Sleman is a regency located on the island of Java inside Yogyakarta Special Region, an autonomous province uniquely governed by a monarchy, which is led by the Sultan of Yogyakarta.
Recognized as a strategic agrarian hub, the regency is blessed with thick, fertile soil, and no fewer than 29 higher education institutions make it a welcoming home for fertile minds.
Sleman also enjoys the distinction of being Indonesia’s first Angels Region, having been formally elevated to that status on 11 May at a high-level gathering at the Pendopo Parasamya, Sleman Regent’s office.
To become an Angels Region, Sleman had to demonstrate its stroke readiness in four areas. That meant having enough stroke-ready hospitals to serve its population, WSO Angels Awards for all the hospitals in the stroke network indicating a high standard of care, stroke-ready emergency services that met the criteria for an EMS Angels Award, and public awareness education through implementation of the FAST Heroes program.
But by meeting the standards for Angels Region status Sleman has also shown its heart.
As a community that values helping each other and working collectively to achieve shared goals, Sleman already had all the qualities needed to become an Angels Region. It was only a matter of measuring, monitoring, and improving performance to ensure the citizens of Sleman are protected from death and disability as a result of stroke.
The beginning of the story
This is not our first meeting with Dr Eni Nurhidayati, Sp.S, neurologist at RSUD Sleman (Sleman Regional General Hospital) where she has been shaping neurological care since 2013. Dr Eni’s interest in stroke is a tribute to her late father who passed away as a result of stroke in 2014, when thrombolysis had not yet been implemented in Indonesia. It left Dr Eni determined that every eligible patient should receive the treatment they need, and every patient be given the best chance for recovery.
Her story was captured by Angels consultant for Central Java, Dr Fiarry Fikaris, in February 2025, in an article titled “Golden Threads Woven by RSUD Sleman”. But that, Dr Fikaris explains, was just the beginning of the story. “The rest is persistence to make even broader impact beyond the hospital.”
Back in 2025, RSUD Sleman had just won their third successive WSO Angels gold award, the result of evaluating previous cases, identifying gaps and taking corrective action. Analysis of their data had also highlighted a need for public awareness and lead to a collaboration between the hospital and Puskesmas, the primary healthcare facilities that provide the first level of care.
Less than 18 months later, Sleman Regency has six award-winning hospitals including, in addition to RSUD Sleman, RSUP Dr. Sardjito, RSA UGM, RS JIH Yogyakarta, RSIY PDHI and RS Hermina Yogyakarta. Sleman Emergency Service has likewise been recognised for its achievements in stroke care, its collaboration with Dr Eni leading to a diamond award.
Commitment and the realization that everyone can be a stroke patient were the key drivers of the region’s success, Dr Eni says, and the guest list and agenda at the celebration on 11 May testified to broad support from regional government and health officials. Speakers included Perdosni (Indonesian Neurologist Association) Yogyakarta’s representative, Dr Rakhian Listyawan, Sp.N, FINA, the Sleman’s Regent, H. Harda Kiswaya, S.E., M.Si, and Dr Gregorius Anung Trihadi, M.P.H of DI Yogyakarta’s Regional Health Office, representing the provincial governor.
They had all become cadres in the fight against stroke. They had all supported the stroke-ready region efforts all along.
Carrying the burden together
When everyone can be a stroke patient, everyone can be a cadre. That is the message from Dr Eni who rallied the region’s community health volunteers to meet public awareness targets.
In Indonesia, a health cadre is a trained, community-selected volunteer who serves as the vital link between primary healthcare facilities (Puskesmas) and local communities.
Puskesmas are the first port of call for patients and their role in detecting stroke symptoms and provide fast and accurate referrals is therefore vital. Once a Puskesmas doctor herself, Dr Eni had already capitalised on an opportunity to save more lives by training Puskesmas about stroke.
Now she turned to cadres to build the next link in the chain.
Given that a high cultural value is placed on doing something for one’s neighbours, volunteering as a cadre is held in high regard. The deployment of cadres also means that health news travels fast. Furthermore, Dr Fikaris says, by activating the cadres concept to promote the goals of the FAST Heroes campaign, the program was incorporated and streamlined into the local culture.
Now officially an Angels Region, Sleman has shown that the collectivist spirit that characterises Indonesian society is a powerful weapon in the fight against stroke, and that a community that supports one another is also one that carries the burden of stroke together.
