Bad Roads a Contributing Factor to Infant Mortality

Kompas/Fransiskus Pati Herin

Celsia Taniwel, 7, is carried by her father Metu Salataniwell, 36, in their house in an isolated village in West Seram Island, Maluku, on Monday (8/1). Celsia is suffering from a bone problem and is still unable to walk.

The cries and coughs of Rista Taniwel, 15 months old, broke the otherwise calming silence at a wooden house in Seram Island, Maluku, on Monday morning (8/1). The baby’s emaciated body was covered with a mixture of betel, areca nut and mashed lime.

Rista has been suffering from bouts of high fever since December last year. Almost every day, her body is covered by the reddish mixture of betel, areca nut and mashed lime. Sometimes, Mimosa shoots are added in. This is a traditional febrifuge in Hukuanakota village, Inamosol district, Western Seram regency.

Since she was born, Rista has never been checked by a healthcare officer. Her father, Metu Salahtaniwel, 36, said he did not know what disease Rista was suffering from. Metu only knows that Rista often has fevers, coughs and seizures. Rista’s weight decreases day by day. Now, she weighs no more than 4 kilograms.

Different from many other children her age who are learning to walk, Rista just lies weakly on her bed or in a baby sling. When her temperature increases, she cries. Her coughs add to her distress. Many times, she lays in bed sleepless all night long.

Rista’s older sister, Celsia Taniwei, 7, is suffering from the same symptoms. Celsia can neither walk nor talk properly. She can only say “papa” and “mama” to call her parents. If she stands for more than five seconds, her legs tremble and she falls. Rista is currently showing the same symptoms that Celsia had years ago.

“We do not know what this disease is. We only use traditional medicine. If there were healthcare officers, we may be able to understand this sickness,” said Metu, who taps dammar sap for a living.

Celsia and Rista are two of six siblings. Metu’s other four children are relatively healthy.

Another baby in the village, Yeisa, 7 months old, is suffering from macrocephaly. The baby also looks emaciated, as if boneless. Roy Kapitan, 33, is only 80 centimeters tall. He has been unable to walk for the past year.

Several other locals are suffering from partial blindness, like John Hendrik Son, 31, whose vision became blurry after a white spot appeared on his pupils when he was 4 years old. Susana Soriale, 53, has been blind for the past 12 years. Susana’s blindness began with an eye pain when she was hit by tropical malaria. She relied only on eye drops for medication.

Kompas/Fransiskus Pati Herin

Celsia Taniwel, 7, is carried by her father Metu Salataniwell, 36, in their house in an isolated village in West Seram Island, Maluku, on Monday (8/1). Celsia is suffering from a bone problem and is still unable to walk.

The luxury of health care

Health care seems like a rare and expensive thing to the villagers. Even common illnesses can lead to years of suffering and eventually death. As a result, the village mortality rate is balanced with its birth rate. In 2017, in the village with 884 residents, 16 babies were born and 16 people died.

There is an integrated healthcare post (Posyandu) built by the government and the people in 2011. In constructing the posyandu, locals walked up to 9 kilometers across steep slopes and muddy roads to transport materials. For the uninitiated, the journey can take up to four hours. The road, which was first opened in 2011, is often hit by landslides and has been repaired numerous times. It is not asphalted.

With church money, locals purchase medicine. They take them according to the dosages written on the label. Nurses and midwives come by only once a month, sometimes less than that. Consequently, many local children do not get thorough vaccinations. Some have never been vaccinated.

Fetal death

Locals’ greatest concerns are for pregnant women going through labor. Four months ago, Hersin Kapitan, 25, was pregnant with twins. Both fetuses died in the womb, and Hersin buried them both in her backyard.

Hersin almost died along with her babies. Fortunately, on Aug. 26 last year, a midwife came to the village to accompany a group of youths. The midwife checked on Hersin, then seven months pregnant, and found that the fetuses in Hersin’s womb were not moving.

Accompanied by around a dozen villagers, Hersin walked on steep roads and crossed two rivers. The 4-km journey took three hours. As her condition worsened, Hersin was then told to sit on a chair, which was carried in turn by other villagers for 5 km towards Inamosol puskesmas in Honitetu village.

However, the puskesmas’ midwife could not help Hersin. Her family then called an ambulance to pick her up. At 11 p.m., she was transferred to Kairatu puskesmas through a 24-km, heavily damaged road. She arrived at Kairatu puskesmas at around 1 a.m. The puskesmas could not care for her and she was referred her to the city hospital (RSUD) in Piru, the regency capital some 50 km away.

The next day, Hersin arrived in Piru and was checked by a doctor. “The doctor told me that my babies had been dead for a week,” Hersin said.

Hersin had an operation to remove the babies on Aug. 28. “I was sad because I could not see my twins. They were immediately brought back home to be buried,” Hersin said.

Hersin is not alone in the village. A pregnant woman once gave birth in the middle of the street. Both the mother and the baby died. When people die from accidents, usually they are carried on slings or stretchers.

A similar method is used when a patient dies at the Honitetu puskesmas or a hospital in the regency capital. Locals take turns carrying the body back to Hukuanakota for burial.

This is all because of poor road infrastructure, despite the region being the biggest dammar producer in Maluku.

Western Seram regency administration’s assistant of government affairs, Polly Pical, said many local remote regions lacked access to proper health care due to problems with road infrastructure and a limited number of medics.

“This year, we will build a road to Hukuanakota. We are also making internal improvements to address the lack of medics. Remote regions are our priority,” Polly said.

Road infrastructure development should be the center of the local government’s attention. If the roads are in good condition, the local economy will grow. People will be able to enjoy health care and fewer babies will die in their mothers’ wombs.