Home Care Nurse WANTED for Rachel House

Yayasan Rumah Rachel (YRR) adalah lembaga nirlaba yang menyelenggarakan asuhan paliatif rawat rumah tidak berbayar bagi anak-anak dengan Kanker dan HIV, terutama dari latar keluarga kurang mampu. Visi kami adalah tidak ada lagi anak dalam nyeri atau kesakitan. Misi kami adalah memastikan asuhan paliatif tersedia bagi anak Indonesia sehingga mereka dapat menjalani hidup bahagia dan bermartabat dalam lingkungan penuh kasih sayang.

Sebagai lembaga perintis asuhan paliatif anak di Indonesia, Yayasan Rumah Rachel berkomitmen untuk terus membina kapasitas tim melalui proses belajar berkelanjutan melibatkan para penggiat dan guru paliatif dari Indonesia, Singapura, Australia, Selandia Baru, Afrika Selatan dan India.

Kantor Slipi (Jakarta Barat) dan/atau Kantor Cilincing (Jakarta Utara).

Tanggung jawab:

  • Menyelenggarakan asuhan keperawatan bermutu.
  • Menyelenggarakan pendidikan kesehatan dan komunikasi terapetik bagi klien dan keluarga.
  • Menyelenggarakan dukungan dasar psikologi sosial dan spiritual bagi klien dan keluarga selama terapi, jelang dan pasca kematian.
  • Berkoordinasi dengan lembaga mitra dan unit pelayanan kesehatan dalam menyelenggarakan asuhan bagi klien dan keluarga.


  • Berlatar pendidikan minimal D3 Keperawatan.
  • Berpengalaman kerja keperawatan klinis minimal tiga tahun. Pengalaman dalam layanan rawat rumah dan/atau anak menjadi nilai tambah.
  • Memiliki Surat Tanda Registrasi dan Surat Izin Praktik yang berlaku.
  • Memiliki kepekaan sosial.
  • Terampil berkomunikasi dengan beragam pihak.
  • Mampu mengoperasikan internet dan perangkat lunak dasar perkantoran.
  • Kemampuan berbahasa Inggris menjadi nilai tambah.
  • Mampu mengendarai motor dan/atau mobil serta memiliki SIM menjadi nilai tambah.

Silakan mengirimkan curriculum vitae ke elsa@rachel-house.org, atau ke Yayasan Rumah Rachel, Graha Indramas Lt. 1, Jl. K. S. Tubun Raya Kav. 77, Slipi, Jakarta 11410.

Nurse – A Force for Change

On 21st of April every year, Indonesia celebrates Kartini Day, commemorating the birth in 1879 of Raden Ajeng Kartini – a pioneer in women’s rights and a champion for the emancipation of women, opening the first school for women in Indonesia.

This year, ConocoPhillips hosted a lunch to celebrate the courageous spirit of Kartini, and invited several outstanding women to share their accomplishments both at work and at home, in the hope of inspiring other women to aim high to break the glass ceilings.

Rachel House’s nurse, Rina, was invited as one of the speakers. A mother of three, Rina first dipped her toes into the world of palliative care in 2008, when a colleague introduced her to Rachel House. Her initial response at the time was, “What in the world is palliative care?” In the ensuing years, Rina’s insatiable thirst to learn – driven by her commitment and her heart’s calling to champion the children she served – quickly propelled her to become the clinical head of the pioneering children’s home-based palliative care team in Indonesia.


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The story of Rina’s exciting journey as a nurse-cum-mother-cum-wife captured the hearts of the audience, most of whom were women. “At first I intended to stay for only a few months,” Rina said, “but I fell in love with the children and here I am, still here after all these years.” Her role as the Nurse Coordinator requires tremendous dedication not only in ensuring that her patients and their families receive the best care possible, she is also in charge of supervising and training the younger nurses, inspiring them to go the extra distance to serve their patients; challenging each of them to open their hearts and be the voice for their patients who are amongst the most forgotten and neglected in the community.

