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Jual Genset Cummins Murah di Banggai Hubungi : 0821 - 1310 - 3112/(021) 9224 - 2423 PT. Tribuana Diesel Adalah penjualan Generating-Set (genset) berkualitas import (builtup) bagi anda yang membutuhkan product berkualitas serta pengadaan yang cepat urgent tanpa berbelit-belit, Genset kami di lengkapi dengan dokumen Certificate Of Original , Manual book engine dan manual book generator, Kami sediakan Genset kapasitas 10 Kva - 650Kva (ANDA PESAN KAMI ANTAR).

Jual Genset Cummins Murah di Banggai Kami juga menerima pembuatan box silent dan perakitan diesel generator set. Produk kami meliputi berbagai diesel generator set model open, silent lokal yang ukuranya menyesuaikan lokasi pondasi genset, mobile/ trailer . Sebagian besar mesin kami menggunakan Merk : Perkins, Cummins, Deutz, Lovol, Isuzu Foton dengan generator Leroy Somer, Stamford, kualitas terbaik brushless alternator. Jual Genset Cummins Murah di Banggai

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Jual Genset Cummins 80Kva bergaransi dan berkualitas di Toraja Utara

Jual Genset Cummins 80Kva bergaransi dan berkualitas di Toraja Utara Hubungi : 0821 - 1310 - 3112/(021) 9224 - 2423 PT. Tribuana Diesel Adalah penjualan Generating-Set (genset) berkualitas import (builtup) bagi anda yang membutuhkan product berkualitas serta pengadaan yang cepat urgent tanpa berbelit-belit, Genset kami di lengkapi dengan dokumen Certificate Of Original , Manual book engine dan manual book generator, Kami sediakan Genset kapasitas 10 Kva - 650Kva (ANDA PESAN KAMI ANTAR). Jual Genset Cummins 80Kva bergaransi dan berkualitas di Toraja Utara

Saco-Indonesia.com - Penderita kanker di negara ini mendapat beban vonis dua kali.

Saco-Indonesia.com - Penderita kanker di negara ini mendapat beban vonis dua kali. Selain usia dipastikan berakhir oleh dokter saat stadium mencapai tahap lanjut, vonis kedua adalah mahalnya ongkos harus dikeluarkan untuk obatnya.

Ambil contoh harga sorafenib, zat kimia penting bagi penderita kanker hati atau ginjal supaya perkembangan sel jahat berkurang. Seorang pasien butuh hingga Rp 50-an juta menebus obat itu buat konsumsi rutin sebulan.

Itu di luar biaya kemoterapi Rp 2-6 juta sekali sesi. Tak salah bila Yayasan Kanker Indonesia melansir kira-kira satu penderita butuh biaya Rp 102 juta per bulan untuk mempertahankan hidupnya.

Komponen obat jadi salah satu paling membebani. Hal itu dibenarkan oleh Marius Widjajarta, dokter masuk tim perumus harga obat Kementerian Kesehatan. "Obat riset itu mencakup 20 persen dari yang beredar di pasaran. Rata-rata memang untuk penyakit-penyakit berat, kanker, HIV, flu burung, dan semacamnya. Harganya mahal karena ada paten yang harus dibayarkan pada perusahaan sebagai penemunya," ujarnya kepada merdeka.com awal bulan ini.

Akan tetapi kondisi ini bukannya tanpa jalan keluar. Khususnya supaya harga obat lebih terjangkau bagi penderita penyakit kronis. Akar dari mahalnya obat paten adalah Trade-Related Aspects of Intellectual Property Rights (TRIPS). Ini beleid perlindungan hak paten produsen obat hasil riset wajib dipatuhi Organisasi Perdagangan Dunia (WTO).

Hal itu disampaikan pengamat isu kesehatan dari lembaga swadaya Indonesia for Global Justice, Rachmi Hertanti. Dia meyakini beban ongkos paten menjerat itu masih bisa dilobi pemerintah.

Itu berkaca pada artikel nomor 31 dari ketentuan WTO mengenai TRIPS. "Setiap anggota bebas menggunakan metode sesuai dalam mengimplementasikan ketentuan terdapat dalam perjanjian sesuai ketentuan hukum mereka miliki."

"Artinya suatu negara dibolehkan memproduksi atau mengimpor obat dari pihak ketiga, tidak harus dari pemegang paten, jika ada suatu situasi-situasi yang dianggap darurat," ujar Rachmi. "Sehingga harganya bisa jadi lebih murah."

Pemerintah bukannya tidak mengetahui celah hukum itu. Terbukti pada Oktober 2012, Susilo Bambang Yudhoyono mengeluarkan keputusan presiden mengesampingkan paten dari tujuh obat HIV/AIDS dan hepatitis C dimiliki oleh Merck & Co, GlaxoSmithKline, Bristol-Myers Squibb, Abbott, dan Gilead.

Dampaknya segera dirasakan pasien karena harga obat paten langsung menjadi lebih murah. Contohnya beban belanja lopinavir dan ritonavir dibutuhkan penderita HIV memperpanjang hidupnya menjadi tak sampai Rp 100 ribu buat kebutuhan sebulan.

