Indonesia’s archipelagic beauty and marine biodiversity lure divers from around the world. As the country’s popularity as an international dive destination grows, so does the complexity of dive safety. Protecting divers is no small feat across this landscape of more than 17,000 islands, many dotted with dive sites in remote locations lacking medical infrastructure. This challenge demands coordinated action from every facet of the industry.
A pivotal moment came during 2022 Deep and Extreme Indonesia (DXI), one of Asia’s largest dive and marine tourism exhibitions. At this event Divers Alert Network (DAN), the world’s leading dive safety organization, and the Indonesian Ministry of Tourism (MOT), the nation’s agency responsible for dive tourism, forged a groundbreaking partnership with a shared mission of making Indonesia safer for divers. This alliance sparked a series of regional initiatives, leveraging DAN’s safety expertise and MOT’s local knowledge.
Mapping Dive Safety Challenges
In September 2022, DAN and MOT launched a fact-finding mission across the archipelago. The team included Matias Nochetto, MD, DAN’s vice president of medical services, and Francois Burman, Pr. Eng., MSc, DAN’s vice president of safety services. They had support from Indonesia Minister of Tourism and Creative Economy Sandiaga Uno and other MOT officials, who accompanied them on their travels. DAN’s Indonesia team — Bayu Wardoyo and the late Rendra “Ronny” Hertiadhi — played crucial roles. Hertiadhi, who died in January 2024, left a legacy of making diving safer in his home country as DAN’s Indonesia Country Manager.
“The Ministry of Tourism’s commitment and our fact-finding mission marked a major milestone in addressing challenges that Rendra Hertiadhi and I had long been grappling with,” said Wardoyo, DAN’s Indonesia representative and liaison for dive safety projects. “By combining our expertise and resources, we’re now implementing a strategy that engages key stakeholders and has a widespread impact on dive safety.”
Indonesia’s geographic area and diveable shoreline exceed that of the entire Caribbean, so the mission’s scope was vast. The team embarked on an extensive 21-day journey that included 16 flights, five boat rides, and 12 destinations. They visited nine hyperbaric chamber facilities, conducted 15 meetings, and presented 19 lectures to dive operators and medical professionals. These interactions provided deeper insights into dive safety challenges, highlighting the need for engagement with industry stakeholders across all levels and regions to effect change.
“Theory, ideas, and words are easy to promote, but achieving safety improvement goals requires direct action,” Burman said. “For DAN in Indonesia, this has largely taken the form of engagement and relationship building. Working alongside the Ministry of Tourism, we met with local dive associations and training agency representatives, visited hospitals and recompression facilities, evaluated emergency medical services capabilities, and delivered presentations at major dive destinations and diver treatment facilities to identify the most pressing needs for DAN to tackle.”
Elevating Dive Medicine Expertise
DAN’s initial assessment found a shortage of medical professionals equipped to provide definitive care for injured divers, including the ability to initiate vital treatments such as recompression therapy.
“Medical school curricula rarely include dive medicine, and Indonesia is no exception,” Nochetto said. “Given the extensive dive activity throughout the country, it’s imperative to provide educational opportunities for Indonesian medical professionals — locally, affordably, and in their native language. Our goal is for them to feel confident in contacting our DAN Medical Services team for support with any dive-related cases.”
To address the need for improved medical care for injured divers, DAN organized the Academy of Dive Medicine in Bali in August 2023. Endorsed by MOT and coordinated by Nochetto, Burman, and DAN’s Indonesia team, this event was the fourth iteration of a successful concept DAN first introduced in Latin America in 2016. The multiday course offered practical dive medicine education while strengthening ties between DAN and local health care professionals.
“Our initial fact-finding mission established relationships with health care professionals from across Indonesia, and the academy in Bali deepened them,” Nochetto said. “Over four intensive days we shared knowledge, laughter, and meaningful conversations. This face-to-face interaction was invaluable in building the trust and understanding essential for lasting partnerships.”
The event gathered more than 50 health care professionals from across the archipelago. DAN sponsored doctors and nurses from remote areas to participate, ensuring broad representation. Real-time translation between Bahasa Indonesia and English facilitated knowledge sharing and a collaborative atmosphere.
Launching DAN’s Indonesian Hotline
The Academy of Dive Medicine in Bali catalyzed the creation of DAN’s Indonesian Hotline. Four skilled and dedicated Indonesian doctors from the event were chosen to manage this new regional service, with DAN’s Medical Services team providing technical infrastructure and operational guidance. This hotline, which is available in Bahasa Indonesia, enhances DAN’s ability to assist Indonesian divers, operators, and medical professionals in their native language.
