Mission Indonesia

In Indonesia, 240,000 people died or were reported missing as a result of the tsunami of 26 December 2004. It was the country most affected by the disaster, and the whole population of Aceh province were hit hard with the destruction of medical infrastructure, a lack of healthcare staff, major population displacements and psychological suffering. The whole local health system is being rebuilt. The Indonesian economy was weakened and 16 million households still live below the poverty line. In addition, the AIDS epidemic is worsening fast especially through the use of injectable drugs and prostitution, which are very widespread practices in Indonesia.

Preventing HIV/AIDS and STIs

Mulia, Puncak Jaya district, West Papua

Activities:

The first phase of the project aims to reduce the prevalence of STIs and the incidence of HIV/AIDS by improving the therapeutic treatment of STIs and the prevention of STI/HIV transmission in this district. 2005 was notable for prevention and social involvement actions (the fight against the discrimination and stigmatisation patients are subject to). An evaluation of the programme carried out in September 2005 highlighted the decline in access to healthcare mainly due to the decentralisation undertaken by the government since 2002 and to the conflicts between independence fighters and the army which prevent access to villages and prevent healthcare workers from going there.

Outlook:
The first phase was completed at the end of February. During the second phase, we are going to refocus our programme on preventing infectious diseases and extending the scope of our work to the neighbouring sub-district subdistrict of Sinak.

Caring for the marginalised population

Jakarta

Activities:

MdMs work is aimed at helping the marginalised people of Jakarta. There are four aspects to the project:

• weekly medical consultations in partnership with the local NGO Aulia;
• training Aulia's social workers and community health workers;
• setting up a referral system appropriate to this population;
• technical logistics assistance, fundraising and management of the NGO partner Aulia.

Outlook:

• Pursue access to primary healthcare (especially for women and under 5s) in Jakarta's northern shanty towns.
• Raise the population's awareness about prevention of the predominant diseases.
• Strengthen Aulia's capacities so that it can run its programmes autonomously.

Caring for the Punans

Kalimantan

Activities:

The Punans, an indigenous Indonesian people, are linked to Malinau district, whose main town is experiencing major economic development (forestry exploitation) with negative consequences for ecology, society and health. They have no access at all to primary healthcare. The main health problems identified are malaria, respiratory diseases and high infant mortality.
We are involved in:

• mobile clinics lasting a month (3 times/year) in 4 sites;
• training 5 health workers from thePunan community for a week before each medical project, with application on the field during the project;
• support for the Adat Punan organisation, which represents the interests of the Punans of Kalimantan.

Outlook:

• Continue medical consultations, in order to help improve the Punans' health in three years.
  Aim: reduce the under 5s' mortality rate by 20%; it is estimated to be 500‰.
• Planned theoretical and practical training of traditional matrons by an experienced midwive and community health workers (prevention of the predominant diseases).
• Recognition and protection of the Punans' rights through the Adat Punan organisation.

Helping tsunami victims

Aceh Besar and Aceh Jaya districts (Aceh province / Sumatra)

Activities:

After emergency work lasting three months following the tsunami, during which MdM put a lot of effort into re-establishing access to primary healthcare for the population (permanent and mobile clinics, vaccinations, nutritional and epidemiological monitoring), the programme has developed around the following focuses:

• getting the public primary healthcare system running again in Aceh Besar and Aceh Jaya districts;
• rebuilding health structures: a district hospital (Lhoknga), two dispensaries (Seulimeum and Jantho) and health centres;
• helping to get the internal medical service of Abidin hospital in Banda Aceh running again (supplying equipment and training teams of nurses);
• developing the treatment of psychological and psychiatric problems (raising awareness and training medical staff in these problems);
• reacting to emergencies (epidemics, natural disasters, etc) in Sumatra (three week emergency project in Nias after the earthquake in March 2005).

Outlook:

In addition to substitution work in the initial emergency phase in the first months, it is vital that we reorganise and support local health structures and healthcare staff as they re-start their medium-term activities. Alongside the physical reconstruction of buildings, MdM is involved in training and supporting medical staff in order to guarantee access to quality primary healthcare.