We were well-established medical anthropologists, teaching at Harvard and primarily focused on studies in Iran, Turkey, and the United States, when we were offered the opportunity to serve as Fulbright lecturers at Gadjah Mada University (UGM) in Yogyakarta in 1996. This began a love affair with Yogya and a deep commitment to Indonesia that continues today. We have spent two to six months every year in Indonesia, developing collaborative research projects with colleagues in the faculties of medicine and psychology at UGM, contributing to the rise of a national movement for medical ethics and supporting the building of innovative forms of mental health services in Yogyakarta and post-conflict Aceh. We also initiated exchange programs that have brought more than 20 faculty and scholars from Indonesian universities to Harvard as visiting fellows.
Mary-Jo’s initial project on the culture of biomedicine and bioethics began as a collaborative endeavor with Dr. Yati Soenarto and Siwi Padmawati and other medical colleagues. She interviewed medical faculty about their life histories, early medical education, and the influence of global flows of knowledge and practice on the profession of medicine in Indonesia. A new fellowship program allowed us to invite UGM faculty to Harvard and to cosponsor a conference at UGM, “Bioethics 2000: An International Exchange,” which was followed by a national meeting of medical educators that set an agenda for medical ethics education in Indonesia. Dr. Soenarto Sastrowijoto, our collaborator and a Fulbright scholar at Harvard, went on to found The Center for Bioethics and Medical Humanities, which continues to provide leadership nationally in medical ethics education. Fulbright and AMINEF supported this work by funding research and conferences to discuss ethical dilemmas faced by physicians providing care for patients with terminal illnesses
Byron came to Indonesia with a longstanding interest in culture and mental illness and in finding new ways to provide mental health services in low-resource settings. He began a close working relationship with Dr. Subandi, and Dr. Carla Marchira, a psychiatrist. Together they developed a team of researchers who launched studies of how Javanese culture shapes the experience of severe mental illness, the role of local healing traditions in responding to such illnesses, the importance of families in providing care for the mentally ill, and the critical need for improving mental health services.
This work prepared both of us to respond to the crisis in Aceh following the tsunami of 2004. Beginning in 2005, we were invited by the International Organization for Migration (IOM) to advise them about providing psychosocial and mental health responses to the tsunami. When the Helsinki MOU was signed, ending the conflict that had engulfed Aceh for nearly two decades, IOM was a lead agency in post-conflict reintegration activities.
We designed a large-scale psychosocial needs assessment that documented the extraordinary levels of traumatic violence suffered by Acehnese civilians during the conflict and the resulting high rates of posttraumatic stress disorder (PTSD) and other mental health problems in rural communities. We helped IOM organize a program of outreach teams of specially trained Acehnese doctors and nurses to provide mental health care in 75 high-conflictaffected villages. Finally, we directed a study of these services, providing rare documented evidence for the effectiveness of mental health care in reducing trauma-related suffering and enabling those disabled by their illnesses to recover and return to productive lives.
In 2011, we were awarded a USAID grant enabling us to continue exchanges between Harvard, UGM, and Syiah Kuala University in Aceh to develop projects aimed at improving the delivery of mental health care in the public health system.
What began as a six-month appointment as visiting professors at UGM, with the support of the Fulbright Program, has led to our deep involvement in Indonesia for 17 years. We are grateful for Fulbright support and look forward to continuing this work as long as we are able.
