Exchange program of obstetrics and gynecology inAirlangga University
26/8/2013~20/9/2013
Kobe University, Faculty of medicine, 6th year
Kyohei Ikeda
I had four weeks of practice in obstetrics and gynecology of Airlangga
University.
In first week, I observed wards. There are a lot of patients and I wasamazed to see that a number of patients were in one room. I think the wards
are very crowded. As regards to treatments, the strategy is very similar toone in Japan such as chemotherapy. And young doctors asked patients
detailed about their symptoms and took physical sign in the same way.
However, the number of cervical cancer is larger than in Japan. I also got theimpression that there are more serious cases such as stage Ⅲ or Ⅳcervicalcancer than in Japan. I think it is important to enlighten Indonesian people
about gynecology.

In second and third week, I observed many cases in the emergency room. I
helped deliveries and saw curettages for abortion. I was surprised to hearthat there were many cases of pregnancy induced hypertension (PIH) andthe risk of maternal death is very high in Indonesia. I think it’s a serious
problem. In regard to young doctors’ training, they did many kinds ofprocedure such as listening to fetal hearts, NST, vaginal examination,

testing protein urine, helping normal delivery, giving oxytocin drip, giving
magnesium sulfate. In Japan, we only observe procedures of obstetricians
and gynecologists.

In fourth week, I observed outpatients. The most impressive thing in thepolyclinic was to hear that though the number of patients of HIV-infected
people has been increasing recently in Indonesia and there were many
patients who were HIV positive in Soetomo hospital, doctors don’t do thescreening test to find HIV positive patients because of a limited budget. Iguess the risk of infection of HIV is very high. I also observed the polyclinicof contraception. Doctors taught me that compared with Japan, the birthcontrol is a big issue and doctors regard intrauterine device (IUD) as
important in Indonesia. Young doctors can practice many procedures
including IUD with simulators. Examinations of obstetrics and gynecology
include practical skills tests.

Young doctors who were after night shift gave presentations every morning
and I was very interested in this morning reports because I was able to learn
practical knowledge. I think Japanese students don’t have a duty to do sucha practical presentation in obstetrics and gynecology. I also took lectures
about abortion, PIH, infertility, cervical cancer and so on. They didn’t give us
basic knowledge but useful tips through interesting cases. Especially,categorizing abortion into 4 groups aroused my interest.
Throughout my practical, I felt that because Soetomo hospital is a public
hospital, it was insanitary and full of patients and relatives. HIV andhepatitis B were also sweeping Soetomo hospital. Public hospitals facefinancial problems in Indonesia. This bitter experience brought home to me
how important politics and health economics were.
We also studied HIV, Dengue fever, hepatitis and influenza in theInstitution of Tropical Disease (ITD) for two days. Professors teach us theirresearch subjects and field works in Indonesia. Especially, I was interested
in drug resistant HIV and the epicenter of influenza.
We lived in a guest house of Airlangga University. Compared with adormitory of the university, there are air conditioners, big beds and modular
baths in the house. Though we had to take a cold water shower, we had agood time comparatively. In regard to Indonesian food, we ate a lot ofdelicious food such as nasi goring, mi goring, bakso, soto, sate, gado-gado.
However, we sometimes suffered from diarrhea.
We went sightseeing over the weekend. We went to Yogyakarta and Bromo
mountain. In Yogyakarta, we visited Borobudur and Candi Prambanan.
These heritages were very beautiful and they were moved by the solemnityof them. In Bromo mountain, we saw the rising sun and rode on horse. We
had a valuable experience.

Doctors and Students in obstetrics and gynecology always helped us andtaught a lot of things. I am deeply grateful to their kindness. I feel happy
about studying in Airlangga University and Soetomo hospital.