Bety Wanena, 47, on Friday, Dec. 8, at around 7am local time left her home next to the Community Health Center (Puskesmas) Timoneri, Lanny Jaya regency, Papua. She brought with her a noken and a box of vaccines.
Without footwear the mother of four rushed through an icy breeze, below 10 degree Celsius, as she scaled the steep terrain of Papua’s central mountains. She headed toward Tabukeker village, on a five-hour journey to administer immunizations for several children.
Tabukeker is one of nine villages in Tiomneri district, which is under Bety’s care as a midwife at Puskesmas Tiomneri. In total there are 12 villages in Tiomneri district. The three villages closest to the Puskesmas are under the responsibility of Bety’s colleague Lisa Titiheru, 29.
Given the large area she must cover, almost everyday, Bety must walk for up to 10 hours, back and forth across the mountainous terrain of Papua’s hinterland to provide health services to residents.
“Each day, I visit a village. Normally, I leave my house at 7:00. After providing health services, I walk again. I arrive home at 4 or 5 p.m,” Bety said.
Not only does she have to walk for hours. Occasionally, Bety also faces heavy rain. At such times, Bety continues walkers, covering her head with only a leaf if her umbrella becomes damaged.
Some villages can actually be reached by motorcycle. Unfortunately, the Puskesmas does not own either a motorcycle or a car.
The limited facilities do not deter Bety from continuing her journey for the sake of the people’s health, especially to provide immunizations for 53 infants and 183 balita (children below five years old) in those nine villages.
Bety has done her job for 22 years, motivated by her love for others. Her husband Kendin Wakur also works as a medical staff member at the Puskesmas.
“I will continue doing this job until I cannot work anymore. They are all my family. I will not leave them,” Bety said.
A similar spirit is shared by Lisa, who has worked for six years at Puskesmas Tiomneri. “The diseases that often affect children at Tiomneri are diarrhea and respiratory infection. That is why we never stop instructing people about healthy lifestyles,” said the mother of one.
Basic immunization coverage in Tiomneri reaches only 50 percent, lower than the coverage in Papua in general, which is 67 percent. It is far lower than the national coverage of 87 percent. Geographic and transportation challenges are the cause. However, these obstacles have not deterred Bety and Lisa.
Forefront
In West Java, health worker Jaenal Aripin, 31, and his wife, Oktavia Handayani, 26, a nurse, are also at the forefront of the administering vital immunizations in Tegalwaru district, Purwakarta regency. Although their work is not as hard as Bety and Lisa’s, this health worker couple at Puskesmas Tegalwaru have had to pass though forests and narrow and damage roads to provide health services to people for six years.
On Tuesday, shortly after sunrise, Jaenal took Oktavia, on motorcycle, to Puskesmas Tegalwaru. After collecting the vaccines, Jaenal drove to elementary school SDN 1 Pasanggrahan. The school was only 10 kilometers away but it took 1.5 hours to get there.
Arriving at the school, they were excited to see the enthusiastic students. The students did not run away in fear of being injected with the vaccine. Instead, they lined up for the immunization. “You’re smart. This does not hurt, right?” Jaenal said after administering an injection to one of the students who was a little afraid.
Along with 39 other health workers, they are the vanguard of the immunization program in Tegalwaru district, which ran from Dec. 11-15, 2017. The program was implemented after 27 cases of diphtheria were reported in Purwakarta with one death, the largest number of cases recorded in West Java this year. In Tegalwaru, seven cases were reported, the largest number in Purwakarta.
“It targeted 15,000 children. Today, we will administer immunizations at SDN 1 Pasanggrahan. The number of students is 135 people,” he said.
A day earlier they administered immunizations to children at the main hall of Citalang village, Tegalwaru district. Hundreds of students came with their parents. One was David Al Zam Zamy, 2, the son of Hendi, 38, and Mimin, 31. Initially, they had doubts about letting their son get immunized, fearing he would get a fever but eventually decided that David should get the DPT immunization.
Nevertheless, not all parents get their children immunized. Even though they have already received information on the importance of immunizations for children, some continue to refuse. Their reasons vary from a fear that the child will get a fever to religious reasons.
“Such refusals could potentially decrease the immunity of the community. However, we cannot push them because it is about someone’s faith,” Puskesmas Tegalwaru head Karmilah said.
These many obstacles, from opposition from the public to limited health access, pose threats to the immunity of communities to disease. This is not only a challenge for health workers, who are the vanguard of the nation’s health services, it is the responsibility of the government.
(SAMUEL OKTORA, CORNELIUS HELMY)
