A human right perspective about hunger in Indonesia

Sudirman Nasir, Victoria

The hundreds of children suffering from chronic malnutrition in West and East Nusa Tenggara, Lampung and West Sumatra should be considered just the tip of the iceberg. There are many other children in remote rural areas or in urban slums in Indonesia who are likely to be ill with symptoms of malnutrition that go unreported because their parents lack access to adequate treatment and prevention programs.

It has become apparent that malnutrition is not merely a public health problem. The root causes of malnutrition are poverty, social deprivation, state neglect, official ignorance and people's lack of access to social services, particularly the fulfillment of their basic needs and fundamental rights to food, health and education.

Malnutrition is definitely a socio-economic and political problem and it is also a human rights problem. The Presidential Commission on Hunger (1980), a commission of the United Nations, outlines it thus: "Whether one speaks of human rights or basic human needs, the right to food is the most basic of all. Unless that right is first fulfilled, the protection of other human rights becomes a mockery for those who must spend all their energy merely to maintain life itself".

The human rights aspect of malnutrition should be taken into account since we can never solve malnutrition problems as long as we treat them merely as health or medical problems. A human rights perspective, which links malnutrition with health, socio- economic and political problems, should also stimulate the need for a multidisciplinary and multi-sector approach to overcome malnutrition.

This perspective suggests how to solve and reduce malnutrition by overcoming its root causes. Poverty alleviation, social and economic development, and the state's responsibility to create a good government that works to fulfill the basic needs of its people are prerequisites to win the war against hunger and sickness.

Furthermore, combating malnutrition should be a strategic part of our efforts to increase people's quality of life since malnutrition has long and even intergenerational effects. Chronic malnutrition, which leads to diseases like kwashiorkor, marasmus and marasmic-kwashiorkor in children, has severe biological and psychosocial consequences, retarding mental and physical development.

It is also clear that without prompt treatment and sustainable prevention programs, malnutrition can cause premature death. Even if those chronically malnourished children can survive and reach adulthood, they may endure many psycho-social disturbances and can transmit weak genes to their offspring.

Many studies indicate that children of chronically malnourished parents (especially mothers) have greater risk of suffering from diabetes (type 2), cardiovascular diseases and many kinds of cancers. This is the so-called the proof of the "Baker hypothesis" that explains the foetal origin of diseases (Siddiq Osmani and Amartya Sen, The Hidden Penalties of Gender Inequality: Foetal Origins of Ill-Health, Journal of Economic and Human Biology, I, page 105-121, 2003).

Taking a human rights perspective it is obvious that malnutrition among children can create lost generations, which can risk the future of an entire people or nation.

Since children and women are the most vulnerable to malnutrition, their human rights need to be taken the most seriously. It is also clear that the state needs to take the main responsibility of ensuring these groups have access to food and nutrition.

Community development programs to enable parents to provide sufficient food for their children, to educate and facilitate parents to maintain good hygiene and sanitation for their families as a way of preventing infectious diseases, and to improve access to strategic social services such as health and education, are essential.

The Indonesian government has addressed the rights to food in the explanation of Law No. 7 on health (1996), which states that eating food is a basic human right of every person in Indonesia and should be guaranteed and available for all.

In addition, the Indonesian government has ratified the Convention on Children's Rights that address the government's obligation to fulfill children's rights of protection, rights of survival, rights of development and rights of participation. Children's rights to sufficient food, education and health are definitely important in this convention.

However, the malnutrition illnesses among children in many provinces in Indonesia that occur nearly every year show that there are wide discrepancies between what is written in the many laws and conventions and the reality.

Depressing but unsurprising was the Minister of Health Siti Fadilah and Coordinating Minister of the People's Welfare Alwi Shihab's response to the issue. Saying how shocked they were that an outbreak of malnutrition could occur in a rice-surplus area like Mataram, they gave the impression that the outbreak was an accident or some kind of isolated incident. Such naive statements show the over-simplistic views many important officials have of what is a complex and reoccuring problem.

It also shows how difficult it is to promote human rights concepts among elected officials. The mentality of Indonesia's leaders in government and the legislature will have to change before they are to understand the multifaceted nature of malnutrition problems or how they are retarding this country. Such a comprehensive understanding is the basic requirement to creating appropriate policies and programs to overcome the root causes of malnutrition.

To help educate our leaders, Indonesia's civil society elements -- NGOs, academics and the media -- need to stress the urgency and importance of human rights to food and basic nutrition.

They must also highlight cases of malnutrition as the product of a state's neglect of these basic rights -- and hard evidence that politicians and officials do not care about the welfare of the people and are ignorant of their proper role in society.

The writer is a postgraduate student at the Key Centre for Women's Health in Society at the School of Population Health in the University of Melbourne. He can be reached at s.nasir@pgrad.unimelb.edu.au