Rachmi menyatakan pemerintah bisa mengupayakan harga obat paten lain diturunkan meniru kebijakan buat penderita HIV. "Penyakit kanker atau jantung, sebenarnya hampir 70 persen dari penyebab kematian di negara kita, butuh kebijakan serupa," tuturnya.

Apalagi negara di kawasan sudah menjalankan negosiasi TRIPS. Ambil contoh Thailand pada 2008 menerbitkan lisensi mengabaikan paten buat beberapa jenis obat kanker. Hasilnya, harga docetaxel dan letrozol turun 24 kali lipat dari harga normal. Negeri Gajah Putih ini juga mengabaikan paten buat clopidogrel biasa dikonsumsi penderita kanker paru sehingga harganya turun 91 persen dari pasaran.

India lebih agresif lagi mengabaikan paten. Data Organisasi kemanusiaan medis internasional Medecins Sans Frontieres/Dokter Lintas Batas (MSF) menunjukkan negara itu mengabaikan paten atas sorafenib. Obat kanker itu dari awalnya seharga hampir Rp 50 juta, turun drastis menjadi hanya Rp 1,7 jutaan.

Negeri Sungai Gangga, melalui Mahkamah Agung , memaksa perusahaan obat Bayer asal Jerman pada 2012 melepas hak eksklusif paten atas bermacam obat kanker.

"Thailand dan India nyatanya berani, ini perkara kemauan politik saja," kata Rachmi menegaskan.

Masalahnya, pemerintah akhir tahun lalu justru memperlemah daya saing industri farmasi lokal melalui revisi Daftar Negatif Investasi (DNI) untuk sektor farmasi. Perusahaan luar tadinya hanya boleh menguasai 75 persen saham, kini diperbesar jatahnya menjadi 85 persen.

Situasi ini akan membuat mereka semakin dominan dibanding pabrik obat lokal. Sebab, 24 perusahaan asing beroperasi di Indonesia menguasai 80 persen pasar obat paten.

Rachmi mengingatkan kesuksesan India dan Thailand disokong oleh kesiapan farmasi lokalnya memproduksi obat tersebut. Artinya, tanpa ada industri dalam negeri kuat, pengabaian TRIPS jadi percuma. "Kalau asing semakin diperlonggar masuk ke Indonesia, dia harus diwajibkan kerja sama transfer teknologi dengan BUMN farmasi," usulnya.

Marius punya gagasan lain lagi. Dia melihat beberapa obat bermerek dikuasai farmasi asing patennya sudah kadaluarsa. Artinya, status mereka hanyalah generik bermerek. Obat-obat semacam itu, misalnya Topamax, dibutuhkan penderita epilepsi, wajib dikontrol Kementerian Kesehatan.

Dia mengaku punya data generik bermerek adalah satu satu sektor harganya gila-gilaan tanpa pernah dikontrol. "Obat merek itu harganya dilepas begitu saja. Data saya ada yang 40-60 kali lipat dari harga generiknya," kata Marius.

Ini juga perkara kemauan politik. Kenyataannya, Marius melihat data harga obat dipasok industri untuk program pemerintah dilepas hanya 3-4 kali dari biaya produksi. "Mekanisme pengendalian harga jual harus dibuat," kata Ketua Yayasan Pemberdayaan Konsumen Kesehatan Indonesia ini.

Editor : Maulana Lee

Sumber : Merdeka.com

GREENWICH, Conn. — Mago is in the bedroom. You can go in.

The big man lies on a hospital bed with his bare feet scraping its bottom rail. His head is propped on a scarlet pillow, the left temple dented, the right side paralyzed. His dark hair is kept just long enough to conceal the scars.

The occasional sounds he makes are understood only by his wife, but he still has that punctuating left hand. In slow motion, the fingers curl and close. A thumbs-up greeting.

Hello, Mago.

This is Magomed Abdusalamov, 34, also known as the Russian Tyson, also known as Mago. He is a former heavyweight boxer who scored four knockouts and 14 technical knockouts in his first 18 professional fights. He preferred to stand between rounds. Sitting conveyed weakness.

But Mago lost his 19th fight, his big chance, at the packed Theater at Madison Square Garden in November 2013. His 19th decision, and his last.

Now here he is, in a small bedroom in a working-class neighborhood in Greenwich, in a modest house his family rents cheap from a devoted friend. The air-pressure machine for his mattress hums like an expectant crowd.

 

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Mike Perez, left, and Magomed Abdusalamov during the fight in which Abdusalamov was injured. Credit Joe Camporeale/USA Today Sports, via Reuters

 

Today is like any other day, except for those days when he is hurried in crisis to the hospital. Every three hours during the night, his slight wife, Bakanay, 28, has risen to turn his 6-foot-3 body — 210 pounds of dead weight. It has to be done. Infections of the gaping bedsore above his tailbone have nearly killed him.

