AMI in Indonesia

AMI in Indonesia

Objective

Support the health system in the district of Teunom [province of Aceh, island of Sumatra] to treat populations affected by the Tsunami.

Intervention context

In order to help populations who suffered from the tsunami, in January 2005 AMI sent a team to the province of Aceh [north-western part of the island], a region strongly hit with more than 131,000 people killed and 800,000 disaster victims or displaced people. Faced with the extent of the catastrophe, AMI decided to support these populations highly affected psychologically with a mental health program. After the tsunami, 95% of health structures were out of service. It was thus necessary to help the reconstruction of a health system already weakened by 30 years of struggle between the government forces and the Free Aceh Movement [GAM], a rebellious group demanding autonomy for the province. This is the reason why AMI decided to support the rebuilding of the national health system. It was also necessary to rethink and restart programs to train health care staff, whose skills had diminished due to the destructured health system. The set up of AMI’s actions was complicated by the destruction of access and communications means as well as by the conflict between the government and GAM. The peace agreement signed on the 15th August 2005 allowed AMI’s teams to access GAM areas, thus extending its activities. Since this respite, the Indonesian government has been considering the possibility, once health structures are operational, of sending health care to this area again.

The activities of the mission focus on three areas

* Re-establishing access to free, quality primary health care for the entire sub-district of Teunom [18,400 beneficiaries]. AMI chose to help strengthen the restoration of the national health system, while answering accasionally the lack of service by treating people directly in mobile clinics.

* Helping the reinsertion of victims by giving access to psychological support in the area of the sub-district of Teunom hit by the tsunami [9,000 beneficiaries]. Providing psychological support was critical for disaster victims already fragile due to the 30-year long guerilla war. The program mainly focuses on helping most the vulnerable people, i.e. children

* Promoting the training of local health care thanks to the publication of the training magazine Health Messenger [see pages 38-39] distributed throughout the province of Aceh [22,000 beneficiaries]

Results

Re-establishing access to health care:

• Helping the reconstruction of the health care system by supporting 3 curative health posts [Pustus] and the district reference health center [Puskesmas] : laboratory, hospital service, equipment, emergency supply of medicines
• Training and monitoring health care staff
• Setting up 5 mobile clinics
• 6,200 curative health care consultations
• Epidemiological watch
• Re-launching the vaccination of children under one year old [hepatitis, BCG, polio, typhus]
• Participation in the referencing of patients to the hospital of Meulaboh
• 3 schools benefited from training in first aid and primary health care

Giving access to psychological support to disaster-victims

• Detection of people suffering from psychological disorders by the managing staff trained by AMI: 20 nurses and midwives and 8 community counselors, and increase awareness
• Psychological treatment: 396 people benefited from individual consultations and 407 from group consultations
• Setting up psychosocial activities [such as cooking or sewing] organized around a mediator for adults [mainly women], for approximately 700 beneficiaries
• Raising awareness on mental health problems: 600 people took part in the World Mental Health Day organized in Teunom by AMI, in collaboration with the US NGO International Rescue Committee
• Setting up activities for children living in camps and barracks and creation of adventure playgrounds, a space where children can express their affects
• Training 40 teachers from 3 schools in problems surrounding child development and mental headline