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A man sings in his cell, his hands moving in an intricate dance, at Pengobatan Alternatif Jasono, a traditional healing center in Cilacap, Central Java. His feet are in a gutter filled with water that he drinks when he is thirsty.
© 2012 Andrea Star Reese

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The Yayasan Galuh Rehabilitation Center in Bekasi, on the outskirts of Jakarta, before it was renovated. Men and women with mental health conditions were locked up in a grilled area of the facility without sanitation, for as long as nine years.
© 2012 Andrea Star Reese

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Before she died, Evi lived chained at Bina Lestari healing center in Brebes, Central Java for over two years. Her family paid for the platform bed and the Islamic based healing she received at the center. Evi's favorite color was pink.Brebas, Indonesia.
© 2011 Andrea Star Reese

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In 2016 the residents of Syamsul Ma'arif faith healing center in Brebes, Central Java, were chained to platform beds that were falling apart. Packs of rats searched for food in the shadows. Kyai Syamsul who runs the shelter with the help of one assistant, admits that he does not know how to help many of the men and women under his care. He is only able to give the method of treatment he learned from his father.
© 2016 Andrea Star Reese

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A woman lives shut in a room built behind her family home in Ponorogo, East Java. She is forced to eat, sleep, and defecate in this room. Except for one month spent at a hospital she has been chained since 2003.
© 2015 Andrea Star Reese

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Ketut Yasa now in his 30s has had a mental health condition since he graduated from elementary school at the age of 12. Pasung is the Indonesian term for restraints or restrained. It is used to refer to chains, shackles, stocks, cages, or to being locked in a room or pen. Pasung is a centuries old traditional response to unacceptable behaviors.
© 2019 Andrea Star Reese

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Men with real or perceived psychosocial disabilities in the Syamsul Ma'arif faith healing center in Brebes, Central Java. As his companion smokes a cigarette a man stands bringing attention to his swollen ankles and feet.
© 2018 Andrea Star Reese

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Jono's father watches his son, 33 years old, who lives shackled in a shed beside the family home in East Java, Indonesia. He says he loves his son but does not know how to help him. Jono's behavior began to change when he was 26 yrs old.
© 2014 Andrea Star Reese

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Jono Rifa, 37 years old lived chained behind his family home for years. Now he is working to support his mother.He was released from pasung  in 2015.
© 2018 Andrea Star Reese

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Yayasan Al Fajar Berseri has 375 residents.The oldest resident is 80 years old and the youngest is 9.  The largest Private SocialCare Institution in West Java, it never rejects displaced elderly people or children. In cooperation with a local health clinic, medications for fever, diarrhea, flu, etc are allowed but psychotropic medications. Instead the Caregivers employs traditional healing methods and "physical coaching for  such as driving, farming, or operating a computer, construction.
© 2018 Andrea Star Reese

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This man calls for my attention as other men resting in the shadows of a mosque sing song after song to me as I photograph. Despite long held stigma, men and women allow me to photograph because they want people to know what is happening, and to see what they must tolerate. Their participation is a fight for life and liberation, recognition and respect. Ponpes Rehabilitasi Jiwa Assyifa, established in 2005 has about 120 residents, largely men. No medications are used with the exception of instances of physical illness. © 2019 Andrea Star Reese

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Supilah sits next to her daughter Siti, in her 40's has been living in this closet sized cell for 12 years. Family members describe her past behavior as angry, destructive and antisocial. According to her mother, "Siti is under a spell cast by a man who loves her."
 Â© 2018 Andrea Star Reese

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Siti  looks out from her "pasung" closet sized cell in her home in Karangan Trenggalek, East Java. Just recently the local clinic outreach team came to visit. Mental health treatment was offered and medication has been provided.
© 2018 Andrea Star Reese

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Supilah now in her 80's watches as Siti, explores her home. She is unable to walk upright, her legs weak from 12 years of disuse.
© 2018 Andrea Star Reese

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Yayasan Jamrud Biru has 97 residents.  The treatment is traditional and includes prayer, healing waters, herbal concoctions and vitamins. Suhartono the founder hopes in the future the treatment is not only traditional but also includes medical assistance and mental health care. To keep the place always clean and not bad smelling is very important Suhartono explains.  They also have Residents take a bath twice a day. Their schedule also includes four regular meals, time for activities, sports, socialization and time for rest.
© 2018 Andrea Star Reese

