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FROM CLINIC RECONSTRUCTION TO REALIZE DESA SIAGA

Background
The proper health service will play an important role in society prosperity growth. The meant service could be either physics facility or health
facility provider. The community awareness to get the health facility access is mostly hampered by their limited information and knowledge.
Besides the socio-economic, the geography condition can also influence the community toe get the health facility access.
In those situations, the role of health personnel or health cadre become is very significant. Only when their skill and capacity are not proper
enough to facilitate the health service, we need to develop their capacity.
The public clinic that provides public health service, especially for mother and child, is the strategic target in making people accustomed to
hygiene, health and disaster resistant behaviour.
With the establishment of the clinic, this health institution that managed by midwife under coordination and supervision of local government
clinic/health department, beside its function as public health service provider, it is also expected to be the communication forum, information
and education media about the quality of mother and child health and behaviour changing effort in making hygiene, health and disaster
resistance as custom.

Principle
The implemented principle is community based program because the program emphasizes on community endeavour. Community will always
be engaged starting from need assessment, initial planning, decision making, implementation, monitoring and evaluation, to follow-up plan
making.
Thus, the need assessment phase in the beginning becomes so important and it will influence the next design programs that are not only
clinic construction design but also the training design and its supporting programs that emphasize on clinic staffs and health cadres’ capacity
building. The implementation of the training results is expected to change community’s thoughts and behaviour gradually and significantly in
realizing the hygiene, health and disaster resistant village. It is appropriate with government program to realize Health Indonesia 2009
through Desa Siaga program, in which community desire and be able to develop their health quality autonomously.
Specific objective

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
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Through clinic reconstruction project, this ’From Clinic Reconstruction to Realize Desa Siaga program is expected to motivate the community
behaviour change in village, especially in health sector. Therefore, the main objectives of this program are not only to reconstruct the clinic,
but also to build the community based health system.

General objectives

1. To increase the health staff and health cadres’ ability and capacity in giving service and struggling the rights in health sector
for community.
2. To increase the community capacity, particularly women by conducting trainings to realize Desa Siaga, the village in which its
community are willing and be able to increase their health quality autonomously.
3. To increase the community health quality, especially mother and child, by communication, information, education and acting
process in changing more environmental friendly behaviour.
4. To engage community in reconstructing the clinic as a mean of health service and can be used as health education and
disaster risk reduction centre.
5. To realize the clinic which is child, environmental, difable and local wisdom friendly
6. To develop the skill of network building with the government, private sector, NGOs and other social groups.
7. To support the government program in realizing Desa Siaga.
8. To motivate the local government in the village level to make the village’s rules in realizing Desa Siaga.

The expected outcome

1. The increasing of health personnel and health cadres’ capacity and ability in giving service and health assistance for
community.

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2. The change the community’s thought and behaviour in supporting health as right and the existence of hygiene, health and
disaster resistance environment.
3. The existence of Village Health Forum, which functioned as ’rembug desa’ (community meeting) forum to solve the health
problems in order to increase family health quality, especially mother and children.
4. The existence of a place functioned as capacity building place, information spreading, and library in health sector and disaster
reduction risk.
5. The active community participation in supporting the reconstruction process, the clinic development and management as the
means of health service and activity centre in realizing the hygiene, health and disaster resistant village.
6. The child, environmental, difable and local wisdom friendly clinic building.
7. The existence of policy in village level that support Desa Siaga program.
8. The existence of CBOs (Community Based Organisations) who will implement and maintain the sustainability program.

Key focuses Program

It is important to understand that there are three key focuses in implementing this community based program, they are:
1. Community engagement
2. Accountability
3. The increasing of local organization capacity

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The working areas
There are 4 (four) villages that are being the working area in reconstructing clinics and increasing community capacities in health sector. They
are:
POLINDES (PONDOK BERSALIN DESA) Reconstruction:
1. Balak village Cawas Klaten Central Java
2. Sukorejo village Wedi Klaten Central Java

PUSTU (PUSKESMAS PEMBANTU) Reconstruction:


1. Kebonagung village Imogiri Bantul Yogyakarta
2. Sumberagung village Jetis Bantul Yogyakarta

PUSTU is directly under the coordination of PUSKESMAS. However, it differs with POLINDES, which is under the village’s autonomy,
although it still coordinates with PUSKESMAS.

COMMUNITY ENGAGEMENT

During the implementation process (January – June 2008), YEAN engages the participation of many components in community,
especially they who are interested in to discuss about health problems, such as health cadres, women and some parties that are
“pushed” to be engaged, like health staffs (village’s midwife and health staffs from Puskesmas) and stakeholders in village level. It
has been done to keep the program well understood as community needs that have to be followed up and to produce real impact to
react the health problems. Therefore, in the implementation, it takes time, high creativity and flexibility in accordance with social
condition and dynamics of each village.

Pre condition

From the results of quick assessments in 4 locations, it shows that there is reconstruction need of clinic/Polindes/Pustu in 4
villages, which is destroyed by the earthquake in year 2006. These results then are discussed and followed up with local
government. They conduct communication forum in the village level to assess the community need completely and engage all
component in community.

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Lesson learnt in pre – condition phase

There is an interesting thing found in the initial survey in 4 villages about community behaviours, especially the village
government behaviours that take whatever program of the organization that donor and invite them to cooperate in at their
village. The village government are afraid if they engage many people in the program, the program will be such a needlessly and
long-term program. They will also be hard to accommodate various aspirations of community. In this behaviour of the top down
program, YEAN facilitator is trying to discuss about the program that will be conducted will and must be based on community.
This means the program should be conducted based on the real community need and engages the community. Besides, the
program should engage much more women because there are many mothers and children who need health services in the clinic.

