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.
How Primary Medical Care Rescued a 10-Year-Old in Remote East Sumba
In the isolated village of Mbatapuhu, East Sumba, a 10-year-old named Jaya faced a life-threatening malaria crisis. Discover how Fair Future Foundation’s Primary Medical Care program intervened just in time to save him. Your support is crucial for such life-saving initiatives.
Eastern Indonesia’s Teachers Become First Responders in Critical Rural Healthcare
In ultra-rural eastern Indonesia, the idea of prompt medical care is often a distant dream. Enter Fair Future’s Kawan Sehat agents—a team of over 60 women transforming this grim reality. Equipped with first-aid essentials and life-saving drugs, they’re not just healthcare providers; they’re community saviors
Transforming Rural Healthcare Through Local Teachers
In Eastern Indonesia’s most isolated regions, the closest hospital might as well be on another planet. Who then comes to the rescue? Not medics from distant cities, but local teachers. Trained by Fair Future, these teachers transform into frontline health agents, acting as the first line of defense against life-threatening diseases like malaria…
Support #TruckOfLife: Your Kilometer Makes the Difference
In the remote corners of Eastern Indonesia, each kilometer counts. Fair Future’s #TruckOfLife isn’t just a vehicle; it’s a lifeline to communities plagued by diseases like malaria and tuberculosis. With just CHF 0.56 per kilometer, you can be a part of this transformative journey.
The #ZeroMalaria Mission: Testing East Sumba’s Population in Extreme Conditions
Embark on a journey with the Fair Future Foundation’s groundbreaking #ZeroMalaria program, aimed at eradicating malaria in East Sumba, Indonesia. This ambitious initiative seeks to test at least 87% of the local population, even in the most remote and challenging terrains.
Disease prevention, detection and treatment in rural areas
Fair Future teams provide prevention, detection and medical care in remote villages where infectious disease and malnutrition are common.
Primary Medical Care Progress Report
The Primary Medical Care (PMC) program has made a remarkable difference in the rural communities of East Sumba, providing over a thousand treatments that offer critical medical assistance to those in need. Through their unwavering dedication and hard work, the women of the region have been empowered to take control of the health and welfare of…
Medical care for children affected by Malaria
A young child with a very high fever and suspected malaria receives initial care before referral to the nearest health centre in rural East Sumba.
PMC program evaluation in Lapinu
These women linked to the PMC program devote part of their lives to saving others. These unsung heroines work tirelessly to keep people from the danger of illness and injury. They put their lives on the line to ensure others can live to see another day.
PMC program evaluation in Kabanda
Kabanda is genuinely one of the most isolated I have ever seen. Getting it is difficult, even dangerous, at times. No road leads to this village; only extremely steep or steep stony paths allow us to go there. It took us over six hours to get there, including four hours of absolute terrain with the Truck of Life, a 4×4 medical truck specially…
Check blood pressure in rural areas
Here in the ultra-rural and poor areas where Fair Future Foundation and Kawan Baik Indonesia work, populations tend to have a higher prevalence of high blood pressure than in urban and wealthier areas. This is mainly due to poor diet, excessive tobacco consumption, and poor hydration.
Check Blood Pressure as part of the PMC program
Kawan Sehat health workers learn blood-pressure measurement as part of preventive care and community health monitoring in rural East Sumba.
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.
