Mental Health Cases in Jakarta, Malaybalay, and Manila: A Map

Posted: Thursday, March 25, 2010 by Bintang in Labels:

Thousands of people in Jakarta, Indonesia and Manila and Malaybalay, Philippines are suffering from mental illnesses or mental disabilities. Although most of them are abandoned, neglected, stigmatized, and are living in poor conditions, there is an effort to take care of them.

See the following reports for a detailed story.

Neglected Lives: Mentally Ill Patients in Jakarta

Posted: Wednesday, March 24, 2010 by Bintang in Labels: , ,

By Samiaji Bintang/Aceh Feature, Indonesia

Hi, my name is John… John Lennon,” says the old man while shaking my hand. He welcomes my visit to Panti Sosial Bina Laras Cengkareng, West Jakarta, one of the mental health centers run by local government. The man is bald, thin and dirty. He plays guitar and likes to sing The Beatles’s songs everyday. I sense a bad smell of his body while watching his ‘performance.’

“He never speaks Bahasa (Indonesian language), and we never know his real name up to now. Also he seldom takes a bath,” says Ihud Saputra, head of the center.

‘Mr. John’ suffers from manic depression or bipolar affective disorder with alternating bouts of mania and depression. He is among hundreds of mentally ill patients in the center that looks more like an asylum. Like ‘Mr. John,’ most of the patients suffer severe mental disorder, such as schizophrenia, manic depression, post-traumatic stress disorder, and obsessive-compulsive disorder.

Originally intended for 400 patients, the government-run facility is crammed with 600 inmates. They are packed into a dozen confinement rooms or cells. As I go into the cells, the air is thick with flies and the stench of feces and urine. Some are naked, others are emaciated or showing oozing lesions, curled up on the floor of the cells.

Over 85 percent of the patients no longer have any relatives. Most are abandoned by his/her family. There are so many stigmas when it comes to mental health. Instead of helping, most of the Indonesian community perceive the patient as ‘crazy’ or ‘madman’ that should be kept away.

Despite the center’s growing number of patients, its funding is very limited because of the weak economy; $1.5 is spent on each patient per day. A doctor stops by the center only once a week for two to three hours; he has numerous other similar institutions to attend to.

“With the current prices of staple food, it's hard for us to provide nutritious meals,” Ihud argues.

Recent data from the Jakarta social agency revealed that 181 people died between October 2008 and May 22, 2009, at four centers in Daan Mogot and Cengkareng, both in West Jakarta, and Cipayung and Ceger, in East Jakarta. For six months, three patients every four days died from tuberculosis, diarrhea and malnutrition at the centers. They suffer from malnutrition since the centers have few officials who are responsible for feeding the patients. Since standards of care are poor and there is failure to protect the basic human rights of people with mental illnesses, the mortality rates at the centers are very high.

“We lack nurses and sufficient stock of medicines. Meanwhile most general hospitals decline to accept or care for mentally ill patients who suffer physical diseases like tuberculoses, diarrhoea and malnutrition,” Ihud says.

The government took immediate response to remedy the crisis in the centers. However, the response is local and piecemeal. “It does not deal with any of the long-term determinants of the problem,” says Irmansyah, dean of Department of Psychiatry, University of Indonesia.

The Girl in the Festival: Mental Health Care in Malaybalay City

Posted: by Angel in Labels: , ,

By Walter I. Balane/Central Mindanao Newswatch

It was almost 5 p.m. and Leah (not her real name) was already dressed. She fixed her wet hair and tucked a yellow comb in her purse. As she prepared her foot wear, she held her green diary notebook tightly. On the cover of the diary was a youthful art work marked “My Kind of Girl.”
“I am going to travel so I cannot stay long. I’m glad you passed by,” she greeted her visitors.

When asked what she will do there, Leah gave a wide smile and bent to fit her sandals.

“I will be meeting my friends. I hope you will excuse me. Thanks for coming over,” she said.

The 15-year old girl stayed and talked about her desires, her mother, her family, and their poor life in the outskirts of Malaybalay City in Mindanao, Southern Philippines.

In their neighborhood, people know her as a cheerful girl with a beautiful face. She is also “so full of life and dreams,” a neighbor described.

Leah wants to become a teacher or a doctor. A village official describes her as a talkative person who speaks well, and carries herself with confidence.

At the back of people’s minds, however, she is “sayang” --- wasted.