During the process, the facilitator intervenes to make sure the community engagement, including women and the poor for always
engage in the program from the need assessment, program planning, decision making, implementation, monitoring and
evaluation, to the follow-up planning in the end of the program. The facilitator also makes sure that through the communication
forum or community meeting; we will have the same objectives and get solutions of the problems in its implementation. In this
comprehension stage, there is an agreement to engage all components in community in implementing the program, which is
written in the term of the reference of the program.

Problem and Need Assessment

Community suggest many ideas when EPM ask the reason why they need the clinic reconstruction. Some of them expect that
there will be a good, cheap, and even free health service for the poor community. The healthy problems examination that often
happen in their village are medical treatments of old people, pregnant mother, breast-feeding mother, and children. Even some of
the community (uniquely, they are men who introduce the idea) suggest that the clinic has to have the facility to treat mother
and her baby during the child-birth and parturition phase.

In this need assessment phase, community engaged are: Village / Posyandu health cadres, PKK cadres, PAUD cadres, Karang
Taruna (youth organization), Pregnant and breast-feeding mothers, Gemas cadres, stakeholders, community, LPMD (Village
Community Endeavour Organisation), BPD (Village Development Organisation), Chief of RT, Chief of RW, Head of Dusun, Head of
village, midwife and Head of Puskesmas.

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The discussion about the clinic needs then continues by discussing much more about the health problems, community behaviour
in health sector, clinic user, disaster risk in the village, clinic concept, building sketch, community who will be involved in,
community who will manage the clinic, and other supported activities to improve the quality in the health sector.

Problem of Health

In assessing the health potentials and problems, including disaster potential, YEAN uses interactive dialogue method, which then
written in the paper. As the result, it is found that some problems are emerged, such as:

• Dengue Fever
• Malaria
• ‘Chikungunya’
• Diarrhoea
• TBC
• Malnutrition
• Skin symptoms
According to community, the causes of those health problems are:
– Defecate in irrigation drain behaviour because of no latrine in their house.
– The lack of water sanitation facility that meet the health standard, such as the septic tank infiltration less than
10 meters from the well and non-water resistant well
– The lack of good behaviour and mechanism of rules of waste management, where people are used to put the
garbage anywhere, such as in yard and irrigation.
– The livestock stalls (birds, goats and cows) that have not been manage yet and is too close with house.
– Community has not been used to hand wash with soap.
– Community no longer familiar with local potentials that can support health
– The less optimal functioned of health cadres forum
– The contaminated disease patient does not examinee to the clinic soon
– During the pregnancy, the pregnant mothers rarely check the pregnancy to the midwife or doctor.
– The child’s growth and development cannot be monitored because they access Posyandu activities rarely
– The lack of health information and activities for Posyandu cadres
– The rare of surveillance activity, such as mosquito larva and other disease potations

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– The Lack of socialisation and education about health sector from the midwife and other healthy officer from
Puskesmas
– The lack of community endeavour through health training and real follow-up activities to prevent health and
disaster problems.

From those opinions, communities then take the initiative to conduct the program in health sector, especially to change the
community behaviour to be more concern with health and disaster resistance sectors. In order to support the Desa Siaga
program, these programs have to be conducted because they are real community needs in health sector. However, community
also expects that the trainings that will be conducted can be followed-up and come up with real result. They feel that much
training held by government and non-government organizations do not touch its problem’s root and it looks like such text book
training. It caused the existing problems cannot be well organized because of the lack of understanding and there is no assistance
in its follow-up activities.

Reasons to develop Desa Siaga

From the problems above, community and Puskesmas apparently have the same needs to make their village into Desa Siaga.
Because the lack of knowledge about Desa Siaga program from midwife and Puskesmas staffs and also disability to facilitate and
inform the community about the program, they do not understand yet about the program. However, they expect they can solve
health problems and decrease the disaster risk that might be happened in the village.

In Balak, according to discussion among community, midwife and head of village, they desire to develop their village to become
Desa Siaga for social status prestige, in which the neighbour village Tlingsing, Cawas has already became a Desa Siaga. It is
shown as well in the Balak Health Forum forming meeting, when the Head of Balak village invited the representative of District
Public Health Department of Klaten, he said that since Balak will form village health forum (FKD) it become a Desa Siaga. In other
side, since the Desa Siaga Program is launched by the government and the establishment of a village becomes a Desa Siaga run
by District Public Health Department, some of Puskesmas Cawas II staff thought that the program will bring big amount of funds
to develop their village.

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It is different for Sukorejo community. They need the waste management program because bunch of wastes, especially livestock
manure around the house and bunch waste in irrigation canal, are their big problem of health in the village. The program of Desa
Siaga that informed by the midwife fits their needs and seems like will solve their problem of health and environment in their
village.

For other reason in Kebonagung, the head of village and head of Puskesmas Imogiri II remind the community about the
importance of Desa Siaga program in Bantul specifically is DB4MK Daerah Bebas 4 Masalah Kesehatan (Free Area of 4 Health
Problems), they are:

– Free from maternal mother death


– Free from babies death
– Free from malnutrition children
– Free from dengue fever

Those four health problems and other problems can be more easily solved if the community can behave hygiene and healthy
autonomously. As long as community always depend on the Puskesmas or other parties’ help, those problems will be hard to be
solved.