A significant part of Rina’s work is in disseminating palliative care knowledge to medical professionals across the health system in Indonesia, working hard to ensure the availability and accessibility of palliative care for all children in Indonesia.

When asked how she balanced the demands of her family and her work, Rina highlighted the importance of support from others. “Both at home and at work, collaboration is key. At home, I work with my husband to care for our children and build our home. In the field, I work with the community, hospitals, primary care centers, and other not-for-profit to provide the optimal care for our patients and their families.”

Her roles are wide-ranging and her duties are demanding, Rina admitted. “But I would not change it for the world.”


The Voice of Youth in Advocating for Pediatric Palliative Care

Students of Sekolah Pelita Harapan (Pelita Harapan School or “SPH”) in Karawaci, Jakarta recently participated in 30 Hour Famine, an event where the students fasted for 30 hours to get a glimpse of what it was like to be without a basic necessity. The 30 Hour Famine is a World Vision program that seeks to unite youths around the world to raise awareness about the plight of children who live in circumstances less fortunate than themselves in the hope of eradicating poverty.

For the students at SPH, this year’s focus was children living with HIV/AIDS and Rachel House was invited to speak about the need for palliative care for children in Indonesia in general, and for children living with HIV/AIDS in particular.



Rachel House shared the current initiatives that are being implemented to deliver care to children living with HIV/AIDS and other life-limiting conditions, and presented the challenges that lay ahead in a country where palliative care is not yet an integral part of Indonesia’s healthcare plan. The students demonstrated a keen interest, asking a host of questions about Rachel House’s advocacy plans at the local and national level to ensure the right of children to live with dignity and without pain can be achieved.

At the end of the presentation, Rachel House facilitated a group activity to encourage the students to think about ways to raise awareness for palliative care in their community and how they can lend their hands to help alleviate the suffering of children living with life-limiting conditions. Divided into groups of three, the students were asked several questions based on a scenario about a young boy living with HIV.

“If you were his neighbor, what could you do as an individual, to provide support to this boy and his family?”

“As a community, how could you provide support to this boy and his family?”

“As a policy maker, what could you do to ensure palliative care is provided for this boy and his family?”


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The responses received from the students were astounding. They came up with inspiring ways in which individuals, communities and leaders can collaborate to ensure palliative care needs for children and their families are met. Listening to their ideas confirmed our belief in the power of the voice of youth to advocate for palliative care in Indonesia.

Rachel House is inspired by the young people with a vision to create a better place for children who are marginalized; we admire their passion, enthusiasm and their willingness to contribute towards a better world. We are grateful to the students of SPH for their fundraising efforts and support for the children and families of Rachel House.


Karsini – Pillar of Her Community

What do we imagine we’ll be doing in our fifties or sixties? When our knees may ache when we walk and our back struggle to straighten when getting up. Will we still be buzzing around the city with the same verve we do now in our youth? Or will we have slowed our pace, perhaps choose less work with more days off and turn in earlier in the evening?

Will we have the strength to opt for the path of Ibu* Karsini, a community volunteer in a dusty neighbourhood of North Jakarta, who continues to help those who are ill in her community with tireless zeal?

On most days, Ibu Karsini’s morning would start with the usual commotion that happens in an average household. Awake at dawn, she cleans the house and prepares breakfast for her husband, her six children and their respective spouse, and her grandchildren. Once her family and home are taken care of, she departs from her modest house and goes off to tend to her other families –the ones that may not be related to her by blood, but whom she treats with the same compassion nonetheless.

One of those families is Tika, four years old and HIV positive. Her father has died long before she was born, and her mother passed away just after giving birth. For Tika, her aunt and uncle are her loving parents, and their five children her dearest brothers and sisters.

Like many children living with HIV whose immunity are compromised, Tika is ailed with malnutrition, lung tuberculosis, diarrhea, breathlessness, and a series of other persistent symptoms. Rachel House nurses visit weekly to manage her symptoms and to provide support for her family, to ensure that Tika is able to live with as much joy and dignity that she deserves even with her life-limiting conditions.

