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The Woes Of Indonesia’s Children

According to Flint, Indonesia’s “reasonably high average income conceals a fair amount of underlying inequality.

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Measles, WHO
Two sick children wait for treatment after being admitTed to a hospital in Agats, Asmat District, after the government dispatched military and medical personnel to the remote region of Papua to combat malnutrition and measles, Indonesia. VOA

Despite its middle income status, Indonesia is dealing with what experts say are unexpectedly high rates of childhood stunting. Now, its government – starting with the the president – is declaring war on the issue and committing to boost its response to the challenge following a World Bank publication that says 37 percent of Indonesia’s children were stunted in 2013, a rate on par with some far more impoverished nations of Sub-Saharan Africa.

Stunting is the medical condition that the World Health Organization defines as “impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation.”

While Indonesia’s health ministry and other agencies have been battling to address the problem for years, the administration of President Joko “Jokowi” Widodo has now elevated the issue to be a national priority, making it a point to include it in last year’s Independence Day address.

“Before he mentioned it in the speech, I doubt it has ever been mentioned by a president in Indonesia,” said Claudia Rokx, a lead health specialist at the World Bank and one of the authors of the landmark book released last month.

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“If you’re malnourished during that first thousand days, the likelihood is that you would have suffered from irreversible brain damage,”

First 1,000 days

Health experts emphasize that the first 1,000 days of a child’s life are vital for preventing stunting, requiring adequate breastfeeding and nutrition, stimulation and activity, clean water and sanitation, and timely treatment of conditions like diarrhea and malaria.

With more than one in three Indonesian children being stunted, this means around 9 million children in Southeast Asia’s most populous country are suffering from developmental limitations.

Nusa Tenggara Timur, an impoverished province of eastern Indonesia, has the highest rate of stunting in Indonesia at 52 percent. Fifi Sumanti is a midwife on Komodo Island, known for its famous dragons and home to just 2,000 people. It is arid and most food must be brought in from other islands.

“Mothers here aren’t used to giving their children enough vegetables and fruit. They’re happier to give instant food to the children,” Sumanti told VOA. Hygiene awareness and access to clean water are also major problems, she said.

While the poorest parts of Indonesia suffer the highest rates of stunting, even among the richest proportion of Indonesians stunting is as high as 29 percent.

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Health experts emphasize that the first 1,000 days of a child’s life are vital for preventing stunting. Pixabay

Dr. Brian Sriprahastuti, a senior advisor to the office of the President of Indonesia on the issue of stunting, said the reasons for Indonesia’s stunting problem today go beyond the traditional factors of poverty and limited access to public services. “Now we have another hypothesis that behavior is the main problem of this stunting issue,” Sriprahastuti said.

Sumanti, the midwife, agrees.

“We need to speak with [mothers] more about what stunting is and give greater care from the time mothers are first pregnant until they give birth, until the time the child is three years old,” she said.

“If you’re malnourished during that first thousand days, the likelihood is that you would have suffered from irreversible brain damage,” said Simon Flint, a donor with the Asian Philanthropy Circle, a Singapore-based charity. It is thus, Flint said, “critically important” to prevent stunting to ensure “any intervention or expenditure on education,” adding it “could be so much more effective later on in a person’s life.”His group plans to launch a $10 million 1000 Days Fund by this March to support anti-stunting programs in Indonesia.

A new commitment

In the forward to the World Bank publication, the Indonesian president called current stunting rates “unacceptable” and pledged to prevent two million children from being stunted by 2021. “Eliminating stunting is therefore a main priority for our Government,” he wrote. “The Government is fully committed to do whatever it may take to achieve this goal.

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“I doubt it has ever been mentioned by a president in Indonesia,” said Claudia Rokx, a lead health specialist at the World Bank. Pixabay

Jim Yong Kim, President of the World Bank Group, said the government is investing in what he said are “evidence-based interventions” across 100 districts, to be expanded to the country’s 541 districts by 2021. “This initiative marks a decisive step up in the ambitions of the world’s fourth-most populous nation to tackle stunting as part of its commitment to sustained, inclusive economic growth,” he wrote.

According to Flint, Indonesia’s “reasonably high average income conceals a fair amount of underlying inequality. Just for example, according to government figures, in 2016 around 30 million Indonesians were still living on less than a dollar a day. There’s obviously a huge problem of inequality and lack of access among the poorest people.”

Sriprahastuti of the President’s Office said that the government was adopting a human rights-based approach. “For all pregnant women in Indonesia, everywhere, for all children under two, everywhere, we have to support them.”

Also Read: A Majority of Children Die Due to lack of Basic Healthcare Facilities: UN

“They know they have a huge problem, they’ve recognized it now. They are ready to do something about it. They’ve thrown a lot of money into it. They have the highest-level commitment, and they know it can be done in Indonesia as well,” said Rokx.

“Everything is in place for them to do it well, they just have to coordinate better, be persistent and make sure that these kids get the best start in life they can get.” (VOA)

Next Story

Reported Deaths from New Coronavirus Probably an Underestimation: WHO

WHO Expects Coronavirus Cases, Deaths to Escalate

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China Outbreak coronavirus
People wear masks to protect themselves from coronavirus on a street in Hong Kong. VOA

By Lisa Schlein

The World Health Organization says the number of reported cases and deaths from the new coronavirus is probably an underestimation. The latest reports put the number of confirmed cases at 830, including 26 deaths.

Most of the infections and all of the deaths have occurred in China. A small number of coronavirus cases have been reported in seven other countries, including the United States. All have been mild, and all of those patients have recovered.

World Health Organization spokesman Tarik Jasarevic says it is too early to draw conclusions about the severity of the coronavirus.

“Because at the beginning of any outbreak, you would focus more on the severe cases and you will have more of those and then maybe we are missing some mild cases because people will just be a little bit sick and will not be ever tested and they will recover,” Jasarevic said. “We may see more mild cases as surveillance intensifies. So, the issue is not really so much on numbers that we know that will go up.”

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People travelling for the Lunar New Year wear protective masks as they head to the departure area at the Beijing Capital International Airport in Beijing. VOA

Michael Ryan, the executive director of the WHO’s health emergencies program, says there is no particular treatment for this new pneumonia-like coronavirus.

“There have been a number of compounds that have been used in the fight against coronavirus, but it is very important to recognize that there is no recognized effective therapeutic against coronaviruses,” he said. “However, there are potential clinical trials that can be done with agents and that is what we are focused on right now — identifying other therapeutic agents and opportunities to test new drugs.”

Also Read- High-Protein Diets May Increase Heart Attack Risk: Study

On Thursday, a WHO expert committee decided not to declare the coronavirus a public health emergency of international concern. WHO Director-General Tedros Adhanom Ghebreyesus noted the virus was an emergency in China, but had not yet become a global health emergency.

He did, however, add the WHO was ready to reconvene another emergency meeting to review the decision if the evolution of the epidemic warranted a re-examination. (VOA)