DOING GOOD IN PARADISE © Duncan Graham 2005
The 26 December tsunami brought a huge wave of international aid to Aceh. But many humanitarian projects in Indonesia aren’t triggered by major disasters. Duncan Graham reports:
After American midwife Robin Lim finished breakfast she strolled down to the Ubud clinic in the Bali hills to check on the mums-to-be. But squatting patiently on the verandah, his forehead corrugated with pain was a stranger and clearly not an inquiring dad.
Many days earlier Made Sujana had tumbled out of a coconut tree and gashed his wrist badly. He said he’d been to hospital and received seven stitches. The wound had got steadily worse. He’d been back five times, then run out of money. Someone told him about the Ubud clinic. Ms Lim inspected the raw suppurating tear exposing white tendons below a puffy red arm, then phoned her nearby Australian friend John Fawcett.
Did he know a surgeon who might be able to speedily clean and stitch the wound for free? Did he have enough antibiotics? She feared gangrene had already started and death or amputation could follow. In a country without a national health scheme, welfare benefits or workers’ compensation a one-armed stonemason would be doomed to penury.
The former Perth academic did have such a contact and the drugs; 30 minutes later Pak Made was in a ute heading for hospital.
Finding help for a 50-year old artisan was clearly not in Ms Lim’s brief. The mother of seven is a volunteer at a birthing centre called Bumi Sehat (Healthy Mother Earth). Although Indonesian politicians push the ‘developing nation’ tag, their nation is resource rich; it also has public and private hospitals, an extensive network of clinics and millions of mega-rich entrepreneurs, many of whom pay little or no tax. (The Australian Government agency AusAID reported that just three million Indonesians are registered taxpayers in a workforce of 98 million, and only half a million submit assessable accounts.)
As a foreigner with a fragile and restricted work permit Ms Lim could have shooed the man away, told him to present himself to the local medical services. ‘But that’s the reason his wound got infected,’ said Ms Lim. ‘He knows the clinic can help, even though that’s not our job.’
Like Ms Lim, John Fawcett, 72, a former potter and lecturer in Australia who had a mid-life crisis following a medical catastrophe, is an unpaid self-appointed health fix-it in a foreign country. After losing job, marriage and health he went to Bali to recuperate. There he chanced upon extensive cataract blindness – a condition seldom seen in Australia - and set out to change the situation.
Cynics observe there’s no place left for people like Mr Fawcett in his homeland. Australian retirees are the refuse of First World efficiency. They’re supposed to quietly putt and sail their way into an anonymous sunset, maybe stand for some committee if they have the ego for politics and like addressing envelopes rather than issues. It’s the government’s job to address serious social problems, not old folk with time on their hands and no appropriate modern qualifications. Australia’s loss – neighbor’s gain.
But in Indonesia these do-gooders are big fish in a tiny pond. Mr Fawcett has transmogrified into ‘Dr John’ despite having no medical qualifications. He’s a modest man and doesn’t like the adulation; it’s the penalty for being a famous and revered active bule (foreign) philanthropist whose achievements are formidable. He and others have chosen to help the poor of Indonesia, though that nation hasn’t asked for their assistance and in many cases resents their interference.
The John Fawcett Foundation, using money from the Rotary Club, the Australian government and many companies, associations and individuals, has established mobile eye clinics and a hospital where thousands of free cataract operations have been performed. That’s won Mr Fawcett and his friends awards and plaudits in Australia and elsewhere, but he’s not a hero with some local ophthalmologists.
‘Of course some say we’re taking rice from the mouths of professional Indonesians who rely on medical intervention to increase their earnings,’ said Ms Lim. ‘ Donor-supported Bumi Sehat advocates pre-natal care and peaceful natural childbirth. We practise minimal intervention unless there’s something seriously wrong. All our mothers breastfeed. Bali has a very high rate of Caesareans and each operation improves a doctor’s income.’ (The maternal mortality rate in Indonesia is 373 per 100,000 live births, the highest in the region. But in Bali the rate is almost double, usually from haemorrhaging, and probably because of extensive malnutrition.)