However, we cannot work alone. Ibu Kar (as the family calls her) stops by frequently to check on Tika. Ibu Kar has become Rachel House’s eyes and ears on the ground, keeping us updated on Tika’s health in between the nurses’ visits. Her over two decades of experience as a community volunteer has equipped her with the skills and a wealth of information that makes her a solid and reliable support for the family. When Tika develops a new symptom, Ibu Kar calls our nurses for advice. When Tika runs out of milk, she goes and finds someone who could help either donate money or milk supply. When Tika needs immediate medical attention, Ibu Kar swiftly arranges transportation to the hospital, accompanies the family and and help them navigate through the administrative maze; and does not leave until she is certain that Tika gets a bed in the overcrowded hospital. Even if that means waiting with Tika and the family until the wee hours of the morning.

Ibu Kar is not paid for her hard work, nor does she want to be. When asked why she continues to do what she does, she merely says, “It makes me happy.” There may be bags under her eyes from the lack of sleep, but the kindness in her countenance does not falter.

*”Ibu” is Indonesian for Mrs.

Ardi’s Story

One and a half years ago, a boy started to lose his ability to move.

One and a half years ago, the boy was diagnosed with HIV.

One and a half years ago, Rachel House was introduced to the boy.

His name is Ardi. He is seven years old. The HIV virus had compromised his immune system and caused neurologic complications. By the time Ardi was admitted to Rachel House, he had lost his ability to see, to hear, to speak, to eat and to walk. His limbs were contorted in awkward angles while he spent his days lying immobile in bed.

The “bed”, which is really a mattress, shared with his parents, his brother and his two sisters every night in a three-by-four rented room. Whenever our nurses visited, they would often find Ardi surrounded by his sisters, who continued to look after him in the most caring manner; they played and joked with him, and caringly wiped the saliva that had dribbled down his chin due to the facial paralysis.

Ardi’s parents continued to harbor high hopes for him. They believe he will one day regain mobility and return to school. He had been their pride and joy; one of the top students in his class, trophies and awards lined the walls of the small room.

He was referred to Rachel House to help manage the symptoms that had compromised his quality of life. Rachel House’s nurses supported Ardi’s parents with the essential skills and knowledge to ensure proper administering of medications, effective ways of managing Ardi’s feeding (nasogastric) tube, methods of easing his breathing (complicated by lung Tuberculosis), and physiotherapy exercises to help Ardi regain his strength and movement. All the big and small things that would help make Ardi’s days just a little bit easier.

But of course, the nurses’ work extends beyond just the patient. With other children to raise, Ardi’s mother needed emotional support, care and compassion; with the additional expense of Ardi’s treatment, his father had to work twice as hard to support the family. Our nurses became their friends, their trusted confidants, with whom they shared their grief and broken dreams.

A doctor once told Ardi’s parents that his paralysis was irreversible.

“But I have faith,” the father said. And that faith gave them courage. Physiotherapy was an arduous journey; with progress so slow it at times tested the father’s conviction. But little by little, Ardi’s conditions improved.

Today, Ardi is able to sit up on his own, and even stand up with support. He has regained most of his hearing and some of his sight; he is now able to watch television with his sisters, laugh at cartoon or some random celebrity gossip show. Ardi is a proof that with compassionate care and appropriate treatment, we can greatly improve the condition of children living with HIV. Being HIV-positive does not mean that these children will have to suffer from AIDS. And it definitely does not mean that they do not deserve to live life to the fullest surrounded by the people who love them.

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Make This Moment Count

In a 1-room house measuring 3 x 8 meters shared by 5 adults and 3 children, lay a little boy on a thin blanket on the floor. The room had no windows other than an open door that let in the hot dusty air, and sometimes a wandering rooster from the streets. For Sani, the skinny little boy lying on the floor right at the doorway, this is his whole universe – where he lies all day, every day.

