The tragic death of a mother and her unborn child after being turned away by four hospitals in Jayapura has sparked outrage, prompting the Governor of Papua, Mathius Derek Fakhiri, to issue an ultimatum to all healthcare facilities in the province.
Governor Fakhiri has declared that no healthcare facility in Papua should refuse patients under any circumstances, regardless of their financial status. He warned that any facility found turning away patients will face severe sanctions.
“Do not play games with healthcare services for mothers and children. Don’t prioritize whether they have money; serve them first. That is my responsibility as governor, and the regents will also handle it,” stated Fakhiri, as reported by Ikbal Asra for BBC News Indonesia on Friday, November 21.
Fakhiri acknowledged that the death of Irene Sokoy reflects the dilapidated state of healthcare services in Papua. “God has shown us, the government, the reality of the broken healthcare system in Papua,” Fakhiri said during a visit to Irene’s family.
The Governor, along with several Papua Provincial Government officials, visited Irene Sokoy’s family at the pier in Ifar Besar Village, Jayapura Regency, on Friday evening, November 21.
During the meeting, the family recounted how Irene, who was from Kensio Village in Lake Sentani, was transported by speedboat to the mainland and then by road to the hospitals.
The family detailed the events leading to Irene and her unborn child’s death after being taken to four Jayapura hospitals without receiving adequate medical attention on Sunday, November 16, 2025.
The Chronology of Events
According to Irene Sokoy’s family, the ordeal began on Sunday, November 16. Irene experienced contractions in Kensio Village, Lake Sentani. With no healthcare facilities in the village, the family transported her by speedboat to Yowari Regional General Hospital (RSUD).
The distance between Kensio Village and RSUD Yowari is approximately 30 kilometers, with an estimated travel time of 40-50 minutes.
“We took Irene to Yowari Hospital and arrived at exactly three o’clock,” said Ivan Ibo, Irene Sokoy’s younger brother.
Upon arrival, nurses immediately conducted an initial examination. “The examination showed that the mother’s blood pressure was normal, the baby’s heart rate was stable, and she was five centimeters dilated. The nurses said everything was still normal,” Ivan explained.
As her dilation remained unchanged, Irene was transferred to the delivery room for further monitoring at 6:00 PM. There, the nurses contacted the on-call doctor for medical directions.
The doctor recommended administering medication to induce labor. The family was asked to purchase the prescription at the hospital pharmacy. Ivan mentioned that four types of labor-inducing drugs were given. “There were four types of drugs: a liquid, antibiotics, and labor-inducing drugs,” he stated.
At 8:00 PM, Irene’s water broke. However, the baby’s heart rate began to decline. The doctor then advised a Cesarean section.
However, there was no obstetrician available at RSUD Yowari. The hospital then referred the patient to Dian Harapan Hospital.
Alfonsina Kabey, Irene’s sister-in-law, who accompanied the referral process, admitted to panicking because Irene’s condition was worsening, but no doctor was attending to her. “If there was no doctor, why didn’t they tell us when we arrived? We could have made a decision from the beginning,” she said.
The family requested that Irene be immediately referred to the next hospital, but an ambulance was not readily available. “We waited from 11:00 PM until 1:22 AM for the ambulance to arrive, while she was in severe pain, restless, and constantly screaming,” said Alfonsina.
Upon arrival at Dian Harapan Hospital in Waena, the patient could not be admitted because the rooms were full. “[Hospital staff] checked her BPJS (Healthcare Security Agency), which is government-sponsored, Class 3. [But the rooms were] full,” Ivan said.
The family then proceeded to RSUD Abepura. Instead of receiving treatment, the family reported that they were briefly informed that the operating room at RSUD Abepura was under renovation, so the patient could not be treated there.
Upon the direction of RSUD Abepura, the family then continued the referral to Bhayangkara Hospital in Jayapura—the fourth hospital they visited that day. However, they once again did not receive treatment.