Then, with the help of a young caretaker, Baka has gotten two of their daughters off to elementary school and settled down the toddler. Yes, Mago and Baka are blessed with all girls, but they had also hoped for a son someday.

They feed Mago as they clean him; it’s easier that way. For breakfast, which comes with a side of crushed antiseizure pills, he likes oatmeal with a squirt of Hershey’s chocolate syrup. But even oatmeal must be puréed and fed to him by spoon.

He opens his mouth to indicate more, the way a baby does. But his paralysis has made everything a choking hazard. His water needs a stirring of powdered food thickener, and still he chokes — eh-eh-eh — as he tries to cough up what will not go down.

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Mago used to drink only water. No alcohol. Not even soda. A sip of juice would be as far as he dared. Now even water betrays him.

With the caretaker’s help, Baka uses a washcloth and soap to clean his body and shampoo his hair. How handsome still, she has thought. Sometimes, in the night, she leaves the bedroom to watch old videos, just to hear again his voice in the fullness of life. She cries, wipes her eyes and returns, feigning happiness. Mago must never see her sad.

 

Photo
 
 Abdusalamov's hand being massaged. Credit Ángel Franco/The New York Times

 

When Baka finishes, Mago is cleanshaven and fresh down to his trimmed and filed toenails. “I want him to look good,” she says.

Theirs was an arranged Muslim marriage in Makhachkala, in the Russian republic of Dagestan. He was 23, she was 18 and their future hinged on boxing. Sometimes they would shadowbox in love, her David to his Goliath. You are so strong, he would tell her.

His father once told him he could either be a bandit or an athlete, but if he chose banditry, “I will kill you.” This paternal advice, Mago later told The Ventura County Reporter, “made it a very easy decision for me.”

Mago won against mediocre competition, in Moscow and Hollywood, Fla., in Las Vegas and Johnstown, Pa. He was knocked down only once, and even then, it surprised more than hurt. He scored a technical knockout in the next round.

It all led up to this: the undercard at the Garden, Mike Perez vs. Magomed Abdusalamov, 10 rounds, on HBO. A win, he believed, would improve his chances of taking on the heavyweight champion Wladimir Klitschko, who sat in the crowd of 4,600 with his fiancée, the actress Hayden Panettiere, watching.

Wearing black-and-red trunks and a green mouth guard, Mago went to work. But in the first round, a hard forearm to his left cheek rocked him. At the bell, he returned to his corner, and this time, he sat down. “I think it’s broken,” he repeatedly said in Russian.

 

Photo
 
Bakanay Abdusalamova, Abdusalamov's wife, and her injured husband and a masseur in the background. Credit Ángel Franco/The New York Times

 

Maybe at that point, somebody — the referee, the ringside doctors, his handlers — should have stopped the fight, under a guiding principle: better one punch too early than one punch too late. But the bloody trade of blows continued into the seventh, eighth, ninth, a hand and orbital bone broken, his face transforming.

Meanwhile, in the family’s apartment in Miami, Baka forced herself to watch the broadcast. She could see it in his swollen eyes. Something was off.

After the final round, Perez raised his tattooed arms in victory, and Mago wandered off in a fog. He had taken 312 punches in about 40 minutes, for a purse of $40,000.

 

 

In the locker room, doctors sutured a cut above Mago’s left eye and tested his cognitive abilities. He did not do well. The ambulance that waits in expectation at every fight was not summoned by boxing officials.

Blood was pooling in Mago’s cranial cavity as he left the Garden. He vomited on the pavement while his handlers flagged a taxi to St. Luke’s-Roosevelt Hospital. There, doctors induced a coma and removed part of his skull to drain fluids and ease the swelling.

Then came the stroke.

 

Photo
 
A championship belt belonging to Abdusalamov and a card from one of his daughters. Credit Ángel Franco/The New York Times

 

It is lunchtime now, and the aroma of puréed beef and potatoes lingers. So do the questions.

How will Mago and Baka pay the $2 million in medical bills they owe? What if their friend can no longer offer them this home? Will they win their lawsuits against the five ringside doctors, the referee, and a New York State boxing inspector? What about Mago’s future care?

Most of all: Is this it?

A napkin rests on Mago’s chest. As another spoonful of mush approaches, he opens his mouth, half-swallows, chokes, and coughs until it clears. Eh-eh-eh. Sometimes he turns bluish, but Baka never shows fear. Always happy for Mago.

Some days he is wheeled out for physical therapy or speech therapy. Today, two massage therapists come to knead his half-limp body like a pair of skilled corner men.

Soon, Mago will doze. Then his three daughters, ages 2, 6 and 9, will descend upon him to talk of their day. Not long ago, the oldest lugged his championship belt to school for a proud show-and-tell moment. Her classmates were amazed at the weight of it.

Then, tonight, there will be more puréed food and pulverized medication, more coughing, and more tender care from his wife, before sleep comes.

Goodbye, Mago.

He half-smiles, raises his one good hand, and forms a fist.

Ms. Rendell was a prolific writer of intricately plotted mystery novels that combined psychological insight, social conscience and teeth-chattering terror.

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