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.
Primary Medical Care: 2024 Report Highlights
In 2024, Fair Future’s PMC Program significantly improved ultra-rural communities by offering essential healthcare services, education, and life-saving solutions. This initiative addresses the severe shortage of medical resources in remote areas with limited access to basic health facilities and trained personnel.
A Book That Saves Lives in Rural Areas
The Primary Medical Care training book gives rural health agents practical guidance on first aid, common illnesses and urgent situations where professional medical care is far away.
New Narration Guide Enhances Kawan Sehat Book Impact
To enhance the impact of the Kawan Sehat book, we’ve created a narration guide for users. This method ensures its messages are effectively communicated to children, parents, and ultra-rural communities. The guide maximizes the book’s potential to inspire and educate, bringing valuable knowledge to those who need it most.
Kawan Sehat: Vital Medical Care in Tough Terrain
Rambu Veronika, a health agent with Kawan Sehat, courageously navigates steep and hazardous trails to deliver essential medical care to the remote villages of East Sumba. Her commitment underscores the remarkable efforts of volunteers who save lives daily despite challenging conditions.
Introducing #MediRider: Supporting Rural Healthcare Access
#MediRider: Erwin, our field coordinator, replenishes the medical backpacks of Kawan Sehat agents with essential supplies such as medications, dressings, and disinfectants. Riding a Revo scooter, he transports these resources to remote villages so health agents are equipped to provide treatment and save lives. An indispensable element of #PrimaryMedicalCare!
Sharing Life-Saving Medical Advice Online and Offline
The Primary Medical Care program focuses on disseminating medical guidance. We offer straightforward, practical advice to Kawan Sehat agents, who then relay it to rural communities. Now, we’re also sharing this information on Instagram (@fairfuturefoundation) and our website. These tips have the potential to save lives—help us spread the word!
Ruth’s Smile: Healing Children with Primary Care
Ruth, a Kawan Sehat health agent in Lukukamaru, supports a sick child with local primary care in a village where professional medical services are difficult to reach.
Kawan Sehat Saves Boy’s Foot from Serious Infection
In Lahiru, Kawan Sehat agent Ibu Sarlota treats a boy’s serious foot injury early, showing why timely wound care and follow-up matter in remote villages.
Kawan Sehat: Health Workers Bring Care to Rural Indonesia
Kawan Sehat healthcare workers provide vital medical services and education to remote villages in Indonesia. Through photos showcasing their resilience and life-saving commitment, this article emphasizes their essential role in underserved communities and the impact of grassroots healthcare initiatives.
New Scooter for Erwin to Deliver Medical Supplies
We’ve invested in a new scooter for Erwin, our Primary Medical Care field coordinator. This off-road-capable scooter will help Erwin reach even the most remote Kawan Sehat health agents to deliver and restock medical supplies. It’s a small investment of 1,000 Swiss francs, but one that will undoubtedly save lives.
Kawan Sehat Agent Tirza Presents Life-Saving Field Work
Kawan Sehat agent Tirza presents the contents of her medical backpack and explains how community-based primary care supports remote East Sumba villages.
Medical Teams Deliver Care in Rural East Sumba
Fair Future’s medical teams, led by Dr. Narni, offer vital healthcare services to remote villages in East Sumba. Utilizing the Truck of Life, they address illnesses, combat malnutrition, and advocate for clean water access to ensure no community is overlooked. Their commitment is essential in regions where healthcare remains out of reach and infectious diseases go unchecked.
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.
