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YAYASAN PENGHIBUR (Member of Emmaus International)

PO Box I Keling – Jepara 59454 Indonesia Telp. : +62 291 579 068 Fax. : +62 291 579 258

E-mail : penghibur_jepara@yahoo.com Website : www.yayasanpenghibur.org

YAYASAN PENGHIBUR ACTIVITY

IN THE FIELD OF HEALTH I. ITS HISTORY

Why We Start these activities?

First : Because a lot of people live in substandard conditions. They are very poor and lack of proper nutrition.

Second : Since they do not have enough money for daily food, they certainly cannot find money for other basic needs, such as medicine.

Third : They have poor education or even none at all. Many of them are school drop out because they cannot effort the school fees. We have to educate them to understand how important the long-term treatment is. For example, in care of tuberculosis, diabetes mellitus, and heart diseases.

Fourth : It is very important to teach healthy ways to live, especially to the very poor people. A healthy lifestyle is easier in rural areas than in the cities, because in the rural area people would be easily to find cheap good food (vegetables & fruits). We should have a small team who would teach sanitary housekeeping, both inside and outside. Namely: 1. Around the house : There should be a place for burning trash or a trashcan that can

be removed and emptied. Then if can be done there would not be so many rats around. So even if we are poor we can be clean. We have to raise people’s self-respect.

2. Small Children, mothers and pregnant women : we need establish a basic health

education to each about many things that are dangerous to health.

Sri Nissi (use nurse clothes) with the patients at our clinic

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These are examples of health hazards : Living things such as bacteria, viruses, worms, amoebae, and so on. Eating or touching certain leaves or fruit. Non-living substances, kerosene. Natural events, floods, earthquakes. Man-made environmental factors, broken bottles, overcrowded houses, open

gutters, stressful and difficult working conditions. Heredity disease, certain disease such as sickle cell anaemia, diabetic.

We can give more examples of dangers. Then people will know about those problems. We can teach how to deal with them and how to avoid them.

3. Healthy and Unhealthy Behaviour

a. Feeding children with feeding bottle, as there are often difficult to keep clean. Continuing breast-feeding rather than changing to a bottle for children which are not completely weaned. We should understand why people behave to. There are many reasons why people behave the way they do. We have to know the reason behind behaviour that causes or prevents illness. Knowledge often comes from experience. Beliefs usually come from grandparents and parents.

b. In our area people think that the modern way to feed a baby is using a bottle as people in big cities are doing. They believe that if baby is fed with the mother’s milk, the babies will be stupid. So, mothers throws away her milk and she will give formula-milk in the bottle instead. The baby does not get enough good milk and liquids. But, there are some mothers that breast-feed until the child goes to school. Baby’s main food is mother’s milks.

People also believe that there are certain foods that a pregnant woman should not eat. Every country and community have their own beliefs. We should find out if the beliefs are harmful, helpful, or neutral. If we understand how the beliefs affect people’s health, then we can focus on trying to change only the harmful beliefs. We have to study local beliefs carefully, we can even find ways to make them useful. We should make a list of the beliefs people in our community have about food, using categories : 1. Harmful 2. Helpful 3. Neutral

c. We should influence people who are very important to us. The village leader, religious leaders, closes friends, and so on. During years 1996 – 1998, via Emmaus Helsinki, we gave about 500 small children our cow milk 100 cc per children per day. At that time the situation around us was very serious. People had no work. Men and women who had been working in the capital city Jakarta had to come back home without money.

Sri Wahyuni, our nurse checking babies at Posyandu (Integrated Service Post)

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The economic recession and the family’s financial situation were getting worse and worse. The babies were weighing less than the normal weight. Children were getting anaemic.

We are working with the state caring for babies and mothers in 11 Posyandu (Integrated Service clinic / post). The clinics are in villages in someone’s home where the children and mothers come to see a midwife and our nurse once a month. We bring them their needs, syringe medicine, and vitamin for immunisation. We are giving green-bean soup to children. To some we give scales. We are working with state staff but we can give health education there. Sometimes we have problem with immunisation because the father of the baby does not allow it. Sometimes the babies cry at home because they have fever. Now babies get medicine and almost all babies will get immunisation. We give vitamins to pregnant mothers. We try to get all mothers to come to the clinic regularly and get tetanus immunisation.