This has to be done because there is Bantul Government’s program in supporting the hygiene and health behaviour by giving
reward to IDR100.000.000,- for the village that is free from those 4 health problems.

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Two Main Needs

From the health problems above, community of four villages in Bantul and Klaten agree to realize Desa Siaga. There are two main
things that are successfully identified as the real community needs, they are:

1. The need of physical facility in the form of clinic building as supporting health service facility.

2. The need of community capacity building improvement (trainings and its support activities) to motivate the change of health,
hygiene and disaster resistant behaviour to realize Desa Siaga.

Lesson learnt of Problem and Need Assessment Phase

There is a tendency of community who want to be active in realizing the healthy environment without waiting the midwife and
paramedics’ action. They feel the service and information from paramedics are too sluggish and paramedics do not respond the health
problems well and quickly. They also feel the information given by paramedics is not clear enough. Midwife and paramedics rarely
keep in touch with community so that they cannot understand the real problems are. Considering the problems, community especially
health cadres and youth need community building through forum to learn and conduct trainings to solve health problems. At least
they can do prevention so that they can realize Desa Siaga.

The community capacity building improvement of health sector plan

Beside to reconstruct the clinic, community also plan to improve their capacity so that the reconstruction of clinic program can be
followed up with the environmental health quality improvement. Some ideas of work plan that will be discussed at Community
Action Plan workshop are:

1. Desa Siaga training


2. Waste management training
3. Health and disaster resistant house training
4. Herbal Plantation training
5. Hygiene water management training
6. Clinic management training

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7. Clinic construction training

These construction and community capacity building plans then are stated in agreement. This agreement has been made to be
consulted with the donor party, that is AUSAID through AIP YCAP and to get approval.

Siaga Cadres

Besides in construction process, community is engaged in capacity increasing process to realize Desa Siaga/Prepared Village where
the community desire and be able to improve the health quality autonomously. To raise that goal, most of community members that
are health cadres routinely hold meeting to analyse the health problems in their own villages and plan the actions to solve those
problems.

Through the community action plan workshop, the community makes the action plan systematically and more focus. Most of them say
that they have not heard about the Desa Siaga program before and this time is the first time for them and also their very first time
experience in arranging a program or action plan. Usually they just run every ordered program that has been arranged by the village
government. For they process from the beginning of the program, they believe can run and follow up the program that they have
been made.

Siaga Cadres and Health Issue

Siaga cadres from each village are different. In Balak, around 10 members are female health cadres, 3 young women and the other 5
are male community figures. The totals are 18 members. The group title is Tim Inti Desa Balak Siaga Sehat Mandiri/Autonomous,
Healthy and Prepared Balak Core Team.

From several health problems that found, they focus on:

1. Health and hygiene water and sanitation facilities, based on:


– The lack of health and hygiene water-sanitation facilities
– The lack of good and hygiene behaviour, especially defecate in irrigation canal

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– The lack of attention on supporting aspect to build the healthy house, like water-sanitation facilities, because they only
focused on house reconstruction funded by government and JRF

2. Waste management in order to exonerate the effect of the diseases caused by mosquito, based on:
– The existing of mud in rainy season, either on the street or on the ground in the garden, especially on bunch of
garbage. To prevent the growth of mosquito larva, they do social gathering to destroy and fight the mosquito larva
place (PSN program).
– The knowledge that they get from the study trip to Dusun Sukunan, Gamping, Sleman DIY, in which they learn that
geographical condition in Sukunan is similar with in Balak and the PSN program can be modified to waste management
activity, so that they can take the benefits in health and economic sector.

In Sukorejo, Wedi Klaten, there are only 15 Siaga cadres. But the movement is very active. The Siaga Cadres group contains of
Village Head Wife, Village midwife, Head of Village Development Organisation, Head of Village community Endeavour organisation,
Kindergarten teacher, Children education cadres (RESA), health cadres and PKK cadres. They give a name to the team is Tim Inti
Desa Sukorejo Siaga/Prepared Village of Sukorejo Core Team, and the name of the program is Prepared Village of Sukorejo that
Children and Environment Friendly.

On Desa Siaga Training for Core Team, there is a fact that is informed by one of the core team member about the water condition in
Sukorejo that is coloured, smell and semi liquid. The team discusses about this condition and agrees to follow up by testing the water
quality in 15 well points. The decision of these 15 well points is based on categories of:

– The well near the livestock stalls


– The well near household liquid secretion canal
– The well near septic tank
– The well 10 meters from septic tank
– Drilled well
– The wells in public facilities

The result of water quality test shows the 11 of 15 well water samples are not meet the health standard because of the numbers of E.
Coli bacteria. For this reason, the Core Team focuses the problem on:

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1. Water and Sanitation, based on:
– The lack of health and hygiene water-sanitation facilities and there is still many well that built near livestock stalls
– One of the soiled water well factor is water-sanitation facility that below health standard
2. Waste management, based on:
– One of the soiled water well factors is bunch of garbage in irrigation canal and in the yard and garden near the well.

Different than two villages in Klaten, the motivator and activator in Sumberagung, Jetis Bantul are 10 youth of Karang Taruna/Youth
Organisation from Dusun Balakan. They are succeeding to involve 18 female health cadres and village figures through Sanggar Ngudi
Kawruh to realise Prepared Village of Sumberagung as the hygiene, health and disaster resistant village. The numbers of active Siaga
cadres are around 18 people.

