From the field in East Sumba. Medical care, clean water, prevention and community health where access remains difficult.
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Health & Medical Program
Primary Medical Care
First-line assessment, treatment, prevention and referral for families living hours from a clinic and beyond reliable transport.
- Active since December 2022
- 27 Kawan Sehat agents
- 700 to 1,000 patients each month
Care starts where the road ends
In East Sumba, distance changes the course of illness. A fever, infected wound or dehydrated child may worsen for hours before transport is possible. Trained Kawan Sehat agents begin assessment, safe first-line care and referral inside the village.
The programme
A local health system built for distance
Here, distance is a clinical risk. A fever can become severe, a wound can progress to sepsis, and a pregnancy complication can turn critical before a family reaches formal care.
Primary Medical Care places trained Kawan Sehat health agents inside their own communities. They are not substitutes for doctors. They are the first safe point of contact: close enough to act early, trained enough to recognise danger and connected to medical supervision when a case exceeds local capacity.
Care is provided without charge at the point of service. Medicines, dressings, diagnostic supplies, education tools and reporting systems are carried into areas where routine health infrastructure is absent or difficult to reach.
Women and men working inside their own villages, with structured training and support.
Assessment, treatment, education, follow-up and referral carried out close to home.
Medicines, dressings and basic diagnostic supplies are checked and replenished regularly.
The programme began in December 2022 and continues as a permanent field operation.
From first contact to follow-up
How care reaches a patient
Every consultation must connect observation to a safe decision. Symptoms, vital signs, treatment, danger signs, referral and follow-up are documented so care does not end when the agent leaves the house.
First contact
A nearby Kawan Sehat agent listens, examines and records the patient’s symptoms and history.
Assessment
Vital signs, danger signs and the limits of community treatment guide the next decision.
Care or referral
Safe basic care is provided locally. Severe or uncertain cases are referred without delay.
Documentation
The Kawan Sehat app and field records support case review, follow-up and disease surveillance.
Follow-up
The agent returns, checks progress, reinforces prevention and contacts the medical team when needed.
Clinical boundaries matter
Care close to home, referral when risk rises
The most important clinical skill is knowing the limit of local care. Agents work within defined protocols, treat what is safe, and refer immediately when symptoms, vital signs or uncertainty indicate higher risk.
What agents can do
- Assess symptoms, temperature and available vital signs
- Clean and dress superficial, uncomplicated wounds
- Provide protocol-approved first-line medicines and oral rehydration
- Support uncomplicated fever, respiratory, skin and digestive complaints
- Monitor older people, children and patients with chronic conditions
- Teach hygiene, nutrition, malaria, tuberculosis, HIV and infection prevention
When agents refer
- Breathing difficulty, altered consciousness, shock or severe dehydration
- Suspected sepsis, severe infection or rapidly worsening illness
- Major trauma, deep wounds, burns or suspected fracture
- Pregnancy complications or danger signs in a mother or newborn
- Possible tuberculosis, leprosy, HIV or another condition requiring medical testing
- Any presentation that is uncertain or beyond available skills, protocols or supplies
Medicines matter, but safe use depends on training, documentation, clean equipment, supervision and regular restocking.
The system behind each visit
Tools that make continuity possible
A bag of medicines alone is not a health system. Each visit depends on trained judgement, a defined medicine list, clean dressings, usable records, follow-up and access to medical supervision. Standardising these foundations reduces unsafe improvisation and makes every case reviewable.
150-page manual
Fourteen training modules covering first-line care, prevention, danger signs and safe practice.
Kawan Sehat app
Offline and online case documentation designed for villages with weak connectivity.
Medical kits
Medicines, dressings, basic diagnostics and prevention materials adapted to field conditions.
Medical supervision
Training, case review, field visits, referral support and regular supply control.
What changes in practice
Earlier care changes the course of illness
Shorter delay to first care
A child, older person or injured worker can be assessed the same day instead of waiting for money, a vehicle or a passable road.
Safer treatment decisions
Defined protocols, supervised medicine lists and case review reduce unsafe improvisation and avoidable self-medication.
Clearer referral
Referral begins with recorded symptoms, vital signs, treatment already given and the danger signs observed.
Prevention inside daily life
Malaria, tuberculosis, HIV, wound infection, hygiene and nutrition are discussed at home, in schools and during care, in language people understand.
Clinical manualPrimary Medical Care field manualOpen the 150-page manual used to structure assessment, treatment, prevention, follow-up and referral.
