Pengelolaan kesehatan reproduksi pengungsi pasca Tsunami di Kota Lhokseumawe

MAFIZARNI, dr. Mubasysyir Hasanbasri, MA

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. dan Manaj. Pe

Latar Belakang: Pasca Tsunami berdampak kerusakan fasilitas kesehatan, terbatasnya penggerakan tenaga kesehatan, kekurangan logistik, serta timbulnya masalah koordinasi. Jumlah korban trauma fisik dan mental meningkat, ancaman penyakit menular, kekurangan gizi, kondisi hygiene dan sanitasi lingkungan yang buruk, serta keterbatasan sumber bahan makanan. Situasi dan kondisi lingkungan pengungsi yang demikian, berdampak buruk terhadap kesehatan reproduksi pengungsi. Untuk itu diperlukan penanganan yang efektif untuk menjamin kemudahan akses pelayanan dan meminimalisasi dampak bencana Tujuan Penelitian : Penelitian ini bertujuan untuk mengetahui jenis-jenis pelayanan kesehatan reproduksi pengungsi, proses pengorganisasian, koordinasi, tenaga kesehatan yang terlibat, serta kelengkapan fasilitas dan logistik Metode Penelitian: Metode penelitian ini adalah kualitatif dengan rancangan studi kasus yang bersifat deskriptif eksploratif, dengan menggunakan metode pengumpulan data wawancara mendalam, observasi dan studi dokumen. Hasil: Pelayanan fase tanggapdarurat bersifat emergency untuk meminimalisasi dampak bencana. Fase rehabilitasi pelayanan terintegrasi dengan pelayanan dasar, akan tetapi belum tercapai kemudahan akses pelayanan bagi pengungsi. Ada pembentukan organisasi posko kesehatan darurat dan poskeslit pasca Tsunami, akan tetapi sistemnya tidak jelas, pencatatan dan pelaporan tidak memakai format standar, digabung antara pengungsi dengan yang tidak mengungsi. Dalam hal Koordinasi timbul masalah ketidakmerataan bantuan, tumpang tindih dan tidak sesuai kebutuhan.Tenaga kesehatan yang berperan adalah bidan desa, akan tetapi terjadi peningkatan beban tugas dan tanggungjawab. Fase tanggapdarurat logistik kesehatan belum lengkap, sedangkan fase rehabilitasi sudah lengkap dan berasal dari bantuan NGO, sedangkan fasilitas transportasi tersedia, tapi tidak sepenuhnya bisa dimanfaatkan. Kesimpulan : Fase tanggapdarurat pelayanan bersifat emergency, fase rehabilitasi sudah terintegrasi dengan pelayanan dasar. Terdapat perbedaan proses pengorganisasian pasca Tsunami dengan situasi normal, akan tetapi sistem dan pelaksanaannya tidak jelas, manajemen dan penempatan tenaga kesehatan tidak tepat, sistem koordinasi kurang baik, serta fasilitas dan logistik yang kurang memadai.

Background: Post Tsunami affected on the destruction of health facility, limited empowerment of health care provider, lack of logistic as well as the occurrence of coordination problem. The number of physical and mental trauma victim has increased, transmission disease threats, lack of nutrition, poor condition of environmental hygiene and sanitation, as well as the limited number of food material. Environmental situation and condition of refugee had poor effect on the reproductive health of refugee. Therefore, effective management is needed to guarantee the accessibility of service and minimize the impact of the disaster. Objective: This research was aimed to find out the types of reproductive health service of the refugee, organizing process, coordination, composition of involved health care provider, as well as facility and logistic. Method: This research was case study with descriptive explorative design by using in depth interview, observation and document utilization. Result: The service of emergency respond phase is aimed to minimize the disaster impact. The phase of service rehabilitation was integrated with basic service, and yet service accessibility for refugee was not yet achieved. There were health service’ emergency unit and Poskeslit post Tsunami, but The system operating procedure was not effective, recording and reporting did not use standard format which combined between refugees with those who did not evacuated. In coordination, there was an assistance uneven distribution, overlapping and not suitable with the need occurred. The health care provider who had significant role was village midwife; however, there was an improvement on duties’ and responsibilities’ burden. The emergency respond phase of health logistic was incomplete, while rehabilitation phase was complete and originated from NGO’s assistance. In addition, transportation facility was available but not wholly utilized. Conclusion: The phase of emergency respond service was in emergency situation and rehabilitation phase has been integrated with basic service. The organizing post Tsunami to be different from in normal situation, but The system operating procedure was not effective, management and placement of health care provider was not appropriate. In addition, coordination system was not efficient, facility and logistic was incomplete. Keyword: reproductive health service of refugee, management in emergency situation, organizing, coordination, health care provider, facility and logistic.

Kata Kunci : Layanan Kesehatan,Kesehatan Reproduksi,Pengungsi Tsunami