Reproductive Health & Education in Pasar Badung & Kumbasari
“HIV/AIDS and other STDs have spread throughout Bali, yet dissemination on these diseases rarely reaches most groups of the population. Women are at risk for STDs through commercial sex work and high risk behavior of men. They are the ones who suffer more consequences due to biological vulnerability and the lack of early symptoms of many STDs in women. Other health problems affecting women, such as breast and cervical cancer, reproductive tract infections, domestic violence and maternal death are also common in Bali.
The Maternal Mortality Ratio has been estimated by a recent study at approximately 112 per 100,000 live births, lower than the national level, but almost triple the levels in Thailand and Malaysia. However, women tend to put low priority on their health problems, failing to allocate time and money for seeking health care. They also tend to have less access to information than men and thus to be less empowered to act to protect themselves,” (from YRS informational material)
Yayasan Rama Sesana (YRS) began in 1999 with the vision of developing high quality human resources among marginal communities in Bali. Their mission is threefold: 1) to improve community-based prevention and reproductive health services 2) to empower families to improve their welfare and self-reliance, especially in marginal communities and 3) to improve empowerment efforts with a view to achieving a sustainable Balinese community based on gender equality and justice. Their modest clinic located on the 4th floor of Pasar Badung, was completed in 2003, and currently services 20 - 25 women a day who are mostly local women working or living close by the pasar.
YRS has recruited and trained a qualified doctor, 3 counselors/outreach workers, a nurse, lab technician, an administrative assistant/accountant and an office assistant. Their clinical services include pelvic exams, STD testing, Pap smears, antenatal care, contraceptive check ups, breast exams, counseling, treatments and referrals. In addition, through a joint project with Prima Medika, YRS is able to offer free mammograms to low income women. All of their services are provided on a donation basis, giving women the chance to make their own health a priority without worry about the cost. According to Dr. Sari, routine check ups can greatly assist women with early detection and prevention of cancer.
Dr. Sari has been a strong advocate for women’s reproductive health for many years. Perhaps this is due to the fact that as a child she recalls her own father going out into the community to promote health. He frequently brought her into the village where they held meetings about family planning, sparking her interest in health. These experiences were the catalyst for her ultimate decision to become a doctor and dedicate her life to helping women with reproductive health services and education. Since YRS is only an NGO, they are concerned with how they can sustain their projects, as the funding they receive from the Anniken Foundation covers only 75% of their operating costs; the remaining 25% comes from fundraisers and private donations.
Some people may find it strange that a reproductive health clinic is situated right in the heart of Pasar Badung, (a traditional food market in the middle of Denpasar) but YRS Founder/Director, Dr. Luh Putu UpadiSari and her team of dedicated staff are happy to be working there, because they know this is the best place to be in order to help low income women who would otherwise not seek out reproductive healthcare for themselves.
Every day three staff members from YRS visit Pasar Badung and Kembusari Art Market to disseminate information about reproductive health. In addition, they sometimes visit other markets in Denpasar by request.
“We’d really like to promote the clinic more, so that women are aware of us and get routine check ups to prevent infections and other medical problems,” says Dr. Sari.
In addition, every year YRS trains 20 women from the market for their ‘Peer Education Program’. About 12 of these women are active, going out every month to educate women on reproductive health. YRS monitors their progress with monthly meetings where they discuss how things are going in the field.
“I have a dream that in the future all traditional markets like Pasar Badung offer services like this,” says Dr. Sari.
Dr. Sari admits that there have been some challenges running a reproductive clinic, as sex is a ‘taboo’ subject in Indonesia. As a result, they have had to be very creative about how they approach the topic of sexuality.
“Another challenge that we face is finding staff that are willing to work in a traditional market, because there is a mindset that a health provider should be based in a hospital,” says Dr. Sari.
Even so, the market is the best place for the clinic because of the numbers of women who come there. These women also play a potentially important function in distributing information about women’s health. In addition, a substantial portion of them may be at great risk of health problems like STDs due to low education, low income, long work hours and lack of information.
In 2011, Dr. Sari hopes to expand her programs to include educational opportunities for women to learn how to read and write, as well as finding ways for them to increase their income. All of these things have a big impact on whether women are willing to make their own health a priority in their lives.
If you would like to find out how you can support Yayasan Rama Sesana (YRS), please visit their website at: www.yrsbali.org or come to their clinic at Pasar Badung or visit their new fundraising branch located at: Jalan Tukad Buaji, #37A, Panjer, Denpasar. Please call in advance on: (0361)247-363.
For questions or comments about this column, please email: michelina630@hotmail.com
