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)