The story of women's extensive contribution to the practice of respiratory medicine in Indonesia begins with education pioneers, such as Kartini, who is recognized as a modern, equal rights heroine in Indonesia. She was born into a noble family in Jepara, Central Java-Indonesia, in 1879. At that time, Javanese women were not allowed to have an education. Kartini befriended and corresponded with the visiting Minister of Education and Industry for Netherlands India, Dr J. H. Abendanon and his wife, who were interested in the education of native girls. Her letters were then collected and edited by Dr J. H. Abendanon, under the title ‘Door Duisternis tot Licht’ (From Darkness into Light), which were first published in 1911. The letters highlighted her spirit and idealism for self-development, self-teaching, self-trust, self-activity and solidarity all within the framework of religiosity, wisdom, beauty and patriotism for women.1 She passed away just 4 days after delivering her first son on 17 September 1904. In 1964, the late President Soekarno declared that her birthday (21 April) be celebrated as Kartini's Day or a day for Indonesian women's emancipation. Her legacy motivated the Indonesian Women's Organization to organize its first congress on 22 December 1928, with the aim of promoting equal rights for women in education and marriage. Since then, 22 December was declared as Indonesian Mothers' Day.1

In 1851, the first medical school in Indonesia was opened, known as Sekolah Dokter Djawa (Javanese Doctors' School), in Jakarta. In 1898, there was a name change to School tot Opleiding van Inlandsche Artsen (School of Medicine for Native Doctors) or STOVIA, which was the origin of the Faculty of Medicine in the University of Indonesia.2 The first woman physician was Dr Marie Thomas, a native Indonesian, who graduated in 1922. She specialized in obstetrics and gynaecology, and established a midwifery school in Bukittinggi.3

The history of pulmonology in Indonesia arose from work in diagnosing and eradicating tuberculosis. In 1930, ‘Stichting Centrale voor Tuberculose Bestrijding’ (SCVT) was inaugurated by Mrs De Jonge, the wife of the governor-general of Dutch East Indies. The first doctor who led the tuberculosis eradication work of SCVT was Professor Dr B. J. van der Plaats, a radiologist. All physicians educated in tuberculosis eradication were then known as Longarts (pulmonologist) or Tuberculosearts. In the 1970s, a group of Japanese thoracic surgeons visited Persahabatan Hospital in Jakarta, as part of a programme of the Japan Overseas Technical Cooperation Agency (OTCA), to teach and learn thoracic surgery for tuberculosis. This collaboration resulted in sending Indonesian physicians to learn more about respiratory medicine in Japan, including flexible bronchoscopy from Professor Shigeto Ikeda at the National Cancer Centre, and at the Research Institute of Tuberculosis. The returning physicians taught and spread respiratory medicine skills all over Indonesia. This collaboration resulted in rapid growth of pulmonology; the Indonesian Society of Respirology was officially established in 1973, consisting at the time of 126 pulmonologists.4 The collaboration of Indonesia and Japan in respiratory medicine continues to the present day.

In addition to their roles as mothers and homemakers, women pulmonologists in Indonesia are actively involved in many clinical settings, including tertiary and university hospitals. Women currently comprise 47.1% of pulmonologists in Indonesia, and 58% of respiratory medicine residents. Currently, half of the directors of pulmonology residency programmes are women, most of whom hold a doctorate degree (Figure 1). In the field of respiratory thoracic oncology, 62% are women. Women doctors have also been pioneers in the fields of bronchoscopy, critical care and interventional pulmonology in Indonesia. 5, 6

Leading women and future leaders in respiratory medicine. Women pulmonologist academic staff (1–7) and women respiratory medicine residents of Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia – Persahabatan Hospital, Jakarta, at hospital's lawn. Of the 96 residents, 63 (65.6%) are women. Number 1–7 staff of department: 1, Dr Hana Faisal, PhD; 2, Dr Fathiyah Isbaniah, PhD; 3, Professor Ratnawati, PhD; 4, Dr Sita Andarini, PhD as Program Director; 5, Professor Elisna Syahruddin, PhD; 6, Dr Erlina Burhan, PhD; 7, Dr Tina Reisa

Some examples of leading women respiratory doctors in Indonesia include: Dr Erlina Burhan, who was recognized among 2020's five most influential national figures by Republika, the largest newspaper group in Indonesia. Dr Burhan disseminated the Indonesian Standard of TB Care, MDR-TB program and the Public-Private Partnership for TB in Indonesia. She has also made leading contributions in clinical trials, organizational activities and COVID-19 responses.7 Dr Ratnawati is the first woman inaugurated as a professor in respiratory medicine in February 2021. She is actively involved in the Indonesian Asthma Foundation. Dr Elisna Syahruddin is one of initiators of the Indonesian Association for the Study of Thoracic Oncology, which offers a multidisciplinary team approach to lung cancer care in Indonesia.8 Dr Priyanti Soepandi was the first woman pulmonologist to be the director of the National Referral Hospital. Dr Laksmi Wulandari has contributed to delivery of high quality care and education in thoracic oncology and tuberculosis in East Java. Dr Dianiati Sutoyo, Dr Helmia Hassan, Dr Susanty Djajalaksana, Dr Triya Damayanti and myself are involved in curriculum development for residents and teaching in basic respiratory immunology, oncology and interstitial lung disease all over Indonesia.5, 6 Among paediatric respirologists, the late Professor Nastiti Noenoeng Rahajoe and Professor Cissy Kartasasmita are notable women. They were among the founders of the Indonesian Child Asthma Foundation (Yayasan Penyantun Anak Asma Indonesia).5 Dr Dangsina Muluk, a female medical physiologist, developed the Asthma Exercise Aerobic Program (Senam Asma Napas Segar).9 Not all leading women in respiratory medicine are pulmonologists. The late Indonesian first lady, Mrs Tien Soeharto, greatly contributed to establishing the Indonesian Asthma Foundation and construction of the Asthma Building in Jakarta, along with Mrs Suryati Roesmin Nurjadin, Mrs Murni Munawir Sjadzali, Mrs Anna Soenjoto, Mrs Djoemardi Djoekardi and leading pulmonologists. The Indonesian Tuberculosis Eradication Organization (Perhimpunan Pemberantasan Tuberkulosis Indonesia) was enacted on 20 May 1968; its current director is Mrs Raisis Arifin Panigoro.5

Many women in the field of respiratory medicine in Indonesia have multiple roles as clinicians, teachers, researchers, homemakers, mothers and some are the main breadwinner for their family. More importantly, Indonesian women doctors are role models for their families, patients, medical students, residents and communities.