Community Care for Mentally Ill in Bekasi
Jakarta Globe, Ulma Haryanto | March 26, 2011
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| While Bekasi hospitals and police have supported the Galuh Foundation, it has come under fire from medical practitioners for its use of physical restraints. (JG Photo/Yudhi Sukma Wijaya) |
Pak Gendu, I really like what you are doing! It is just too sad to see and hear consistently how the state neglects mentally ill, and also how many families see a mentally ill person in their midst as a stigma which needs to be hidden. A while ago I saw a slide show in an online Australian newspaper which showed terrible photos of mentally ill people in an compound, I think it was in the West Java area, I forgot the exact location and the link to this slides, but what I did not forget were the pictures...
He might not have had any formal education, and was branded a Betawi street fighter by many, but Gendu Mulatip saw people being neglected by the state and set out to help them.
Recognizing that the city of Bekasi did not provide any healthcare facilities for the mentally ill, Gendu, with the help of his most trusted friends, set up a foundation to provide care and treatment for the mentally challenged — usually free of charge.
Gendu took his last breath in January, at the age of 95, but the Galuh Foundation, which stands for “ Gagasan Luhur ” or “noble ideas,” remains his legacy. Its traditional methods might not have the acceptance of the medical establishment, but the foundation is convinced it is doing good.
Set up in 1994, the foundation is now run by Suhanda, 58, Gendu’s eldest son, who took over operations when his father died. Suhanda is assisted by 45-years-old twins Suhartono and Suhandoyo, who are the sons of Gendu’s trusted aide, Amir, now in his 60s.
“The treatment for our patients here focuses on how to prepare them for society. That’s why we never confine our patients or shackle them, unless we absolutely have to,” referring to a traditional method of restraint.
Situated in a 3,000 square meter compound in Rawa Lumbu, Bekasi, the foundaiton has plenty of space for its 245 patients.
“What we have now is a significant improvement on our previous facility,” Suhandoyo says. “We were overburdened with patients before we purchased a bigger property.”
Family
When Suhandoyo says patients are prepared to live with mainstream society, he really means it. The patients at Galuh Foundation live side-by-side with the families of their caretakers.
“For married workers we provide living quarters in the compound,” Suhanda says. “The employees here are social workers. They only get Rp 400,000 [$46] a month.”
Despite the meager pay, Suhandoyo, who was deeply inspired by Gendu, says he learned a great deal from working at the foundation.
“Gendu taught me about patience and to care and love our patients,” he says. “Living here means that we don’t have to worry about accommodation and food, and when it comes to the education of my children, most schools, when they know we work at the foundation, are willing to make exceptions.”
Suhandoyo says about 40 staff help to care for the patients. An additional 15 people — ex-patients — had decided to stay and help.
“Patients who are more stable and can follow instructions are asked to carry out daily chores such as going to the neighborhood shops,” he says. “We usually rotate their chores once in a while.”
The compound has a field where patients can walk around. A large fenced-off building serves as the living quarters for the male patients, while the female residents live in a more closed off area at the back of the facility.
“We have more male patients here. More than 70 percent,” Suhandoyo says.
The foundation does not charge for its services, only asking for a meal fee of Rp 20,000 to Rp 25,000 per patient per week.
“It is up to the patient’s family how much they would like to contribute,” Suhandoyo adds.
Traditional Approach
None of the caretakers at the foundation has a medical degree or background. Gendu never went to school and used to be known as a Betawi street fighter.
“Suhanda is an elementary-school graduate. The only person with a degree here is my father,” Suhandoyo says.
Gendu believed that mental illness could be cured. He said he received the knowledge to cure mental illness from his parents, and he passed this knowledge on to Suhanda.
“Here we use prayers, traditional herbs, counseling, and sometimes, exorcism,” Suhandoyo explains.
“We believe too many foreign chemicals are bad for you,” he says. “That’s why each patient has to undergo a purification process using herbs, followed by a vegetarian diet, no carbonated drinks or sugar and no red meat.”
Suhandoyo adds that general hospitals in Bekasi and even the police have handed over mentally ill patients to the foundation.
However, the traditional methods used at the Galuh Foundation, including the use of physical chaining instead of sedatives, are largely frowned upon by medical practitioners.
Conflict
Dr. Gregorius Pandu Setiawan, a leading mental health expert, points out that the herbs used in the foundation’s treatments are not clinically proven, and therefore it can be hard to judge the real effect on patients’ bodies.
“They use physical restraint with shackles and chains, doctors use sedatives,” he says.
Gregorius views such methods as “an embarrassment,” especially since Bekasi is located so close to Jakarta.
“The hospitals and police officers who send people to the foundation are foolish,” he says
Meanwhile, Dr. Irmansyah, the director of mental health at the Health Ministry, says he regrets that the foundation is not considered a formal health-care facility by the state.
“The ministry and other health institutions such as Soeharto Herjan Mental Hospital, Duren Sawit Hospital and Bekasi Health Office visited the facility a couple of times to check the conditions,” he says.
However, offerings of medical assistance were rejected by the foundation. “Every individual suffering from disease should be treated, the state should provide medical facilities, including for those with mental illness.”
Irmansyah says he does not have anything against traditional medication, “as long as it does not make someone worse.”
“We realize that there are places that medical science has not reached yet, such as Galuh, but we hope this would not last for long,” Irmansyah says.
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