The biggest health problem in our area in 2001 is Tuberculosis, while in 2011 infection of respiration is the biggest health problem. There is the list of diseases from Community Health Centre for year 2001 and 2011 :

No. Disease Name Number of cases 2001 2011

1. Malaria 3.458 persons 60 persons 2. Tuberculosis 6.465 persons 729 persons 3. Infection of respiration 4.030 persons 2.370 persons 4. Rheumatism 1.770 persons 1.940 persons 5. Dermatitis 1.707 persons -- 6. Hypertension 1.182 persons 2.060 persons 7. Typhus 1.154 persons 868 persons 8. Asthma 1.100 persons 1.511 persons 9. Diarrhea 1.074 persons 915 persons

10. Urine infection 518 persons 676 persons 11. Diabetic -- 678 persons

4. More important is the preventive work

In Asia – Africa – South America, there are 105 different leaves, which can be eaten to prevent or stabilize the condition from illness. Malaria is a very big problem in a few villages, because people who come from another island back to home. In there they have caught Malaria. Now they spread it in here. In order to control and prevent Malaria, the state clinic has given mosquito nets for beds and has also brought small fish to the swamp. We need to try to teach change of lifestyle and habits. For example : cows that live with people, they should live further from house. That is difficult because security

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is not good at nighttimes thief or wild animals can easily take a cow or a sheep, goat or a chicken. For anti-Malaria, papaya leaves or whole papaya can be used. Also Carica Papaya. In that fruit there are enzyme Papai and chymopapai which are diuretic. For treatment of worms, we can use leaves, seeds, papai essenseaftik, which destroy body protein in worm.

For diabetic we can take Spring Cucumber. For hypertension, there is white onion and celery also ‘Pace’ fruit in Indonesia which can help treating diabetic too.

In our areas we all have to learn why people behave the way that is not good for their health. Then we should work if possible with local leaders. We have worked with them in our area, and via Emmaus Helsinki we have built several toilets and have dug a well. Work is sometimes very difficult but don’t give up – don’t give up. We have to learn to listen to people and have respect for their opinions. “Sahabat Penderita” policlinic had been created in the year 1998. The word “Sahabat Penderita” means Friend of Patients. In the year 1999 this clinic had four general doctors, three nurses, one midwife, and one personal administration. Besides giving general service, this clinic has also given dental service. But the dentist only worked for one year. He worked until 2001.

In the year 2005 after government have opened two hospitals and three PUSKESMAS (COMMUNITY HEALTH CENTRE) in the two sub districts, a lot of patients has chosen to get treatment from these government hospitals. So four doctors, three nurses, and one midwife had resigned from working in our clinic.

Poor people can get free treatment in the hospital and Community Health Centre, if they bring a JAMKESMAS (Jaminan Kesehatan Masyarakat - Community Health Insurances). It is difficult to get that insurance. People who want to get “Jamkesmas” insurances must asking certificate letter to community leader which is telling that they are not able to pay any payment. Not easy to get this certificate. Many procedures must be passed. For the villagers, it is difficult. So there are some people who cannot get it, even though they are really poor and need the insurance.

II. FOUR VILLAGES SERVICE There are four villages which have Integrated Post Services. There are Tulakan Village with one post, Blingoh Villages with five posts, Jugo Village with two posts, and Kelet Village with one post. Yayasan Penghibur has joined these posts activities by giving extra food for small children and their mothers, to weigh the children under five years old, as well as their height.

Examine high & heavy of the children at first day of milk distribution

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Some times Penghibur has also joined doing immunization for babies and small children and helping pregnant women. In one year time there are 350 young pregnant women come to this post. While the small children under five years old there are 2’900 children. Besides giving help for small children and pregnant women, this post are also giving help for old people. In one year time there are about 150 old people coming to this post.

III. AID FOR SCHOOL CHILDREN A. DENTAL CONTROL

Every six months, Yayasan Penghibur organise free dental and health examination for kindergarten and elementary school children around our location. In this event, we also weighing them and gave health education, teach them how to brush their teeth properly, etc, so they can take care their health.

B. FRESH MILK DISTRIBUTION

By the sponsorship of Emmaus International and Emmaus Ruffec Group in France, Yayasan Penghibur has also given help with fresh milk for kindergarten and elementary school children in this area. Everyday Penghibur has distributed about 10 liter of fresh milk to 100 school children in this area (each children got 100cc of fresh milk). There is one school which have got milk from this project for one time, then turn over to the other schools. This help has been lasting for more than two years. And the result is quite good for the health of the children, not only physically (they are getting more strong and healthier) but also getting better mentally and intelligent.

