Yayasan Rama Sesana and the Quest for Female Reproductive Health in Bali
(Disclaimer: the above photo was taken prior to the outbreak of COVID-19 in Indonesia)
Yayasan Rama Sesana is a non-profit organization in Bali, Indonesia, which helps vulnerable women in both urban and rural areas take care of their reproductive health by educating them about healthy behaviors and by providing them with donation-based health services at its community centers and mobile clinics. As a service for women from mostly women, the organization aims to create a healthier generation through female empowerment. We spoke to founder, director and general practitioner Dr. Luh Putu Upadisari about her inspiring work and her vision. Through her work, more than 72,000 people have received educational and health services, which have contributed to increased community knowledge, female empowerment and gender equality.
Initially, Yayasan Rama Sesana was founded to conduct outreach work for AIDS prevention among high risk groups including male migrant workers. Over time, you re-focused the project’s attention to reproductive health of low-income Balinese women. Why did you decide to target this group and how has your own experience as a Balinese female general practitioner shaped your desire to meet the health needs of vulnerable women?
From my experience of doing activities for men around the risk of HIV transmission and other diseases, I decided to focus more on women’s groups in increasing the achievement of a healthy society because women have both a very high risk and are more prone to experiencing health problems than men. In my opinion, women should be empowered with their knowledge and awareness about reproductive health, because they are anatomically more vulnerable than men. Moreover, there is less access to health information, especially for Balinese women with various, time-consuming domestic tasks as well as their roles in many traditional activities and religious ceremonies and are added to other domestic duties of mothers and wives.
Personally, as a mother and wife with a career as a doctor, I perceive Balinese women as hard workers full of responsibility for their families. As they give their whole life to the family including the extended family of the husband in accordance with patrilineal culture, they take very little time for and care of themselves, including their health. Growing up, I witnessed first hand the effects of this, which has informed my desire to help Balinese women live healthier and happier lives.
Your organization believes in the power of education and is committed to helping disadvantaged women realize their human rights by empowering them to stand up for their sexual & reproductive health. What are some of the challenges for Balinese women to access and educate themselves about health services? How is Yayasan Rama Sesana helping them overcome these?
As Balinese women have more domestic duties than other women due to cultural traditions on top of family and work responsibilities, they have limited time to think about themselves and their health. As a result, they have to find special time to access health services in between their busy daily activities. This stops them from accessing health services, especially when the time taken up by them can result in complaints within the family or at work. Moreover, given that illnesses can interfere with their busy lives, many women try to avoid seeing doctors. Recognizing these challenges, the Rama Sesana Foundation provides education and health services for women in traditional markets, where many Balinese women work all day long. Through these service centers, they can easily access services between their work hours without having to find special time, and without disrupting their routines.
Apart from educating women about health issues, you are also providing donation-based clinical health services at your clinic in Denpasar. Through a mobile clinic program launched in 2014, you extended that reach to rural villages across Bali. How are your services received and is there a difference in reception between urban and rural areas?
In general, women’s response to the services we provide is very enthusiastic, especially at the beginning of activities at traditional markets. Over time, we have increased awareness about the importance of women’s reproductive health, so that they are happy to donate to the services that have been provided. The donations we receive are in accordance with the ability and willingness of our clients.
There is a slight difference in receptiveness in villages as compared to urban areas. In the early stages of the program, more women were shy and afraid to get screened. They felt that they did not need an examination because they had no complaints. With time, many understood the importance of women’s health problems. As a result, we have seen that people in rural areas have become even more enthusiastic to access health services than urban women. This could be due to the limited availability of health services in villages as compared to more choices in cities. In addition, they also have to pay dearly for access to several health services such as breast ultrasounds or pap smears, while we provide them for free, so they take advantage of the opportunity at the Mobile Clinic to get free health services.
Yayasan Rama Sesana is dedicated to building a healthy generation through women’s empowerment. Thereby, you are helping achieve progress in gender equality, recognized as one of the Sustainable Development Goals. With expansion plans of your services across Indonesia and eventually the region, what is it that makes you hopeful about the future?
We feel the need to help more women out there because nowadays many women are still disproportionately burdened with all household work and do not have time to develop themselves. By helping women manage their health, we believe they can realize their important role for creating a better, healthier and more educated generation. Therefore, in our opinion, by providing opportunities for self-development and education to more women, we are helping create a better future for the next generation.
Find out more about Yayasan Rama Sesana here: https://www.yrsbali.org
This column is co-authored by:
Svenja Kirsch is a Masters in Public Policy (MPP) Candidate at Harvard University and previously studied International Relations at Jacobs University and Sciences Po Paris. She specializes on business and government policy and focuses particularly on corporate government affairs, CSR, female economic empowerment and sustainability. Before joining GRI, she worked in academic reviewing, political campaigning, think tank research and corporate sustainability management.
