INDONESIA

Indonesia's practice of pasung — the shackling and confinement of people with mental illness — disproportionately affects men and reveals the country's mental health crisis in its most extreme form. An estimated 57,000 people have been subjected to pasung, confined in backyard cages, chained to walls, or locked in rooms by families who have no access to psychiatric care and no alternative. The government has pledged to eliminate pasung, but the infrastructure gap — fewer than 1,000 psychiatrists for 277 million people — makes the pledge aspirational rather than actionable.

The smoking crisis is uniquely Indonesian and uniquely masculine. Over 60% of men smoke — the highest rate in the world — and the tobacco industry is deeply embedded in the economy and culture. Kretek (clove cigarettes) are a masculine social ritual, and the tobacco lobby is powerful enough to have prevented graphic health warnings for years. Men start smoking in their early teens, and the health consequences — lung disease, cancer, cardiovascular disease — kill hundreds of thousands annually. The economic cost to families when the male breadwinner becomes too sick to work compounds the health crisis into a poverty crisis. Meanwhile, the recurring natural disasters — the 2004 tsunami, the 2018 Sulawesi earthquake, the 2010 Merapi eruption — create a cycle of male trauma-and-rebuild that has become the background radiation of Indonesian masculine life.