(The counter-argument is that the people being helped by bule are the authenticated poor who could never afford a surgeon’s services, so the professionals aren’t losing a single rupiah.)
There’s an extensive network of ex-patriots in Bali and to a lesser extent on other islands who regularly rally to a deserving cause. They are often backed by tourists astonished and dismayed by the poverty beyond the bars and boutiques. In late 2004 fame struck a four-year old Lombok boy with advanced and untreated encephalitis which caused his elephantine head to distort, popping his eyes. After successful operations funded by Australian and European donors and organised by a group called One Garden Foundation, a more normal little Ahda was pictured at a Bali hospital surrounded by his grateful Islamic family.
The awkward and whispered question remains: Why didn’t Muslims raise the cash to pay for the boy’s surgery? And where were the local doctors ready to do the odd pro bono job? Indonesia is famous for the principle of gotong royong, or community self help where all in the village assist the unfortunate – but in this and many other cases it’s the ex-pats who do the job. Indonesians have their own acronym for blow-hard politicians and administrators who promise to deliver – NATO (No Action, Talk Only.) It’s seldom applied to bule.
‘I’m not religious, but our Christian culture seems to promote compassion, while other faiths believe a person’s handicap or accident has been pre-ordained by an omniscient and vengeful deity so intervention is useless,’ said Mr Fawcett. ‘Errors in a previous life or recent sins rather than malnutrition, genetic defects and disease are accepted as valid reasons.’
To counter such fatalism he argues that the sufferer’s encounter with the foundation and the opportunity for a cure must also have been part of God’s master plan. And if the cause of the illness or handicap was diagnosed as black magic, the cure must be white magic in the shape of inter-ocular lenses, drugs and plastic surgery.
‘Most Indonesians cannot understand what motivates foreigners to come here and volunteer,’ he said. ‘When we explain that our services (which have now extended into cleft palate surgery and tuberculosis detection) are free, they respond with surprise and disbelief. In this country everything has a price ticket. If you’re too poor then you just have to tolerate the disabilities and die prematurely.’
Charitable work inevitably exposes gross deficiencies in the Indonesian health system. White skinned critics are as unwelcome in Indonesian government offices as foreign loudmouths are in Australian agencies. ‘If you don’t like it here, butt out,’ is a national mantra on both sides of the Arafura Sea.
Australians are especially vulnerable to such attacks; senior Indonesian administrators and politicians know well their affluent neighbor’s Achilles’ Heel: ‘Why don’t you go home and sort out your own Aboriginal problems?’
The difference is that indigenous health is being tackled by the Federal and State governments, albeit inadequately. So Bali provides a convenient outlet for under-employed Australian and other civic-minded foreigners. Americans seem to be driven by anger at their government’s foreign policies so seek to make amends in some small way; others are drop-outs from a materialistic culture. Some are driven by gratitude or guilt because Bali has given them profitable businesses and rich experiences.
Then there’s the environment. Bali isn’t a hardship posting, a desert strewn with landmines. It’s accessible, beautiful and the Hindu religion is benign. You can slurp through a dish of dew-fresh mangoes amongst the bougainvilleas, then work in a stricken village, the scene softened by tropical green and lush landscapes. Later back to the pool for sundowners. It helps offset the frustrations in dealing with an alien culture and an often obtuse bureaucracy.
An exception to this pattern was the huge and spontaneous help expats gave to victims of the 2002 Kuta bomb; the John Fawcett Foundation alone flew 48 Balinese to Australia for treatment. Others toiled in the gore and grief to the point of collapse, offering aid and comfort.
The unmet needs are genuine, great and not confined to Bali. Adjacent Muslim Java, the source of the fundamentalist bombers, is not such an attractive location for donors, though poverty and inequality are widespread, the health and social problems huge. Mr Fawcett and others are slowly trying to push their yayasan into Java and other islands, but the going is tough.
