Writing at the Narita lounge during our 5-hour layover back to the states. Long travels and time to mull over the 2 weeks we were in Bali. Christmas morning we had a very productive meeting with our Yayasan Board, discussing some exciting future projects. It will be good to be home, back in Brooklyn, and have time to process all that Bali has offered.
sunset and mt. fuji from narita airport lounge
Here are some action shots of the practitioners who came to Bali. Everyone took the GAHP continuing education classes, raised funds for their own airfare, solicited donations for supplies, and put in a whole-hearted effort to bring their compassionate care to the people of Bali:
Katie, Frank, Grainne
Julie
Matthew
Linda
Dan
Ann
Renate
Mimi
Jen
We are learning more background information to our situation. We have recieved great support from the Yayasan members. We have had amazing meetings with brilliant people, all trying to help us meet our mission. While this trip will not bring us back into the field, we are growing stronger as an organization. If we can succeed in our goals, we will become an even stronger presence here in Indonesia. I can’t say yet what the outcome will be, but we have great plans in place. Once the pieces settle, I will let you all know. We have another meeting scheduled for Christmas Day. More than half of our group will return to the US, myself included, in the next couple of days, depending on our ability to change airplane tickets.
Meanwhile, Pak Dharma, one of our sponsors, has offered to lend his car and our translator Agus so that some of the team can go to see more of the island. Renate, Ann and Matt took him up on his offer. Linda is visiting new friends in Candidasa. Dan, Frank and I stayed behind to sort out and store our supplies for next time. Julie, Mimi and Katie are preparing to leave tomorrow.
We all met at Cafe Batujimbar (our local expat hang out who serves a great latte and everything from Nasi Campur to Spaghetti) for Xmas eve dinner. And then reconvened after for those of us suffering from “Bali Belly”, otherwise known as dysentery.
Daily treatment helps a lot! Well, it’s the same treatment we give to villagers who complain of “ma” or digestive upset. So we know this protocol very well!
Back to Sanur for a lunch time meeting. An appeal is being made on our behalf by our yayasan. We are hopeful that we might be able to start up again. If we can, we will go out as one group and try to maximize our time. We are planning a day of re-organizing of supplies, and an afternoon of training for the practitioners to hone our model that we have been working out in the field.
So while we are here working on paperwork, I have a little time to write about the model we are using here in Bali as our treatment delivery. Which is a formal way of saying: how in the world can we treat 200+ people in a day effectively, compassionately and efficiently with 2-4 practitioners!
Last year we found that when we went to more remote villages the need was much higher that what we saw in the Bumi Sehat clinic. In Ubud, there were still a few options for people to engage with the health care system, though even there the options were not great and often hugely expensive.
But imagine walking into a village of 300 or 500 families, NONE of which has seen a doctor before. There’s 2,000 patients right there. Most of rural Bali is quite poor with families living on $1/day. People do intense physical work in the rice paddies, carrying heavy bundles and working the land without electricity or running water. Even though the climate is mild compared to the northeast US, constant rain makes for constant damp and we see a lot of conditions related to “cold-damp” such as painful arthritis, asthma, colds and flu. Under these conditions, people often have a limited diet of rice, few vegetables and small amounts of meat and fish. Children of 10 years often look 7, and we warn practitioners at orientation not to judge a child’s age by their appearance. The adults also often look much older that we would expect coming from the US. I often had the experience treating people last year who I assumed to be in their 50’s or 60’s only to find they were much closer to my age of 42. So with the help of a member of parliament (who was up for re-election and wanted to make good on his campaign promise of helping villagers with better health care), we had targeted poor and remote areas where we felt we could do the most good.
We divided up our group of volunteer practitioners into two groups of 5, one group to stay in the northeast area of Karangasam–a poor region on the slopes of volcanic Mt Agung and famous for its rocket-fuel version of fermented palm sap: Arak. The other group would work around southern Bali for the first week and then travel up the central corridor to Singarajah in the north and finally finish in Negara in the west.
This way we would maximize our ability to reach poor villagers. Each team consists of 4 practitioners, 1 logistics manager, and 2 translators. In addition to our herbs and acupuncture supplies, we are also bringing 12 “beds” or portable mattresses with bamboo mats that we can set up in the community banjars to create a make-shift clinic. We also used plastic chairs to create community style acupuncture where we can treat small groups at the same time.
