Malnutrition -- it's the economy, not health, sir!

Endy M. Bayuni, The Jakarta Post, Jakarta

The government has launched a series of measures to tackle the growing incidence of malnutrition affecting hundreds, probably thousands, of under-fives.

President Susilo Bambang Yudhoyono has initiated Community Self-Help Month and National Health Week, promising billions of rupiah to revive the Integrated Health Services Posts and to further empower Community Health Centers.

Every effort is being made to tackle this problem head-on.

The picture that has emerged in recent weeks is certainly disturbing. Dozens of children have died due to malnutrition. Unless the government is swift to act, more will follow.

Images of emaciated children with bloated stomachs -- until recently, scenes one associated with Africa's Darfur -- have been appearing in our newspapers and on television almost every day. Only these are images of Indonesian children, from Papua, East and West Nusa Tenggara, Central Java and even Jakarta.

Malnutrition is not restricted to particular villages or provinces in the country, as was the case in the past. In Jakarta, the most affluent city of the nation, hospitals are treating children who are chronically undernourished.

As slow as the government's response has been, it is better late than never. Even so, one disturbing aspect of the response has been that the government is treating malnutrition cases purely as a health phenomenon. This has been the job of Coordinating Minister for People's Welfare Alwi Shihab and Minister of Health Siti Fadilah Supari, falling outside the domain of chief economics minister Aburizal Bakrie and finance minister Jusuf Anwar.

This is yet another example of a government action that seeks to cure the symptom, but leaves the real disease largely untreated.

Malnutrition is not an epidemic like malaria, polio or dengue. The high incidence in Indonesia does not indicate an "outbreak of malnutrition". Although it is becoming widespread, it does not spread through physical contact or proximity. Cases of malnutrition emerge independently of each other. Although there is a common denominator: Poverty.

Even if we put some of these cases down to ignorance on the part of parents who cannot distinguish between nutritious food and food that is low in nutritional quality, that too can be put down to poverty. And poverty in most, if not all cases, stems from lack of income, which in turn comes from lack of work.

The high incidence of malnutrition in recent months suggests the problem of poverty in this country is only getting worse. More and more people are in desperate need of support.

The irony here is that all of this is happening at a time when the government is proudly touting the rapid recovery of the economy. Most analysts are predicting the economy will soon be growing at a yearly rate of 6.5 percent.

Clearly there is something wrong with a model that shows the economy growing at such a fast pace, while among the population, there are people who have no way out of poverty and are facing the terrifying prospect of being unable to feed their children.

Yet, this is precisely the model adhered to by the administration. Going by the logic of its economic strategy, the way to eradicate poverty is to create jobs, and that can only come from higher economic growth rates, which in turn can only occur if there is enough investment. Economic policies are thus designed to attract investment first and foremost, and every thing else falls into place: growth, jobs and income.

There is nothing wrong with this textbook macroeconomics except that the poor will be the last to benefit. If economist Keynes argued for short rather than long-term economic policies to boost growth because "in the long run we are all dead", well, here today in Indonesia, some children are dying even in the short run because we are prescribing the wrong economic policy.

At any rate, the old economic model that assumed so many million jobs would be created if the economy was growing by 5 percent to 6 percent -- hence the obsession with growth targets -- has already been widely discredited. The foundations have changed, and 5 percent growth can no longer be assumed enough to generate work for the two million or so newcomers to the job market.

What Indonesia needs today is an economic strategy that puts poverty, or at least employment, at the center, in place of investment. Investment is indeed important, but more important is an economic policy that leads to the right kind of investment, one that creates jobs. Presently, this is not happening, and unless we change course, we are likely to see more malnutrition cases, even as the economy is rapidly growing.

What we see instead is the government's economic team, which seems to be indifferent to the problems of poverty and malnutrition. The trouble with an economic team run largely by a bunch of businessmen is that, in spite of the malnutrition crisis, for them, it is business as usual.

Malnutrition is a serious health issue that needs to be addressed quickly by the government. Better access to health facilities would ease the situation to some extent, but would not drive the problem away.

Malnutrition is also a serious economic issue that needs to be treated with the right strategy, one that leads to paid work for the jobless.

Malnutrition, ultimately, is a political issue. President Susilo calls the shots and has the capacity to revamp his economic strategy, or at the very least revamp the government's economic priorities and put poverty eradication and employment at the center of his policy.