The history of the Obstetrics and Gynecology Study Program at Dr. Kariadi General Hospital, Semarang, is inextricably linked to the history of Dr. Kariadi General Hospital itself, spanning the period from the Dutch East Indies to the present. Obstetrics and Gynecology services in Semarang are generally inextricably linked to its human resources. The individuals and figures involved in and working in the Obstetrics and Gynecology Department of the Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital can be broadly divided into two periods:

PRE-OBSENT SPECIALIST PERIOD

1925–1942 (Dutch East Indies)

In 1919, Dr. N.F. Liem conceived the idea and plan to replace and merge the City Hospital (Stadverband Ziekenhuis) in Tawang with the Subsidiary City Hospital (Hulp Stadverband Ziekenhuis) in Semarang’s town square. This plan was realized by building a larger hospital in Semarang. Construction of the hospital began in 1920 and was completed five years later.

On September 9, 1925, the Centrale Burgerlijke Ziekeninrichting, known as CBZ, was established. At that time, the hospital had a capacity of 500 beds. The hospital consisted of large wards accommodating forty-five beds. The facilities were adapted to the lifestyle of the Dutch East Indies at that time. Several specialties were already in place, including internal medicine, surgery, obstetrics, and gynecology. Planners Ooiman Van Leeuwen and Wijanarko (the implementing officer) were thoughtful, so the architecture of the building clearly separated the polyclinic and inpatient wards.

The first director of this hospital was Dr. N.F. Liem. The names of Dr. N.F. Liem and his wife, Liembergsma, were later used to name the streets in the nursing home complex.

Initially, this hospital focused on medical services, providing curative treatment and paramedical education. Several specialized departments existed, including Internal Medicine, Surgery, Pediatrics, and Obstetrics and Gynecology. This was followed by the establishment of other departments, including Ophthalmology, ENT, Dermatology, and Venereology. This was related to the establishment of the Semarang Army Hospital, which already had experts in these fields.

1942–1945 (Japanese Occupation Period)

During this period, the hospital underwent few changes. The Japanese authorities limited themselves to continuing and operating existing businesses, and no Japanese worked at the hospital. This was advantageous, as it allowed the hospital’s youth to more freely join other freedom fighters in Semarang.

During the Japanese occupation, Dutch doctors were taken prisoner, and to fill the vacant leadership position, the hospital was led by an Indonesian, Dr. Notokuworo, who was succeeded by Dr. Buntaran Martoatmodjo until 1945. This demonstrates that since the Dutch East Indies government surrendered to Japan, this hospital has been under the leadership of the Indonesian people themselves. The Japanese government changed the name CBZ to Purusara, an abbreviation for “central people’s hospital,” which in Japanese is called Chuo Simin Byoing.

1945–1950 Period (Revolutionary/Transitional Period)

Japan was then defeated by the Allies; at the same time, Indonesia proclaimed its independence. Apparently, the Japanese only wanted to submit to the Allies, resulting in the five-day battle in Semarang, which erupted on October 14, 1945. This battle pitted Indonesian youth against the Japanese army, unwilling to relinquish their power. The battle was felt throughout Semarang and experienced by all the city’s residents.

This battle marked the death of Dr. Kariadi, shot by Japanese soldiers while inspecting a drinking water reservoir that was reportedly poisoned by the Japanese. A fierce battle ensued in front of the hospital, with Japanese soldiers firing machine guns at the hospital staff, killing them. Over the following days, the hospital, considered a place for young people to strategize their struggle, was surrounded and constantly monitored by Japanese soldiers. It wasn’t until October 17, 1945, that Dr. Kariadi’s body was finally buried, three days after his death.

The arrival of the Netherlands-Indies Civil Administration (NICA) in Semarang could no longer be stopped. Many doctors and nursing staff left Semarang for areas within the Republic (areas controlled by Indonesia during the First Dutch Aggression). Since Dr. Buntaran was already primarily in Jakarta, from 1945 to 1948, the hospital was led by Dr. Soekardjo.

AFTER THE ADMISSION OF AN OBSTETRICS SPECIALIST

In 1955, RSDK had a permanent Obstetrics and Gynecology specialist, Dr. Sardjono Dhanudibroto. During this period, obstetrics and gynecology services began to receive greater attention and improvement.

The limited number of obstetricians and gynecologists and the limited supporting facilities at that time significantly impacted the department’s work structure. The number of patients increased, while there were very few doctors. At that time, approximately 300 women gave birth each month. Sometimes, two women would share a single bed. If one was about to give birth, the other would sit.

