David & Christine Cloughley – Indonesia
27 May 2010
When Aussie's think of Bali they think of "The Island of the
Gods", "Land of Sun and Surf", "Shapelle Corby", even the Bali
Bombings of 2002 and 2005 or they may even think of their next
holiday destination, but behind the images seen by the two week
tourist is quite a different story, there is extreme poverty and a
stretched health system.
Seeing what the tourists don't see
When Aussie's think of Bali they think of "The Island of the
Gods", "Land of Sun and Surf", "Shapelle Corby", even the Bali
Bombings of 2002 and 2005 or they may even think of their next
holiday destination, but behind the images seen by the two week
tourist is quite a different story, there is extreme poverty and a
stretched health system.
Children with facial abnormalities such as cleft lip and palate
can be seen in the Balinese society as having done something wrong
or angered the Gods and the abnormality is the result. These
abnormalities are not corrected straight after birth as they are in
Australia. There is also the situation where the families are
too poor to have the abnormality corrected or they can be
completely ignorant of how to go about having the operation done
through the Indonesian health system.
Two AVI volunteers David and Christine Cloughley are working for
a small NGO in Bali which deals with patients with cranio-facial
abnormalities. The organisation Yayasan Senyum Bali (Smile
Foundation of Bali) is a non-profit organisation set up in 2005 by
a lady originally from England but now an Indonesian citizen.
She saw the need to assist patients who had cranio-facial
abnormalities with the sourcing of funding to enable them to obtain
surgery either within the Indonesian health system or in Australia
through the assistance of the Australian Cranio Facial Unit in the
Women and Children's Hospital, Adelaide, Australia.
Yayasan Senyum Bali also employs four Balinese staff consisting
of an office manager, patient coordinator, assistant coordinator,
and a house keeper. All work alongside David and Chris out of
an office in the "Smile House" - a patient halfway house - in
Bali's capital, Denpasar.
Since 2005 Yayasan Senyum has helped in excess of 300 patients
with cranio-facial abnormalities. It has also sent several patients
with severe cranio-facial abnormalities to Adelaide for
surgery.
Dave, who retired in 2007 from the position of Director with the
WA Ambulance Service, and Christine, an accountant, who had
previously worked in private practice before also retiring, work
with the Yayasan to assist with management systems and coordination
of a building project to construct a new half way house for the
patients.
In January 2009 Dave, Chris and their Yayasan Senyum colleagues
embarked on a project to locate patients in the poorer eastern part
of Bali in an area known as Karangasem which is about a two hour
drive from the capital Denpasar.
Two Balinese outreach workers who lived in the eastern
Karangasem area were employed and trained by the Yayasan Senyum
team on all aspects of the Yayasan Senyum organisation and also
what to look for with regard to cranio-facial abnormalities.
This training also included how to recognise either cleft lip or
cleft palate patients as opposed to cranio-facial patients and also
included the viewing of photographs of previous cleft and
cranio-facial patients to ensure that the outreach workers knew
what they were going to encounter while working in the remote
area.
These outreach workers were also trained in how to handle the
taboos associated with the Balinese culture although employing
local residents of the Karangasem area was a big help for Yayasan
Senyum Bali to establish credibility in the area. Another factor
which also assisted in the identifying of patients was that it was
easy for the Outreach workers to talk with families and local
health workers as they were already known by many in the area as
locals.
By the end of the first month the two outreach workers had
visited all five districts in the Karangasem area spending time at
the local health clinics and chatting with the local residents,
educating them in the services that Yayasan Senyum Bali can offer
to people with cranio-facial abnormalities. By the end of January
their first month they had located ten patients with cranio-facial
abnormalities.
Over the next few months each of these patients found by the
outreach workers will be assessed to ensure that each patient
receives the correct hospital treatment for their abnormality.
Because of the success of the program the team from Yayasan Senyum
Bali has decided to continue with the program and keep the two
outreach workers in the area continually through the coming months
to locate more patients.
This Eastern Bali Outreach project involved many aspects of
capacity building within both the team challenges as well as within
the training of the Outreach workers to ensure that each felt
confident in their own unsupervised environment.
For more information on Yayasan Senyum Bali http://www.senyumbali.org/.