The weak worst hit by crisis

By Solita Sarwono

WASSENAR, the Netherlands (JP): The economic crisis hitting Indonesia in the past year has affected different aspects of people's lives -- income, jobs, education, health, housing and security -- with the poor and low-income groups suffering the most.

Immediate effects can be seen in the drastic shortage of food supplies, as well as increases in unemployment, crime rates and the number of children forced to leave school.

It is heartbreaking to read press reports of two small children crying from hunger in a village in West Java as their mother cooked water and a stone in a pot, or that a few poor farmers gave away their children to other families because they could no longer afford to keep them.

In the long term, the crisis will also affect people's health. Government subsidies for health services and medical supplies, a major factor in the improvement of the public health status in the past decade, have been severely cut.

As a result, health services and medicines have become unaffordable for low-income people and preventive care will inevitably be neglected. Diseases will be left untreated, leading to a higher mortality rate.

Many people are turning to the help of traditional healers and birth attendants, with fees much lower than conventional medical personnel. Given the often poor hygiene and improper practices of the healers, the alternative care may also cause more deaths.

In addition, the shortage in the food supply will cause nutritional problems, particularly among babies, children, pregnant women and the aged. Malnutrition among young children will disturb development of their intellectual capacity, which in turn will produce low-quality human resources.

Although the crisis is a problem for the entire nation, the biggest burden falls on the shoulders of women as the key figures and pillars of families. As wives and mothers, Indonesian women have the responsibility of taking care of the health and welfare of their husbands and children, maintaining social contacts with relatives and friends as well as generating income.

In most households, with the exception of a small group of the rich, the family budget is declining sharply due to the crisis. Millions of families have even lost their income since their breadwinners have been laid off or dismissed by their employers.

Naturally, the wives have to adjust and cut the monthly household expenses. They have to reassess the family outlays and decide which should be trimmed. They will make a list of priorities and think first of the needs of their children and husbands, putting their own in last importance.

Protecting and sacrificing for the family is a normal maternal instinct, manifested each time the wives feel a threat to their families. However, this unselfish attitude can cost them their health. Lack of food, poor nutrition and harder work is gradually destroying their physical well-being. On top of that, wives are under extra stress, as they often become the husbands' object of frustration and anger, which are escalating nowadays.

The role of a mother has become more difficult, too. All mothers want to give their children the best care and education. They hope to see their children obtain a better life and reach higher status than their own. It is thus very sad and frustrating for mothers when they are forced by this turmoil to end their children's education.

As many as eight million children have been unable to continue their primary and secondary education in the past few months. This is a huge increase from the annual average of dropouts, estimated at 2.5 million by the Central Bureau of Statistics. It is easy to assume that the majority of the dropouts are girls.

To provide better living conditions and education for children, millions of mothers in Indonesia have been able to limit the number of children with the help of contraception.

The slogan "two children is enough" for family planning campaigns seems to have been internalized in the minds of young women. Continuous information and persuasion by the government and private institutions have made young women aware of the importance of education and good health in raising children. But that costs money, and young women currently prefer to have fewer children.

In order to promote family planning programs, the government has provided subsidies for family planning services, including contraceptives. But the situation has changed now. Lack of funding has forced the government to cut its subsidies. Prices of contraceptive pills and injectables have become unaffordable to low-income families.

The situation has forced some women to resort to traditional contraceptive methods, such as using herbal medicine and the rhythm method. These measures seldom work. As a result, the number of pregnancies will significantly increase in the coming months, to be followed by an increase in the abortion rate or a baby boom in the near future.

With the increased costs of medical care, the cost of abortion by licensed doctors has become too expensive for members of the low-income group, forcing them to turn to back-street practitioners and traditional birth attendants. Experience shows these practices lead to high maternal mortality.

On the other hand, keeping the pregnancy also brings its negative consequences. Deliveries assisted by traditional birth attendants increase the risk of death for both mothers and babies. When a baby is born safely, it may not get proper nutrition, which is crucial for its physical and mental development. And if the child does survive infancy, it will probably get only a few years of schooling or none at all.

In the long run, Indonesia is expecting a "crippled" generation -- people with low education and in poor health.

Moreover, frequent pregnancies and births, worsened by poor nutrition, will weaken women's health and may even cause their death, leaving the families in poor care.

Women suffer the most in this turmoil. During the mid-May riots, some were reportedly raped and murdered; and the recession has made them cry in hunger and worry about the future of their children. Those who voiced their concern for the children were put in jail.

Some may think that this whole issue is blown up out of proportion because they do not see it happening in their immediate surroundings. But if they give a closer look at people they meet in the street or marketplaces and have a chat with them, they will see how real the problem is.

The economic recession has been going on for more than one year now and it is high time for the authorities, decision-makers and everyone else who cares to take action and help brighten this gloomy picture. When the health of poor women and children, which form the half of the population, is at stake, the future of this nation is indeed gloomy.

We must save the women and children because the future of the nation depends on them. The privileged must be grateful and not be selfish.

Let us pool our resources and give our support to the needy. Talking only and feeling pity for the poor will not help. Let us try to cut short the red tape of bureaucracy and thus limit the chance for corruption or misuse of the power. Do not wait for too long. We do not want to see our nation collapse.

The writer is a psychologist, sociologist and health educator in the Netherlands.