Mission Indonesia

With more than 40 million inhabitants living below the poverty line, Indonesia is faced with a precarious health and socio-economic situation, weakened by many natural disasters. In these circumstances, access to healthcare for the archipelago’s remote populations and the shantytown residents remains difficult. Indonesia is still, therefore, dependent on humanitarian organisations to deal with the spread of the AIDS virus and the emergence of new epidemics related to the significant population movements as people have fled the worst affected areas.

Project 1 :

Providing primary healthcare and preventing infectious disease - Mulia and Sinak, Puncak Jaya district, Western Papua

Activities :

As part of the programme on access to primary healthcare and prevention of infectious disease, the activities have continued with the local partner PRIMARI. These include:

• training 18 trainers, mainly concentrating on training nursing staff and community staff in primary healthcare and prevention;
• running mobile clinics in the villages far from the Sinak health centres (235 consultations and 109 children vaccinated in three visits).

Outlook :

Supporting the health facilities and mobile clinics as well as training health professionals. Implementation of a safe maternity community component, and HIV/AIDS prevention activities among secondary and primary school pupils.

Project 2 :

Access to healthcare for the shantytown populations - Jakarta

Activities :

MdM works in the north of Jakarta, within the shantytowns where many rural people now live. Their illegal occupancy status prevents them from accessing health services or benefiting from social services for the poor. In 2007, MdM continued its activities in four clinics with:

• nutritional support to children with malnutrition or tuberculosis;
• vaccination and growth monitoring of young children and pregnant women;
• access to treatment for chronic conditions;
• training health workers from the communities (kader), training sessions in first aid, child monitoring, vaccination (Posyandu) and family planning;
• supporting patients needing medical referrals;
• lobbying the health authorities for access to healthcare for the illegal communities.

Outlook :

2008 will constitute a turning point in the future of the programme. There are two options under consideration: the withdrawal and closure at the end of August 2008 or the continuation of the programme if significant long-term funding can be obtained.

Project 3 :

Primary healthcare for the Punan population of the Tubu forest - Kalimantan

Activities :

Because of their distance from health facilities and the cost of river transport, the Punan Tubu do not have access to appropriate healthcare. Respiratory infections, epidemics, tuberculosis and infant mortality are the main health problems identified. Several activities have been carried out:

• three visiting medical teams and three vaccination campaigns;
• distribution of insecticide-impregnated bed nets;
• training nine community health agents who have since been able to carry out Punan language education sessions in each community;
• discussions with the Adat Punan association which represents the interests of the Punan of Kalimantan.

Outlook :

A final medical campaign will take place during the first months of 2008 (mobile clinics and a fourth vaccination campaign) with the health staff of Pulau Sapi reference health centre, who will take over the MdM activities and run two mobile clinics a year.

Project 4 :

Tackling malaria - Lembata island

Activities :

A programme to tackle malaria in the worst affected communities on the island began at the end of November 2007, with the recruitment of a local team. Malaria is endemic in these areas, with infection rates of more than 20%, and the programme should reduce the infection rates within 16 months. Since December, the team has begun to evaluate eight health centres, the district health centre and the pharmacy supplies.

Outlook :

• Set up two mobile teams to carry out early diagnosis and treatment.
• A study on malaria in young children in at least ten selected villages.
• Training health personnel and community health workers to prevent and treat malaria.
• Supporting seven district health centre laboratories.
• Distributing 5,000 long-lasting insecticide-impregnated bed nets in high risk communities which are furthest from the reference health services.

Project 5 :

Emergency medical aid - Tanah Datar district, Sumatra

Activities :

Psychological care for people traumatised by the earthquake on 6 March 2007. The Indonesian authorities and all the humanitarian organisations based in Jakarta, mobilised to provide:

• individual consultation and counselling, referrals, group work, awareness-raising and training of health personnel in the prevention and identification of psychological problems;
• support, in collaboration with Action Against Hunger, to the health system and local rescue workers, by providing emergency medical kits for health facilities, providing basic necessity kits, construction of emergency latrines and re-establishing access to drinking water;
• periodic support for the healthcare teams, through supporting human resources in general consultations in the first week, and the implementation of epidemiological monitoring.

Outlook :

Quickly after the earthquakes, the Indonesian Ministry of Health was able to take over the MdM activities. With the emergency phase over, MdM withdrew.

Project 6 :

Emergency response to floods in the shantytowns - Jakarta

Activities :

Following the floods that submerged Jakarta for several days causing severe damage, MdM carried out an emergency intervention in the north and east of Jakarta, in collaboration with our local partner AULIA, which included:

• 146 mobile clinics;
• a vaccination campaign in four communities;
• distribution of food, blankets and hygiene kits;
• refurbishment of premises and provision of equipment to hospitals, health centres, midwives, community health workers, community clinics, schools and local NGOs;
• creating structures to drain rainwater and maintenance work on the paths in the Tanah Merah Bawah community.

Outlook :

From our base in Jakarta, MdM was able to monitor the emergencies, participate in co-ordination meetings and keep in touch with the key players (OCHA, NGOs). The staff of the base and of the medical project are able to respond rapidly if we need to intervene. In addition, our emergency stocks – which include medicines, medical equipment and logistics equipment – facilitate rapid emergency response.

August 2008