Sando dan dokter kontestasi pelayanan kesehatan tradisional dan modern di Sulawesi Tengah :: Studi perilaku masyarakat Kaili Daa mencari pelayanan kesehatan di Desa Dombu

SIRAIT, Esron, Promotor Prof. dr. Hari Kusnanto, Dr.PH

2009 | Disertasi |

Dalam rangka mewujudkan kesehatan yang optimal bagi seluruh masyarakat Indonesia, pemerintah telah berupaya membangun sarana pelayanan kesehatan modern seperti rumah sakit, puskesmas dan puskesmas pembantu serta menempatkan tenaga kesehatan (dokter, bidan dan para medis) sampai ke pelosok desa. Kenyataannya, masih terdapat kelompok masyarakat yang sakit terkendala mengakses pelayanan kesehatan modern dan mengobati sendiri penyakitnya dengan cara pengobatan tradisional berdasarkan pengalaman dan pemahaman warisan budaya. Tujuan penelitian ini adalah untuk mengungkapkan gambaran perilaku masyarakat Kaili Da’a mencari pelayanan kesehatan di Desa Dombu Kecamatan Marawola Kabupaten Donggala Provinsi Sulawesi Tengah. Penelitian ini adalah penelitian kualitatif yang mengandalkan pengumpulan data lapangan (field study). Data diperoleh melalui wawancara mendalam tak terstruktur, observasi,pengamatan dan diskusi kelompok terarah. Informan berjumlah 17 orang, terdiri dari 8 tokoh masyarakat, 4 ibu rumah tangga, 3 tokoh pemuda dan 2 petugas kesehatan termasuk sando. Hasil penelitian ini menunjukkan bahwa masyarakat Kaili Da’a di Desa Dombu merupakan masyarakat tradisional di tengah-tengah arus modernisasi. Hidup sebagai petani ladang kering dari pola berpindah menjadi petani ladang menetap di lereng-lereng pegunungan Kamalisi. Masyarakat Kaili Da’a di Desa Dombu pemeluk agama Kristen Bala Keselamatan (Salvation Army). Agama sebagai instrumen sosial dan merupakan salah satu perekat identitas masyarakat Kaili Da’a dalam menanamkan norma-norma, ritus dan kebiasaan yang mereka jalani bersama. Mereka selalu mengupayakan kebutuhan sosial dan ekonomi dengan cara resiprositas, yaitu melalui pertukaran yang lebih mementingkan keutuhan sosial antara sesama komunitas daripada mencari keuntungan ekonomi. Masyarakat Kaili Da’a di Desa Dombu menilai sehat dan sakit berdasarkan perasaan dan kondisi fisik tubuh yang teramati. Sehat apabila tubuh terasa segar, dan dapat beraktivitas seperti biasa. Sakit apabila perasaan terganggu yang ditandai dari perasaan tidak enak badan, terlihat pucat, loyo dan tidak dapat beraktivitas seperti biasanya. Masyarakat cenderung mengobati sendiri penyakitnya dengan cara pengobatan tradisional karena tidak mampu membayar dokter dan membeli obat akibat keterbatasan uang kontan yang mereka miliki. Faktor lain adalah waktu buka pelayanan di puskesmas tidak sesuai dengan kebutuhan masyarakat yaitu kebutuhan pada waktu ketika mereka berkesempatan memeriksakan keluhan sakit yang mereka alami. Masyarakat memanfaatkan puskesmas sebagai sarana alternatif pengobatan jika dipersepsikan lebih efektif dibandingkan dengan cara pengobatan tradisional dan ketika waktu lebih luang.

In order to realize the optimum health for the entire Indonesian society, the government has made serious efforts of building the facilities of modern health services such as hospitals, community health centers and sub community health centers and allocating health officers (doctors, midwives and paramedics) to the remote villages. As a matter of fact, there are groups of community finding difficulties to acces the modern health services when they are sick so that they cure their illness with traditional medication based on experience and comprehension of the cultural heritage. The objective of this research is revealing the behavior description of the Kaili Da’a community seeking the health services in the Village of Dombu, Marawola District, Donggala Regency, the Province of Central Sulawesi. This is a qualitative research relying on the field data collection (field study). Data were collected by way of unstructured, deep interview, observation and directed group discussion. The number of the research informants were 12 persons, age 30-49 years, consisting of 8 community leaders, 4 housewives, 3 youth leaders and 2 health officers including a sando. The results of the research show that the Kaili Da’a Community in the Village of Dombu is a traditional society amids the modernization current. They live as dry land farmers shifting from moving to fixed pattern at the slopes of the ‘Kamalisi’ mountain. The community of Kaili Da’a in the Village of Dombu believe in Salvation Army Christianity. Religion serves as a social instrument and it is one of the things uniting the identity of the Kaili Da’a community in inhibiting norms, rites and customaries they live together. They always earn their social and economy needs by way of reciprocity, namely through the exchanges prioritizing the social unity among the community members rather than gaining economic profit. The community of Kaili Da’a in the Village of Dombu considers being healthy when they feel the body fresh and they can do daily activities. They are sick when they are not feeling well, pale, weak and they cannot perform daily activities as usual. The community tends to cure their ilness by themselves using traditional medication due to their incapibility to pay doctors and to buy medicine because of their short of cash money. Another factor is the opening hours of the community health centers that is not suitable with the needs of the community, that is the time whent they can go to the community health centers to check their illness. The community makes use of the community health center (puskesmas) as an alternatif medicating facility when it is perceived to be more effective than the traditional medication and when they have time to do it.

Kata Kunci : Pengobatan,Tradisional,Moderen,Kesehatan,Perilaku,Resiprositas,medication, traditional, modern, health, behavior, reciprocity