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Health visiting in Indonesia

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After 18 years supporting families in Gloucester as a health visitor, Jo Clements wanted a new challenge on her retirement. She is now in her third year working to improve maternal and child health in eastern Indonesia, where in rural communities, malnutrition remains a major cause of disease and death among under-fives.

In central West Timor, small local organisation Yabiku is seeking to improve the health of women and children in remote villages, building on its work to combat domestic violence. Jo is sharing her technical expertise in maternal and child health to help make this happen.

'My key objective is to improve understanding of health and nutrition, especially child health, in the community,' says Jo. 'It's more than doing health promotion at community level; I have a commitment to build the health knowledge and upgrade the skills of staff in Yabiku.'

Learning from the community

Crucial to Jo's work is learning from the village communities themselves, agreeing with mothers and children how to work together on the issues that they identify as important. She stresses the importance of understanding the local context: 'Working on nutrition, I find out from villagers what the food options are, what is seasonally available. There may not be the facility to spend money on transport to the town in order to buy food. Taboos or social practices around eating may mean pregnant women and weaned children are especially at risk.

‘We then agree with women the practical education and support they would like, perhaps with a specific group they identify, such as children between six months and one year.'

Successes are gradual and achievements small but significant. Training volunteer health workers who assist monthly rural baby weighing clinics, Jo has found building the confidence of staff in new approaches takes longer than boosting the numbers of women who attend.

Mastering the language

Learning Indonesian has been vital for Jo to work directly and effectively - and it's the skill she is most proud of mastering. 'We had eight weeks’ language training in Bali before going to the field, but it took me a long time to actually get the language. Here no one speaks English and my Bahasa Indonesia has improved tremendously!'

As guest of honour at weddings, birthday parties and baptisms, Jo needs to be able to chat with neighbours, as well as respond to the friendly curiosity of the town. 'You can't go outside the door without engaging in conversation with somebody!'

Looking to the future

Personally and professionally, Jo feels her time in Indonesia has been a learning curve: 'You adapt your approach to fit in with local availability: I've learnt a lot about how to work with what you've got.'
'I've never regretted volunteering,' Jo says. 'After my current placement finishes, I am heading back to the UK to retire! But I'd like to continue with the option of occasional short-term volunteering with VSO. That would be lovely.'

VSO urgently needs more experienced professionals like Jo to help combat malnutrition and improve the health of vulnerable women and children in Indonesia and Cambodia.

If you’re a registered and qualified nurse, midwife or health visitor, and would like to follow in Jo’s footsteps, find out more about VSO’s 12-24 month opportunities at www.vso.org.uk/healthjobs or call us on 020 8780 7500.

Alternatively, come to our Health Information Day on Saturday March 8th in London: more details here http://www.vso.org.uk/events/information_days.asp


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