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Monday, March 21, 2016

In Indonesia Thousands with Mental Illness Shackled in Chains

Kriti Sharma of Human Rights Watch speaks to Yahoo News about the heartbreaking prevalence of ‘pasung,’ the superstitious practice of locking or chaining away people with psychological issues, throughout the nation.

By Michael Walsh for Yahoo News | March 20, 2016

Human rights advocates are calling upon the Indonesian government to crack down on the inhumane detainment of people with mental health conditions in its country.

A new report finds that more than 57,000 people in Indonesia with psychosocial disabilities have been chained or locked inside overcrowded or grimy rooms at least once in their lives. And roughly 18,000 are trapped in these confined spaces today, according to government data.

Human Rights Watch (HRW), an international nongovernmental nonprofit, released the report “Living in Hell,” which focuses on the neglect and abuse of the nation’s mentally ill population, on Monday morning.

To compile the information, Kriti Sharma, a researcher in HRW’s disability rights division, said she interviewed about 150 people on the islands of Java and Sumatra and visited 18 mental hospitals and similar institutions.

“The practice is basically illegal and yet the abuse continues. We found cases of people who were shackled fairly easily,” Sharma said in an interview with Yahoo News.

HRW decided to conduct research into this topic in November 2013 because it was not documented well beyond the realm of photojournalism.

Despite a 1977 government ban on pasung, the practice of shackling those with (or thought to have) psychological issues, families and traditional religious healers still lock away people or admit them to institutions where they are denied basic human rights and subjected to a variety of other abuses, according to the report.
YouTube published by HumanRightsWatch

“Across Indonesia, there is a widespread belief that mental health conditions are the result of possession by evil spirits or the devil, having sinned, displayed immoral behavior, or lacking faith,” the report states. “As a result, families typically first consult faith or traditional healers and often only seek medical advice as a last resort.”

The human rights organization documented 175 cases of people in pasung or having recently escaped it, and obtained information about another 200 recent cases.

One of the first cases Sharma documented was also one of the most haunting. In West Java, a senior citizen locked up his daughter, who is in her 50s, for 15 years because of her mental health condition. He reported that his daughter repeatedly dug up crops on a neighbor’s property. To halt the behavior, he took her to a “faith healer.” When that didn’t work, he locked her in a room of their house for 15 years.

“I saw this woman who was completely naked, crouching in a corner in the room. She couldn’t even stand up because her muscles had atrophied from lack of walking,” Sharma told Yahoo News over the phone from India.

“She had been eating, sleeping, urinating, defecating in that room for 15 years, so you can just imagine the smell she had to live with. She was never given a bath or taken out. The only contact she had with the outside world was a hole in the wall through which the family fed her,” she said.

Sharma said neighborhood children would taunt the woman, call her crazy and even throw stones at her; the woman saved a stone so she could try to dig her way out, but the family tied her arms behind her back after seeing she had made progress.

“She had to crouch and eat off the floor. That is the kind of situation people with mental health conditions are in in Indonesia. She is one of many cases in pasung,” Sharma said. “Luckily she has been rescued and is receiving the support she needs.”

If one manages to escape, chances are high that he or she will be returned to pasung, Sharma said.

According to HRC, Indonesia suffers from a startling lack of access to medical advice or mental health services. The country has a population of 250 million people but only 48 mental hospitals, and over half are in just four of the nation’s 34 provinces.

Data from the Indonesian Ministry of Health, which calls pasung “inhuman” and “discriminatory,” suggests that close to 90 percent of people who might want to use legitimate mental health services do not have the access.

To its credit, the government has launched several anti-pasung programs — such as “Indonesia Free from Pasung 2014” — with the goal of abolishing the practice. But that effort has not yet produced tangible results.

“It’s important to acknowledge that the government has made progress at the national level,” Sharma said. “But what we are seeing is that the rhetoric in Jakarta is not translating into practice on the ground. There is a disconnect between the national level policy and the implementation, which is extremely weak at the provincial level.”

HRW is calling on the Indonesian government to take several steps to confront this issue: 
  • (1) amend the Mental Health Act and Rights of Persons with Disabilities Bill so they comply fully with the U.N. Convention on the Rights of Persons with Disabilities, 
  • (2) monitor the practice rigorously and implement policies that prevent redress abuses, 
  • (3) teach government health workers and others about the needs of persons with mental illnesses, (4) create a confidential complaint system for victims to report abuse, 
  • (5) develop voluntary community-based mental health services,
  • (6) work with international donors on programs and services.
The organization also launched a social media campaign — #BreakTheChains — compelling the health minister to provide mental health care at the community health centers in Indonesia as a first step.

“I do think there is hope,” Sharma said. “There are tremendous challenges but nothing that cannot be addressed.”


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