Many reason that if Westerners are offering assistance there has to be a catch. Either they are attracting overseas cash and stealing a percentage, or they are spies for John Howard and George Bush, or subversives planning dismemberment of the Unitary State. If such motives are proved hollow, then the bule must be out to ‘Christianise’ the locals.
This slur gained substance when a US Christian group planned to take 300 tsunami orphans. Aceh is staunchly Moslem. The idea was scrapped in the face of a hostile media and political response.
Missionaries are tightly controlled in Indonesia but it’s clear a few US English teachers have another agenda. Mr Fawcett has been forced to add a new clause to his foundation’s mission statement to head off the suspicions: ‘ … to operate without alignment to any governmental, institutional, political or religious organisation.’
US nationals Jenny and Maria O’Donnell who recruit specialist volunteers to work in village schools screen for proselytisers. Their Volunteers and Interns for Balinese Education (VIBE) foundation stresses its independence and makes foreigners pledge no interference.
‘In a country as religious as Indonesia most people can’t understand how humanitarian aid can be divorced from faith,’ said Mr Fawcett. ‘The idea of humanists having values with no strings attached is hard to grasp.’
Prior to spending her holiday helping at Bumi Sehat Australian veteran midwife Shirley Tidy encountered a doomsayer among her colleagues. The woman told her: ‘You can’t change the world.’ Ms Tidy reported that all nurses on duty responded: ‘But you can give it a go!’
It’s not just health problems which get the golden bule touch; in Bali there are projects to help kids go to school, employ the handicapped, recycle waste, open libraries, clean up the environment, develop organic farms, offer micro-credit, train teachers, empower women, combat AIDS … who needs government?
Ms Lim (a lapsed Catholic) and her Indonesian colleagues have been winning the thanks of locals for their selfless service for years. But she’s sufficiently long-toothed to know the malicious eye such successes with envy. As in the West, jealous opportunists are poised to invoke xenophobia, oust the intruders, then plunder their resources and cash streams. Cultural and political sensitivity plus a deft tongue are other necessary qualifications for bule in Indonesia.
In Indonesian law yayasan (charitable foundations) must have local directors and not all are altruists sharing the foreigners’ values. Board coups and rip-offs by staff are an occasional occupational hazard. And as long as foreigners are prepared to dig deep in their pockets, the pressure on Indonesian politicians to collect taxes, cut funding on grandiose projects and boost education and health budgets is lessened.
Can bule-backed yayasan survive the inevitable retreat when the foreigners remember aged parents back home and hunt out the return tickets? Ms Lim is optimistic: ‘The tremendous efforts Indonesia has made in education have started to pay off. The new generation won’t abide corruption and is supporting projects which can provide future stability. These are baby steps. There are growing pains for sure, but we’re heading for a more humanistic future.’
Sometimes the best intentions turn bad. Mr Fawcett has suffered the trauma of persuading a family to let their daughter have a cleft palate operation; the girl died during post-operative care throwing the Australian into another bout of soul-searching. And there’s a five per cent failure rate for cataract surgery. Those who stay blind are not a good advertisement for trying the bule cure instead of praying or making offerings. Fortunately for philanthropists (and slipshod doctors) Indonesia is not yet litigation crazy; the medically damaged tend to forgive rather than blame.
‘There’s the proverb of the monkey doctor who helped a sick fish,’ said Ms Lim. ‘He took it to his surgery in the tree and told the fish he was now safe. We do our best but can’t always anticipate the consequences.
‘When you encounter terrible things and you know you have the ability, knowledge, resources and education required to help – and no-one else is prepared to do so - then you have to do what you can. You just can’t walk away. Somehow you have to make a difference. What happens later is another matter.’
(Donations to the John Fawcett Foundation are tax deductible. Click www.balieye.org for details. To help Bumi Sehat and other yayasan check www.gentlebirthsbali.org and www.idepfoundation.org )