PeopleMeet the Kawan Sehat agentsUnderstand who provides care and how community knowledge becomes clinical action.
Field toolsDigital tools for rural careSee how field applications support patient records, follow-up, evidence and safer decisions.
ResearchSumba Sepsis Study 2026Explore evidence on infection, delayed care and household risk across 1,001 families.
Live field recordField Notes from Eastern IndonesiaFollow short, dated updates on care, prevention, research, logistics and the realities teams meet.
Field guide & glossaryHealth and care, explainedExplore clinical terms and practical field guides grounded in Fair Future’s work in remote communities.
Medical referenceWHO primary health careRead the international framework connecting treatment, prevention and community participation.
Live from the field
Medical Field Notes, as the work happens
Two recent signals from care, research and prevention in East Sumba. These notes refresh from the Field Notes archive when a new medically relevant update is published.
Directly from the field
Latest Primary Medical Care reports
These field reports document the care actually delivered: clinical problems encountered, prevention work, referrals, supply constraints and the decisions our teams make in remote villages.
Work in preparation includes community care days connecting consultations with practical prevention and support for the next medical care day in Bidi Hunga.
Ibu Anggi receives her certificate
This new photo of the day shows Erwin delivering a Kawan Sehat certificate to Ibu Anggi in Laindatang. It’s not just a document, but a symbol of her essential role in healthcare delivery where there are no doctors.
Kawan Sehat Training in East Sumba Villages
In May 2025, Kawan Sehat agents completed a powerful three-day training in East Sumba, boosting their medical skills, restocking kits, and preparing to treat hundreds in ultra-rural areas.
Empowering Health in Remote Indonesia
Fair Future Foundation has published two essential guides: an updated training manual for health agents and a booklet on using educational posters, helping communities in remote Indonesia manage health challenges and save lives.
Medical Backpack That Saves Lives
In East Sumba, women carry life-saving care on their backs. These medical backpacks contain over 50 essential items and are central to Fair Future’s Primary Medical Care program. A tool of autonomy and survival.
Medical Logistics in Rural Indonesia
Erwin prepares life-saving medical kits for health agents working in villages without doctors, pharmacies, or roads. Logistics becomes a vital part of healthcare for thousands in East Sumba.
Primary care day saves lives and builds health
Throughout a full day dedicated to primary medical care, our teams screened and treated over 150 patients with an emphasis on malaria and tuberculosis. The provision of vaccinations, medications, and health education not only saved lives but also fostered trust within the community.
Mosquito nets save lives every single night
Families in remote East Sumba receive mosquito nets designed to reduce malaria exposure at night, as part of Fair Future’s wider prevention, education and care work.
Rural doctor shortage solution initiatives
Our foundation addresses the severe shortage of doctors in rural Indonesia through a multifaceted approach that includes training local health agents, upgrading infrastructure, and implementing solutions to alleviate the doctor scarcity, ultimately improving access to medical care.
Fair Future Launches a New Anti-Tobacco Poster
Fair Future’s latest anti-tobacco poster highlights the grave dangers of passive smoking. Annually, tobacco claims the lives of 1.2 million non-smokers, affecting children, pregnant women, and whole families. This campaign is set to be launched throughout rural Indonesia with the aim of educating and safeguarding those most vulnerable.
Mira a Health Agent Saving Lives in Rural Villages
Mira serves as a Kawan Sehat health agent, delivering medical care to thousands in remote villages. Armed with essential medical supplies, she addresses injuries, manages illnesses, and educates families on improving their health practices—ensuring that healthcare reaches those who need it most.
Support Life-Saving Primary Care in Rural Indonesia
Today, Fair Future transferred 23,529 Swiss francs to fund the second quarter of the Primary Medical Care program in Indonesia. This life-saving initiative still needs support for its final quarter. Thank you for making this possible, and we encourage you to donate to keep this vital work alive.
Kawan Sehat: Humanity Through Rural Healthcare
Kawan Sehat health agents treated hundreds of patients—children, elderly, and the injured—throughout the holiday season as part of the #PrimaryMedicalCare program. Their dedication never paused. Visit our site to see the latest photos of their remarkable work. Thank you for your ongoing support!
Accountability
Care must remain measurable, reviewable and transparent
A programme caring for 700 to 1,000 patients each month must show more than activity. We document medicines used, care delivered, referrals, prevention work, field limits and how resources are engaged. What works is strengthened. What fails is corrected and reported.
