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Suffer the little children


The plains are polluted. On a windless day – and they’re common – there’s no need for a sniff-o-meter to count the particles – just stand in a high place and scan the smogscape below.

This is Java, the big island next door. In parts it’s beautiful and mystical, but also one of the world’s most overcrowded places where the environment can be poisonous. To the list of lung and heart diseases and shorter lives add a searing statistic from international nutritionist Jee Hyun Rah: ‘Indonesia is considered to have the fifth-highest number of stunted children in the world.’

According to UNICEF: ‘Millions of Indonesian children and adolescents remain threatened by staggering rates of stunting and wasting and the ‘double burden’ of malnutrition where under-and over-nutrition co-exist.’

Stunting is irreversible. It’s the failure of kiddies to reach normal growth rates, caused by chronic malnutrition and continuous sickness. ‘It can permanently limit a child’s physical and cognitive capacity and cause lifelong damage.’ About seven million listless littlies struggle in this wretched state.

Wasting is acute inanition that can lead to death – two million in this category show their xylophone chests, staring eyes and shrunken cheeks. They can recover if fed well and regularly; they live in a lush and fructuous country. Whoever imagined a Garden of Eden must have visited Java.

So what’s the problem? Give the kids medical checks and lashings of tucker, and then all will be well. If only.

The reasons for the calamity are complex. They include land ownership, uncontrolled urban spread, and hopes for a better life, all compounded by inequality. Any fix requires a whole-of-government assault powered by continuous political will.

There’s a National Strategy to Accelerate Stunting Prevention involving 22 agencies. It’s made some progress (the rate was reportedly 37 per cent in 2013) but the incidence remains ‘stubbornly high’ says the World Bank.

More than half of Indonesia’s 273 million citizens live in Java. It has 38 mountains including active volcanoes dusting the land with mineral-rich ash. In some areas, three crops can be harvested across the two seasons – hot/wet and hot/dry.

But every year hundreds of square kilometres of precious soil vanishes forever under asphalt and concrete as the cities sprawl to handle the rush from airy uplands to the Big Smokes. This has a bearing on the stunting tragedy.

Late last century the rural-city divide was roughly 60-40. Now it’s the other way around. Fed up with rough work, low wages and few opportunities for betterment, more than nine million Indonesians head to labour-hungry countries. That’s seven per cent of the nation’s total labour force.

It’d be logical to assume that swapping manual labour in the clean outdoors with fresh fruit and veggies at the doorstep, for factory toil, denser living and streets awash with carbon monoxide would lead to poorer health.

However, it’s the other way around according to Dr Sirojuddin Arif of the SMERU Research Institute. He told an ANU forum on rural Indonesia that villagers aren’t getting the choices facing city folk.

To be aware of stunting, parents need access to clinics and doctors. As in Australia, rural life doesn’t attract, so the quality of health care shrinks as the kilometres increase between city and bush.

Then there’s nutrition. Villagers live on rice, corn, some veggies and the occasional chook. Red meat is dear and rare. Not enough protein; the results are obvious and serious.

The pandemic has aggravated the crisis, says UNICEF: ‘Overburdened health facilities, disrupted food supply chains and income loss due to COVID-19 could lead to a sharp rise in the number of malnourished children in Indonesia unless swift action is taken.’

Stunting and wasting levels in Australia are below one per cent and among the lowest in the world. Our problem is obesity.

If Jakarta palace statements are the prescription, then the government has heard the alerts; if posters, social mapping and milk handouts are the dosages, then they’re not listening.

Joko ‘Jokowi’ Widodo said that stunted children meant the next generation would have difficulties competing with their peers from other countries. The President comes from a poor family and carries a reputation for compassion, but his reasoning is that of a heartless economist. The kids’ lives and futures with their families will be stunted.

Layered across all the issues are politics. Worried a growing reliance on imports makes Indonesia look like a dependency has pushed the need for ‘food security’ giving the impossible dream a patriotic fervour. But stunting is more an absence of quality than quantity.

Little capital has been invested in farming so it remains labour intensive.

In rural Thailand, big tractors are a common sight. In Indonesia, it’s oxen, walk-behind cultivators and small rice threshers. Workers paid around AUD 5 a day and often less, swing scythes and hoes pre-dating the Industrial Revolution.

Then there’s hygiene: In hamlets without tap water women bathe babes in irrigation ditches, while neighbours upstream defecate and tip rubbish despite warning signs.

Land reform remains a never-ending pain. In 1870 the colonial Dutch introduced domein verklaring (land declaration) giving the State ownership of all land where owners don’t have clear titles.

Despite the Republic rejecting Dutch controls, the policy remains – meaning the government holds about 63 per cent. So the Ministry of Forestry can allocate great tracts to corporations for palm oil plantations, mining and timber cutting.

The World Bank says: Holding clear rights to access, use and own land is a crucial means for the poor to improve their food and livelihood security. Secure land tenure can stave off worsening poverty or even be a means to move out of poverty.

Late last year a forum on the economy told Widodo that one per cent of the population controls 59 per cent of the nation’s land. He said he’ll distribute 12 million hectares to the poor, but so far has transferred around a third.

Last month he urged citizens to ‘work hard and work together with the government’ to lower stunting prevalence rates from 24.4 per cent to 14 per cent across the next two years.

The goal is unambitious. The political will needs more than a mild Presidential nudge if the 650 Indonesian babies born in the hour while you’re reading this website are to get a fair crack at life.

About Writer:

Duncan Graham has been a journalist for more than 40 years in print, radio and TV. He is the author of People Next Door (UWA Press) and winner of the Walkley Award and Human Rights awards. He is now writing for the English language media in Indonesia from within Indonesia.

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