The decision was then made to provide only 24-hour care for women in labor. This policy faced opposition from legislators, who called it inhumane. However, after receiving information from Dr. H.A.S. Dhanudibroto, he accepted the decision. Considering it preferable to send home patients who had passed the critical period rather than turning away those who arrived in the critical period, the Regional People’s Representative Council (DPRD) finally accepted the policy adopted by the Obstetrics and Gynecology Department.

These postpartum mothers were discharged one day after being discharged and then handed over to the nearest midwife for further care. A subsequent problem arose regarding the financing of this service. Patients were unwilling to pay for follow-up care, while midwives were unwilling to provide it without compensation.

To address the imbalance between the number of women about to give birth and the number of health workers and service providers, Dr. Kariadi General Hospital implemented a policy in 1958 that only provided referral services. Women about to give birth were encouraged to go to the Mardi Waluyo clinic or give birth at home by calling the nearest midwife. The term used at the time was “External Partus.”

Due to the perceived lack of service facilities, a maternity clinic was established in 1955 in the Peterongan area, and in 1956-1957, another was established in the Pandanaran area. Those responsible for providing services during this “external delivery” are student midwives, midwives, and medical students. The equipment and consumables used are still provided by Dr. Kariadi General Hospital. Approximately 90 deliveries are handled each month.

During this period, RSDK also received an additional obstetrics and gynecology specialist from Gadjah Mada University, Dr. Sudibyo Tjokrodiprojo. However, he later died during surgery of a heart attack. Then, in 1964, an additional obstetrics and gynecology specialist from Surabaya, Dr. Ariawan Soejoenoes, joined the hospital.

By this time, medical assistants and students had begun to join the hospital, especially after the establishment of Diponegoro University in 1961. Although this collaboration was only officially formalized by Decree of the Minister of Health dated May 2, 1975, number 132/V/Kab/Bu/1975.

1950 – Present

One phrase that might be most appropriate during this period is, “Doctors are very expensive.” Not financially, but in terms of quantity. Before Dr. H.A.S. Dhanudibroto arrived in Semarang as an Obstetrics and Gynecology expert in 1955, several doctors also led the Obstetrics and Gynecology department, including:

Goenadi Wreksoadmodjo 1948 – 1950
R. Sardjono 1948 – 1955
Soediono 1951
Liem Khe Tjong 1950 – 1958
Suhardi 1952 – 1955
Giovani Garbarino (Italy) 1954 – 1957
Suwondo 1954 – 1955

Dr. Goenadi Wreksoadmodjo after 1950 transferred to Jakarta. Dr. Suwondo, meanwhile, was a colonel assigned to the Army Hospital. At that time, obstetrics and gynecology services were primarily performed by midwives, while doctors served as operators for major surgical procedures and as consultants. Doctors were still assisted by midwives while on duty, either as operating assistants or as narcotics. Other operative procedures, such as forceps extraction, embryotomy, manual placentation, and breech deliveries, were performed by midwives.

In the field of medical and midwifery education, midwives were the educators at this time; external deliveries were also performed under midwife supervision. At this time, there was no regularity among midwife educators; the theoretical assessors also assessed the practicals. For medical education, the current students were from Gadjah Mada University, as Diponegoro University had not yet been established. During this period, after Dr. Goenadi moved, he was replaced by Dr. R. Sardjono, and the Army Hospital received a part-time obstetrics and gynecology specialist, Dr. Soewondo. The additional medical staff included Dr. Liem Khe Tjong, but he was later transferred to the Netherlands.

During this period, RSDK also received specialist staff in four basic fields from Gadjah Mada University. During this period, the name Purusara was replaced by Semarang Central General Hospital (RSUP Semarang). It continued to develop in line with the demands of independence, and was also involved in the education of medical students, paramedics, and specialist doctors.

Since 1953, in collaboration with the Faculty of Medicine, Gadjah Mada University, Yogyakarta, the hospital has served as a medical student practice facility. With the establishment of Diponegoro University in 1961, a collaboration between RSUP Semarang and UNDIP (Undip) in medical student education was established. However, it was not officially designated as a teaching hospital until May 2, 1975, by Decree No. 132/V/Kab/Bu/1975, issued by the Minister of Health.

The assistants registered after Dr. Ariawan Soejoenoes’ arrival were:

• Sudibyo
• Rustanto (who later served as Head of the Central Java Health Service, currently Regional Office)
• Abimanyu Sadiman (retired before completing his education)
• Sumarsono
• Lilik Gunawan (later moved to the Anatomical Pathology Department)
  Untung Praptohardjo