Jakarta’s Sick Lack Palliative Care, One NGO Offers Relief

At the Rachel House center in Jakarta
At the Rachel House center in Jakarta
Nicole Curby

JAKARTA — Yanti, 93, lives in a tiny room along with three other family members in the Indonesian capital of Jakarta. She's unable to move or get up so she lies on a bed that dominates the cramped space. The air is thick with the stench of stale urine.

Yanti tells me she can't pass a bowel movement. She says she's constantly urinating. She lies on a layer of opened diapers. She grabs the flesh on my arm, which suddenly feels more chubby and elastic than ever before in her bony hand covered in thin, papery skin.

Palliative care is practically unheard of in Indonesia. Those living with chronic and terminal diseases have little access to pain management and support that could help make their lives more comfortable.

Yanti's neighbor Ibu Deti is a firecracker brimming with energy and jokes. She brings a gust of fresh air into the tiny room. Deti chats and shares stories with Yanti and her family. Yanti likes to remember the past. Yanti "will share stories, laugh and joke. But in the end she would always say, ‘why haven't I died yet?"," Deti recounts. Deti is part of a team of more than 900 community volunteers spread throughout Jakarta who've been trained in the basics of palliative care by Rachel House, a local NGO.

"Volunteers have been trained in how to respond to those kind of questions, how to comfort the patient when they have those kind of worries," says Prita Rifianti, program manger of Rachel House. "If the patient is sad or angry, the volunteer knows how to respond to that in a way that is hopefully relieving for the patient."

Deti and other volunteers do home visits to check on the basic needs of the patient and his or her family. They make sure the patient is being turned over regularly to prevent bed sores and has access to nappies, wheelchairs and anything else that can make the patient's life more comfortable.

But Indonesians still largely lack access to pain management.

"One of the biggest challenges being patients with chronic or serious illnesses tend to have a lot of pain, physical pain, that tends to go unrecognized or untreated by our current healthcare system," says Rifianti. "Sometimes the patient and the family think, well if you're sick of course you have pain, if you're sick of course you're going to be uncomfortable. Or there are people who might think this is a test or a punishment from God, so this is something I have to live with."

Yanti says her whole body hurts. Even though she was struggling, she wasn't taking anything to ease the pain. Painkillers aren't easily accessible in Indonesia, even for those who need them the most.

Rifianti says that the World Health Organization recommends oral morphine tablets, a cheap and effective painkiller, but a lot of healthcare professionals aren't familiar with the pill and don't know how to administer it.

"There's a certain fear among healthcare professionals and also the community that oh, these are addictive drugs and it might cause addiction, it might cause death, and therefore all of that combined cause it to be very difficult to access painkillers," she says.

Journalist Nicole Curby at the Rachel House care center in Jakarta — Photo: Nicole Curby/KBR

Painkillers have the stigma of narcotics – a stigma that is prevalent throughout Indonesia.

Rachel House trains volunteers in pain management. "When you see a patient you want to treat not just the illness, not just a body, but the patient as a whole human being, and you want to treat not just a body but all the emotional and social and spiritual needs of the patient," says Rifianti.

After visiting Yanti, Deti consults Rachel House's medical team and arranges for a doctor to make a home visit and prescribe pain relief medication to Yanti.

Rifianti says community volunteers like Deti who live in the same neighborhood as their patients are a vital link in the chain.

"There is this potential in the community, these volunteers who know their neighbors, who know their community, who know where to get healthcare and all of that," she says. "They become another set of eyes and hands on the ground, where they can identify patients that are hidden in the community."

Deti says that she feels proud when she can make patients happy. "We can help people through other means besides money. We can give them attention, energy, love. I think we all need that."

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Air Next: How A Crypto Scam Collapsed On A Single Spelling Mistake

It is today a proven fraud, nailed by the French stock market watchdog: Air Next resorted to a full range of dubious practices to raise money but the simplest of errors exposed the scam and limited the damage to investors.

Sky is the crypto limit

Laurence Boisseau

PARIS — Air Next promised to use blockchain technology to revolutionize passenger transport. Should we have read something into its name? In fact, the company was talking a lot of hot air from the start. Air Next turned out to be a scam, with a fake website, false identities, fake criminal records, counterfeited bank certificates, aggressive marketing … real crooks. Thirty-five employees recruited over the summer ranked among its victims, not to mention the few investors who put money in the business.

Maud (not her real name) had always dreamed of working in a start-up. In July, she spotted an ad on Linkedin and was interviewed by videoconference — hardly unusual in the era of COVID and teleworking. She was hired very quickly and signed a permanent work contract. She resigned from her old job, happy to get started on a new adventure.

Others like Maud fell for the bait. At least ten senior managers, coming from major airlines, airports, large French and American corporations, a former police officer … all firmly believed in this project. Some quit their jobs to join; some French expats even made their way back to France.

Share capital of one billion 

The story began last February, when Air Next registered with the Paris Commercial Court. The new company stated it was developing an application that would allow the purchase of airline tickets by using cryptocurrency, at unbeatable prices and with an automatic guarantee in case of cancellation or delay, via a "smart contract" system (a computer protocol that facilitates, verifies and oversees the handling of a contract).

The firm declared a share capital of one billion euros, with offices under construction at 50, Avenue des Champs Elysées, and a president, Philippe Vincent ... which was probably a usurped identity.

Last summer, Air Next started recruiting. The company also wanted to raise money to have the assets on hand to allow passenger compensation. It organized a fundraiser using an ICO, or "Initial Coin Offering", via the issuance of digital tokens, transacted in cryptocurrencies through the blockchain.

While nothing obliged him to do so, the company owner went as far as setting up a file with the AMF, France's stock market regulator which oversees this type of transaction. Seeking the market regulator stamp is optional, but when issued, it gives guarantees to those buying tokens.

screenshot of the typo that revealed the Air Next scam

The infamous typo that brought the Air Next scam down

compta online

Raising Initial Coin Offering 

Then, on Sept. 30, the AMF issued an alert, by way of a press release, on the risks of fraud associated with the ICO, as it suspected some documents to be forgeries. A few hours before that, Air Next had just brought forward by several days the date of its tokens pre-sale.

For employees of the new company, it was a brutal wake-up call. They quickly understood that they had been duped, that they'd bet on the proverbial house of cards. On the investor side, the CEO didn't get beyond an initial fundraising of 150,000 euros. He was hoping to raise millions, but despite his failure, he didn't lose confidence. Challenged by one of his employees on Telegram, he admitted that "many documents provided were false", that "an error cost the life of this project."

What was the "error" he was referring to? A typo in the name of the would-be bank backing the startup. A very small one, at the bottom of the page of the false bank certificate, where the name "Edmond de Rothschild" is misspelled "Edemond".

Finding culprits 

Before the AMF's public alert, websites specializing in crypto-assets had already noted certain inconsistencies. The company had declared a share capital of 1 billion euros, which is an enormous amount. Air Next's CEO also boasted about having discovered bitcoin at a time when only a few geeks knew about cryptocurrency.

Employees and investors filed a complaint. Failing to find the general manager, Julien Leclerc — which might also be a fake name — they started looking for other culprits. They believe that if the Paris Commercial Court hadn't registered the company, no one would have been defrauded.

Beyond the handful of victims, this case is a plea for the implementation of more secure procedures, in an increasingly digital world, particularly following the pandemic. The much touted ICO market is itself a victim, and may find it hard to recover.

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