Here are some photos of Sunday and Monday’s village visits to see the set-up: In the first one you can see the villagers waiting to be interviewed. Then, once they have been interviewed and we have determined their chief complaint they are sent to wait at the table until a bed is available for their treatment. This was Dan’s first village in Selat, and had 250 people registered for GAHP’s first visit. Dan also roped off the banjar–a great idea to help eliminate the chaos of people wandering through our treatment area so they can check out what is happening…
Independently of each other, Dan and I both came up with similar systems for managing the crowds. Organize the larger crowd, determine the chief complaints, and treat in small groups. The village leaders also helped us in this task by organizing the crowd and having everyone register first and then come in groups of 20.
However, in my first village we didn’t have our matresses until later in the day–and space was very limited. 
So we chose to set up chairs and treat as many people as we could seated. I also didn’t think of roping of the banjar so you can see that the space is a bit more chaotic. If you look closely you can see multiple practitioners working at once, and also a youth leader helping us to moxa (the guy in the green shirt kneeling to do moxa in the lower right corner). Aslo present: me doing an intake with Matt following to do the acupuncture, and Julie (blue shirt center, back to the camera), needling a patient.
So necessary to this model are our amazing logistics managers. On this trip we were lucky to have two powerhouse moms from Wyoming–who have not only taken all of the GAHP continuing education seminars, but also took Tui Na Level One so they could help with body work. Katie is taking this picture and she is the one seeing the flow of the day, making sure we have all the necessary equipment sorted and available, and jumping in when needed to perform tuina or do moxa! We really would have been suffering without Katie and Mimi helping out in this way.
Also critical to our success were our 4 highly capable translators. These guys rocked! They were all young recently graduated students and incredibly skilled and enthusiastic to help out.
Chrisma and Agus Maye and Nisa
When Agus learned that we needed to go up to Amed to meet with Dan’s team, he volunteered to drive us up there. That is how we learned that in Bali whenever you drive past a temple, over a bridge, see a cat or a dog, you must honk quickly to greet the spirits there. And that when asking directions, it is very rude to roll down your window and stick your head out–instead, you must get out of the car to talk to the person respectfully. Poor Agus had to do that several times as we made our way up the island!
Frank, Dan and I are holed up at Candidasa (pronounced Chandidasa) trying to figure our our options. It is the weekend so no paperwork can go through. We have been told that Jakarta is notoriously slow with such things and that our chances of expediting our paperwork through is slim. Team members are disappointed, but everyone understands that this kind of set-back comes with the territory of doing aid work in the developing world. If we are successful with the government’s request, then it will push our organization up to another level and allow us to have an even greater impact here in Indonesia. Still it’s hard not to think of all the villages that were waiting for us to come to treat.
There are worse places we could have ended up with an enforced rest: Candidasa is a beautiful old fishing village halfway between Amed (where Dan’s team was staying) and Sanur (where my team stayed and the location of our Yayasan) so at least there is time for rest and reflection while we try to sort things out. Meanwhile we are all on our computers drafting the needed documents, and sending email to the US tracking down others.
sunset over Candidasa: waiting and reflecting…
Surprising news from Denpasar (the capital and government seat in Bali): we have been asked to temporarily stop our outreach sites. We received news from Frank as he met with officials to discuss our project. There is additional paperwork we need to process through Denpasar and Jakarta before we can proceed. Dan and I had already set out on our second treatment day, so we turned around and headed back. We met first with my team in Sanur and then Frank and I drove up to meet with Dan’s in Amed.
Suddenly this trip has become a very different one than what we planned. We are all assimilating the information. More to come soon.
Start Up
It was an early morning start to load up the vans. We just had time for a group shot before Dan’s team headed off to Karagasam (north-east of Bali).
It felt strangely lonely to have ½ of the group gone, but we soon my team was loaded up too and heading north to Badung, which is in central Bali. The parlament member who helped us organize our sites sent his wife to accompany us, and since our car was late we all jumped into her car, commissioned another and headed up. Our Ibu (honorific for a woman—the male equivalent is Pak) brought us to the Banjar. We were late due to the car problems and already there were about 50 people waiting for us, seated around the Banjar. We quickly set up and started registering people. Some extra challenges were presented to us: we were missing one of our bags of supplies, which meant we had no cotton balls (we substituted small rolled up balls of tissue) not much selection of needles, and all of our sharps containers were full from last year! (we substituted water bottles…) The banjar was quite small so there was no room to set up our mattresses—which hadn’t yet arrived anyway—so we set up circles of chairs, community style. We also found that someone had sent a doctor and several nurses, all dressed in whites to help us. At first that was a bit of a challenge, but then Agus, our translator, had the brilliant idea to put them to work helping to fill out patient cards with their health complaints. Oh, and one more obstacle: we had to move out of the banjar at 3:00 due to a ceremony scheduled to happen there and move to another one up the road!
