Sunday, March 14, 2010 - 20:30

When video journalist David O'Shea visited Bali in May 2009, he found a desperate group of mentally ill people chained up for years by their families; and a courageous woman trying to help them.

Now he's returned to Indonesia for Dateline to see what psychiatrist, Dr Luh Ketut Suryani, has been able to achieve, and he's amazed by the results.

Gusti, pictured above before and after treatment, is just one of the success stories she's had from tirelessly treating the ill and educating their families.

But now the work of Suryani and her volunteers is under threat, because of a lack of resources and financial support from the government.

So what future for Bali's mentally ill? Watch David's report.

You can also still watch David's original report from May 2009, Bali's Shame, online and David talks more about this story in a feature for Dateline's 30th anniversary.


Go to the website of the Suryani Institute for Mental Health to find out how to make a donation.




Last year, Dateline's David O'Shea showed us a side of Bali life that the tourists who flock there never see, mentally ill Balinese held like animals in chains, cages and even medieval stocks - in this day and age, almost unbelievable. Later last year, word reached Dateline that there'd been some 'good news' developments to that story. Intrigued, our man O'Shea went back to Bali and discovered that the work of one good Samaritan psychiatrist and her team had resulted in dramatic improvements in their patience, but that progress it seems, has come at a pretty hefty price.

REPORTER: David O'Shea

While most women her age are taking it easy, Bali's leading psychiatrist is on a mission to expose an uncomfortable truth, and nothing will stop her, least of all, the terrain.

DR SURYANI, (Translation): Can you please hold my hand? You are younger. Can you hold my hand too?

Once again, she is taking me on her round visiting her chronically mentally ill patients.

DR SURYANI, (Translation): I generally help people who are not being helped by anyone. I want to remind the families, society and the government that these people are not useless.

This is how she found Komang last year - chained up in the backyard. With the anti-psychotic medicine Dr Suryani provided. This is how she looks now.

REPORTER, (Translation): So what do you do each day?

KOMANG, (Translation): I pick chillies.

She's happy and healthy and contributing.

REPORTER: What else?

KOMANG, (Translation): I cook. In the kitchen.

Time and again I see dramatic progress in the patients we met last year. Some are doing better than others but, overall, the change is remarkable. Not so long ago, 26-year-old Gede was chained up next to his own excrement, unable to communicate. Here he is now, working on this building site.

REPORTER, (Translation): So, is he doing a good job?

FOREMAN, (Translation): Yes, kind of.

This is Nyoman, who spent decades with his foot in these crude stocks.

BROTHER, (Translation): We never thought he would make a full recovery because I have known him since I was little. He has been in chains for 40 years.

He's now free to roam around the village as he pleases.

DR SURYANI, (Translation): Do you have grandchildren?

MAN (Translation): I do

DR SURYANI, (Translation): How many?

MAN (Translation): Too many to count.

The recovery in Dr Suryani's patients show what's possible with the right medication and treatment - something the health department has been unwilling or unable to give. According to this man, staff at Bali's mental hospital advised him to lock up his sons, which he did - for eight years in this double-sided cage - before Dr Suryani showed up and helped them recover. After his initial treatment, the eldest son, Komang, got married and the latest news is his wife, Ayu, is three months pregnant.

DR SURYANI, (Translation): Komang, now you know she's pregnant, how do you feel?

KOMANG, (Translation): Happy.

DR SURYANI, (Translation): You don't look as if you are happy?

KOMANG, (Translation): I didn't think she would ever fall pregnant, but she has.

And these two sisters I met last year in a dark room in Bali's north have also been rescued by Dr Suryani. Back then, it was a confronting scene, with the older sister screaming at us to leave.

REPORTER, (Translation): Do you remember me?

SISTER, (Translation): Yes, I do. I remember everyone. Everyone was trying to tie me up in order to give me an injection.

REPORTER, (Translation): At the time, you wanted to protect your sister?

SISTER, (Translation): Yes, I felt sorry for her. She was tied up.

Like many of Dr Suryani's patients, these women need regular treatment with anti-psychotic medicine. Without it, they will relapse. She provides the medicine free of charge but, now, this good Samaritan's inspiring work is under threat. After we went to air last year, she finally received 1 billion rupiah, or about $120,000, from Bali's governor - enough to treat over 300 patients for one year. But, then, in December, he slashed that budget by 90% without consulting her, apparently after listening to jealous critics of her program.

REPORTER: What sort of criticism did you hear of her work?

MADE PASTIKA, GOVERNOR: You know, I must be responsible for this budget management to the parliament and the people. So why... there are some questions to me. "Why do you put the budget so big to this foundation?" "There is no foundation that you allocate that big of money. " There's a kind of political... political judgment or criticism.

REPORTER: Do you think that, perhaps, you were over-sensitive to that criticism?

MADE PASTIKA: Not over-sensitive but I must take into my consideration.

The budget cut has shaken Dr Suryani.

DR SURYANI (Translation): I felt ashamed that I wasn't trusted. In the end, I wondered whether I shouldn't just stop. That would mean that I'd stop giving out the medication and I would tell the volunteers to tell the village leader, the local authorities, the health authorities and the doctors that the therapy for these patients has been stopped.

