Featured Doctor

FUJIATI Isti Ilmiati

Indonesia - WONCA Conference Chair

Isti Fujiati is chairwoman of the Host Organizing Committee for The Wonca Asia Pacific Regional Conference coming up in Bali, on December 8-10, 2022.

1. What are you currently working on? 

I am currently a lecturer at the Community Department, Faculty of Medicine, Universitas Sumatera Utara in Medan, about a 45-minute flight from Penang, Malaysia. In addition, I am also the Chairwoman of the Indonesian Association of Family Physicians (IAFP), to which I was elected in December last year, after the passing of the previous IAFP Chair, Dr Yulherina, from Covid-19. As the new Chair of the IAFP, our focus is to develop a strategic three-year plan for IAFP aligned with the community needs. 

The Indonesian Ministry of Health is currently carrying out a Health transformation based on six pillars, including a Primary Health Care Transformation Pillar focused on preventing stunting and non-communicable diseases. Now, it is a good time for changes. With the Universal Health Insurance financing system, quality primary services are crucial.
In addition, we also need to make quick preparations to welcome all WONCA members at the Asia Pacific Region Conference 2022 in Bali this coming December. With a deep longing to meet and share face to face, after more than two years, Bali will be a beautiful place to engage. We invite all WONCA members to come to Bali to share their visions and experiences for family medicine and primary care after the Covid-19 pandemic. 

2. Tell us about your experience as a family doctor? 

I completed my Medical Education in 1992 and mostly practised as a private doctor in companies and clinics before undertaking a 3-year compulsory undergraduate work at a rural community health centre called Puskesmas.

While working there, many questions arose regarding clinics. I encountered undifferentiated cases that were very diverse from what I studied in medical school. I learned a lot about clinical practice, but I was not exposed to simple problems that turned out to be very complex with a meaningful impact on families and the surrounding community.
One of them was the case of a woman with tuberculosis who was working part-time as a nanny for her husband's employer. 

I figured then there were so many things I needed to learn from that woman's case. Tuberculosis was one issue, but the bigger one was how tuberculosis impacted that woman's life as a wife with the stigma of a hereditary disease, as a mother, as a worker, and on her husband's work. It shocked me, and I wanted to learn more, but I did not know where, as we don't have a special education on the topic in Indonesia.

I also thought of becoming an internal medicine specialist but by becoming an internist, I would have worked in a hospital because Specialist Postgraduate Education is only for doctors who work in hospitals. Are there services that look at patients not only from their disease? Is there Education for it? Can I improve my competence but still work in primary care? Is there a system where I can serve patients in practice, at home, in the community without having to think about whether I will be paid or not?

I found the answer to these questions when I had the opportunity in 2001 to continue my studies with a Master of Science in Clinical Medicine Family Medicine at the University of The Philippines, Manila. It turned out that what I was looking for the whole time was family medicine services, and Prof. Zorayda Leopando became one of my best teachers. I studied a lot in the Philippines because the culture and people are similar to Indonesia.

I fell in love even more with family medicine after joining WONCA, attending inspiring conferences and motivating me to build strong family medicine in Indonesia. WONCA is like a big family that makes me very comfortable. I can have everything, not only family medicine, but also the vision of the great people who are part of it, friendship from multiple countries, and sometimes even brotherhood. 

In 2019, I had the opportunity to meet Prof. Lynda Redwood in Aceh and continued to meet new colleagues by joining the Besrour Center Advisory Board. 

3.  What other relevant activities have you participated in? 

I am often involved in local and national activities related to diabetes, especially prediabetes, diabetes coinfection Tuberculosis, and vice versa since the incidence of diabetes and Tuberculosis in Indonesia is high.

For diabetes programs, I am an active member in the Cost and Quality Control Team called TKMKB of the Health Social Security Body called BPJS, in collaboration with Provincial and District of Health, designing many activities for the community that involved many professional organizations.  

I have also been a national coach and pioneer developer of the North Sumatra Coalition of Professional Organizations for Tuberculosis Elimination called KOPI TB, with Provincial and District Health and non-profit organizations like USAID. We are trying to make a difference in tackling Tuberculosis in Indonesia. With this coalition, we have involved a lot of private practice doctors, where previously tuberculosis control has mostly handled by government providers at Puskesmas. Through KOPI TB, we support the public-private mix program to eliminate Tuberculosis. 

At this time, I also started to work in maternal and child health for stunting prevention, a very strategic matter to implement family medicine based on life cycle services for prospective brides, pregnant women, nursing mothers, and children under five. The first thousand days of a child's life, from conception, will determine the quality of the nation's future human resources. We try to start stunting prevention upstream in teenagers, especially teenagers and young women, by conducting structured education with various universities.
I am also often involved with various stakeholders at the local and national levels. 

4. What are your interests at work and in private? 

I like to meet multiple people who have visions and dreams for the benefit of society. Building dreams together is one of my favourites. In my belief, the best human being is the one who benefits other humans the most. This philosophy applies to both my work and personal life.