced the probability of neonatal mortality and infant mortality. Antenatal care is critical in improving care of pregnant women, reduce the risk of pregnancy complications and defects, providing accurate nutritional advice and keep track of the fetus’ development.

The Reminders

According to dr. Dara, pregnancy care or examination is crucial to achieve an optimal pregnancy, both for the mother and the baby in the womb.

“The desired output is a healthy baby who is perfectly developed,” he said.

When asked about how some people fear the effect of USG in antenatal care, dr. Dara said that the technique is perfectly safe. By using a high-frequency sound wave, it captures live images from inside the body. There is no radiation involved and it does not pose any danger to the mother or fetus. Moreover, with recent developments USG results can present very detailed images which will immensely help doctors to detect any abnormalities.

dr. Dara also said that in recent years he saw how pregnant women have become more educated due to social media. “We appreciate the YouTubers or Instagram stars and influencers that inform their audience. When expectant mothers come for consultations now, they have a bit of knowledge and they can cross-check the information they received on social media with us,” he said.

Should an expectant mother worry about the cost of antenatal care, he said that there are options ranging from numerous hospitals to community health centers. The latter, for instance, are to be found across Indonesia and provide health care for population on sub-district level.