Monika Setiawan: Transforming Health in Jakarta's Hidden Communities

By Alumni UK Team, British Council Indonesia

20 July 2026 - 16:07

The first time Monika Setiawan visited Tanah Merah, she came across a settlement squeezed into the margins of the city: densely packed, legally precarious, and largely invisible to the formal systems meant to serve it. The residents were mostly migrants from across Indonesia, many of them women who spent their days sorting through waste. The landscape, she recalls, was chaotic. But the people were something else entirely.

Monika, a general practitioner who completed her postgraduate studies in Cardiovascular Science at the University of Glasgow, saw hidden health issues and the opportunity to address them.

“I saw a lot of health problems, infectious diseases like tuberculosis, hepatitis B, like yellowish skin and eyes that attack the liver, and very contagious diseases like tuberculosis,” said Monika. “And then also non-infectious diseases such as cancer, cardiovascular diseases like hypertension, cholesterol.” She noted that most of the health issues come from the lifestyle and the lack of understanding that some of these diseases can be prevented by simple steps like immunization and regular testing.

Even though the health issues are extremely worrying, Monika also found that the community there, especially the mothers, are very eager to learn. The spirit of the community inspires her to create Srikandi Peduli Sehat, a community health empowerment project that Monika launched with support from the British Council's UK Alumni Social Action Grant.

She worked together with a couple who runs a small informal study centre for the community's children that has earned deep trust of the community for over 13 years called Rumah Harapan. Together, they support female waste pickers in Bintara Jaya, West Bekasi, to be health cadres for their own neighbourhood.

Many mothers in the community had no active national ID registered to their current address, which meant they could not access national health insurance (BPJS) and therefore could not access subsidised healthcare, including diagnosis and treatment for tuberculosis, a disease that requires a six-month treatment course and an active insurance card to access formally.

"Tuberculosis has been one of the most deadly and unresolved diseases," Monika says quietly. "And these families were dealing with it essentially alone."

It was her experience studying at the University of Glasgow that changed how she sees health: from a set of diseases to be diagnosed and treated, to a complex human experience shaped by circumstance, culture, and context. "I stopped seeing health only as a problem, disease, treatment, and drug," she says. "I started seeing it in the light of the human, with so many complexities, but also with potential."

This shift in perspective is what makes Srikandi Peduli Sehat different from a conventional outreach programme. Monika is not trying to fix the community. She is trying to accompany it.

Monika knew from the start that arriving as a doctor with a clipboard would not work. She spent months simply being present, attending informal gatherings, and listening to personal stories.

The entry point was a general health check-up for approximately 120 children at Rumah Harapan, starting with raising awareness about childhood immunisation. From there, relationships with mothers deepened naturally.

Monika worked with Puskesmas Bintara Jaya to reopen immunisation access for the community, accompanying mothers on their first visits. Over time, mothers began attending independently, a small but profound shift in their relationship with formal health systems.

Once trust was established, Monika's team introduced more targeted health interventions. Two rounds of mobile tuberculosis screening were conducted in collaboration with Puskesmas Bintara Jaya, using chest X-rays and Mantoux skin tests for children. From the first round alone, which screened 79 patients from the community, adults and children, approximately a third tested positive for either latent or active TB infection. These individuals were referred for further testing and, where indicated, began six-month treatment programmes.

Of the 15 mothers who participated in cervical cancer screening, using Visual Inspection with Acetic Acid (IVA testing), three, or one in five, received a positive result and were referred to a gynaecologist for follow-up smear tests. Many of the women in this community had never heard of cervical cancer, which makes their willingness to do a screening to be a significant step.

"At first they shared their fears and hesitations," Monika says. "These things were so unfamiliar to them. But they came."

The results were striking not only as health data but as evidence of what had been going undetected.

Running in parallel with the screenings were regular health education classes, attended consistently by 30 to 35 mothers. The sessions covered balanced nutrition, food hygiene, chronic disease prevention, tuberculosis awareness, and the importance of immunisation.

But Monika is clear that the work is far from finished. She has applied for more funding and is planning a second phase focused on participatory planning and co-design, working with the mother, local government representatives, and formal health cadres, to build a more structured training programme. The long-term vision is for women from the community to be equipped for formal health cadre roles.

For other alumni considering similar initiatives, her advice is to embrace the multidisciplinary and to let go of the idea that expertise is the same as understanding.

"Any project that aims at the betterment of communities needs contributions from many different disciplines," she says. "Even though I understand health, I need to learn from different subjects and different people. The community itself teaches you things that no training can."