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At Yayasan Bani Syifa in Banten Indonesia, this very young man is confined in a large cell with more then 30 adult males, one of them shackled. In another building a child younger the ten years old is also housed solely with adult men. Just as I was photographing a man harrassed him grabbing at his sarong suggestivly. Although a guard and other residents watched I was the only one who protested.
© 2019 Andrea Star Reese

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A man cleans the screens used for silk screening the tshirts available for sale at the Rumah Berdaya, Drop in Center's gift shop.
© 2019 Andrea Star Reese for Human Rights Watch

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Rumah Berdaya (Empowerment Center) is a Government supported community drop in center that offers socialization and work to persons with a mental health condition, some of them pasung survivors.
© 2019 Andrea Star Reese for Human Rights Watch

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In one of the Rumah Berdaya work rooms, two men, including a pasung survivor, assemble shopping bags to be used by area shops.
© 2016 Andrea Star Reese for Human Rights Watch

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Music, coffee, conversation and artwork at Rumah Berdaya in Denpasar, Bali.
© 2019 Andrea Star Reese for Human Rights Watch

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Dzikrul Ghofilin was founded by Ibu (Ms.)Utiyah following her personal experience with  post partum mental condition that was successfully treated.
Ibu Utiyah provides "compassionate support for men and women with a
mental health condition". Access to a Psychiatrist is available monthly.
© 2019 Andrea Star Reese

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This man is a resident at Marsiyo's House in Kebumen Indonesia. He is shackled to a a large round cylinder with a short length of chain. His skeletal unnaturally positioned body appears to be impaired by injury or disability. Marsiyo, the elderly founder provides this crumbling home for people with a real or perceived mental illness but does not provide any rehabilitation program of his own. Those who are able have the opportunity to become laborers working on his property.
© 2019 Andrea Star Reese

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A young man with a real or perceived psychosocial disability is restrained and surrounded by filth and traces of human waste at Marsiyo's House, in Kebumen, Central Java, Indonesia. He has not been able to bath and his clothing appears to be unwashed.
© 2019 Andrea Star Reese

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Muji, a 24-year-old man with a mental health condition, has been living in chains for months at Marsiyo's House, a private family-run institution in Kebumen, Central Java, Indonesia. When this photo was taken, Muji said he was "very, very hungry" and, pointing to the chain around his ankle, told me it is "against human rights."
His family pays for his care because “My brain is not good”. Muji explained that a doctor comes once a month but in his opinion “doesn’t do anything.”
© 2019 Andrea Star Reese

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Sodikin, a man with a psychosocial disability, was held in pasung in the shed next to the family home in Cianjur, West Java.
© 2016 Andrea Star Reese for Human Rights Watch

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Sodikin a man with a psychosocial disability, eats his dinner in a shed outside the family home where he has been locked up. His family gives him food and water through a small hole in the shed.
2016 Andrea Star Reese for Human Rights Watch

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Sodikin, a 34-year-old man with a psychosocial disability, at his workplace. Sodikin, who was shackled for more than eight years in a tiny shed outside the family home in Cianjur, West Java, now works in a clothing factory stitching buttons onto boys’ school uniforms. He became the main breadwinner for his  family that used to see him as a burden
© 2018 Andrea Star Reese for Human Rights Watch_

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_Ibu Maliah cooks lunch for the 280 men and women held at Galuh Foundation Mental Rehabilitation Center in November 2012. She is assisted by former residents Siti, who had been living there for ten years and Datir a transgender man who had been at the shelter for thirteen years. Government assistance consisted of two months of food supplies. No one was turned away if they could not pay.
© 2012 Andrea Star Reese

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Meta was brought to Galuh suffering from mental issues complicated by drug use. For eight years she has lived without privacy in a large outdoor cage separated from the men by a wire wall. Sarja, one of the 40 member staff also lives at the shelter. © 2012 Andrea Star Reese

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A man in pasung at his family home in Bali, Indonesia.
© 2019 Andrea Star Reese for Human Rights Watch

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A man in pasung at his family home in Bali, Indonesia.
© 2019 Andrea Star Reese for Human Rights Watch

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Siti Zaenab, feels the floor before she decides in a spontaneous moment to emerge from her closet sized room after 12 years of confinement.
A man in pasung at his family home in Bali, Indonesia.
© 2018 Andrea Star Reese

