This is one of the many harrowing Indonesian villages where people with mental illness are chained to the floor and made to live in cells.
Across the country, thousands of people with disabilities are currently shackled, according to a Human Rights Watch report released on Monday.
The 74-page report, ‘Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia’ investigates how people with mental illness often end up chained or caged in unsanitary and overcrowded conditions.
These victims live below the poverty line, with their family earning between £20-£35 a month. Many suffer from malnutrition, visual and hearing impairment – but villagers and government officials blame incest and iodine deficiency as the cause for their illnesses.
Many of the people who live in villages like this suffer from a severe physical disability known by locals as ‘Kampung Idiot’, which is comparable to Down Syndrome.
A disturbing and common practice in these villages is to keep those with disabilities under pasung – shackled or locked up in a confined space. And although the government banned this method nearly 40 years ago, families and traditional and religious healers continue to practice it.
According to the report, more than 57,000 people have been subjected to pasung once in their lives and almost 19,000 are currently being shackled.
And based on research across just the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of people with psychosocial disabilities who were in, or recently rescued from, pasung. They also obtained another 200 cases documented in recent years, with the longest case belonging to a woman who was locked in a room for nearly 15 years.
They say that a shortage of limited mental health services, psychiatrists, misinformation, and stigma about mental illness are some of the reasons people with disabilities go to these villages without first getting treatment. In a country of 240 million people, there are less than 600 psychiatrists – with many of them based in urban centres.
Across Indonesia, it is widely believed that mental health conditions are the result of lacking faith, displaying immoral behaviour, having sinned, or even being possessed by the devil. As a result, families typically consult a faith or traditional healer first, and only seek medical advice as a last resort.
If they do look for access to medication though, it’s not easy to find. With 250 million people, the country only has 48 mental hospitals, with more than half of them located in just four of Indonesia’s 34 provinces. And, in the entire country, there is just one trained psychiatrist for every 300,000-400,000 people. Data shows that nearly 90 per cent of those who want to access mental health services cannot.
The Indonesian Ministry of Health has recognised pasung as an ‘inhuman’ and ‘discriminatory’ treatment of people with mental health conditions, and they have launched many programs to put an end to it.
But the lack of understanding and awareness around mental health and the shortage of volunteers has caused the practice to continue.