Leah has a mental illness. On certain times of the day she has unpredictable behavior, her father Antonio, 42, a construction laborer said. At times, he chains and locks Leah inside their house. Sometimes she is uncontrollable, he added. Most of the time, however, she is tamed and behaved. She just stays there in the corner.

Leah has been to many unlikely situations before because of her condition but what happened to her on February 27 was enough to shake her family and the city.

The crime
In the middle of the celebration of Bukidnon’s biggest annual gathering, the Kaamulan festival, police caught three young men in the act of raping Leah inside a tent in an area opened for backpackers.

The crime scene was 50 meters away from the Session Hall of Bukidnon’s Provincial Board.

At 10 p.m., a witness tipped the police and in the middle of a nightly musical variety show, they arrested the suspects.

Rape suspects Marciano Oclarit, 22; Rocky dela Pena, 23; and Ernut John Javier, 18 were detained at the Malaybalay City Police Office’s detention cell.

Earlier, Leah was selling mobile phone cards with friends. At least twice during the day, she caught public attention by playing some tricks even with strangers. Nobody kept the unaccompanied person with mental illness to safety. Not until the rape incident.

Her father filed a rape complaint at the City Prosecutors’ Office. The crime is heinous so no one can bail from it.

Leah hogged the headlines. The news caused a stir in the city, which is this year’s Child-friendliest city in Northern Mindanao, according to a government evaluation procedure.

Most observers said it’s going to be a case to watch for because a minor was raped, and she was also a person with mental illness. But news of her rape has to take the sidelines four days after the complaint was filed.

Case withdrawn
Malaybalay City Prosecutor Carlo Mejia dismissed it after her father filed an affidavit of desistance on March 3 saying “I and the accused have already settled our differences.”

Sources said the father agreed to withdraw the case for $1,250 dollars as “assistance” for Leah’s treatment at a mental institution.

Many neighbors, including a village official, were wary of this, cautious of the father’s alleged gambling habits.

After the alleged payoff, Leah is still in the neighborhood, out in the streets, and still vulnerable.

On March 10, she was in the Capitol grounds again, where she was raped 11 days earlier. She was accused of allegedly attacking a bystander with a knife, a report her family denied. She was never violent, they claimed.

Her father said she escaped after breaking a chain he tied to her.

“Yes, he tied me but I got away,” Leah said before a loud laughter. “I got away and sold the chain for something to eat,” she said.

Police brought her back in a traffic car through village officials.

“Gov. Jose Ma. Zubiri Jr., who was managing the foundation anniversary celebration of the province that day, ordered that she be brought back to the village,” health worker Bibeth Cañete said.

On March 16, on a village foundation day celebration, she was spotted playing around the basketball court while a game was going on. Her father, again, chained her in their house.

The City Social Welfare and Development Office was alarmed at the dismissal of Leah’s case. Virginia Flores, CSWDO chief, said rape is a crime not only against chastity. "It is a ‘People of the Republic of the Philippines vs. the suspects’ case. If the father surrenders on the case, the state can appeal the dismissal and pursue the legal action,” she said.

Flores said the decision of the fiscal to dismiss is suspect but they will still look into that as they have no legal counsel.

Fiscal Mejia, however, blamed the absence of social welfare support, as one of the basis of his dismissal.

He said any minor going through litigation would need the assistance of the social welfare office to go through the process.

“But they were not there at the inquest proceeding. The police said the social welfare office has already given up on her (Leah),” he said.

PO3 Dorothy Leono, city police children’s and women’s desk officer, said the girl has been going in and out of police and social welfare custody.

But Flores clarified they did not give up on Leah.

"At the moment, we just do not have the facility, the resources, and personnel to take care of cases such as Leah’s. We just have no capacity.” she said.

The city government, which has won acclaims for programs on health and social services such as the child friendly evaluation, has built no hospital of its own.

With at least, P560 million revenue every year, the city has no regular appropriations for the welfare of the mentally ill. Flores said, a local law proposed since 2001, has remained a proposed legislation at the city council.

“That is why contingency funds for these cases keep on getting diverted,” she said.

The Department of Health, which should initiate a mental institution in each province, has no funds, Flores added.

“Patients from Bukidnon are no longer welcomed in the Davao City Mental Hospital, which is the closest public facility on mental health from Malaybalay,” she said.

