Urban dwellers vulnerable to physical and mental ills

Urban dwellers vulnerable to physical and mental ills

JAKARTA (JP): The pressures of economic development combined
with explosive population growth have led to numerous health
problems in the country's urban areas, a public health expert
said.

Speaking during his inauguration as a professor at Atma Jaya
University's School of Medicine yesterday, Dr. Charles Suryadi
discussed major urban health problems related to poverty, the
environment, industrialization, family and community.

Born in Jakarta in 1951, Charles Suryadi is among the few
doctors in Indonesia specializing in public health.

He graduated from the University of Indonesia's School of
Medicine in l976 and continued his graduate studies at the
Institute of Public Health at the University of the Philippines.

He earned his doctoral degree from the University of
Amsterdam's School of Medicine in l997.

Charles said health problems related to poverty and the
environment included respiratory and digestive illnesses.

Many people living in slum areas suffer from respiratory
problems such as tuberculosis and asthma because of unhygienic
and polluted surroundings, he said.

Lack of food, water and sanitary facilities also cause many
impoverished people to suffer from typhoid, diarrhea and
nutritional problems, he said.

Charles added that urban health problems could result from
industrialization and changing lifestyles and eating habits,
saying chronic diseases like diabetes, hypertension, cancer and
heart-related diseases were mostly caused by diet and lifestyle.

People in urban areas often face great pressure in their work
and lead unhealthy lives. They consume food and beverages which
contain fat, salt, chemical ingredients, etc., which may
negatively impact on their health, the professor said.

Changing lifestyles, such as irresponsible sexual activity,
can also cause serious health problems such as sexually
transmitted diseases, AIDS and unwanted pregnancies, he said.

Fatal accidents frequently occur among urban workers. Factory
and construction workers, traffic police and drivers are among
those at risk of on-the-job accidents, Charles said.

"These people receive little protection from the possible
risks at their work."

The health of teenagers, the aged, the unemployed, beggars,
street children and sex workers are also major problems in urban
areas, the professor said.

Teenagers are a vulnerable group in society, according to the
professor, who said unscrupulous people including drug dealers
often targeted this age group.

"Special attention must be given to teenagers who are easily
drawn to drugs, sexual misbehavior and brawls."

The professor also said urban health deals not only with
physical illnesses, but people's mental condition.

According to Charles, living in big cities is difficult, with
the loss of family ties, an overcrowded living environment and
stressful jobs causing urbanites to suffer from psychological
problems.

Serious depression and drug addiction are frequently caused by
the apprehension of living in a large city, the professor
explained.

"Urban health is a complex global problem. It requires a
strong cooperation among experts from multidisciplinary sectors."

To solve urban health problems, medical experts must work with
sociologists, urban planners, architects, engineers,
environmentalists, psychologists and other related experts, he
said.

In Indonesia, urban health has become a crucial issue, with
the country's urban areas growing from 85 middle to large-size
cities in l994/l995 to around 235 in l998/l999.

The movement of people from rural areas to cities has
traditionally caused difficulties in finding work, housing,
transportation, public facilities and basic health care for the
population, the professor stated.

"Many cities in Indonesia and elsewhere in the developing
world have limited basic health care services," Charles said,
adding that there are only a limited number of hospitals and
community health centers in urban slum areas which function
properly.

"It is ironic because the people who badly need inexpensive
and proper health care facilities are those living in slum
areas."

Further aggravating the situation is the fact that most health
care centers focus their service on richer patients and emphasize
curative medicine, he said.

"To deal with urban health issues, health centers in cities
must emphasize promotive and preventive efforts."

Charles said doctors and other medical experts must change
their orientation from individual and money-oriented services to
public-oriented services.

"A lot of doctors are now working individually cut off from
the outside world. They are only examining their patients."

Medical schools and institutions also have significant roles
to play in promoting public health services, he said.

"It is high time for the country's medical schools, hospitals
and the Ministry of Health to actively inform the public about
how to take preventive action against various diseases."

Presently, these institutions are only producing guidelines to
cure certain illness, he said.

"With better cooperation among experts and a stronger
political will from the government, our public health care will
be more effective." (raw)