Indonesia: Caring for vulnerable people in a turbulent archipelago

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Access to these people is hampered by insecurity and logistical constraints. Public health is further affected by disease outbreaks, inconsistent access to clean water, and the isolation of many areas. West Timor About 90,000 East Timorese are still refugees in the Indonesian province of West Timor. The frontier with East Timor remains closed. Most humanitarian actors withdrew from West Timor after the murder of three UN workers at the hands of militia in September 2000; much of the province is still under militia control and access by aid organizations and international agencies is difficult. MSF, which had been providing care for 15,000 East Timorese refugees in the Tuapukan refugee camp just outside of port city of Kupang, temporarily halted this project in September 2000. However, MSF continued work begun in 1998 to prevent HIV and sexually transmitted diseases (STDs) at a drop-in center for sex workers in Kupang. In June 2001, this project was turned over to a local NGO. MSF restarted its work with refugees in March 2001 in the Naen refugee camp (with 2,200 inhabitants) in north-central West Timor and in May 2001 in the Kupang refugee camps. Since August 2001, MSF has also been assisting 2,300 refugees in the Olbinose refugee camp, a few hours drive northwest of the Naen camp. The Moluccas MSF continues to provide primary health care and sanitation for over 50,000 displaced people around Ambon and the nearby island of Buru, and in several camps for displaced people in Manado, Bacan, and Ternate. An MSF team is also working to improve surgical care in Ambon through training of medical personnel. In April 2001, an immunization campaign in isolated areas of Halmahera Island took shape as a basic primary health care project. Mobile clinics now provide care to people near Loloda, a town on the island's northwest coast. Aceh An MSF program training health care providers in emergency response in Aceh province was cut short in March 2001, when insecurity forced the evacuation of the MSF team. Trainings were later carried out for some Aceh health workers in the town of Medan, in Sumatra Utara province. MSF also worked with about 20,000 displaced people in the areas of Pidie, Aceh Timur, and Aceh Utara. West Kalimantan and Irian Jaya Since 1999, MSF has fought skin disease and diarrhea among a group of 17,000 displaced Madurese sheltering in various public facilities in the city of Pontianak. In Irian Jaya, an MSF program supporting community health workers continues, now focusing on training for epidemiological surveillance in remote areas. MSF is also working on an emergency preparedness project at the provincial level. Sulawesi A mental health program in Buton, which focused on counseling people and training mental health professionals to deal with post-traumatic stress disorders, was handed over to local authorities in June 2001. CAPTION: A baby with AIDS lies with its mother at Sihanouk Hospital in Phnom Penh, where MSF runs a 60-bed AIDS ward. International staff: 39 National staff: 239