isrrt Newsletter Volume 6. No.2 - 2010

Report
Radiology in Indonesia
Denpasar, Bali
September 2010
Report by Angela Borella, Radiology Advisor to Sanglah Hospital,
Australian Volunteers International (AVI)
I have always been interested in
international health issues, particularly those
faced by developing countries, and in 2009
I started a Masters of International Health.
In late 2009, I was offered a position with
Australian Volunteers International (AVI)
for a 13-month placement in Indonesia at
Sanglah Hospital in Denpasar as a radiology
advisor and mentor. I took leave from my
role as Operations Manager at St Vincent’s
Hospital, Melbourne and deferred my
studies to pursue a life-long ambition.
Sanglah Hospital is a large public
hospital with approximately 730 beds.
After the Bali Bombing in 2002 it became
apparent that the hospital needed significant
development in order to be able to cope with
the community’s medical needs. AusAID,
the Australian government’s overseas aid
program, provided much-needed funds
and built a new burns unit and ICU. AVI
provided volunteers in the fields of nursing,
clinical education and infection control.
I arrived in February this year for one month of
intensive language training in Yogyakarta, Java, before
beginning my role in Bali in March.
In nearly six months at the hospital, I have seen many
things and learnt much. I spent the first two months just
observing and getting to know the staff. This was incredibly
important. I think it could be very easy for someone
to jump straight in without being aware of the cultural
complexities. What works in your own environment will
not necessarily work in the context of another culture. The
Indonesian culture is extremely strong and the way society
operates is completely different to anything I have ever
known. About 90% of the population in Bali are Hindu,
with about 10% Muslim and Christian. It was really
important to take the time to understand the workplace
and the local customs and culture and also to build trust
with the staff.
Effective cross-cultural communication is the key. I
Joining in with the staff wearing my batik shirt. Batik is a traditional
Indonesian textile made using a manual wax-resistant dyeing
technique.
became acutely aware of the potential for miscommunications
and misunderstandings and also the effects of culture shock.
Even though I had experienced one month of intensive
training in bahasa Indonesian, navigating my way through
conversations in the first few months felt like being
permanently gagged and blindfolded. The loss of being
able to communicate effectively was and still is extremely
challenging.
The radiology department has almost fifty staff
(Radiologists, Residents, Radiographers, Nursing and
Administration staff) and is split across three locations - the
main department, the emergency department and the private
department in the International Wing of the hospital).
It also operates across three shifts - morning, afternoon
and night shift. Three locations and three shifts makes
communication, education and training very difficult,
especially in a department with no information technology
(IT) infrastructure. On average there are approximately 100
patients examined every day across the three areas using two
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