IV. DIABETIC CLINIC

In Indonesia, with an population of 235 million people, there are 5,6 million people who are suffering from Diabetic, and in 2020 there will be 8,2 million people. We started the diabetic clinic because a lot of diabetic patients are poor. So, they need health education to know better about this disease, and we give facility to control their blood sugar with cheaper cost. The medicine has also can be bought from our clinic. Every two moths the doctor will come to do examination for the patients and to discuss about diabetic. We have also DVD for diabetic gymnastic. When we are gathering together we can do diabetic gymnastic with that DVD Cassette. In our clinic, there was a 75 years old diabetic patient. We have looked after her since 2004 until March 2010. When we started treating her, we gave medicine regularly without any payment. So, the result is even though she did not take any best medicine, but her health condition is better and almost quite normal. After observing five years, we can prove it.

Children brushing their tooth together. Toothbrush & toothpaste provided by Penghibur.

Ms. Anna-Liisa, doctor, & nurse exam blood sugar & blood pressure at Diabetic meeting in Penghibur

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The activity has also needed funds. This fund comes from the donation given by school children, church members, and privates. From the school children donation we bought 7 (seven) cows while from private donation we bought 5 cows. All together are 12 cows. But, because there were no rains for long time at 2011, then we sold all cows and bought 5 goats, and 1 milk cow. We put these goats in the villagers families to raised by them, while the milk cow raised by Yayasan Penghibur. Total money we received for diabetic clinic are Rp. 79.360.000,-. Now, the remainder are still Rp. 17.500.000,- We have been using these money for following activities : 1. 6 persons all medicine free, and others 40 % from the normal price. 2. Bought 1 Blood Glucose test meter, two test strips, DUD for diabetes patients. 3. Bought blood pressure meter. 4. Transport to hospital 5. Payment to doctor ( 3 times ) 6. Meeting with doctor, nurse, and diabetic patients.

- Exam patients with doctor - Medicine - Discussion on “How to life normal – Good Healthy Life With Diabetic”.

7. Transport for meeting + to see cows and goats. 8. We will be buy 10 – 12 more goats.

Kelet, February 27, 2012 “Sahabat Penderita” Public Health Clinic Yayasan Penghibur Anna-Liisa Jaanu Ismudjito

Coordinator * Note :

Attached 2 documents : - Patient Visiting for the year 2009 to 2011 - Posyandu (Integrated Service Post) 2001 to 2011 Visiting

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Appendix 1 :

"Sahabat Penderita" HEALTH CLINIC PATIENT VISITING

FOR THE YEAR 1999 TO 2011

NO YEAR PUBLIC HEALTH CLINIC

DENTAL CLINIC

DIABETIC MELLITUS CLINIC

1 1999 976 - - 2 2000 1044 53 - 3 2001 686 93 - 4 2002 761 54 - 5 2003 107 28 - 6 2004 128 15 - 7 2005 205 37 - 8 2006 365 30 - 9 2007 269 7 -

10 2008 246 52 34 11 2009 207 84 46 12 2010 106 28 34 13 2011 114 44 49 TOTAL 5214 525 163

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Appendix 2 :

" Sahabat Penderita " HEALTH CLINIC POSYANDU (INTEGRATED SERVICE POST)

2001 TO 2011 VISITING

NO YEAR UNDER 5 PREGNANT MEDICINE MEDICINE VIT B. GREEN BEAN EXTRA FOOD

OLD OLD PEOPLE MEDICINE YEAR BABY WOMEN PARACETAMOL SULFAS FERROSUS COMPLEX PEOPLE ( VIT B. COMPLEX )

1 2001 1415 142 626 4260 4260 80 - - 2 2002 3707 403 1061 12090 12090 80 - - 3 2003 2031 232 579 6960 6960 80 - - 4 2004 1725 203 469 6090 6090 80 - - 5 2005 3245 192 902 5160 5160 100 74 2220 6 2006 4114 288 510 7410 7470 109,5 91 2700 7 2007 2733 151 210 4530 4410 116 12 210 8 2008 3189 276 384 7830 7950 117 176 2230 9 2009 3087 284 416 11220 11160 121 143 1470 10 2010 2459 293 372 7560 7560 113 214 1275 11 2011 2860 325 387 5560 6935 113 94 670 TOTAL 30565 2789 5916 tablet 78670 tablet 80045 tablet 1109,5 kg 804 10775 tablet

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