At the age of just one, Sani lost his mother to HIV. When he was two, he was diagnosed with HIV with an obstructed bowel complication that resulted in a need for a colostomy.

When he was first admitted under Rachel House’s care, his father was still around and his grandfather was still alive. Both are no longer around, leaving him with his grandmother as his sole caregiver. She was the one who would nurse him through his endless fits of cough, his fever and breathlessness; the one who would change his colostomy bag ten times a day, and administer his medications – or at least tries to, as she constantly struggles to remember which medication to give and at what time.

Alone, caring for Sani and his 2 older siblings, his grandmother grows despondent. She tires easily, emotionally and physically. Sani begins to miss his doctor’s appointments at the hospital. A trip that would involve taking 4 changes of buses and a motorbike-taxi ride; a trip that not only takes 3 to 4 hours, but also one that would require funds that the Grandma no longer has. No appointments means no medications. No medications mean a compromised immune system that threatens Sani’s survival.

Rachel House’s nurse, Neng, who visits every week has watched the deterioration of the family condition with alarm. Sani has grown quiet since his father left. He has stopped eating, rejecting and throwing up food even with a feeding tube. Being close to his grandmother, Sani must also be sensing her worries.

Whenever he sees Neng enter the room, he will reach out with his feeble hand, motioning her and grunting for her to hold him. The grunt only stops when he feels her hand stroking his arm gently, while she speaks to him and his grandmother. Sani craves for a hug and a human touch – all of which is no longer available as his grandmother grows tired and preoccupied with financial worries. Neng sees the dark circles under the grandmother’s eyes and senses the burden she is carrying. So she listens to her stories and tells her what a remarkable job she’s doing.

“Come on, let’s care for Sani together,” Neng rallies behind her. “Let’s go to the hospital next week. I’ll meet you there so you won’t have to be alone,” Neng promised.

Determined to deliver the love and human touch that Sani craves for, however many remaining days he has left, Neng rallies the support of volunteers to take turns to visit – bringing him the love that he longs for.

For Sani, and many children like him, this may be all he will ever have; and so we make this moment count.


Community Network in Palliative Care (“CNPC”) Training

Community-based volunteers play an essential role in reaching out to Jakarta’s marginalised population who are sick at home without access to basic healthcare. 

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In the month of March, coinciding with the International Women’s Day, Rachel House provided basic community-based palliative care training to 52 volunteers from the Kalibaru neighbourhood in North Jakarta. The majority of the volunteers are women who are selected based on their long-term commitment to helping others and their eagerness to learn. The training seeks to empower them with skills to provide care to the most vulnerable in their community, allowing them to act as the effective bridge between those requiring care at home and the Primary Health Centre (Puskesmas).

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The first day of the training brought the volunteers and the medical professionals from the Puskesmas together in a classroom in order to introduce the idea of collaboration to bring better accessibility to health assistance for those who are sick at home. 


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The ensuing two days of training included a structured, in-class discussion about the critical role of volunteers in helping bring health assistance to those at home. The prevalence of people living at home with chronic disease, HIV and cancer is on the rise in Indonesia and management of their needs in the community can be very complex and often inadequate. The volunteers learned how to identify those who need help; to assess and care for not only the physical needs, but also learn to identify and address the emotional, psychosocial and spiritual needs that are often just as great as the physical needs. They learned the importance of communication skills when working with people living with life limiting conditions, and the importance of collaboration in order to bring a holistic care to those in need. 

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The CNPC’s interactive method of teaching engaged the volunteers in activities such as patient case discussions, role-play and group work. The use of role-play emphasized the importance of communication during volunteer interaction with the patient and family in the community setting. Discussing health concerns, especially conditions which are life limiting, can be difficult and confronting. It was therefore essential that volunteers learned how to develop a trusting rapport with the patients and family and interact with great care, awareness and respect, while at the same time acknowledging their own emotions and values about end of life.