For the Avian Influenza case, the focus of the program is the problem solving of:

1. Avian Influenza, based on:


– The real case of the sudden death of fowls in Dusun Balakan causing by AI virus that is worried to infect human and
causing death.
– Avian influenza case in Dusun Balakan can be the entrance to campaign the good and hygiene behaviour.
1. Waste and Manure management, based on:
– The distance of stalls and houses are close to each other
– The good waste management behaviour can resist human from AI virus infection

Kebonagung village in Imogiri Bantul has another characteristic. The existence health cadres are passive, but the youth from Youth
Organisation and Tourism management group have interest and needs in realising the health and disaster resistant households.
Around 20 persons actively support the Village as Agriculture and Culture based Tourism Village. They appoint the issues of:

1. Waste management related to the needs of hygiene and disaster resistant house for homestay, based on:
– The Tourism program in Kebonagung
– The needs of special and exclusive souvenir from Kebonagung that produced by waste, so that the waste can have
economic value.

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1. The local potential development, especially traditional food and beverage, and food plants and herbal plants in the village.

Dusun Model

The six months assistance program in four villages makes the implemented program by YEAN impossible to solve the entire health
problem in village level. Related to the number of people and time that own by YEAN, in community action plan meeting in four
villages, community agree to create one Dusun model. From this Dusun Model, we expect that the movement can influence the other
community in the village.

In Balak, the Core team agrees that Dusun Gunden be the dusun model of Desa Balak Siaga program, based on:

1. Reference from Cadres who have seen the high active level of Dusun Gunden community to improve the quality of hygiene and
health in their Dusun.
2. Many activities in village level are inspired by the movement in Dusun gunden.
3. Dusun Gunden is the worst damage area when the earthquake attacks on May 2006 in Balak.
4. After the earthquake, none of NGO assists Gunden community to create hygiene and disaster resistant environment.

Desa Sukorejo Siaga Core Team and YEAN have been conducted Good and Hygiene Behaviour Socialisation. On the socialisation, they
explained about autonomous community based waste management in two dusuns, Dusun Dukuh and Dusun Daratan. Dusun Dukuh is
in the same RW area with Dusun Giren. The participants from Dusun Dukuh seem active, enthusiastic and desire to have waste
management training. This high enthusiasm and spirit of Dukuh community causes the core team to make Dukuh and Giren as RW
priority and as dusun model of Desa Sukorejo Siaga.

It is expected that the movement in those two dusuns can spread the positive effects to the environment in Sukorejo and realise the
health and hygine village in Sukorejo. Before the action, Mr. Suranto coordinate Dukuh and Giren community to conduct community
meeting, which is facilitated by core team and YEAN, to form waste management team called Forum Kesehatan dukuh “DUGIR
LESTARI” (Dukuh-Giren Luwes, Elok, Sehat, Tentram, Aman, ramah dan Indah) that will be the motivator of health and hygine
environment program in RW Dugir.

In Kebonagung, FKD Kebonagung on CAP meeting agrees to make Pedukuhan Jayan as priority dusun in implementing health and
disaster resistant household program, based on:

1. The location of Pustu Kebonagung is in Pedukuhan Jayan

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2. The tourism program in Pedukuhan Jayan that will be very supported with the existence of community health quality
improvement program and disaster risk reduction program.

The reasons of the choosing of Dusun Balakan as the priority dusun in Sumberagung are:

1. The agreement of community in community meeting


a. The location of Pustu Sumberagung is in Dusun Balakan
2. Avian Influenza case in Dusun Balakan
3. The existing of Sanggar Belajar Anak Ngudi Kawruh that is coordinated by EMBA (Elite Muda Balakan), actively youth
organisation in dusun Balakan

Trainings and Supportive Activities

The Siaga Cadre is always having routine meeting to discuss every new progress. Apart from that, several training activity tp upgrade
the capacity are also have been done, such as;

The trainings of upgrading capacity for the community which was done in the Balak village are:

1. Photo documentation training of health problems in Balak Village. This training followed by the women from health cadre,
Head of RW and the representative of Puskesmas Cawas II. The result of this training is that the participant able to create the
documentation of health problem in photo which contains hopes and steps that will be taken to overcome the health problem
that has been documented.

2. Training of Detektif jentik which followed by the representatives of health cadre consists of 7 posyandu (clinic) and 14 kids
from RT area that chosen as the location sample of monitoring with another 2 of health officer from Puskesmas Cawas II. The
result showing that the cadre and the children receive information about the mosquito carrier the dengue fever vector, the
mosquito life cycle and the knowledge about the dengie fever disease it self, also the agreement to do the monitoring on the
RT 7 environment about the existence of mosquito larva at least once every two weeks.

3. Training of Posyandu management for the cadre of Yandu Desa Balak. This training attends by the yandu cadre and the
representatives from Puskesmas Cawas II. The material learned is to identify the problems that exist in the Posyandu and the
positive communication towards children and effective communication with parents also towards the yandu cadre.

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4. Trash Management Training with community based. The method of the training is through doing the visits to the dusun of
Sukunan Gamping Sleman to give the learning, and it is attend by 27 people of Balak Siaga Sehat mandiri cadre. The result of
the training is that the cadre knows and understands about how to manage the trash by them self and it is community based.
The RTL from the activity done at the Dusun Gunden cadre is through the socialization of training results at Dusun Gunden
and the agreement to do the management of trash at dusun level. The trash management team of Dusun Gunden is called
Paguyuban Gunden Bersinar (Clean, Health, Beauty and Neat). Apart from Dusun Gunden, the socialization of the learning
visits results was also done in another Dusun that has the similar interest towards trash management, which is Dusun
Walikukun. But the results from this twice socialization meeting, was that there still no agreement for the continuity of action
plan that will be done.

