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

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.