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After the in-class program, the volunteers were provided with the opportunity to take what they had learned and applied it in practice in the patient’s home. Rachel House Senior Nurses facilitated home visits where volunteers used what they have learned to holistically assess the needs of the patients and help them access the assistance they need in order to live comfortably at home. This in-field experience allowed the volunteers to see how they can be an effective bridge for these patients to access not only medical assistance from the Puskesmas but also other social and economic assistance when necessary. 


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After the completion of the training, volunteers felt more confident and expressed their enthusiasm and commitment in wanting to become community advocates for those who are ill at home. With the training provided by Rachel House they felt more prepared to reach out to their community to ensure suffering by those with life-limiting conditions can be alleviated as much as possible.

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Rachel House thanks the CNPC volunteers who have dedicated their time to provide care and support to their community. Engagement of volunteers is critical in Indonesia where the health system is still struggling due to the shortage of medical professionals. Trained volunteers can be the health extension workers that supplement the health care system and hopefully provide better accessibility and availability to health care for all in Indonesia.

Through The Eyes Of Our Volunteer

A home visit with Rachel House’s newest nurse – Dadan

Approaching a group of houses in the late morning, there is evidence that a hard days’ work has already begun. On the ground, mung beans lay drying on a tarpaulin and the smell of fresh laundry hangs in the damp but hot air. As Dadan approaches the entrance of a modest sized room, he is greeted quietly by Ira’s* father. He quickly escorts us to his wife and daughter, then slips away. Ira is sitting on a mattress on the ground. Her legs are limply sprawled out in front of her and her upper body is hunched over a long yellow pillow. It is hard to see her tiny frame as it is hidden in blankets. Dadan softly takes her hand, greets her and asks how she is today. She whispers a “halo” and looks back up to the television. Her mother smiles warmly as she sits beside her.

Ira is seven years old and has a cancer called neuroblastoma. It has spread throughout her body- to her lungs, liver, heart and stomach, making her condition terminal. She has recently been discharged from hospital and Dadan has come to see how she is doing at home. Sitting on the floor beside her, he reaches into his bag and pulls out two books about princesses. Ira accepts them with interest. A princess crown decorates her pink shirt.

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Dadan chats to mom to get an update on how Ira is doing. She informs him that Ira has an appointment tomorrow to get an echocardiogram. This will show how her heart is functioning under the stress of her cancer and recent chemotherapy treatment.

Dadan is the most recent member of the Rachel House team of registered nurses who visit children at home; these are the children who have been diagnosed with life-limiting illnesses. After three years caring for children in a Jakarta hospital, he decided to expand his skills as a peadiatric nurse in the home care setting. When asked what he finds special about the work Rachel House does, he humbly explained how the organisation reaches out to children and their families who otherwise may not have easy or affordable access to health care. He says he has received very positive reactions from patients, their families and their communities about the care Rachel House provides.

Ira reaches to her foot and tells Dadan that it is painful and pounds her fist into her hand in an attempt to try to describe how it feels. A tear falls down her cheek and Dadan comforts her by gently rubbing her back. Mom tells her to be brave. Her medical notes indicate that she does not have any pain medication prescribed, only tablets for her ailing heart. Dadan collects more information about her pain. It is a new pain. It started suddenly. It comes and goes. It is only on the left side. She had paracetamol this morning. She can’t move her leg or wiggle her toes and she becomes slightly annoyed by this question, maybe because she knows she should be up dancing and playing like other kids her age.

Despite this, Ira remains stoic and shows off her sense of humour. Dadan asks about her pain again, “If there are five ants, how many ants are biting you?” She replies smartly “I don’t want ants to bite me!” She returns to flipping through her new books and proudly tells us that she likes to draw. Her mom, proud of her too, produces a bag of all her colouring and drawing that she has done during her hospital admissions. This seems to distract Ira momentarily from her discomfort.

Dadan enquires about her wounds that have developed on her sacrum. Previous nurse visits have documented the progress of two pressures sores that have developed into deep wounds. This probably contributes to her inability to move her legs.  Ira states that they do not cause her any pain. Fortunately the dressings do not need to be changed today which spares her the long and uncomfortable process.