5. Construction Training – The construction of health sanitation and disaster resistance model at dusun level, at Dusun Gunden.
The participant consists of male that represent each of RT and the female within total of 24 person, with the composition of 16
male and 8 females, doing the practice of constructing the health sanitation and disaster resistance bulding for 12 working
days by using the guidance book of PMI earthquake resistance building construction. The women that become the participant
function as the pratice implementation monev team of construction. The results are that the construction of health sanitation
and disaster resistance which consists of two rooms with sit and squat toilet. Based on the agreement, the location for the
training is at community yard that usually function as place for community of one dusun gathered.

6. Diging the needs and problems of the preparedness of herbal medicine. From this activity it was identified the needs of
knowledge about the potential local herbal which will be useful for health and can be manage as herbal medication to fulfill the
needs of medication when disaster happened. The amount of participants consists of 24 women and 6 male. The results is
that the mixing of TOGA (herbal plantation) that formed as skin unguent and massage oil also traditional medication to cure 6
types of main disease that often occurred after the earthquake, which are; fever, acute respiratory tract infection, strained,
hypertension and itchy.

7. Organic waste training management to convert it into coal at Desa Sidomulyo Bambanglipuro Bantul followed by 2
representative of Karang Taruna Gunden. The result is that the two of karang taruna member know and understand about the
technique of making the coal as the fuel so that they can manage the organic waste by themselves and convert it into the
coal.

The training for capacity upgrade that had been done in Desa Sukorejo :

1. Training of Desa Sukorejo Siaga ramah anak dan ramah lingkungan for the core team to become the community facilitator to
realise the Desa Sukorejo Siaga. The objective from this acticity is to increase the understanding and the knowledge of the

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core team member as the inspiring cadre in community and also to build the cadre motivation in implementing the program
together with the community at the village.

2. PBHS (Good health and Hygiene Behaviour) Socialization at 2 pedukuhan on Desa Sukorejo attends by the female from both
pedukuhan. The outcome of this activity is that the agreement from the community which represented by the female that
attend the training, to separate the garbage according to its type to be manage and use.

3. Trash Management Training at dusun Sukunan, Gamping, Sleman which followd by the Core Team of Desa Sukorejo Siaga.
The training is aimed to increase the understanding, knowledge and ablity of Village Core Team to manage the trash at desa
Sukoharjo by themselves. The understanding created is not just on the way of how to manage the trash, but also the effort to
reduce the production of trash and the clean of environment. From this training it is hoped that the Core Team have the
willingness and the bility to invite the community at desa Sukorejo to manage and reduce the trash at their village.

4. Giving the additional food supply in Posyandu activity on desa Sukorejo which aimed to increase the nutrition quality towards
the baby in Sukorejo and to increase the understanding and knowledge for the parents about the resource of nutrition. And
this activity had done with the aim of no more babies suffering the lack of nutrition at desa Sukorejo.

5. Discussion and talk show of ”Airku Bersih Desaku Sehat” was done as first step from the continuity of water problem that
happened in desa Sukorejo. From 15 sample tested of water that taken from several water resources/wells at Sukorejo for the
quality it was found that the 11 sample state as not safe to consume because it contains the E coli bacteria for more than
50/100ml (health standard. From this talkshow it is hoped that the Sukorejo community know that the water that they
consume are not so healty and they need to do some action towards this issue.

6. Organic waste training management to convert it into coal at Desa Sidomulyo Bambanglipuro Bantul followed by 2
representative Sukorejo village, which are the Village Core Team of trash coordinator and the trash coordinator of FKD DUGIR
LESTARI. The results is that the two of karang taruna member know and understand the technique of making the coal as the
fuel so that they can manage the organic waste themselves, convert it into the coal.

7. Training of Posyandu management for the cadre of Yandu Sukorejo Village. This training attends by the yandu cadre that
exists in Sukorejo village. The material learned is to indetify the problems that exist in the Posyandu and the positive
communication towards children and effective communication with parents also towards the yandu cadre.

The training for capacity upgrade that had been done in Sumberagung :

1. Training of English that talk about health and hygiene for children. The participant is more less 13 people at the beginning of
the meeting and it is now develop into 25 person at the near of program ending. The outcome of this activity is that the

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
children as the participant know about the vocabulary in English and will be able to practice it in daily life. The method of
learning which also consist of the practice, such as; learn the color by creating the garbage bin from box, make the participant
easier to remember the lesson material and as well as the clean life style and healthy by separating the trash. Apart from that
the outcome of this this activity is that the children able to create simple song about ‘Siaga Flu Burung’ and ‘PHBS – wash
hand using soap and brush teeth using tooth paste’ in English version. The next action plan from this activity is created by
EMBA is that this activity will continue by using the budget that are collected from the community it self.

2. The English training about health and hygiene for teenager. The participant consists of the teenager of Balakan Village within
total of 12 people learning English with the material of Garbage and Avian Flu because it is related with the main issue that
are exists in Balakan Village. The results of this activity are that the teenager will be able to create a poster of Avian Flu
readiness and the Trash Management in two languages, Indonesian and English.

3. Work together to establish the Sanggar Ngudi Kawruh. Suggestion for creating a place for community to gathered for a
meeting and also function as the information center, communication and education reveal when the community having
discussion together with the EMBA youth, at the first time. At this meeting it is agreed that they need a place where it can be
function as learning center, not only for adult, but also for kids and youth. So they establish the Sanggar Belajar Ngudi
Kawruh which located at Dusun Balakan.

