Empowering people to become survivors
Compounding the challenge of cultural diversity in treating trauma in the country's far-flung archipelago is a linguistic factor: No word exists in Bahasa Indonesia for "survivor".
"An alternative is korban, but this means 'victim' and carries a negative nuance in that it suggests passivity and powerlessness," said Nelden.
The closest, direct translation would be orang yang bertahan hidup, which literally means a person who has survived, with an emphasis on having endured or lived through something, and does not carry the resilience, perseverance and willful determination of "survivor", as in "I am a survivor".
"We may have to invent a new word," she said.
Witnesses also experience psychological trauma -- or secondary trauma -- through indirect contact, such as television viewers and journalists. Furthermore, direct survivors can experience retraumatization, a reliving of the triggering incident.
Recognizing the need to address this issue within the context of a nascent free press, Pulih initiated an educational campaign focusing on media coverage of traumatic events and its counterpart, an awareness and self-help campaign for journalists covering such events.
"The 'trigger' for this was the infamous Cirebon sodomy case a couple of years ago that affected 40 elementary and junior high students," said Nelden.
When a Pulih assessment team arrived in Cirebon, they quickly encountered resistance and even hostility from the affected children and their families. Eventually, they learned that a television crew from "outside" - Jakarta - had been there the week before to film a reconstruction involving the survivors themselves. Furthermore, the crew had requested the children's participation in front of the local neighborhood chief, which made it virtually impossible to refuse for fear of loss of face.
In time, several children spoke to Pulih, but most did not.
Encountering situations as these, even for trained psychosocial counselors, can result in secondary trauma through sustained exposure, retraumatization, compassion fatigue and in the most severe cases, burnout.
"So we're fortunate that our office is full of psychologists," said Nelden.
Pulih has peer-counseling facilities such as sharing sessions, and case conferences also provide its staff with an outlet. In addition, it is part of an informal network of psychosocial crisis NGOs and institutes that meet bimonthly to discuss current and developing issues.
Yayasan Pulih is building upon the individual experiences of their staff by designing a self-help program for caregivers working in related fields. Meanwhile, it is also expanding, developing a resource and database center with an aim to share its knowledge among other trauma centers and international aid organizations.
It is hoped that, through such coordinated efforts, a nationwide support network can be implemented to safeguard the mental health of the nation.
-- Chisato Hara