Reza Abel during a health promotion in Sawa Erma, Indonesia
© Veronique Terrasse/MSF
In July 2008, MSF, in partnership with the Indonesian Ministry of Health, launched a health campaign in the remote district of Asmat, in the Papua region of Indonesia. The project, which is scheduled to last for two and a half months, provides prophylaxis treatment for filariasis to the semi-nomadic population of the district. With the help of government staff, drug administration should continue over a five-year period in order to eradicate the disease.
MSF health promoter, Reza Abel, describes his daily work and explains why liaising closely with the population is critical to the success of the campaign:
“Every morning, a team of MSF health promoters travels to the villages to tell people about the forthcoming visit of our medical teams. It is important to meet the head of the village and explain about filariasis and the reasons that we want to provide treatment to the population. Once they have agreed to receive our assistance, we arrange a date for our teams to return.”
“Our medical teams offer basic health care screening for malnutrition and for cases of hydrocele - swelling of the scrotum. Those showing symptoms of filariasis can then make an appointment for a consultation with a surgeon.”
What kind of challenges are you faced with?
The logistics are problematic; the villages can be difficult to reach so we use speedboats. We need to reach the whole population but this is hard because they are semi-nomadic and constantly move between their villages and the jungle. They also periodically stay in temporary shelters along the river. We try to visit these shelters but it’s very hard to track down all of the population. Nobody knows their exact number and we have only the Ministry of Health’s estimation to go by.
Why is health promotion so important to the campaign?
It is extremely important because people don’t witness the benefits of the campaign immediately. It can be difficult as people here are not used to western medicines. It’s very new to them; sometimes they don’t know what to do with the pills so we have to take one in front of them to show them how.
Explaining the treatment is challenging in itself but it’s crucial for us to correct any misunderstandings they might have. For example, a rumour went around one village that people had died as a result of taking the medication. It was only a rumour but it made our work much more difficult. People are reluctant to take the medication so it becomes important to clearly explain the process, including the possible side effects, in order to make people less apprehensive about taking their medication. Establishing a good relationship is crucial in gaining the population’s trust.
Is the work difficult?
It can be, but the team is very motivated. We have to travel several hours by boat. The river and the sea can be rough and the weather is very unpredictable. If the weather conditions make returning to the base impossible then we have to stay in one of the river shelters - it’s uncomfortable but we’re happy to do it. However, although the work can be difficult, it’s rewarding because the drugs will help eradicate this disease from Asmat.
What has this experience brought you?
It’s my first time in Papua. I come from Ambon and although it is the same country, Papua is so different! I like the job. Every day is like an adventure. The people of Asmat are different and very interesting. They live close to nature and have a unique culture. By talking to them, we get to know more about them and are able to develop a relationship; it’s a very interesting experience.