4. Workshop of Children Education. The participant are the representatives of Education department , teacher, PAUD teacher,
parents of students of SD Sawahan, village elements, representatives of Jetis District, representatives of Puskesmas Jetis I,
midwife, EMBA and children of Sanggar Ngudi Kawruh. The aimed of this activity is to give the understanding towards parents
and teacher about the importance of education for their children by using attractive method, not only from formal education
but also come from the informal education such as study group. The result is that the participants that attend the workshop
understand about the alternative way of delivering lesson effectively by using the visual facility and practice.

5. Avian Flu Training for SD Sawahan students and Dusun Balakan community which was done separately, aimed to give the
understanding for the children and community about steps of prevention and steps of overcoming the AI virus, correctly, to
their pets and human. This activity also comprehended community about the importance of clean and health life style, such as
wash the hands with soap before eat, separating the animal farm from the house, and do the routine cleaning/wash using
detergent water to the animal farm. This activity involving partner from Farming Department of DIY Province, Mr. drh.
Witanta, midwife and promotion department of Puskesmas Jetis I.

6. Training through watching the movie of Avian Flu and discussion, together with the community of Dusun Ngentak and Bulus
Wetan which was done in each Dusun. This activity came from community initiative to prevent the spread of AI virus from
neighborhood. Apart from the understanding of how to prevent and handle the AI virus, this activity also resulting agreements

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
from community which stated in BAP, which are; routine spray every week on each of their farm by each of avian-farm owner
and the budget come from the community at the dusun itself, collected for two month long and after that continue with
routine spray/wash using detergent water, which function as disinfection and will be done by each of avian-farm owner.
Community also agrees to do caging for their avian pets within duration one month of tolerance since the activity of watching
the avian flu. Sanction will point at the person who breaks the agreement, which is; the avian that running around will be own
by the community and manage together by community.

7. Trash Management Training that has community based using method of visit learning to Dusun Sukunan in Gamping Sleman
area that followed by TISA (tim inti siaga) Sumberagung, EMBA, member of Pokcilik and community of Dusun Balakan. The
result of this activity for the environment is that there’s agreement between the community to separate and manage the
garbage becoming one useful form for the environment and health also to give economical benefit. The continuity of this
activity is that the system of dusun garbage management which has community based, where community have already done
the separation of garbage at the housing level and the facilities prepared by the teenager, which are, 3 sacks on each house,
2 drum and 1 bucket at three point which are; at the side of RT 10 house, the intersection of mosque and at the side of TISA
cadre house. Organic trash agreed to manage by each people at their house and the community agree to work together to
clean dusun environment monthly.

8. Training of introducing and management of TOGA (herbal plantation) as one of traditional medication as one way to fulfill the
needs of the readiness of traditional medication, especially when the disaster happened. The participant of this activity
consists of TISA Sumberagung and EMBA, will understand about the potential of herbal plantation which can be manage as
traditional medication also able to mix the herbal their self as skin unguent and rub oil. The next action from this activity is
the development of the herbal plantation on empty field at the back of Sanggar Ngudi Kawruh by TISA and Pokcilik.

9. Training of creating fertilizer to community at dusun Balakan from domestic organic trash and yard by using traditional sack
and chaff. This method developed first time in dusun Balakan by Mrs.Subdiyati, one of TISA cadre which also cadre of PKK
dusun Balakan. The objection of this activity is to reduce the garbage on the yard and domestic kitchen garbage that they
usually burn it.

10. Printing training to create campaign media of PBHS (good health and hygiene behaviour). This activity aimed to give printing
skill on media such as shirt, cloth and plastic to make it easier for the participant to do campaign of routine activity of health
and hygiene behavior in their village. The participant, especially youth, looks very enthusiastic in following this program. Since
the beginning of the process of printing, the youth try to understand on every detail of printing technique so on the next
occasion they will be able to create their own best printing. Result of this activity was shown at their creation of printing the
shirt for first prize winner of LIGA PISANG, and Pokcilik sticker.

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
11. Sumberagung LIGA PISANG which held in form of food creation and healthy drinks which are made from banana and also the
kid’s football competition inter Sumberagung. The unique of this activity is that everything starts from the court until the
competition sign and attributes of players were made from any parts of banana plant. Apart from that the banana campaign
through brochures contains the potential and benefits of banana in sides of health which spread through Pokcilik to the
participants. Other than that, there was also the competition of the most trash collecting at the field to introduce the types of
trash to the participant that attend the LIGA PISANG.

12. Poskesdes management training. This activity needed because there was suggestion from Desa Siaga which in it consist of
poskesdes as one of Desa Siaga component. This things stated by health promotion department of Puskesmas Jetis I at the
planning meeting of Desa Sumberagung Siaga. The participant of the training which were hoped came from many community
elements on Sumberagung, but on the running of the programs, it was only attend by the chief of RT 10 Dusun Balakan and
head of dusun Balakan, the youth and TISA cadre also the representatives of puskesmas Jetis I. The material was about the
relation between Poskesdes and clinic which is necessarily needed remembering the function of the clinic as the
communication center, information and education for the health cadre and community that will based on the function of clinic
as poskesdes.

