Posts Tagged ‘pasung’

Mental Illness = Life in Chains

June 20, 2010

Life is hard if you are poor and living in a developing country such as Indonesia.  But it can be miserable if you also suffer a mental illness.  For most, there is effectively no treatment.  In the most severe cases, I’m sure that many are abused and eventually ‘disappeared’.  Those that have the protection of their family are usually condemned to a life of confinement, chained to a post or in stocks (pasung), often kept in tiny shacks.  The idea is to protect the patient and the community from each other.  Sadly, what should be a temporary solution becomes a life sentence.  Unable to easily find a cure, the family must leave their loved one in stocks for decades, causing disfigurement, withering of unused limbs and worsening their mental health.

The Western media in Australia have recently taken up this cause with this article from the Age: http://www.smh.com.au/world/the-face-of-indonesias-shame-20100618-ymuq.html

The article talks about one particular facility where the inmates are chained naked to their posts with nothing to rest on but a tiled floor.  An open sewer runs past each inmate.  This makes it easy to clean, but what’s the point of that when the place reeks because of the uncovered feces and many of the inmates become sick from contact with the contents of the sewer?  I use the term ‘inmate’ rather than ‘patient’ as there is apparently no useful treatment.  According to the article, the chains are blessed before they are put on, perhaps there is some form of exorcism and if the inmate gets excitable, he is shown a big snake (I didn’t make that up).  This facility is in Bekasi, within the Jakarta metropolis.  Even though it’s not in an isolated location, I’m told there are other better facilities in Jakarta, but it wouldn’t surprise me if this one in Bekasi is better than many others.

For patients living in the country, the situation is not greatly improved, although at least they have the comfort of their families.  It is in the country that patients are most likely to be kept in pasung which are often huge tree trunks which look positively medieval.

A recent study sponsored by the University of Melbourne surveyed Samosir Island, which is situated in Lake Toba, Sumatra.  The researchers discovered 15 cases of pasung in a population of 130,000.  Surprisingly, of those cases, 9 had been given psychiatric treatment, but the families were unable to continue because that would require travelling to the city of Medan, which is prohibitively expensive for them.  Even more surprising was that the researchers were able to treat and free all of the ones they found, trained the local puskesmas (government clinic) staff , educated the community and at the end of the 6 month study only two had returned to being restrained.

The study is easy to read and contains much more fascinating information:

http://www.ijmhs.com/content/2/1/8

Of course, you are unlikely to see someone in pasung if you are a normal traveller in Indonesia, however it is quite common to see people who are obviously mentally ill.  They are often naked or in rags, their skin blackened by the sun, long hair and beard, they look like ancient mystics.  Despite their appearance they are usually under the care of a family member who is not far away.

The following link will take you to a video composed by the same Age journalist responsible for the article cited above.  It’s quite harrowing to watch, the story of Suharto and Darwina, which he relates, is pitiful:

http://www.theage.com.au/multimedia/world/lost-lives-indonesias-mentally-ill/20100618-ylk1.html

Please bear in mind that this practice is not unique to Indonesia.  It is also common through many parts of Asia, the Middle East and Africa.  Furthermore, it was not very long ago that Western medicine treated the mentally ill much like this.  The people caring for these ‘pasung people’ have the best intentions, but lack the knowledge and the capacity to give better care.  For those who can afford it, treatment is available, there are special schools which in some cases are better staffed and resourced than many in the West.  As the research report says, when better treatment is offered, the carers jump at the opportunity.

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