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Though Ira willingly engages with Dadan, she indicates that she doesn’t want a male nurse to look at her belly or listen to her back. Dadan respects this request and remains sitting beside her. He asks about her appetite, her ability to sleep, and if she is taking her heart medications as prescribed. Ira’s mom asks questions too, “Is this cancer genetic?” “Will my daughter be healed?” Ira suddenly looks up to her mom and sternly says, “Why would you ask that? Of course I will be healed!”

Too often, Rachel House nurses have these conversations with anxious and scared parents and carers of children who are dying. Before working at Rachel House, Dadan had only heard of palliative care while in nursing school. Before now he did not know what it looked like, or how it influenced patient care and treatment. Part of Rachel House’s mission is to raise the awareness of palliative care by engaging the community in discussions around death and dying and to teach health professionals the knowledge and skills to care for someone at the end of their life.

With time Ira becomes comfortable with Dadan and tells him that he can look at her stomach and listen to her chest. Dadan exercises care while he continues his nursing assessment. Ira’s stomach is very distended and firm, her chest sounds are coarse and her skin is very warm. Dadan encourages Ira’s mom to give her paracetamol again to ease her pain and bring down her temperature. Dadan provides assurance that he will follow up with them again after her appointment at the hospital tomorrow. He reminds Ira’s mom to tell the doctor about the pain on Ira’s foot so that she can be prescribed proper analgesic. Mom says she will and tells Dadan that if she forgets, she is sure Ira will tell the doctor about her pain; she is very upfront like that. Ira tells us that she once told the nurse who was taking her blood that if they didn’t get enough from her arm, they could try her neck or eyebrows.

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Dadan thanks Ira and her mom for the visit this morning and he leaves to return to the Rachel House office where he will meticulously document his assessments and nursing care. Dadan believes that Rachel House is a real pioneer of palliative care in Indonesia. As a beginning practitioner in this field, he acknowledges that his own understanding of palliative care is the most challenging part of the job, especially in a healthcare environment where the concept of end of life care is relatively new. “I am still learning,” he says, “there is no doctor in the home, you have to be able to work independently.” But he sees the positive outcomes from the work he and the other Rachel House nurses provide and holds hope that palliative care will become an important part of Indonesia’s overall healthcare plan. Of all the things that Rachel House has taught him so far, he says he has learned the importance of patience and kindness, the attributes that are without a doubt, the hallmarks of palliative care nursing.


*name changed to respect patient’s identity

Through the Eyes of a Summer Intern… on the World Hospice & Palliative Care Day


(By Joyan Tan, a Rachel House Summer Intern from Yale-NUS College Singapore)


Death – The Last Frontier

I have asked myself the question, “How do I want to die?” countless times in my life. Depending on how I feel at the time and at what stage of my life I am at, the answer often varies – from passing away peacefully in old age to dying heroically in a fire trying to save a kid. Of course, all this assumes I even have a choice in the matter. All too often, we don’t have a choice. Death comes quickly and takes us, and our loved ones away. But what’s worse is that sometimes death comes slowly and you’re dragged through the dying process painfully and slowly.

In the two months I’ve spent with Rachel House, I’ve come the closest face-to-face with death than ever before. It’s easy to write off death when you’re only 20, because you think- surely it’s not going to come soon! I still have so much more time! But the patients at Rachel House don’t even have the opportunity to reach 20 years of age before they are robbed of their lives forever. It’s infuriating and saddening.

The first patient I met was a tiny little baby boy named Andi. He was HIV positive. He was so tiny- “like a melon”, was how Prita (Rachel House’s Program Officer) described him. He was only 4 months old, and had the tiniest fingers and toes, and it just makes you marvel at how small a human being can be. Andi’s mother was only 18. She was two years younger than me, married and had a boy to call her child. She was also wholly unprepared to be a mother.