The Urgency of Providing Ambulance Boat in Nusa Penida Sub-district, Klungkung Regency, Bali

Klungkung Regency is one of the districts in Bali with the smallest area. Administratively, Klungkung Regency is divided into 4 Sub-districts namely Klungkung, Dawan, Banjarangkan and Nusa Penida Sub-districts. The Nusa Penida sub-district is geographically a small archipelago consisting of the islands of Nusa Penida, Nusa Lembongan and Nusa Ceningan. Nusa Penida sub-district is the most extensive sub-district compared to other sub-districts, which is almost about two-thirds of the total area of ​​Klungkung. This geographical condition causes Klungkung regency to have different types of diseases as well as more complex types of health services when compared to other districts in Bali. Although Nusa Penida District is the largest area, the population is the least compared to other districts. Population density in Nusa Penida is 225 people per km2. Even though the population of Nusa Penida is relatively small compared to other districts, due to its remote location, adequate health facilities are needed.

In recent years, there have been reports of patient referral cases from Nusa Penida that cannot be dealt with optimally, thus generating ideas from the regional government in this case through the Klungkung District Health Office, for the provision of sea ambulance facilities. The provision of sea ambulances/ ambulance boat is intended to facilitate the transportation of patients who will be referred from Nusa Penida to the mainland of Klungkung district, as well as to the Provincial Hospital in Denpasar. The availability of this ambulance facility can later increase access to health services for the people of Nusa Penida. In addition, the increasing flow of tourist visits both local and foreign tourists visiting the islands of Nusa Penida, Nusa Ceningan and Nusa Lembongan, then the sea ambulance is also expected to be an additional facility for tourists who experience medical emergencies such as suffering from an acute illness that must be referred immediately to the mainland as well as accidents related to tourist activities. Provision of sea ambulance is expected to provide many benefits to the surrounding community and tourists, but behind that there are pros and cons that arise whether sea ambulance is needed when viewed from the number of referral cases and the impact of the delay in handling medical emergencies for patients in Nusa Penida.

This preliminary study on the feasibility of a sea ambulance procurement plan has been carried out in 2019 which resulted in several initial conclusions, namely stakeholder holders from the government, health department, Klungkung Regional Public Hospital and Nusa Penida Hospital, and the management of Ambulance Land (KRISS) agreed that the ambulance boat is very much needed by the people of Nusa Penida. Funding the Regional Government will be ready to allocate APBD funds for the period of 2021 to prepare for the procurement of this ambulance. However, a detailed analysis of the number of cases that need to be referred monthly to the Klungkung mainland still needs to be explored in detail, therefore  the presence of an ambulance will be of maximum benefit later. Another thing that needs to be explored in depth is the acceptance of the surrounding community related to the plan to procure ambulance boats in Nusa Penida.