Widarti Rahayu / © Jurnasyanto Sukarno
A Day in the Life: Widarti Rahayu
Surviving cervical cancer in JakartaWhen guests arrive at her quiet house on the outskirts of Jakarta, Widarti Rahayu springs into action.
“Someone fry the corn fritters!” she calls to the kitchen, marshalling family members to get fruit, cakes and tea, while she hurries to a back room to fetch a head scarf.
Moments later, she is sitting at a well-laid table, a stack of medical records in front of her, ready to tell the story of how cervical cancer and a misdiagnosis almost killed her. The 45-year-old schoolteacher, who is called Mrs. Widarti according to local custom, wouldn’t characterize her ordeal that way, but it’s not too far from the truth.
In early 2008, she went to an ObGyn for a check-up because she noticed bleeding outside her menstrual cycle. The doctor concluded she had a benign growth on her cervix and scheduled her for surgery.
After the procedure, the bleeding didn’t stop. Widarti felt discomfort in her lower abdomen, but the doctor dismissed her complaints, saying she was just feeling the stitches from surgery.
Widarti, sensing the problem was more serious, considered going abroad for treatment, the way rich Indonesians do to overcome inadequacies in the country’s health system. She considered herbal medicine and alternative cures, the traditional refuge of the poor. Instead she decided to go back to the hospital, where she pushed for more tests. Finally she got the correct diagnosis: cervical cancer, a disease that takes the lives of 20 Indonesian women each day, according a 2010 World Health Organization report. In comparison, 14 women die every day in the U.S. from cervical cancer, but Indonesian women and girls over 15 years old are about 2.25 times more likely to die from cervical cancer than their American counterparts.
“These white patches are the cancer,” Widarti says, jabbing at an X-ray with her pinkie. “And there are three spots, not only one. That’s what my first doctor missed.”
After two more months of bureaucratic delays, Widarti was prescribed 25 radiation therapy sessions and three courses of chemotherapy. By now the cancer had spread to her bladder and rectum.
Even at this critical stage, Widarti almost had to wait another month for treatment, due to another problem with Indonesia’s healthcare system: equipment shortages. The hospital had only two radiation machines, but she got lucky. Widarti’s case had been so bungled, one of the doctors at the hospital chose it as a teaching example for medical students, and her treatment was moved up.
Today Widarti is cancer-free—at least for now. She and her husband Sutardi decided not to make a fuss about the misdiagnosis “in case it would make more problems,” she says.
“Yes, he was a bit—how should I put this? Careless,” she says of her doctor. “I didn’t want to blame him.”
In fact, Widarti considers herself fortunate. Sutardi is a government employee, so she and her two children are covered under the civil servants’ health insurance plan, which pays for 30 to 50 percent of medical costs. Without insurance, Widarti’s radiation treatments alone would have cost more than 9 million rupiahs (about USD $1,000). For half of the country’s 220 million residents, who live on less than two U.S. dollars a day, expenses like that would be impossible to meet.
But misdiagnoses are only partly to blame for Indonesia’s high rate of cervical cancer deaths. In nearly three fourths of the reported cases of cervical cancer in Indonesia, women wait until they have physical symptoms before getting checked. By that point the cancer has already taken hold. Many more simply stay home and hope for the best.
Widarti was among the estimated 95% of Indonesian women who don’t get annual pap smears, a precaution that has reduced mortality from cervical cancer by about 60% in some developed countries, according to the WHO.
Her work as a teacher, Widarti says, helped her through her cancer treatment. “As a cancer survivor, I have to be prepared for death, but I’m also prepared to live,” she says. “Besides, these kids are really my alternative therapy.” Now she volunteers with the cancer foundation to raise awareness of the risks.
Walking around the halls of Sekolah Menengah Pertama No. 257, a public middle school in East Jakarta, where she has taught art and music for 22 years, Widarti is engulfed by affectionate greetings from children and teachers.
She recalls a constant stream of students visiting at her home during the worst parts of her illness. “It gives me chills to think about that now,” she says, eyes dampening.
Seated in front of a class of restless teenagers, she walks her fingers down an electronic keyboard, playing the first few notes of a traditional Indonesian song. The class joins in meekly, and she stops. “Let’s try that again— and this time, use your voices.”
Author Bio:
Chad Bouchard is a freelance journalist based in Jakarta, where he has reported on health and development for four years. He files regularly for Public Radio and print media in the U.S.
Photo: Widarti Rahayu / © Jurnasyanto Sukarno