Our team was resourceful, and eager to get their feet wet on their first day of treating. The systems we had created worked well, and we ended up treating 210 people that day!
Photos from Sandakan
Here are the patients lined up ready for treatment:
and here is the community style treatment method we used.
Some of the people we met in Sandakan.
an allergies patient
baby with fever
patients young and old…
sisters 
This lady said she was 60…but I kinda doubt that… she was so sweet and happy to get acupuncture plus tuina and moxa for her arthritis. She charmed us all with her smile.
This boy is having some developmental problems, plus hyperactivity and insomnia, and maybe some mild autism. He had a high fever as a child which could be a contributing factor. I did a treatment for him and then taught his dad how to do moxa St36 and DU20 for him. Agus was my model to locate the points. I also gave him some herbs and told his dad how he can get some more if they help.
Halfway through our treatment day we had to relocate to another Banjar—ours was preparing for a ceremony. Here’s the call for everyone to come: this guy climbs up the ladder and bangs on a resonant piece of wood that can be heard throughout the whole village.
Many of our patients were now in their ceremony finery, especially the women, preparing offerings. It was sweet to walk by and be greeted by smiles of those we had just treated.
It’s been a while since I’ve had internet connection so I will catch up on the last few days
We all arrived in Sanur in ones and twos over three days or so. David and Janine Thomas, who live here in Bali are helping us a great deal. David and I made several trips to the airport to pick up team members and to wait anxiously to see whether we were able to get our bags of supplies through. Some bags made it, some did not. We have a wonderful supply of donated herbs and needles from several generous donors, and we want to have all of our supplies to treat as many people as possible, so it was very disappointing that some bags were stopped by customs. But still we had lots of supplies to get started, so our next task was to organize everything during our Orientation Day
(Me, Janine and David)
Meanwhile, Frank, Dan and I, who all arrived early, started treating our local supporters at their home. I was happy to discover that one of our sponsors, though born and raised in Bali, spoke Mandarin—her grandparents had come over from China—so I was able to recruit her to help translate—from Indonesian to Chinese to English! By Friday night, most of our team was here to join us for dinner at Café Batujimbar:
Batujimbar
Saturday was scheduled to orient the team to Bali, discuss our treatment strategies as well as to familiarize the practitioners with common conditions they will see while treating in Bali. We also planned to inventory and organize our supplies and prepare travel kits to send off with the teams to different parts of the island. We met at the location of the local foundation, or yayasan, who is sponsoring our activities on Bali. At 9:00am our yayasan board came and sat with me and Dan and introduced us to a local politician who then proceeded to get on his cell phone and rapid-fire call heads of villages throughout Bali to set up locations for us to treat. Within two hours, our entire 12 days were filled with enough sites for us to have two teams treating every day!
Meeting
Meanwhile, the rest of the group were busy unpacking an inventorying our supplies.
Linda and Matt 
David and Janine had portable mattresses custom made for us, with durable vinyl covers to protect them and woven mats to place underneath—this would be a huge improvement on the makeshift beds we used last year.
Mattresses photos 
Frank demonstrated an intake using our translators and showed how to do a treatment with the materials we have at hand. (the only difficulty was our volunteer spoke perfect English and kept answering Frank’s question without giving the translator a chance to translate!)
Frank treating 
Then we divided the group up into two teams and gave them their first assignemt: to go to Hardy’s (the local department store) to purchase plastic tubs and trays to organize our supplies in the field. While they were gone, Frank, Dan and I ran around doing treatments, printing up paperwork, and writing herbal formulas.
When the groups returned we assembled our travel kits for the next day. It was a very full day and we didn’t leave Sector until after 10:00pm!
Getting my Bali-feet back. Hot, but not too bad. some rain but nothing like the downpours of last year. still working out the kinks of how to access the internet. so far have treated the families of some of the people here who are doing outreach. Our GAHP team are arriving one by one. We will have our welcome dinner tonight, tomorrow is orientation and organizing our supplies. On Wednesday we all head out to different locations to begin treating. We will have three teams of 3-4 people, and we hope to treat 300/day. We are getting lots of support from local Balinese in doing outreach, and we are acting as an official “yayasan” or foundation here in Bali which will give us more access to the remote villages. so the forces are coalescing and we are about to dive in. More to come…
