The dark side of Indonesia’s economic growth

Indonesia/Film. An estimated 7.6 million Indonesians live with diabetes, but only half of them are aware of their condition. This lack of awareness coupled with poverty and a lack of access to care is driving people to postpone seeking medical care until complications force them to do so.

In the film Silent Killer in Indonesia, Prof Sidartawan Soegondo, Chairman of the Indonesian Society of Endocrinology (PERKENI) explains, “They will come to us when the complications are there; when they are not able to see anymore. They come with wounds which are not curable, and then we have to amputate them.”

Patient education is a huge challenge
The film portrays two individuals affected by diabetes complications. When we meet Rudy (62), he is bed-ridden and suffering from reduced sight and diabetic foot complications. Arafin (59), now in a wheelchair, ignored his diabetic foot symptoms which resulted in an amputation. "I didn't know any better. It was only when the doctor explained to me that I learned about diabetes," he says.

Dr Wisnu Wismandari, Department of Internal Medicine at the Faculty Medicine Universitas Indonesia, admits that patient education is a huge challenge. She says, "The most difficult part is to educate our patients. To make them understand that diabetes is a chronic disease if not treated properly. It is not easy to make them understand that it is a disease they will have to cope with their entire life. Most of them think that every disease including diabetes is curable with simple treatment and that's not true."

A film to shock and educate
“What surprised me the most while filming was the little knowledge people have about their disease and how to lead a healthy lifestyle. It was extremely painful to see all the patients with amputated limbs as a direct consequence of this,” says Simon Rasing who shot the film. “I made the film to shock and educate about the serious increase of diseases like obesity and diabetes in developing countries,” he says.

Simon Rasing is an ethnographic researcher and student filmmaker from Utrecht, Netherlands. This film was made as part of the Beyond Your World program of Lokaalmondiaal, a Dutch NGO.

Greater focus on diabetes prevention and education
The projects supported by the WDF in Indonesia seek to address this situation by raising awareness about diabetes in the population as well as training health care personnel. The training includes prevention, management and treatment of diabetes and its complications. In addition to the training of health care staff, the projects also seek to improve the referral system by collaborating with hospitals and clinics to cater for patients with more complicated diabetes.

Community awareness on World Diabetes Day
World Diabetes Day on 14 November is widely celebrated throughout Indonesia to increase awareness about diabetes and its risk factors. The main organisations behind the campaign are PERKENI (Indonesian Society of Endocrinology) and PERSADIA (Indonesia Diabetes Association). See more.