Healthy Lungs from a Global Perspective: An Interview with Made Pramana

This article was written by Stephanie Williams, BS, RRT.

Recently, the COPD Foundation’s Stephanie Williams spoke with Made Pramana, an individual from Indonesia who has been diagnosed with bronchiectasis. Read on to learn more about Pramana, his life in Indonesia, and how he helps people learn more about lung diseases.

If you could describe where you live in 100 words or less, how would you describe it? What is an average day like?

I live in Denpasar, which is the capital city of the island of Bali, Indonesia. Denpasar is a busy place, with lots of street vendors. People usually drive motorcycles or cars to commute. There is also public transportation, such as buses or taxis. There are some public places such as beaches, rice fields, parks, and a mangrove forest. Denpasar also has traditional markets, amusement parks, museum, hotels and pools. The housing in Denpasar is quite crowded since many people choose to live and work here.

People usually start the day by buying groceries at 5.30 AM in the morning. If they don’t have time to prepare a meal, the street vendors also sell breakfast. People also can buy foods for breakfast from the street vendor when they don’t have time to cook. Students used to go to school at 7 AM and many people go to work at 7-8 AM. For those that have time, they use the morning for exercise in the park, including yoga, walking, or jogging.

How are things different for you and your community now compared to before COVID?

The schools are still closed because of the COVID-19 pandemic and students have to learn online. There are fewer tourists in Bali since the start of the pandemic. Most people are still going to work; some wear masks and others do not. The same is true for recreational activities. I was at the beach the other day and saw many people swimming, biking, running, and walking. Many people were not wearing masks.

Are you vaccinated? What about your family? People in your community? Are they excited or skeptical of the vaccine?

My immediate family members and I are already vaccinated. Some of my relatives and neighbors are also vaccinated. Some people were hesitant at first but now people are accepting the vaccination program. People are willing to get vaccination as soon as they can get access. The vaccination sites are in hospitals, community health facilities and hotels.

Can you describe the air quality where you live?

The air quality in Denpasar is moderate. We do have some trees which helps to improve air quality. I think the motorcycles and cars are the major sources of air pollution. Also, many people still independently burn their trash in their home. Some houses also don’t have a proper air circulation. For example, there are many houses that don’t have a kitchen hood. There is mold in some houses caused by tropical weather, high humidity, and poor air circulation. And smoking is so prevalent in here which contribute to lower air quality.

Do you think the air quality affects the population? Respiratory illness, allergy, etc?

I think the air quality affects the population. Many people have respiratory illness or allergies. I found an article (linked below) that discussed the factors associated with acute respiratory tract infection in East Denpasar children, with exposure to cigarette smoke and population density being some of the significant factors (Lebuan & Somia, 2017).

What about smoking? Do many people smoke there? Is it mostly people of a certain gender and age?

Many people still smoke cigarettes. It’s common to see men and women of all ages smoking. I sometimes see neighbours who smoke cigarette while their children are close by. E-cigarettes are also common in here. I found an article (linked below) that mentioned the prevalence of smokers in Denpasar was 27.4% (Suarjana et al., 2020).

What is the awareness of lung conditions? (of any variety: asthma, bronchiectasis, emphysema, etc)

I don’t think many people know much about COPD and bronchiectasis, but I think they are more familiar with asthma. I don’t think people in Denpasar are aware of how air pollution affects respiratory health. People still burn their trash at home and smoke cigarettes in public places that are supposed to be smoke free.

Would you say that people who live near you are concerned that exposure to pollution or other irritants can cause lung disease?

I would say that some people who live near me are not very concerned about exposure to pollution or other irritants can cause lung disease. As I mentioned, many of my neighbours burn their trash at home.

What health or health education resources are available?

People can access online resources about health promotion and health education that were created by the government, medical schools, and community health facilities. But I don’t think that there is a support group for patients with respiratory disease (COPD, bronchiectasis, etc) in Bali. I don’t think there is a foundation in Indonesia to provide people with information and support related to COPD and bronchiectasis.

We know that you have your YouTube channel where you share videos to help educate people about bronchiectasis. What a great idea! How did you come up with the idea to create that channel? Can we share it here?

I created some YouTube videos as a way to share my experience living with bronchiectasis. I do not believe there are many Indonesian people who know about bronchiectasis. I also think that Indonesian people living with bronchiectasis don’t get enough support or information to maintain their condition. I would like to increase the visibility of bronchiectasis in Indonesia through the videos that I made.

How did you get diagnosed with Bronchiectasis? Just based on symptoms? Or CT scan? How old were you when diagnosed?

I was diagnosed in 2014, when I was 18 years old. I was coughing up blood. The doctors performed a chest x-ray and later a CT scan to diagnose my condition. I probably first started showing signs around 2011 when started to cough mucus.

What else would you like to share with the COPD360social community?

It’s been amazing to be on COPD360social. I joined COPD360social on 2015 and it was the first resources that really explain the detail of COPD/bronchiectasis for me. COPD360social gives support and information for me living with bronchiectasis.