Irene Sokoy’s family said that Bhayangkara Hospital in Jayapura requested a down payment of Rp4 million before providing medical assistance, even though the patient was in an emergency and registered as a Class 3 BPJS Kesehatan participant, which is government-funded.
“When we arrived at Bhayangkara Hospital, they checked her identity and BPJS, which is government-sponsored, Class 3. But it was full. There was a VIP room, but we had to pay 4 million rupiah as a down payment to be treated,” said Ivan Ibo.
According to Ivan, the family did not have that amount of money, so no medical action was taken in the emergency room. “So, the only medical action was in the car,” he said.
After an initial examination outside the emergency room, the family was directed to continue to Dok II Jayapura Hospital—the next hospital to which they were referred.
However, Irene’s condition worsened on the way. “My sister was already feeling restless and hot in her chest… short of breath,” Ivan recounted.
In the middle of the journey, Irene leaned on Ivan before eventually losing consciousness. “My sister fell on my chest. She said, ‘If there was a brother, I wouldn’t be able to anymore.’ Those were her last words before she closed her eyes,” he said.
Ivan shouted at the driver to turn back to the nearest hospital, Bhayangkara Hospital. “The driver turned back… we arrived and took my sister out and laid her on the bed. They attached equipment from her feet up to her chest, but nothing worked,” Ivan said.
He believes his sister died in the car before arriving back at Bhayangkara Hospital.
Hospital Responses
The director of RSUD Yowari, drg. Maryen Braweri, stated that the Papua Health Office would immediately conduct a maternal audit to investigate the cause of death of Irene Sokoy and her unborn child.
In a brief message, drg. Maryen Braweri said that the audit is a formal step by the local government to ensure that all service procedures are carried out according to standards.
“This audit is to ensure that all service procedures are carried out according to standards and to clarify the series of events experienced by the patient before her death,” she told the Antara news agency after attending an online meeting with the Papua Provincial Health Office.
According to her, they are still waiting for the announcement of the audit results from the Provincial Health Office.
Furthermore, Dian Harapan Hospital denied rejecting the referral patient from RSUD Yowari.
RSDH claimed to have communicated the service conditions and the availability of doctors and treatment rooms to RSUD Yowari officers before the patient was brought in.
At that time, the NICU room was full with eight babies, the obstetrics room was full, and the Obstetrics and Gynecology specialist was on leave.
In addition, the partner anesthesia specialist who would be called required additional coordination time if an emergency operation had to be performed.
However, when this notification was conveyed, RSUD Yowari officers were already on their way to Dian Harapan Hospital with the patient.
RSUD Yowari officers who arrived at Dian Harapan Hospital at around 1:10 AM then asked the on-call doctor at Dian Harapan Hospital to stamp the hospital’s document and inform the patient’s family that the Obgyn and anesthesia doctors were not on standby and the treatment room was full.
After the explanation was accepted, the family decided to continue the referral to another hospital.
The management of Dian Harapan Hospital emphasized that all procedures had been carried out according to standards and there was no element of patient rejection.
The Director of Bhayangkara Hospital, Rommy Sebastian, said that his party never rejected referral patients. However, RSUD Yowari did not go through the referral procedure, namely filling out the Integrated Referral System (SISRUTE)—an internet-based information system used to simplify and speed up the process of referring patients between health facilities.
“We never reject patients, but the question is, did RSUD Yowari go through the procedure for the referral? Because every referral patient must fill out SISRUTE so that we can read it, but this was not done, so don’t blame us,” he told Kompas.com on Friday, November 20.
The Head of the Papua Provincial Health Office, Arry Pongtiku, stated that the death of Irene Sokoy after moving from one hospital to another without receiving medical treatment, shows a failure of the referral system and emergency handling in the region.
Arry explained that the patient should have been treated as an emergency case requiring rapid action, not repeatedly transferred. “If it’s an emergency, there should be no patient rejection. They must be served first. Administration can follow,” he emphasized.
