Piloting new ways of working in Indonesia

September 28, 2013

The Ministry of Social Affairs Indonesia is instigating new ways of working through the delivery of a pilot project in Sukabumi, West Java.  This unique project is connecting all levels of government, from village head, to sub-district, to district level across both Social Affairs and Health Ministries.

Kebonpedes village

The pilot project is taking place in the village of Kebonpedes, Sukabumi – an area 5 hours south of Jakarta.  A significant number of women in the area have travelled to Saudi Arabia as maids to earn money to support their families. Reports indicate terrible working conditions for these women, with reported cases of violence, psychological stress, and not receiving pay. Over the last few years, as many as 120 have returned home with severe mental ill-health.  

We met with a few of these women, each with a similar story of hardship, but equally a good story of how they were being supported by the community in their recovery.

The pilot site has a psychiatrist who visits once a month from Bogor hospital.  For the first time, necessary medication is maintained by district Puskesmas (community health centre) for management by staff.  Previously, medication was provided at the Provincial hospital, usually very far away.  We met with ten extraordinary volunteers who are critical in connecting clients, families and the puskesmas.  This communication link is critical to the success of the project.

The village head took us to visit another family who are receiving support from this project.  Four of the members of the family had a diagnosis of schizophrenia.  The daughter had been in pasung or shackled up till a few years ago, with visible scars from the shackles on her wrists.  She spoke openly about her experience and her recovery, supported by the volunteers, puskesmas and village.  The son, with the help of the village head had been provided with a small start up fund to buy the necessary equipment to sell corn to the local school.  He is now the breadwinner of the family.

There are a couple of factors that make this project so successful. The first comes through strong leadership across all areas, in particular from the local village head, who had a visible commitment to care for his people.

The second is through an integrated partnerships model. Each area from health to social affairs worked effectively together to support their clients.

The third area of success was in the community awareness raising that has been done in line with development of the service system. Support from those in the community is critical to the success of any community mental health program.