International staff: 37
National staff: 164
MSF work in Indonesia over the last year was marked by the independence struggle and ensuing violence in East Timor (see opposite page), as well as religious, ethnic and economic conflict elsewhere in this archipelago nation. MSF provides emergency care for displaced people and others affected by violence throughout the country, and also runs longer-term projects designed to improve access to care for some of Indonesia's many poor and isolated inhabitants. MSF has also responded to several natural disasters, providing relief to earthquake victims in Bangi and Bankuku.
Litany of conflicts
Conflicts are many in this vast country, home to over 200 million people. Religious strife between warring Christians and Muslims in the Moluccan islands has caused thousands of deaths and sparked massive population flows. In Kalimantan, the Dayaks and the Malay have fought the Madurese in an ethnic conflict with economic roots. In Aceh, the Free Aceh Movement has called for independence and is fighting the government. In Papua, which has received large numbers of displaced people from other parts of Indonesia, calls for independence are intensifying. And people fleeing the violence in the wake of the East Timor referendum sought refuge in West Timor.
Following a series of exploratory missions throughout 1999 to evaluate the condition of IDPs and area health care facilities, MSF started projects in or near the cities of Pontianak (Kalimantan), Manado and Buton (Sulawesi), Banda Aceh (Aceh), Kupang (West Timor) and Ternate (North Moluccas), and on the island of Bali for people fleeing religious conflict in Lombok.
This conflict continues to spread, encompassing more and more islands and causing a great movement of people. Over 100,000 internally displaced persons (IDPs) have stayed in the Moluccas, often in IDP camps, and tens of thousands more have fled the area for the Sulawesi island group to the west. It is not likely that these people will be resettled in the immediate future. MSF has clearly stated its concern over the deteriorating conditions in the Moluccas.
Since March 1999, MSF has been active in Ambon, one of the islands in the Moluccan group, providing help to nearly 50,000 displaced in more than 100 camps in both Christian and Muslim areas. In February 2000, assistance was extended to the North Moluccas, focusing on displaced people and area residents near Ternate.
MSF teams initially organized temporary shelters, set up waste disposal systems, provided water supplies and washing products and distributed information on health and hygiene. This was later complemented by direct health care for displaced people and area inhabitants, replenishment of drug supplies and training of local health workers. Long-term health facilities receive, when possible, drugs, trauma care equipment and the means to monitor diseases and deaths.
MSF also has long-term medical programs in the Moluccas. In the Halmahera Islands, 70,000 children have been vaccinated against measles. In the southern part of the province, where access to the population is particularly difficult, a mobile clinic provides medical care.
Since September 1999, MSF has been active at IDP camps in the southern Betun, Atambua, Kefa and Kupang areas of West Timor, still home to about 100,000 refugees from East Timor. Militias exert control over many refugee camps, raising concern about the protection of refugees. Nearly one year after the referendum, continuing tension reached a peak with the deaths of several UN aid workers at the hands of pro-Indonesia militia in early September.
West Kalimantan and Aceh
In Pontianak and Singkawang, 13,000 Madurese live in eight IDP camps. MSF provides safe water and sanitation, and has set up an early warning system to monitor for disease. Educating people about safe hygiene is an important aspect of this work. Similar activities are carried out for some 20,000 IDPs in several districts of Aceh province. MSF also pushes for humane treatment of IDPs by the authorities.
Many people who have survived Indonesia's recent violence and subsequent waves of displacement have been afflicted by post-traumatic stress disorders. In southeast Sulawesi, in BauBau, MSF is training community health workers to identify people - many of whom have fled the violence in the Moluccas - who might be suffering from mental trauma. The organization has also trained health center staff in counseling. MSF is considering running a similar mental health program in Aceh in 2001.
Highland Irian Jaya
In a remote highlands area in the district of Jayawijaya, indigenous people are particularly at risk for disease, especially malaria. Since 1998, MSF has supported local health centers with medicine and training and has renovated health facilities. In 2000, MSF has focused on infectious disease control in the area and has also turned its attention to training community health workers, midwives and traditional birth attendants to work in some of the area's many small villages. This work is based on an ongoing medical-anthropological study begun by MSF in 1998.
Fighting AIDS and other infectious diseases
As in other southeast Asian countries, AIDS is a growing problem in Indonesia. In Kupang City, in Nusa Tengarra Timor province, an STD (sexually transmitted disease) program reaches prostitutes, port laborers, fishermen, taxi and bus drivers, students and prisoners. In collaboration with the Ministry of Health and local NGOs, MSF works in area clinics on STD training and treatment and conducts education outreach activities for the general public.
In Jakarta, the capital, MSF is developing a comprehensive disaster management and response program in close cooperation with the authorities.
MSF has been active in Indonesia since 1995.