Arry admitted that there were a number of serious issues in the referral system, including weak coordination between hospitals. “These hospitals must be aware if a patient wants to be referred. Earlier, there was only communication from Yowari to Dian Harapan. The next referral just went on like that. This is one of the main problems,” he said.
The Papua Health Office has gathered 43 representatives from hospitals, district/city health offices, IDI (Indonesian Doctors Association), BPJS, and the Hospital Association in an emergency meeting.
Arry said that all parties agreed to form a small joint audit team with UNICEF to trace the entire service and referral process. “The audit team will see if there are any errors and how to fix them. The audit results will determine,” he explained.
Responding to claims that money was requested before treatment at one of the hospitals, Arry emphasized that emergency patients should not be asked for upfront payment. “In an emergency, there should be no patient rejection. If there are things that BPJS cannot claim, the Health Office can help pay for patients of Indigenous Papuans,” he said.
Arry reiterated that the safety of mothers and babies must be the top priority of all healthcare facilities in Papua.
Weak Healthcare Governance in Papua
Papuan public policy observer, Methodius Kossay, stated that this case not only concerns technical medical aspects, but also touches on issues of public policy governance, regulatory implementation, and public service accountability.
He sees at least three fundamental problems in this event:
First; failure of the referral system;
Second; alleged violations of hospitals’ obligations in emergency handling;
Third, weak supervision and coordination of healthcare services at the regional level.
“In an emergency obstetric situation, the first hospital is obliged to provide medical stabilization, not immediately refer without assistance. The inability of healthcare facilities to provide a rapid response to critical cases like this is a form of serious healthcare disparity in Papua,” he said.
According to him, in Irene’s case, there is a strong suspicion that the hospital violated its obligation to treat patients in emergency conditions, as regulated in Article 174 of Law Number 17 of 2023 concerning Health.
Article 174 (1) Health Service Facilities owned by the Central Government, Regional Government, and/or the community are obliged to provide Health Services to someone who is in an Emergency condition to prioritize saving lives and preventing disability.
Article 174 (2) In an Emergency condition as referred to in paragraph (1), Health Service Facilities owned by the Central Government, Regional Government, and/or the community are prohibited from rejecting Patients and/or requesting down payments and are prohibited from prioritizing all administrative matters thereby causing delays in Health Services.
Methodius Kossay recommends that the Papua Provincial Government carry out:
* Hospital emergency service audits;
* Enforcement of administrative sanctions;
* Development of an Integrated Referral System (One-Gate Referral System) Papua;
* Strengthening 24-Hour Comprehensive Emergency Neonatal Obstetric Services (PONEK);
* Ensuring that there are no down payments in emergency cases.
“The death of Ibu Irene Sokoy is not just a family tragedy, but a public policy tragedy in fundamental healthcare services. The regulations are clear that emergency patients should not be rejected. But the reality shows the opposite,” said Methodius.
“The Provincial Government of Papua must step in to ensure that every pregnant woman, in every village, has the same right to live and be helped,” he concluded.
Maternal and Infant Mortality Rates in Papua are the Highest in Indonesia
Maternal and infant mortality rates in Papua far exceed the national average.
The 2020 Population Census shows that the maternal mortality rate (MMR) in Papua Province is 565 per 100,000 live births. Meanwhile, the MMR in West Papua Province is 343 per 100,000 live births.
These maternal mortality rates far exceed the national average of 189 per 100,000 live births.
The infant mortality rate (IMR) in both provinces is also high.
The IMR in Papua is recorded at 35 per 1,000 live births and West Papua records 27 per 1,000 live births. Meanwhile, the national average IMR is only 19 per 1,000 live births.
The high infant mortality rate is related to a number of factors, ranging from limited neonatal services, a lack of health workers, to difficult transportation access for mothers and babies in remote areas.
Journalist in Papua, Ikbal Asra, contributed to this article.