Junior Doctor's Death In Indonesia Exposes "Open Secret" Of Bullying In Medical Schools

The death of a junior doctor in Indonesia has reignited debate over the issue of bullying prevalent in medical schools across the country. According to the South China Morning Post (SCMP), 30-year-old Aulia Risma Lestari, resident in the anaesthesia specialist programme at Diponegoro University in Semarang, was found dead in her living quarters on August 12. It is reported that she may have injected herself with a lethal dose of an anaesthetic. Police are still investigating her death as a possible suicide, and are looking into whether bullying documented in her diary may have contributed to her depression. 

Following her death, several WhatsApp conversations between the 31-year-old and several senior residents at Kardinah Hospital in Tegal revealed troubling claims. According to SCMP, they suggested that the junior doctor faced pressures from senior doctors to cover expenses beyond her tuition and living costs, including demands for food, entertainment and even car rentals. 

Reacting to the incident, Indonesia's Health Ministry suspended the hospital's anesthesiology residency programme until a police investigation is concluded. Separately, Indonesia's Health Minister Budi Gunadi Sadikin called bullying an "open secret" in the country's medical institutions and labelled it a "huge phenomenon". 

"I will push for legal action to ensure maximum punishment for the perpetrators and to create a deterrent effect," Mr Sadikin said, vowing to implement better monitoring and reporting measures.

On the other hand, Diponegoro University's rector, Professor Suharnomo, has refuted allegations of bullying. He asserted that the junior doctor faced health issues that affected her studies. The professor also stated that the university would cooperate with the police in their investigations. He added that the school has already implemented a zero-bullying policy, actively monitored by the Bullying and Sexual Violence Prevention and Management Team since August 2023.

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However, in the wake of the tragic incident, other junior doctors across the country have opened up about their ordeals.  Agung Purnama, a 29-year-old medical student specialising in oncology surgery during his residency at a hospital in Bandung, West Java, said that he had experienced pressure from senior doctors to work long hours.

"Or else they would say we will not get a good grade, or we are not worthy of becoming doctors," the medical student said. "You feel like (you) have no choice but to do as they say ... I spent so much time and money to get to this point (in my studies) so it feels like you don't want to do anything to risk that," he added.

"I think there is a tendency to normalise and see bullying as being natural because of the high amounts of pressure and demands of specialised medical education ... but this shouldn't be normalised or tolerated," founder and chief executive of advocacy group Centre for Indonesia's Strategic Development Initiatives, Diah Satyani Saminarsih, said, reported SCMP.

"The more junior you are, the higher the risk is that you will be exposed to bullying," she added.
Meanwhile, citing the health ministry, the outlet reported that it had received 356 formal complaints related to bullying between July 2023 and August this year. Out of these, authorities investigated 156 cases, resulting in suspension or dismissal. The complaints by the victims contained details of physical abuse, financial coercion, verbal abuse, and even intimidation.

"The Health Ministry will always take stern action against the bullies. Their names will also be flagged in the system as perpetrators," health ministry's spokesman Mohammad Syahril told the outlet.