Bridging Hyperbaric Care Gaps
The academy’s lectures also addressed hyperbaric chamber facility safety and diver treatment standards. DAN advocated transitioning from U.S. Navy Treatment Table 5 (TT5), commonly used in Indonesia, to U.S. Navy Treatment Table 6 (TT6), the industry standard for treating decompression sickness. Although TT6 is more time-consuming, its proven safety and efficacy make it the preferred treatment. DAN strives to align Indonesian doctors’ and chamber operators’ practices with international best practices.
“Our work in Indonesia is rooted in collaboration and recognition of local established practices,” Nochetto said. “The trust we’ve built with local professionals — reinforced by interactions such as our chamber visits and the Academy of Dive Medicine in Bali — helps DAN effectively encourage positive change and adoption of recommended protocols, such as U.S. Navy Treatment Table 6.”
DAN conducted thorough on-site inspections and operator training in Indonesia’s most popular dive regions as part of its commitment to expanding access to safe, high-quality hyperbaric treatment. While many existing facilities can accommodate only stable, ambulatory patients, there’s a growing need for centers that can provide advanced care to critically ill divers, especially in remote areas.
Consequently, DAN has extended its Recompression Chamber Network (RCN) by adding nine safe, well-equipped Indonesian chamber facilities and identifying those with advanced capabilities. This expansion enables more efficient referrals of divers needing recompression treatment to Indonesia’s nearest suitable hyperbaric chamber.
Training 1,000 Providers in 1,000 Days
DAN set out to bolster on-site first aid response within Indonesia’s dive industry by drawing on insights from the fact-finding mission. Dive first aid is a critical initial step in managing injuries before professional medical care. Accident preparedness is essential for all staff levels, including support crew, and every operation should have at least one trained dive first aid provider. Equipping a broader range of individuals with these skills improves safety at every potential incident site.
DAN and MOT launched the ambitious “One Thousand Providers in One Thousand Days” initiative to increase first aid capabilities across the archipelago. Also known as “One Thousand in One Thousand,” it aims to equip 1,000 dive support staff with basic life support and emergency oxygen first aid skills within 1,000 days.
“We’re widening our reach to include dive hands, deckhands, skippers, and dive shop staff, as dive professionals already must maintain current first aid training,” Burman said. “Whether it’s an underwater emergency during an entry-level class, a propeller injury from a charter boat, or a head injury from a falling tank, these frontline workers must be prepared. Our One Thousand in One Thousand initiative empowers the staff onsite during emergencies.”
DAN works with various dive training agencies — including NAUI, PADI, SDI, and SSI — to deliver this training throughout Indonesia. DAN funds One Thousand in One Thousand, MOT provides support, and training agencies supply instructors. The instruction and materials are available in Bahasa Indonesia, ensuring accessibility for local staff. Each trainee receives a complimentary DAN first aid kit. DAN will also distribute emergency oxygen kits to qualifying operators, which is a significant investment in dive safety.
“The local dive industry has embraced the One Thousand in One Thousand initiative,” Wardoyo said. “We’ve received positive feedback from operators about its benefits. Frontline staff gain important first aid skills, businesses can promote their safety standards with greater confidence, and guests feel reassured knowing a trained first aid provider is always nearby. Our training events serve Indonesia’s entire dive ecosystem.”
As of August 2024, more than 500 individuals have received first aid and emergency oxygen administration training across four major regions in Indonesia. DAN held these training events in key dive locations, including Labuan Bajo, Sanur, Amed, Tulamben, Pemuteran, Nusa Penida, and Southeast Sulawesi — with more to come. Building on One Thousand in One Thousand’s success to date, plans are in motion to expand to other areas in the Asia-Pacific region.
Shaping Dive Safety’s Global Future
DAN continues to strengthen the safety net at every stage of a diver’s experience in Indonesia through various initiatives — from first aid training for dive crew members through One Thousand in One Thousand to specialized education for medical professionals at the Academy of Dive Medicine in Bali, comprehensive hyperbaric chamber inspections, and 24/7 multilingual assistance via the DAN Indonesia Hotline.
“Our success in Indonesia stems from uniting medical practitioners, dive industry professionals, and government officials around our shared goal of enhancing dive safety,” Nochetto said. “By supporting local doctors and fostering trust between them and dive industry professionals, we’re building a robust medical infrastructure to support the local dive industry. Our initiatives have helped cultivate a collaborative culture of dive safety within the country, and the personal connections we’ve established will undoubtedly contribute to future partnerships as our current programs evolve.”
DAN’s impact in Indonesia represents more than just local improvements; it signals a paradigm shift in global dive safety approaches. As these initiatives prove their effectiveness, they have the potential to be adapted and implemented in dive hotspots worldwide.
DAN’s innovative approach in the international dive community envisions a future where divers can explore underwater environments more safely across the globe — from local quarries to Indonesia’s vibrant coral reefs.
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© Alert Diver – Q4 2024