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Siti's sister is surprised and overwhelmed when Siti decides to leave her pasung closet. "Family never takes Siti to hospital because we have no money." says her sister
© 2018 Andrea Star Reese

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As her sister watches, Siti pulls herself up onto a chair and stares with apparent fascination at photographs that depict her family. Her legs are weak and she is not able to stand.
© 2018 Andrea Star Reese

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Erita is nineteen. Her family brought her to Galuh Foundation Mental Rehabilitation Center after her decline “because of her love life.” About a year ago Taufik’s family brought him all the way from South Selawesi. Since 1999 Arie, in white, has spent alternating years living at the shelter and living at his home.
© 2012 Andrea Star Reese

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This man lived shackled in stocks, a traditional form of pasung, for nine years in a back room in his family’s home in Cianjur in West Java. When he was released, his legs had atrophied from disuse.
© 2012 Andrea Star Reese

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A afternoon rainstorm pours through a leaking roof at Galuh Foundation Mental Rehabilitation Center. Women in the female section lived separated from the men by a wire fence wall. By 2014 the pavilion cage was rapidly crumbling.When the rain came a cooler breeze arrived. The flies were gone.
© 2012 Andrea Star Reese

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This man with a real or perceived psychosocial disability is one of the residents at Marsiyo's House, a private facility in Central Java. The crumbling structure where he is chained leaves him exposed to hours of hot direct sunlight and constant dust.
© 2019 Andrea Star Reese

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Muhammad Ikromudin, 25 was trained to have special powers. He assists the men and women attending a mass healing in Tegal, Central Java, that will last throughout the day and night. Participants pray, drink herbal drinks, vomit, and eventually enter a hypnotic trance. Afterwards, cleansed of their sins they are showered with fragrant herbal water. Bahril Ulum, a charismatic Ulema holds these mass healings assisted family members and neighbors.
© 2012 Andrea Star Reese

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Haji Hamden, an Islamic faith healer, chants as his assistant Abdul slaps the leg of a shelter resident at Pengobatan Alternatif Nurul Azha, a traditional healing center, in West Java. Abdul also uses a hard implement to massage patients, causing extensive bruising, as part of the daily healing routine. © 2012 Andrea Star Reese

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02.24.12_ Didin, 25 years old receives treatment from Abah Sanuk, a traditional healer in West Java who was trained in using Silat martial arts methods. Shamans and traditional healers are the most popular and more affordable mental health care providers throughout Indonesia.
© 2012 Andrea Star Reese

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A traditional healing method is used to assist a man in distress at Galuh Foundation Mental Rehabilitation Center
© 2012 Andrea Star Reese

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A man in pasung at his family home in Bali, Indonesia.
© 2019 Andrea Star Reese for Human Rights Watch

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A man in pasung at his family home in Bali, Indonesia.
© 2019 Andrea Star Reese for Human Rights Watch

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Siti at work in a home salon she runs with her sister. In 2018 Her sister told Human Rights Watch "Before, we had to travel all the way to the mental hospital to get medication. Sometimes we didn’t have time to go or the transport was too expensive. Since we got help from the community health center, Siti’s condition is much better. In addition to medication, the center provided counseling, connected us to support groups, and is facilitating support for her business. My dream for Siti is that she is completely independent."
© 2019 Andrea Star Reese

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Emelia has been depressed for years. Her trouble began around the time she was raped while still in her teens. She lives with her mother and son on the tracks in Jakarta. Her mother hits her and refuses to allow her to seek treatment at a clinic or to move into a shelter. Her mother has threatened people who have tried to help her.
© 2011 Andrea Star Reese

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Pondok Pesentren Al Gufur is a "boarding school" that houses 160 men and women some from places as far away as Singapore and Malaysia's founder Haji tells me the people are there because of drugs, depression, stress, economic crisis, and mysticism. If the family abandones a resident the school will employ them and assign work in rice fields or at their farm. to take back Although a nurse or a doctor from a local clinic visits monthly, Owner/Founder Haji Nawawi does not allow Psychotropic medications to be used.
© 2019 Andrea Star Reese

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Yempi's mother watches him with concern.She does not know if he can improve. Father Andi's Community Pasung Release Program in Flores is in process of building Yempi a secure and safe bedroom where he can live with dignity as he receives treatment for his mental health condition.
© 2019 Andrea Star Reese

