at a rehabilitation centre for mentally ill people in Galuh, Indonesia.
Shackling was banned in the country in 1977, but the practice remains
widespread. Photograph: Andreas Star Reese/Human Rights Watch
Lack of mental health care and community
support leaves nearly 19,000 Indonesians vulnerable to outlawed practice, finds
Human Rights Watch
Almost 40 years after banned the practice of shackling
people with Indonesia conditions, nearly 19,000 are
still living in chains, or are locked up in institutions where they are
vulnerable to abuse, according to mental health from a new report
(HRW). Human Rights Watch
The study says that although – shackling or confining people
with psychosocial disabilities – was banned in 1977, enduring stigma and a
chronic lack of mental health care and community support services mean its use
remains widespread. pasung
People subjected to pasung
can have their ankles bound with chains or wooden stocks for hours, days,
months or even years. They are often kept outside, naked and unable to wash.
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South Sudan, but says people with mental illness are marginalised Recent figures from the
Indonesian government suggest that more than 57,000 people in have endured Indonesia pasung at
least once, while an estimated 18,800 are currently chained or locked up.
In 2014, 1,274 cases of pasung
were reported across 21 provinces and people were rescued in 93% of cases.
There is, however, no data on how many of those were successfully rehabilitated
and how many were later returned to their shackles.
HRW researchers spoke to one man who
kept his daughter shackled for 15 years because he feared she had been
bewitched and didn’t have the money to take her to a doctor.
“She became destructive, dug up other
people’s crops and ate raw corn from the plant. I was ashamed and scared she’d
do it again,” he said.
“First I tied her wrist and ankles
together with cables but she managed to untie herself so I decided to lock her
up because the neighbours were scared.”
Although he released his daughter two
months after the visit from HRW, he told the group that, for a decade and a
half, she had been left to defecate in her room, which was never cleaned. She
was not bathed in all that time, and was neither clothed nor visited. Her only
contact with the outside world, beyond the meals pushed twice daily through a
hole in the wall, came when local children pelted her with stones.
“Shackling people with mental health
conditions is illegal in Indonesia, yet it remains a widespread and brutal
practice,” said Kriti Sharma, disability rights researcher at Human Rights
Watch and the author of the report.
“People spend years locked up in
chains, wooden stocks, or goat sheds because families don’t know what else to
do and the government doesn’t do a good job of offering humane alternatives.”
faces ‘explosion’ of mental health conditions
struggle with the cultural and financial challenges of mental illness, and in
under-resourced private clinics, patients are routinely chained The report recognises that
the government has taken action to address the practice through initiatives
such as the “Indonesia free from pasung” programme, which aims to
eradicate the practice by 2019. But it says progress is being stymied by the
decentralised nature of the governmental system and by inadequate resources and
The study says that Indonesia, a
sprawling archipelago country of 250 million people, has only about 800
psychiatrists and 48 mental hospitals, more than half of which are in just four
of its 34 provinces.
Noting that the ministry of health’s
budget is 1.5% of Indonesia’s central government expenditure for 2015, the
report describes mental health spending as negligible, adding that the latest
data shows nearly 90% of those who may need to access mental health services
are unable to do so.
Those locked up in institutions,
meanwhile, can fall prey to physical and sexual violence, or find themselves
subjected to involuntary treatments such as electroshock therapy, seclusion,
restraint and forced contraception.
HRW found some of the facilities were
overcrowded, while personal hygiene levels in many were “atrocious”, with
people “routinely forced to sleep, eat, urinate and defecate in the same
The organisation also documented the
use of “magical” herbs, Qur’anic recitation and electroconvulsive therapy
without anaesthesia and without consent. Cases of physical and sexual violence
were noted by researchers: in seven of the institutions visited, male staff
were either responsible for the women’s section or were able to come and go as
they pleased, raising the risk of sexual violence.
The report calls on the Indonesian
government to make mental health a priority by putting an end to pasung, ordering
immediate inspections of state and private institutions, and instigating
Other recommendations include
amending the 2014 Mental Act to give people with psychosocial
disabilities the same rights enjoyed by their fellow citizens, training mental
health workers, and developing community-based services. Health
Equally important, however, is
listening to the voices of those affected by mental illnesses, consulting them
over their treatment, and seeking their informed consent.
“The thought that someone has been
living in their own excrement and urine for 15 years in a locked room, isolated
and not given any care whatsoever, is just horrifying,” said Sharma. “So many
people told me, ‘This is like living in hell’. It really is.”
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