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On the Indonesian Island of Lombok, a Model of Gentle Care

A new maternal and community health center provides care to an island still recovering from a series of 2018 earthquakes.


Community Health

Patients check in at the new Bumi Sehat Lombok facility. (Photo courtesy of Bumi Sehat)

When a magnitude 6.9 earthquake struck the island of Lombok, Indonesia, in 2018, it was destructive and deadly in its own right.

“The whole north half of Lombok was fairly devastated…they were utterly cut off from the world for five days, with no electricity and no heat,” recalled Robin Lim, a renowned midwife and maternal health activist whose nonprofit, Bumi Sehat, provides maternal and family health services in Indonesia.

Lim, who goes by the Indonesian title “Ibu,” meaning “mother,” flew into the island with a medical team in the wake of the earthquake, and met Gordon Willcock, a member of Direct Relief’s emergency response team, on the ground. “We saw people surrounded by rubble, just staring six feet out into space,” she said.

Damage after the 2018 Lombok earthquakes. (Photo courtesy of Bumi Sehat)
Damage after the 2018 Lombok earthquakes. (Photo courtesy of Bumi Sehat)

But the first night of their arrival, another magnitude 6.9 earthquake struck the island. “It was a really eerie experience,” Willcock recalled. “Everyone was traumatized by the previous earthquake.”

All told, that summer’s earthquakes would kill more than 500 people and cause widespread devastation.

In addition, some medical facilities were damaged, and forced to move their patients into tents and tarp structures outdoors, Lim said.

“A warm, dry bed to rest in after you gave birth – this was just not possible in Lombok,” she recalled.

And Lim’s team, headed by midwife Budi Astuti, began providing maternal and primary health care on the ground, dealing with everything from lacerations to deliveries. Because no structure was available, they cared for their patients in tents.

Budi Astuti, now director of Bumi Sehat Lombok, examines a patient in a tent in the wake of the 2018 earthquakes. (Photo courtesy of Bumi Sehat)
Budi Astuti, now director of Bumi Sehat Lombok, examines a patient in a tent in the wake of the 2018 earthquakes. (Photo courtesy of Bumi Sehat)

But a new center, Bumi Sehat Lombok, designed to provide both maternal and family health services, has just been erected on the island of Lombok, and that’s where the midwives and other health care providers of Bumi Sehat will practice from now on.

The facility’s land purchase and construction were funded by Direct Relief.

Astuti, who will be the head of medicine at the new center, explained that the idea for a permanent facility came to her when she returned to the island – she is originally from Lombok – and saw her family living in tents, their home destroyed.

“Our services really support the preservation of nature and humanity,” she said. “From all my life experiences as a midwife, I want to share that love, compassion, trust will give strength in every process.”

Willcock explained that the decision to fund the center was motivated not only by the high quality services that Bumi Sehat provides, but by its capacity to serve as a “center of excellence” for maternal and child health services in the area.

“I would anticipate that through training programs and the example they will set in the community, in addition to their clinical services, they will have a profound and sustained impact.”

Lim explained that the center is also meant to provide public support. They have a rented car – although a proper ambulance is needed – and nurses all have their driver’s licenses, so they can transport a patient to a local hospital quickly if need be.

And sometimes that support comes in unconventional ways. One young woman came to the facility asking for work as a cleaner. Astuti quickly discovered that the young woman was close to becoming a midwife – and to being able to support herself and her younger brother – but couldn’t afford the fees to take the exams.

Bumi Sehat Lombok quickly paid the young woman’s expenses and, once she’d completed the requirements, hired her as a midwife.

The completed maternal and community care center in Lombok. (Photo courtesy of Bumi Sehat)
The completed maternal and community care center in Lombok. (Photo courtesy of Bumi Sehat)

While the center’s presence on the island is meant to increase access to health services, Lim said that her goal is also to foster a “respectful, gentle, humanitarian model of care.”

“Empathy and compassion – those are really important words to us,” she said. “Everyone’s talking about gentle childbirth.” Bumi Sehat Lombok, which is on a wide stretch of land complete with fruit trees, is fully open for prenatal and community care.

And the maternity services come none too soon, Lim said. Thanks to Covid-19, she’s expecting to see an increase in deliveries. “After every disaster, there’s a spike in the birth rate,” she said.

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