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A woman with a real or perceived psychosocial disability sits with her ankle chained to a platform bed at Yayasan Bina Lestari faith healing center in Central Java.
© 2018 Andrea Star Reese

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Several men with real or perceived psychosocial disabilities held in crowded conditions in the male section of the recently rebuilt and renovated Yayasan Galuh Mental Rehabilitation Center.
© 2018 Andrea Star Reese

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A nurse reassures a resident as a visitor talks to his mother in the geritric section  of Dr. Radjiman Wediodining-Lawang State Psychiatric Hospital. The Institution is is considered by many to be the best mental hospital in Indonesia. Lawang was the first hospital in Indonesia to recognize the need for a geriatric department.
© 2014 Andrea Star Reese

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A woman wanders lost on a road near Klaten, Central Java. Just before this moment a man living nearby threw a rock at her to discourage her from staying in the area.
© 2012 Andrea Star Reese

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In Tasikmalaya, Ade Martin and Sulaiman, search the surrounding area nightly to for people like Komandan. They find Komadan and another man who does not remember his name. These men will stay at the run down former bus depot private foundation run shelter where herbal treatments are used, daily activities are scheduled and no one is in chains. Komamdan will die there at the end of April in 2013 and the man with no name will persist in not talking about himself. Keris Nangtung Foundation is funded by private donations and has been awarded a grant for their extraordinary work.
© 2012 Andrea Star Reese

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Siti reaches out of her pasung cell to touch the floor. For twelve years when given an opportunity to leave her pasung closet prison Siti would become agitated or unresponsive according to her mother and sister.
© 2018 Andrea Star Reese

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Siti settles down in the front door of her home staring at the sky as her mother surrenders to the freedom Siti has seized.
© 2018 Andrea Star Reese

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Siti smiles
© 2018 Andrea Star Reese

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A large challenge to reform is the stigma of mental illness. Common belief attributes abnormal behaviors to weak faith, demonic possession, or magic spells.
A man wanders a walled courtyard at Ponpes Rehabilitasi Jiwa Assyifa in East Java.
© 2019 Andrea Star Reese

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An outreach team from a local clinic visits brings mental health care support and medications to men and women with a mental health condition. The door to door program was begun in 2016 under the Department Of Health.
© 2018 Andrea Star Reese for Human Rights Watch

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 At Salafiyah Al-Bajgur, a Pesantren (Islamic boarding school) in Madura, East Java. KH. Masturrahman, in charge of students brought there because they are suffering from "disorders of the mind and spirit" says "It needs patience to treat them"  Â© 2012 Andrea Star Reese

Public Story
Disorder
Copyright Andrea Star Reese 2022
Updated May 2021
Topics @AndreaStarReese, Mental Illness, photojournalism

DISORDER_2011 and ongoing

 The  photographs  posted on this website are the result of ten years of work on DISORDER, a documentary photo reportage about abuse against people with  a real or perceived psychosocial disability in Indonesia and efforts to address Disability Rights and Human Rights:

Since January 14,2011 I have visited and re visited more than 100 government-run and private social care institutions, faith healing centers, psychiatric hospitals and numerous private homes throughout Indonesia. I discover new places, revisit previous places, and plan a focus of special interest.

Being a part of the catalyst that will deliver informed choice, a full spectrum of care options, individual enfranchisement and self determination to persons with a mental health condition is my purpose.
My initiative is very simply to operate as a vehicle for factual information. I work on the frontlines of a war against stigma, a struggle for disability rights and human rights. I deliver my dispatches to governments, policy makers, donor agencies, rights organizations, local/international audiences, and ordinary people who have no idea of what is occurring.
Despite long held stigma, men and women allow me to photograph because they want people to know what is happening, and to see what they must tolerate. Their participation is a fight for life and liberation, recognition and respect.

For me, the most important part of this work is not the photography. I report from a neurological battleground. So maybe the critical part of that work is to ask/beg/urge countless men/women/children to survive, to value living, and to hold onto hope amidst the unspeakable evidence of their circumstance while they battle and manage a mental disease that could be successfully treated. I get a few hours to accomplish that armed with respect, focus, attention, bits of conversation, and vital information. Then I leave carrying their message and report what I have discovered.