13. Posyandu Management Training for Yandu cadre on Sumberagung village. This activity attend by 38 out of 40 Yandu cadre
that exist in Sumberagung village. Based on the information gained from the participant, they took a lot of learning from the
requirements introduction of material and the cadre potential so some of the cadre, which has lack of information, now they
can work together with the posyandu team, to be aware and wants to cooperate. This training were also remind the cadre of
the importance of delivering pure information without any additional or diminution which can reveal the conflict.

Community capacity improving activity in Kebonagung:

1. Teenager Health Reproduction Training which followed by the participant from Karang Taruna Mekaragung, Kebonagung
village and the youth of Dusun Balakan, Sumberagung village. The implementation of this activity was based on the problems
of too many young pregnancies outside the marriage in Kebonagung. The teenage age is not safe age for pregnancy and to
give birth so the pregnant women in young age will have high risk and having the potential of sudden death during the
delivery of the baby or the sudden death of infant when it is due. The participants of the training understand of the
importance of health reproduction for teenager and agree to have the continuity of the activity by creating health reproduction
campaign media for teenager in Kebonagung village.

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
2. Herbal plantation training and the management/mixing to be instant traditional healthy drink, to fulfill the needs or readiness
of herbal medication during the disaster and to elevate the potential of local herbal healthy drink. The participant contains of
youth, health cadre and the tourism management group to gain more information about the herbal plantation potential that
are exist in their village. This activity continuity is by planting the herbal plantation on the yard of Sanggar SAPOE LIDI by the
youth and the planting at the yard of Kebonagung clinic by community.

3. Self-management Trash Training which has community based using learning visits method to Dusun Sukunan on area of
Gamping Sleman which followed by 30 participant which are; youth, health cadre, and group of resort owner and village
government officer, the new Dukuh leader. This activity continued by the youth of sanggar SAPOE LIDI by doing the
separation of sanggar trash and the management of plastic waste also the organic waste to be handicraft which has the art
value and economical value. Apart from that, the resort owner do the continuity by doing the Socialization of Self-
Management Trash with community based on dusun level at Pedukuhan Jayan which attend by almost 60 person health cadre
and community of Pedukuhan Jayan. In the socialization meeting, the communities that attend agree to have clean and health
life style by managing their domestic trash. But the conflict that reveal in this pedukuhan after the earthquake and the
election of dukuh become the barrier which obviously huge in implementing the results of agreement. Community tends to not
working together to implement their own agreement. So, until the end of the assistance program of community by YEAN in
Kebonagung village, the program of the trash management still not running.

4. Training of Organic Waste Management by using Takakura method for the community at pedukuhan Jayan. This activity is
also one of the continuity of the program of self-management trash community based in pedukuhan level. The easy method
and also easy to implement makes the training participant, which most of them are female and teenager of Pedukuhan Jayan
became interested to practice the technique of creating the organic waste fertilizer in their own house.

5. Training of Healthy house and Disaster preparedness for the group of tourism management group and the youth of Sanggar
SAPOE LIDI. The training which were held in two different places based on this various needs, make the participant
understand about the function of the house and the house requirements or the healthy building where they life. The group of
tourism management group having the needs to create the housing and inn for tourist, which are healthy and disaster
resistance, meanwhile the youth of sanggar SAPOE LIDI need the knowledge of healthy sanggar, friendly and disaster
resistance.

6. Posyandu Management training for Yandu cadre in Kebonagung village. This activity followed by 22 out of 25 Yandu cadre that
exists in Kebonagung village. Other than talk about the disease that often strikes the babies and the problems digging and
potential cadre, this training was also trained the cadre to be able to communicate positively and effectively with children and
towards the cadre it self.

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
7. Outbound Management Training. To strengthen the relationship bound and cooperation among three local organizations that
become partner of YEAN in Kebonagung village, and was also held the activity of Outbound Sehat Desa Kebonagung Siaga
that establish at Tegal Pedukuhan Jayan Desa Kebonagung Dam. This activity followed by Youth from Sanggar SAPOE LIDI
Health Cadre, and group of tourism management group of POKDARWIS Kebonagung village. A lot of experience that the
participant can get, such as; MR. Sudiharja, 55, Chief of RT 01 Pedukuhan Jayan from tourism management group, that this
Outbound activity helped him to know more about self-potential and friends in his groups, other than local potential that
almost forgotten. His hope from this activity is to enable the harmony work relationship among the people which join in the
tourism management group with youth and women from health cadre.

Changes Occur

A lot of changes occur since YEAN entering these four villages. This changes are not only physically, such as the establishment of great clinic,
which fulfill the requirement of health and earthquake resistance (as Mrs. Tri Haryani said, Midwife of Sukorejo and Core Team of Desa
Sukorejo Siaga Children and environment friendly), but also the non-physical such as the awareness of people about the importance of clean
environment to create the cleaner village, health and disaster readiness, such ass; increasing the awareness to have clean and health
lifestyle, and it can be seen through the reducing of number of people that doing their feces on the river, a lot of people have collected their
domestic trash and separated it so the village looks esthetical, clean and neat (as it is stated by Edyati, 55, teacher and Core Team of Desa
Sukorejo Siaga Children and environment friendly). The following are several comments from community about the benefits also the changing
that they feel after YEAN doing assistance at their village.

Dalbiyo, Pokdarwis Kebonagung: Now the people in Kebonagung start to aware the importance of education, culture, unity, clean and health.

Suprihatin, Karang Taruna Kebonagung: YEAN is really helpful for the community to create the awareness and to teach the clean lifestyle also
care about the environment and until now, the people care about clean environment.

Duwono, labour & desa sukorejo siaga core team: YEAN have helped the people to be aware of the benefit of clean and showing us the way
how, which most of people now start to feel the importance of clean, and they have start to handle problems of trash and water.

