13-year-old Besidam is an indigenous adolescent who lives with his parents in the indigenous Orang Rimbo community in Sungai Terab. His current home is amid a palm and rubber plantation. Contrary to most children of his age, Besidam is not going to school. Instead, he learns how to continue the nomadic lifestyle of a hunter-gatherer.
The team from the Oxford University Clinical Research Unit - Indonesia (OUCRU - Indonesia) must pass through a slippery and muddy road that can often only be accessed by a four-wheel-drive during the rainy season. It takes four hours from the capital city of Batanghari district to reach Besidam and his community.
Malaria, locally referred to as demam kuro, is a common disease among the Orang Rimbo. The most frequently mentioned symptoms of malaria are intermittent fever, chills, and headache. But members of the community prefer to use their traditional remedies such as the leaves of Ngai Champor (local names: campo or sembung, Latin: Blumea balsamifera), the shoots of white teak (sungkeh or sungkai, Peronema canescens), and the roots of long jack (pasak bumi, Eurycoma longifolia).
If an illness becomes more severe, the patient will get some food and be moved to a sesudungan, a temporary shelter without walls, with a roof made from tarpaulin and a raised wooden plank floor in the jungle. If the patient recovers, he or she will return to the community.
“Four to five years ago, many of us died from malaria. No healthcare worker would examine or treat us. The medicinal plants were gone because companies have cleared so much of the land. Look around. How can medicinal herbs grow in this palm plantation?” said Sigerum, Orang Rimbo’s deputy community leader for social and cultural issues.
Orang Rimbo often face barriers to access health services: their nomadic lifestyle, the difficulty communicating with healthcare staff due to language barriers, geographical isolation, limited road access and high transportation costs are the most common problems.
Tumenggung Ngelambo, describes his expectations for better health care: “We wish that health authorities could be more attentive and provide our community with regular health services, at least once or twice a week. It would be better if they were closer to us. So that if one of us catches a fever or anything else, we can seek health care. Unlike nowadays. When the fever gets serious, the road is bad.”
As part of the effort of leaving no one behind in health care, the government is offering free health services to the community of the Orang Rimbo. Moreover, at least once a month, a team from the nearest primary healthcare centre reaches out and provides health care services, including malaria detection and treatment. This will contribute to reducing malaria cases and deaths in the Orang Rimbo communities.
*WHO Indonesia’s malaria programme is supported by the Global Fund.