Thousands of mentally ill people are locked away in rooms, cells, cages, or animal sheds, restrained in chains or wooden stocks. Many are left naked, hungry, with no ability to wash, and vulnerable to malnutrition, assault, and rape. In Indonesia, this form of abusive “treatment” is called pasung. It is often imposed on individuals of any age who exhibit behaviors, attitudes, or emotional expression that are atypical. Pasung can be enforced for weeks, months, or even years. Although pasung has been banned by the government since 1977, it continues to be a traditional response to mental conditions throughout Indonesia. Yeni Rosa Damayanti, head of Perhimpunan Jiwa Sehat-Indonesian Mental Health Association, in Jakarta, (January, 2016) told me, “You can throw a stone anywhere in Java and you will hit someone in pasung. That’s how prevalent it is.” She added “People with a mental health problem are at the bottom of the chain/cycle of violence that results in human rights abuses….the difference between having access to service and no access at all is to be forced to live in hell. It is between living and not living.”

            Although pasung still occurs in several institutions and healing centers, it often takes place at home. It is imposed by family members who cannot afford a higher level of care, have no support system, cannot or do not know how to access services, fear medications, worry about addiction, or most significantly, want to avoid the stigma linked to a diagnosis of mental illness. Most commonly, they feel pasung is a necessary step to protect the family, community, as well as the nonconforming individual.

In 2016 Human Rights Watch reported that Indonesia is estimated to have over 19 million people with psychosocial disabilities. Indonesia has about 48 mental health institutions and roughly 700 psychiatrists. More than half of the psychiatric hospitals are in four of the country’s 34 provinces, while eight provinces have no psychiatric hospitals at all. Of Indonesia’s psychiatrists, half are based in Java, and half of them practice in Jakarta. Needed prescriptions can be unavailable for months due to shortages. Patient compliance and lack of family support can also lead to treatment failure. To further complicate efforts for reform the Ministry of Health oversees mental hospitals while shelters for the mentally ill are the responsibility of the Ministry of Social Affairs

Faith healers and traditional healers remain a preferred first choice for care. Most concerning is the continuing belief that one’s perceived atypical behavior stems from a lack of faith or sinful behavior, caused by mysticism, spells, or by possession. 

Inadequate access to the medications and treatments commonly available throughout much of the world has devastating consequences. Many people have no idea that their mental condition can improve, they can be better and with opportunity, they can live their dream.


I operate according to Journalism ethics and standard practices under National Press Photographers Association. (NPPA) and  International Federation of Journalists (IFJ) 

Many of the people I photograph have not been seen by a Mental Health Professional or a Doctor able to diagnose  and attribute their perceived symptoms or atypical behaviors as due to a Mental Health Condition or caused by a Physical Disease. Often family members and Caregivers prefer an explantion of possession, mysticism, malicious spells, or stress due to unrequited love, or joblessness. 

In 2013 Human Rights Watch contacted me after seeing my photographs which led to an investigation and world wide exposure. On March 21, 2016 Human Rights Watch released their Report: "LIVING IN HELL", followed in 2018 by "INDONESIA: Shackling Reduced But Persists"; and in 2020 by "People with Mental Health Conditions Living in Chains". Along with my Fixer Gunawan, also a video cameraman, I am honored to have worked with him as a team on visual content for these reports.

Iin Purwanti Cox
Researcher/Consultant, formerly with Yayasan Lembaga Bantuan Hakum Indonesia-Indonesia Legal Aid Foundation

Consultants: Yeni Rosa Diamanti,Perhimpunan Jiwa Sehat-Indonesia Mental Health Association; Dr. Pandu Setiawan, Former Head of Directorate General of Mental Health, Department of Health, Jaringan Rehabilitasi Psikososial-Diaabled People’s Association; Dr. Irmansyah, Former Head of Directorate General of Mental Health, Department of Health, Bogor Mental Hospital; Dr. Harvita Diatri, Department of Psychiatry, University of Indonesia, Cipto Hospital; Dr. Yunier Sunarko, RSJ Dr Radjiman Wediodiningrat State Mental Hospital; Bagus Utomo, Ketua Komunitas Peduli Skizofrenia Indonesia; others









Andrea Star Reese

Andrea Star Reese is a VISURA photojournalist/documentary photographer based in New York, Seattle, and Jakarta.
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