Children in Sungai Kaki village of Katingan Kuala district, Katingan regency, Central Kalimantan, fish in a river in front of their houses, Monday (5/6). In this remote village, dirty river water is still consumed for everyday needs, such as drinking, cooking, washing fish, washing clothes and also defecating. Health facilities are extremely limited and early marriage is rife in this village.
Umar Bakri, 44, appears tired after braving the waves of the Java Sea. He has just come home from taking his son, Bima, 4, to get medical treatment in Pagatan Hulu, Katingan Kuala, Katingan, Central Kalimantan. The Sebangau Jaya secondary community health center (Puskesmas) in his village has not had a medical worker for a long time.
It had been three days since Bima started vomiting, locally called muntaber. The sickness comes every year in Sebangau Jaya, Katingan Kuala,Central Kalimantan. Worried that his son was getting worse, Umar took him to the Puskesmas in Pagatan Hulu.
"If there is a medical worker [in the village],they come only once every six months. After that, there aren’t any," said Umar, Saturday (3/6). Therefore, the sick must be taken to Pagatan Hulu, where there are nurses and orderlies. If they receive a referral, they must go to a hospital in Banjarmasin, South Kalimantan, because it is the closest.
Umar has had a bitter experience. Five years ago, his first wife died in a motorboat on her way to the Puskesmas in Pagatan Hulu after giving birth. "After the baby was born with the help of the village shaman, she was bleeding and had to be taken to the Puskesmas. My wife gave birth at 5 p.m., and died at 9 p.m. on the way to the Puskesmas," he said.
The distance between Sebangau Jaya village and Pagatan Hulu is about 32 kilometers, or 19.8 nautical miles,and can be covered in four hours by a motorboat called kelotok. In a speedboat, the journey can be made in two hours.
Umar only owns a ces, which is smaller than a kelotok. So he rented his neighbor\'s kelotok at a cost of Rp 900,000, not including fuel. The local price of fuel is Rp 12,000 per liter, for both gasoline and diesel.
Based on official district data, Sebangau Jaya is inhabited by 278 families with a total population of 728 people. However, on observation, one family consists of 4-5 people.
The Banjar tribe is dominant in the village because the area is close to South Kalimantan. The village is located about 350 kilometers from Palangkaraya, the capital of Central Kalimantan. The way from Palangkaraya to the village is usually taken through swamps full of rasau screw pines (Pandanus helicopus) that have thorns.
Puskesmas workers
That Saturday afternoon, the Sebangau Jaya secondary Puskesmas (Pustu) was empty. Its door was locked. In the window, there was a noticethat read, "Do not damage Pustu property–signed Endang."
Head of Central Kalimantan Health Office Suprastija Budi said his office had tried to meet the need for health workers. However, budget constraints meant they were not yet able to do so, or even to propose hiring non-permanent staff (PTT) doctors. "Next year, if the budget is adequate, we will again propose hiring PTT doctors. I hope the regency administration also has the initiative to recruit doctors," Budi said.
Data at the Central Kalimantan Health Office show that 28 of 197 Puskesmas in the province do not have doctors or medical workers. About 80 percent of its 1,024 secondary Puskesmas are not served by doctors,but by midwives or nurses.
A similar condition is found in the neighboring village of Sungai Kali. The village is very remote without any land access and is short of medical facilities. The village is accessible only by river or sea.
The village has no access to clean water,so villagers consume the river water. Of the 238 houses in the village, only one has a toilet. The others are equipped with makeshift toilets by the river, where they also bathe, wash clothes, and draw drinking water.
Early marriages
The condition of residents in Sebangau Jaya and Sungai Kaki is worsened by the local custom of marrying at a young age. Parents in the two villages allow their children to marry at 12-14 years old after graduating from elementary school.
One of these is Musahada, 35. He got married when he was 18. His son, AD, 14, is already married and has one child. "The important thing is to bring a dowry, and you can get married," he said.
Sebangau Jaya village head Resno explained that before he became the village head, there were many child marriages. However, since three years ago, he has introduced a village regulation preventing them. "If it is violated, I will not issue the letters or documents required for marriage. Now, the number of child marriages is falling," he said.
In Sebangau Jaya, child marriages were a solution to reduce the financial burden of families. On the other hand, they have increased maternal and infant mortality rate. Village records show that, in the 2014-2015 period, there were two cases of infant mortality at birth because their mothers were too young.
Based on data from the Family Planning program’s Population Survey Indicator and the Family Welfare Development of the 2016 National Medium-Term Development Plan, Central Kalimantan has 49 infant mortalities per 1,000 births and 345 maternal deaths per 100,000 births.
Child marriage at 15-19 years of age is 75.45 percent of the population, or 498,800 of 661,000 adolescents in Central Kalimantan. The national child marriage rate is only 34.65 percent.
The number of families who allow their children to marry at an early age is 18.7 percent, while the national figure is only 15 percent.
Djuwiyanto, head of Advocacy and Communication, Information and Education at the Central Kalimantan office of the National Population and Family Planning Agency, said that the high infant and maternal mortality rates in Central Kalimantan was an impact of early marriage. "Most of the deaths occur among pregnant underage children. In terms of maternal health, the mothers\' womb is still underdeveloped, increasing the risk of death," he said.
Minimal education
In Sebangau Jaya and Sungai Kaki villages, most of the residents have only elementary and junior high school education. Resno is the only villager studying at university. And Eko, 22, a teacher at the elementary school in Sebanggau Jaya, is the only one who has graduated from senior high school in the village.
This sad portrait shows a great need for the presence of the state in local issues. The lack of health workers, health facilities and education is a domestic issue that must be addressed to save the younger generation of this nation.
