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Wednesday, September 4, 2013

Between "Humanity" and "Necessity"

Andrea Star Reese presented an interesting photo essay about mental health facilities in Indonesia. As much as it broke my heart to read it and be reminded of the severe lack of health facilities in Indonesia, it also reminded me of the opportunity I currently had to speak out and set the record straight. Like a proboscis monkey or a komodo dragon which represents Indonesia's fauna, you can comment on how ugly they look with their big hideous nose (monkey) or how primitive they are with deadly saliva dripping on their jaws (komodo), or you can know more about them and understand them a bit more to see the beauty within.

Andrea's pictures tells a lot about the living condition on the health mental institutes in Indonesia. What Andrea missed out is that these so-called mental institutes are privately owned even though sometimes they did receive help from Indonesian government. In US, think Planned Parenthood: it receives government fund to cover eligible patients but it is not a state-endorsed health institution. The official mental hospitals are available in some big cities. The numbers are not plentiful, but they were clean and well maintained and have nurses and doctors and medication. As for the medication, I would like you to reflect for a moment and think: what is your definition of poor? In Indonesia, medication is a luxury. When you had to choose between a meal (which you can scarcely afford and can barely satisfy your hunger) and medication to heal yourself and/or ease your symptoms, it's not even a choice. What's the use of being healthy if you died from hunger? The constant point of "no medications" given by Andrea was completely moot, because the people put in these mental institutes pictured in Andrea's essay are the poorest of the poor else they will be cared by their own family or receive a better care elsewhere.

Even though the "educated" or "civilized" readers might raise issue on how these mental institutes disregard human rights and  abusing their "patients", they were not. Mental illness had long been associated with negative stigma, whether it is a defect in the family or being possessed by the spirits. It was considered bad luck to be near "orang gila/crazy people" or have them in a family, let alone to care for them. These mental institutes have done their best to help the unfortunate souls, even though it might not live up to the normal health standards. Quack medical shaman is a dime a dozen in Indonesia, and sadly some did raking up and live luxuriously from their victims' money; however it is hard to believe that these mental institutes are in it for the money because there is no money there, mental issues are considered as a sin or plague and not something anyone would assist with. It's just not sexy enough to gain revenue. The thought of these people who tried to help their fellow human in need but being labeled as "Torturer" instead shuddered me. They deserve a better credit because they are in fact trying to help.

Sunset at the beach

It's easy to then point finger to Indonesian government for not providing better health care, both in man power or medications. But do you know how big Indonesia is? And how diverse it is? Indonesia is the largest country wholly on islands, and it is number 15 on the UN country size list. And when you read "Island", please stop imagining those cute islands of Bahamas or Fijis. Indonesia's islands rank no. 2, 3, 4, 6, 11, 13, in the list of island with the size of 39,000 - over 97,000 square miles. For comparison, Sumatra which landed on number 6 on the list (and wholly owned by Indonesia and does not share border with other country) has the size of 184,954 sq mi, bigger than California (USA's third biggest state) which has the size of 155,939 sq mi. And it was not all fun and game, long smooth highways and stops along the way; traveling within these islands often means going into the wilderness with no form of convenient transportation. It can take days or weeks to reach some part of the islands where some citizens reside. As a matter of fact, even Andrea's photo essay seemed to be taken exclusively in Java and Bali, the two most notable islands in Indonesia.

As noble as it sound to screamed: "The government need to take action!!!", one also need to understand the difficulty the geographical location  posed to the overall well-being of Indonesian citizen and governing this country. It was hard enough to register and provide ID card to all the citizen of Indonesia, even in the main island of Java, let alone to provide proper medical care. As for the doctors, I can't blame them for sticking in "the most modernized island of Indonesia", Java. Imagine spending at least 7 years of your life (often more) in the comfort of modern living in form of medical school in Java or universities in big well developed Indonesian cities, plus the thousands and thousands of dollar you spend to get the psychiatrist degree, only to find yourself in an area without any clean water and the nearest civilization is 4-5 days away which include various mode of land/air/water/combination of all three transportation (and a great deal of walking) and saps out your whole month's salary. You can do it if you are so inclined and felt "called" to help, but I won't judge you if you opt out.

A Balinese-Hindu on her coming-of-age ritual

It is also very easy, almost all too easy as a matter of fact, to point finger on the people of Indonesia and blaming them for their trust in Shaman or as this man write: Maybe if the world's largest Islamic country and its people stopped focusing on the Quran and more on science they country would be in a better place. Well for one thing Indonesia has the largest Muslim population but it is not an Islamic country, and it has so many different religion including branches of Christianity as well. And how does religion and love for God and/or higher being translate to be a lesser value than science? Science doesn't teach kindness or compassion. Science doesn't teach morality and dignity. Science doesn't recognize love and laughter (except on correlation on brain synapses and muscles include). People in Indonesia are happy with what they believe, so why interfere just because current civilization deemed it is not good enough? I strongly agree with better education and health system, but I disagree with any attempt to convert my fellow Indonesia towards the "right civilization", to change our way of living because it is "so not 21st century". We believe in our God and in our way of life, so let us be.

The bone-thin people shackled to their "bed", the distinct filth and the hard "bed", the inhumane living condition, the poverty and the horror, these are what most people see and perceive at first with Andrea's photo essay. I see instead the struggle of people to live by, the effort one made to ease the life of their socially rejected fellow human. There is more to the story. There is a "why" that leads these people to live their lives like that, and a "why" that leads the mental institutes to provide that kind of treatment. This too should be told, instead of only a haunting image of woman with blank stare and a padlock with chain around her ankle. Screaming "Human cruelty!" and "Savages" will not help, because it did not happen because we wanted it to be like that or rejecting proper medication and health care, it happen because we can't do much about it. Understand us, don't just judge us.

By the way Malmn: *their, not *they
Regards, a Balinese-Hindu woman from "Largest Islamic Country" who has a four-year undergraduate degree in Medicine

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