A five year documentary reportage about abuse against people with psychosocial disabilities in Indonesia:
Pasung is the Indonesian term for chains, stocks, or shackles, but can also refer to being locked in a room, pen or cage.
Banned in 1977, it is the widespread traditional response to mental disorders throughout Indonesia and an act of desperation. Caregivers resort to pasung when they cannot afford care, fear medications and addiction, want to avoid the stigma attached to a diagnosis of mental illness or most commonly, feel it is necessary to protect family, community, and the disturbed individual. Indonesia is estimated to have over 19 million people with psychosocial disabilities.
Even with the passage of the 2014 Mental Health Law, effective regional programs continue to be rare and underfunded. Common obstacles for Indonesians include access to care, cost of seeking treatment, and the lack of basic information.
Indonesia has about 48 mental health institutions and roughly 600 to 800 psychiatrists. More then 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. A new development is the multi-billion dollar deficit affecting Government Health Insurance. Lacking reimbursements, doctors have begun to charge patients additional costs that families are unable to pay. People who have survived pasung worsen, are locked away and chained. To further complicate efforts for reform the Department of Health oversees mental hospitals while shelters for the mentally ill are the responsibility of a separate department.
And furthermore, Shamans and traditional healers continue to remain the popular choice of mental health care throughout the country. For Indonesian’s, it is better and cheaper to attribute confusing or abnormal behavior to spiritual weakness, spells or possession. There is no stigma attached to being under a spell or possessed.
In 2013 Human Rights Watch contacted me after seeing my photographs, which led to an extraordinary experience assisting them with images, access, contacts, investigation and with their multi media production. On March 21, 2016 Human Rights Watch released their Report: LIVING IN HELL. In mid April, “Indonesia’s Minister of Health, Nila Moeloek, committed to providing mental health medications in all 9,500 community health centers (puskesmas) across the country. Achieving this could turn the tide against shackling” wrote Kriti Sharma, HRW investigator.
Inadequate access to the medications and treatments commonly available throughout much of the world has devastating consequences. Many people don’t even know they can get better.
Walking through the door is easy. It is leaving that is hard. I am drawn to men and women who are invisible to mainstream society. My reportage is in response to what I am able to discover about the complex realities that challenge the men and women I photograph. I cannot walk away from this story.