The dramatic budget cut comes despite Governor Pastika's own family experience.

REPORTER: Before Suryani uncovered the problem of untreated mental illness in Bali, were you aware of the problem?

MADE PASTIKA: Not exactly. Not exactly.

REPORTER: No? But she tells me your own grandmother was chained up.

MADE PASTIKA: I keep on asking, "Why she is just sitting on that place?" That was a long time ago.

REPORTER: So you were shocked when you found out this was going on?

MADE PASTIKA: Still going on now? Yeah, of course.

WOMAN (Translation): I can't contribute anything. I beg for rice, I beg for everything. I'm so poor.

DR SURYANI (Translation): You aren't begging, you're helping out.

Dr Suryani knows her patients won't be able to afford the expensive medicine she's been giving out for free. But, with the governor's money drying up, she needs to find out whether the families can afford to pay at least some of the cost.

WOMAN, (Translation): Pray that this illness doesn't recur.

DR SURYANI (Translation): What if it does?

WOMAN (Translation): Let's hope it doesn't. We don't have anything. We live hand-to-mouth.

DR SURYANI: The money not only for the patients but for the volunteers to help the patients. Because the doctor and the nurse at the health centre doesn't want to help these patients. They said they are busy and they don't know how to handle mental disorders.

Of all Suryani's success stories, there is no better example than 36-year-old Gusti. I don't even recognise him when he is sitting right in front of me.

REPORTER: How are you? You look so different - so healthy, happy. It's great.

When we first met, Gusti was refusing to wash and spent his days singing songs from the epic Hindu tale 'The Mahabharata'. He'd been chained up for eight years. He was clearly intelligent and creative. Locking him up for years on end seemed such a tragic waste. Dr Suryani ended up threatening his family, who were refusing to let her treat him.

DR SURYANI, (Translation): Leaving a sick person untreated is an offence. We have come here to help. So, if you leave him there, we'll go to the police. Because you have left someone chained up. That violates human rights.

They finally relented and, now, with the results before their eyes, they trust Suryani completely.

BROTHER, (Translation): I thank you so much. Thanks to Mrs Suryani and her team and to you, too, for making my brother better. Thank you very much.

Gusti now paints and makes intricate papyrus paper etchings, and is no longer a nuisance to his family.

DR SURYANI, (Translation): The families we saw are happy because they feel they're no longer a nuisance to them or the neighbours. They're of the pressure of having a crazy family member, of disturbing other people and of other stigmas.

REPORTER, (Translation): Do you still hear voices?

GUSTI, (Translation): Less.

DR SURYANI, (Translation): Do you still hear voices?

GUSTI, (Translation): No.

The voices in Gusti's head had told him to desecrate local temples and, when he did, his family locked him up. Now he can walk the hundreds of steps to the temple whenever he likes. After years of inactivity, Gusti finds the climb to the top gruelling, but says it's worth it.

GUSTI, (Translation): This place is beautiful. There is a great view.

REPORTER, (Translation): What do you feel here?

GUSTI, (Translation): I feel... I feel peaceful.

REPORTER, (Translation): You weren't allowed here when you were sick?

GUSTI (Translation): No. Now I am.

Bali's governor has just launched a major public health initiative, offering free health care for all Balinese. Part of the plan is to expand the island's mental hospital, and he wants Dr Suryani to work within the system and not as a maverick. But that's not going to happen. She sees an inefficient health system prone to corruption, and a mental hospital that is more like an old-style asylum.

DR SURYANI, (Translation): This system has been in use for a long time. But it doesn't produce results. In my opinion, treating in a hospital requires much more funding than the funding required to use my methods of giving the responsibility to the community and to the doctors in the local clinic so they are aware of the situation.

Meanwhile, budget cuts haven't stopped desperate families seeking her help, as news of her work spreads. But, without the government's assistance, its back to using her own money and begging for donations.

MAN, (Translation): How long has she been sick?

SISTER, (Translation): It's been more than five years. More than five years. But like this for 1.5 years.

MAN 2, (Translation): 10 years.

This woman is another still in chains and, despite Dr Suryani's treatment, she still believes she is a god.

NENGAH, (Translation): Mabes, the god Mabes.

DR SURYANI (Translation): Who is Mabes? Oh, you are the god Mabes. Doesn't the god take showers?

REPORTER, (Translation): Why is she still chained up?

SISTER, (Translation): If I release her, she'll climb up.

DR SURYANI (Translation): But she's looking better now. Can't we free her? The injection she's had will help her get better. Will you release her? She's calm.

SISTER, (Translation): Okay, I will need to consult my brother first.

This woman is lucky to be under Dr Suryani's care but, now, with her budget cut, there are, she says, thousands more she will never get to see.

NENGAH, (Translation): This is very wrong. Is this the way to treat a god?

GEORGE NEGUS: David O'Shea filming and reporting there. Well done, Dave. Surely, millions of dollars must flow into Bali's tourist traps but very little of it if any, it seems - makes it out to poor, local villagers.





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