D Prenggono, MD Ulin Hospital, South Kalimantan, Indonesia

Abstract THE OVERCOMING CHALLENGES TREATING CML IN SOUTH KALIMANTAN INDONESIA Indonesia is a developing country with big population. Similar with other countries that have big population and lower-middle economies, the public health is one of big problem in Indonesia, include in South Kalimantan. Nowadays, the change of disease pattern also happened in Indonesia. The case of hematology malignancy including Chronic Mielocytic Leukemia is increased. The problems that were faced in Indonesia especially South Kalimantan (Banjarmasin) province are the wide area, low income, big number distribution of population in rural area, and facility in the public health center are limitated. South Kalimantan and Central Kalimantan provinces have one hospital only as center of refferance. It is Ulin Hospital in Banjarmasin. The program for treating CML in Indonesia is Novartis Oncology Access. Since 2010, NOA program are doing in Banjarmasin. Since October 2011, NOA program rule is changed because of tax for Imatinib Mesilat (Glivec). Patient are grouping to be four (4) categories depend on the insurance that cover them. Because of that, patient must buy Glivec for a half month or a month. It makes new problem because the big cost for buying Glivec. The other problem is the laboratory examination for Philadelphia Chromosome. It cant done in Kalimantan. The facility for checking Philadelphia Cromosome only in two center. There are Dharmais Cancer Hospital in Jakarta and Tropic Disease Center UNAIR in Surabaya. It will spend much cost for examination and transportation. We have done the projects as solutions for the challenges treating CML patient optimaly, with the limited resources. The goal of the projects are the improvement of screening new patient especially in rural area, the simple access for Philadelphia Chromosome examination, and economy supporting for patient. The one of project was done in Banjarmasin for overcoming challenges is the project for improving knowledge of general practioners by symposium or workshop about CML temporally. It was done for increasing screening new patient in South Kalimantan and Central Kalimantan provinces. The other project is the cooperation with Dharmais Hospital and Tropic Disease Center for Philadelphia Chromosome examination. The long distant between Kalimantan and Jakarta or Surabaya, is one of problem. The solution for this challenge is by delivering blood sample of CML patient. It will reduce the cost for transportation. We is supported by Novartis Indonesia company for the cost of delivery service. For overcoming economy challenge, the effort that we have done in Banjarmasin, is the cross subsidy between CML patient who has higher income to the lower ones. Although there is a few of them have upper-middle income but this subsidy give support enough. There is the organization of CML patient in Indonesia, it is named ELGEKA. ELGEKA in Banjarmasin was standed at 2010. Every member of ELGEKA pay contribution every month. The money from that contribution are used for helping Philadelphia Chromosome examination. ELGEKA is the forum for patient for sharing information or their experinces. These projects outcomes give support for overcoming challenges treating CML in our region. There is improvement of screening new diagnozed CML patient. We can only deliver blood sample of CML patient for checking Philadelphia chromosome that decrease the cost.

By the cross subsidy and routine contribution from ELGEKA members, it help the member who has low income. This forum contribute to make ties of friendship between them. As the next step for overcoming challenges treating CML, we will built Social Foundation for Hematology Disorders including CML in Banjarmasin. This foundation will organizing CML members better than before. By foundation, we hope to make good network with company or pesonally to collect donation. Keywords : CML, Philadelphia chromosome, glivec, low income

iCMLf Forum for Physicians from Emerging Economic Regions

Overcoming Challenges Treating CML Best practices in emerging economic regions Applicant Information Form
Full name: Dr. Muh. Darwin Prenggono, dr, SpPD, KHOM Position title: Hemato-Oncologist Institution: Ulin General Hospital Department: Hemato-Oncology Full mailing address: Bunyamin Permai I Ray IV No. 175 RT 014 RW 01 Kertak Hanyar Kab Banjar, South Kalimantan, Indonesia Telephone: Degree(s) ! MD graduation date: 20/11/1992 Date of Birth: 30/12/1963 Citizen of: Indonesia Languages spoken: Indonesia (bahasa) English ! PhD graduation date: dd/mm/yyyy ! Male ! Female Residing in: Indonesia 085349532323/08161827979 Email: prenggonodarwin@yahoo.co.id

Applicant works in a: ! Research laboratory ! Hematology department (non-clinical post) ! Clinical hematology department ! Other (specify): Checklist for application: ! Abstract ! Applicant information form ! Applicant CV/biosketch