Hello, my name is Kanta Kiyohara. I had the opportunity to volunteer at ASRI for two weeks, and I would like to share the insights I gained from this experience.

The reason I decided to join ASRI as a volunteer was to better understand its efforts to protect people’s livelihoods as a means of safeguarding their health. I am a medical student in Japan, aspiring to become a doctor. My goal is not only to treat patients in hospitals but also to contribute to public health and disease prevention on a broader scale. During my clinical practicum, I realized that most patients who visit hospitals have already developed illnesses. This experience underscored the importance of preventive healthcare—addressing health issues before they arise. ASRI’s approach of improving livelihoods as a foundation for better health deeply resonates with me.

At ASRI, my primary activity was observing clinical operations. One of the most memorable experiences was participating in home visits for tuberculosis (TB) patients. In Japan, TB cases have been decreasing, making it a relatively rare disease (TB incidence rate: 8.1 per 100,000 population). In contrast, in Indonesia, TB cases are on the rise (TB incidence rate: 354 per 100,000 population), and the Sukadana region, where ASRI operates, is no exception.

To combat the TB epidemic, ASRI has implemented a unique home visit system. First, medical staff known as Health Guardians are assigned to each village. They primarily oversee patients’ daily lives and ensure adherence to their TB treatment. This system has likely improved treatment compliance among patients. Building trust is essential to ensuring that patients follow their treatment regimens. Since Health Guardians are local residents, they have a deep understanding of patients’ lifestyles and challenges. Additionally, ASRI serves a vast region, making it impossible for the central medical staff to conduct frequent home visits alone. Thus, the involvement of Health Guardians, who live within the communities, is indispensable.

Furthermore, I learned that patient education plays a crucial role in reducing the number of TB cases. Initially, I assumed that the high TB incidence in Indonesia was primarily due to economic factors, limited medical resources, and poor healthcare access. However, I discovered that TB medications and vaccines are provided free of charge in Indonesia. The real challenge lies in the stigma surrounding TB treatment and vaccines. In rural areas, skepticism toward Western medicine remains strong, with many people placing greater trust in traditional or natural healing methods. For instance, some villagers turn to shamans who claim to cure illnesses through prayer rather than seeking medical treatment. ASRI actively works to educate these communities and address misconceptions about Western medicine.

Through this volunteer experience, I reaffirmed the importance of education in protecting public health. The need for education is not limited to TB in Indonesia—it is a global healthcare issue. For example, during the COVID-19 pandemic, widespread vaccine hesitancy demonstrated the critical role of accurate medical information in public health. Addressing stigma toward new medical technologies is a universal challenge, and I believe that all healthcare professionals must be aware of their responsibility in tackling this issue.