Sutarno, Sukorejo village element: With the existence of YEAN, the people that used to not aware about the importance of health now they
realized it and start to act and live healthy. And with the coming of YEAN, can create the clean and health environment by having right
handling of trash management.

Besides that, there are some benefits and other changes that the community feel since YEAN start the activity for upgrading the capacity of
community on each village, in Karang Taruna, YEAN helped them to give different point of view in dealing with problems or even in running
the program also opening their view and giving new idea, because before YEAN come to Kebonagung village, the youth which join as member

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
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of Karang Taruna are barely meet and there is no meaningfully activity, but since YEAN came, the situation in the Karang Taruna getting
more alive because they often held a meeting and activity which able to teach and unite the aspiration of the member of Karang Taruna (as it
stated by Suradie, 25, member of Sanggar SAPOE LIDI Karang Taruna Mekaragung, Kebonagung village and written as private employee in
form).

In Sukorejo village, one way to do the campaign of healthy lifestyle is through song. One Siaga cadre, Mrs. Edyati, have created two songs,
which are Mars Desa Sukorejo Siaga and Cuci Tangan Pakai Sabun to make it easier in delivering the information about accustoming the clean
and healthy life style, especially it is assigned to PKK cadre and children.

MARS DESA SUKOREJO SIAGA


Oleh: Ibu Edyati
CUCI TANGAN PAKAI SABUN
Kami warga
Oleh: desa Sukorejo
Ibu Edyati
Siap menghadapi desa siaga
Ramah anak tangan,
Cuci…cuci dan lingkungan
biasakan cuci tangan
Hidup
Kalau akan dibiasakan
bersih makan dan sehabis kegiatan
Buang sampah
Cuci pakai janganlah
sabun sembarangan
janganlah dilupakan
Agar badan kita terhindar dari kuman
Tanggap pada bencana
Bersih sehat
Banyak lingkungannya
cara saat mencuci tangan
Aman
Lihat kawan akan desanya
dan nyaman kuperagakan
Indah
Yangdipandang mata telapak tangan
pertama gosok
Yang kedua gosoklah punggung tangan
Jamban kluarga
Sela jari telah
dan juga tersedia
kuku tangan
Menanam TOGAberputar-putar
Ibu jari gosok tlah terlaksana
Sampah dikelola dengan sempurna
Taman bermain dan gizi balita
Saluran air limbah yang tertata
Ambulan desa siap siaga

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
In Kebonagung village, the group of Gejug Lesung Larasati which coordinated under a Health Cadre Pedukuhan Jayan is able to create a song
titled Rumahku sehat dan tanggap gempa as one way to deliver information of Clean and Healthy Lifestyle and healthy house also towards
the disaster preparedness.

MARS ANAK SANGGAR DAN POKCILIK NGUDI


RUMAHKU
KAWRUH SEHAT DAN TANGGAP
BENCANA
Oleh EMBA dan Pok Cilik Balakan,Sumberagung
Oleh: Kelompok Gejug Lesung LARASATI
Kebonagung
(Indonesia)
Ayo cuci tangan sebelum kita makan,agar terhindar dari
Aku berlindung di rumah sehat
kuman
Kutempati
Juga gosoksemua
gigi 2kluarga
kali sehari agar gigi tetap sehat
Sarana
Untuk menjagahandai
bertemu taulan
diri,agar dapat terhindar dari sgala
Tempat belajar dan bercandaria
penyakit
Karena aku percaya kebersihan sebagian dari iman
Rumah bersih dan tanggap bencana
Ramah
Reff : anak dan ramah lingkungan
Cukup cahaya
Tak perlu dan udaranya
repor,tak perlu risau untuk menjaga diri kita
Karena
Untukbanyak pintu dan jendela
tetap sehat,badan jadi kuat,belajar pun semangat

AirDengan
dan sabun
cuci untuk
tanganmencuci
sebelum kita makan,agar terhindar
Agar
daribadan
kumanterhindar bakteri
Seringlah
Dengan menguras
gosok gigi tempat mandi
2 kali sehari,agar gigi tetap sehat
Jentik nyamuk semuanya mati

Buatlah sumur dan resapannya


(English)
Kebersihan
Let’s washMCKour dijaga
hand, before we eat, to prevent our self
Agar
from germ serta sehat
air bersih
Juga
Andlingkungan
brush yourkita semua
teeth twice a day to keep our teeth clean
and healthy
Semua
To staysampah
healthykita
andgunakan
prevent our self from all of the
Diolah jadi
sickness kompos buatan
Because I believe the hygiene is part of my believe

Reff :
Need no burden, need no worry if we stay clean
everyday

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
Output of clinic:

Site: Polindes Balak, Cawas, Klaten

Picture 1: 0% progress.

Picture 3: 100% progress.

Picture 2: 50% progress.

Site: Polindes Sukorejo, Wedi, Klaten

Picture 1: 0% progress.

Picture 3: 100% progress.

Picture 2: 50% progress.

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
Site: PUSTU Kebonagung, Imogiri, Bantul

Picture 1: 0% progress. Picture 2: 50% progress. Picture 3: 100% progress.

Site: PUSTU Sumberagung, Jetis, Bantul

Picture 1: 0% progress. Picture 2: 50% progress. Picture 3: 100% progress.

Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management
Final Report of Community Engagement in Clinic Reconstruction Project and Community Assistance in Post-earthquake Relieves
YEAN Project Management