The P240 million Bukidnon Provincial Medical Hospital, just two kilometers from where Leah’s family lives, also has no ward on patients with mental problems.

That’s why, she said, the CSWDO has asked the family to send her to the mental institution in Maramag town, about 60 kilometers away.

But Leah’s father said they could not afford the cost of admitting her to the privately-owned facility. Besides, he said, no one could serve as Leah’s watcher there, a requirement upon admission.

“I have to earn a living for my other children,” he said.

The pay off money
Antonio confessed that when he agreed to withdraw the case, the suspects only gave him an advance of $208 only, a sixth of the agreed amount. 
The suspects pledged to pay on March 18, but Antonio said, they did not show up. They sent an emissary a day before that they still cannot pay because they haven’t sold a parcel of land intended for it.

“Now I don’t know to whom I will turn to. I have withdrawn the case for my child’s treatment. But I don’t have the money now,” he said.

Antonio said on top of this, he is also looking for his wife who sought greener pastures in Manila.

“She was duped by an illegal recruiter. We have lost contact of her since five months ago, we don’t know if she is still out there,” he said.

Antonio said poverty is the only reason why he withdrew the case denying accusations he was making money out of his child’s situation.

“We need money for her treatment and for our daily needs,” he said.

Leah said she sourly missed her mother. “I could still remember the house where her recruiter lives. I will go there and find her,” she said.

She admitted having problems with her mental health. But she said “I am not like that all the time, I am okay.”

Where to go
Bibeth Cañete, the health worker who is the wife of their village chief said Leah can still recover.

Her case must have worsened, Cañete said, when her mother left because we haven’t heard of her problems before that.

In December, a month after her mother left, Leah was also raped. But they did not know the assailants, her father admitted.

It might be triggered by the absence of someone who could provide enough care, Cañete said.

One time, she added, Leah told her she has a hundred boy friends and she meets all of them every now and then.

“She should be admitted immediately. She is in a precarious situation now,” Cañete said.

Upon hearing from Cañete that her father received money for the withdrawal of the rape case, Leah was angered.

"How come he did not give me a share? I should have a bigger share because I was the one who was raped,” Cañete quoted Leah as saying. 
“This is a very serious situation she is into. But I know of others who recovered with timely assistance,” Cañete added.

After the news of the withdrawal came out in the media, the CSWDO vowed to shoulder the cost of Leah’s treatment at the Happy Home Foundation, Inc. three towns away from home.

On the day visitors from the media came to check on her situation, she was dressed up. 

Her father warned her of the requirement for a watcher, but she was excited at the prospect of her treatment. She told her neighbors and friends, including strangers who passed by, that she would miss all of them.

“Please visit me there. We can play. I heard it’s a happy home,” she said. (Walter I. Balane)

Special Olympics: Caring for People with Mental Disabilities

Posted: Tuesday, March 23, 2010 by Angel in Labels: , ,

On March 11 and 12, 2010, a hundred athletes from all over the Philippines gathered at the PhilSports Arena in Pasig City to participate in the National Athletic Games. But these are no ordinary athletes. They are members of the Special Olympics Philippines.

Omar is an 18 year old boy with Down syndrome from Davao City. He has been an athlete since he was 12 years old. This is his second time to participate in the National Athletic Games, where he competed in the shotput and running events. Aside from sports, he is also into the arts like painting and dancing.

Omar’s mother says he was teased and bullied as a child. Neighbors would keep their kids away from him. But in Special Olympics, Omar has found a place where he is loved and accepted by others.

In the Philippines, 3 to 7 per cent of the population are born with mental disabilities. Groups like Special Olympics Philippines believe that through sports, they can develop their talents and achieve their full potential.

Alex Babst, National Program Director of Special Olympics Philippines, says, "The Special Olympics is a worldwide organization. Right now we have 170 countries with 3 million registered athletes. Our mission is to uplift and work for the advocacy for the inclusion of intellectually disabled persons throughout the world. Special Olympics Philippines has about 10,500 members, all intellectually disabled. We’re really showcasing our athletes because we want to show our community that through sports they have the ability to succeed, to do their best, and to become winners."

Medals were given out during the event. Omar took home a bronze medal for running. His mother Joy says participating in sports improved his confidence and social skills.

In October, Omar will join the national games for rhythmic gymnastics. But for the meantime, he will celebrate his success with a victory dance.