Results of student fieldwork in Tambak Lorok, Semarang, August 2018
From 10 until 20 August 2018, a fieldwork exercise on health, hygiene and sanitation in Tambak Lorok, Semarang, was conducted by a group of university students from Universitas Katolik Soegijapranata (Unika, Semarang, Indonesia) and from Gottfried Wilhelm Leibniz Universität Hannover (LUH, Hannover, Germany). The joint fieldwork training in Tambak Lorok was the core element of a seminar organised by Program Magister Lingkungan Perkotaan of Unika in collaboration with Institut für Soziologie (ISH) of LUH and Kirchlicher Entwicklungsdienst der evangelisch-lutherischen Landeskirchen in Braunschweig und Hannovers (KED, Hannover, Germany). It was coordinated by Hotmauli Sidabalok (lecturer at Unika) and Andreas Kurschat (lecturer at ISH/LUH and project leader at KED).
The fieldwork was linked to a small-scale local development project, which was launched in Tambak Lorok on 28 March 2018 by Lembaga Pendamping Usaha Buruh Tani dan Nelayan (LPUBTN, Semarang) and the Indonesian diaspora association Bildung und Gesundheit für Indonesien e.V. (BUGI, Hannover, Germany). The project aims at improving sanitation in Tambak Lorok by constructing a clean and sustainably managed public toilet near the harbour in order to provide an alternative to open defecation in Tambak Lorok and reduce water pollution.
In order to support this local development project and, as a precondition for that, in order to learn more about the present conditions of health, hygiene and sanitation in Tambak Lorok and about the problems that the residents themselves perceive, the students collected empirical data by distributing structured questionnaires to 187 residents, who were randomly selected, and by conducting openly structured interviews with 20 randomly selected residents. Moreover, they organised two workshops about body hygiene and drinking water usage, which were attended by around 40 residents altogether, who were randomly selected as well.
The fieldwork group from LUH/KED would like to thank all the partners involved in this collaboration and especially the residents of Tambak Lorok and their local administration for making this fieldwork possible, for welcoming the group so warmly and for participating so willingly in the data collection.
Eight months after the fieldwork, the students from LUH finished a variety of partial analyses of the data collected in Tambak Lorok. The content of their analytical papers, which were submitted to the lecturer in charge at ISH/LUH, Andreas Kurschat, is subject to data protection policies and must not be disclosed. This report, however, provides a descriptive overview of the fieldwork results. The final versions of the questionnaire database and of the English translations of the interview transcripts, which this report is based on, were produced by Andreas Kurschat under contract to KED and LUH. This report is not intended to judge any individual answers or general results, but only to document the outcome in a neutral way.
A. Questionnaire results: Socio-demography
More than half of the randomly selected respondents were women (62,2%).
The respondents’ average age was 44 years, ranging from 18 to 76 years.
The share of respondents who had received school education from SD level upward was 87,0%.
Half of the respondents (50,8%) had been working during the previous three months, many of them as wirausaha (37,9%) or wiraswasta (25,0%), smaller shares as day labourers (13,8%), non-permanent employees (8,6%) or permanent employees (8,6%) and a small share as pemekerja/employers (4,3%). Among those respondents who had not been working during the previous three months, many had been busy with household chores (37,7%) or child care (18,9%) or looking for a job (21,3%), a smaller share had been jobless (16,4%), an even smaller share had been pensioners (4,9%) and a very small share had been permanently unfit for work (0,8%).
The respondents’ average household budget during the previous month was 2.161.384 Rp.
The average household size was 4,7 people per household.
The average number of children among the respondents was 2,5 children per person.
Most respondents lived in their own house (80,7%), a smaller share lived with another family without paying rent (15,5%) and a very small minority (0,5%) lived in a rented place; for a small share (3,2%) none of these categories applied.
More than half of the respondents were born in Tambak Lorok (62,9%).
B. Questionnaire results: Hygiene behaviour
Handwashing
Most respondents had the possibility to wash their hands in the toilet/bathroom (65,8%) and/or in the kitchen (26,7%), a small share elsewhere on their premises (2,1%) and a considerable share outside their premises (9,6%). It should be noted that multiple answers were possible.
On average, the respondents had washed their hands 8,5 times within the previous 24 hours altogether and 6,1 times with soap.
A large majority of respondents regularly washed their hands before eating, either always (64,3%) or often (29,2%), a smaller share (5,9%) did this sometimes or seldom and a very small minority (0,5%) never.
A large majority of respondents regularly washed their hands after going to the toilet, either always (65,0%) or often (26,7%), a smaller share (5,0%) did this sometimes or seldom and an even smaller share (3,3%) never.
A large majority of respondents regularly washed their hands before preparing food, either always (58,8%) or often (26,6%), a smaller share (7,9%) did this sometimes or seldom and an even smaller share (6,8%) never.
A large majority of respondents regularly washed their hands after preparing food, either always (50,6%) or often (27,2%), a smaller share (15,5%) did this sometimes or seldom and an even smaller share (6,7%) never.
A large majority of respondents regularly washed their hands when entering their house after activities outside, either always (49,7%) or often (24,3%), a smaller share (20,3%) did this sometimes or seldom and an even smaller share (5,6%) never.
A large majority of respondents regularly washed their hands after having contact with animals, either always (52,6%) or often (22,8%), a smaller share (9,4%) did this sometimes or seldom and a considerable minority (15,2%) never.
Use of body hygiene items
Many respondents regularly used antibacterial soap for body hygiene, either very often (26,5%) or often (33,1%), a smaller share (21,5%) sometimes or seldom and a considerable minority (18,8%) never.
A large majority of respondents regularly used a toothbrush for body hygiene, either very often (46,4%) or often (47,0%), a small share (5,0%) sometimes or seldom and an even smaller share (1,7%) never.
A large majority of respondents regularly used toothpaste for body hygiene, either very often (46,7%) or often (46,1%), a small share (5,6%) sometimes or seldom and an even smaller share (1,7%) never.
A large majority of respondents regularly used shampoo and/or shower gel for body hygiene, either very often (38,8%) or often (47,0%), a smaller share (14,2%) sometimes or seldom and none of the respondents never.
The average amount of money that the respondents spent for body hygiene items during the previous month was 483.907 Rp.
Time spent for hygiene activities per day
A major share of respondents (43,7%) spent 1-2 minutes for washing their hands within one day altogether, a smaller share (30,1%) spent more than 2 minutes altogether per day, an even smaller share (26,2%) spent less than 1 minute altogether per day and none of the respondents no time at all.
More than half of the respondents (51,4%) spent more than 2 minutes for brushing their teeth within one day altogether, a smaller share (41,4%) spent 1-2 minutes altogether per day, an even smaller share (5,0%) spent less than 1 minute altogether per day and a small minority (2,2%) no time at all.
More than half of the respondents (60,0%) spent more than 6 minutes for washing their body (taking a bath) within one day altogether, a smaller share (30,6%) spent 3-6 minutes altogether per day, an even smaller share (8,3%) spent up to 2 minutes altogether per day or and a small minority (1,1%) no time at all.
A major share of respondents (47,7%) spent more than 6 minutes for cleaning their kitchen within one day altogether, a smaller share (31,3%) spent 3-6 minutes altogether per day, an even smaller share (10,2%) spent up to 2 minutes altogether per day and a considerable minority (10,8%) no time at all.
A major share of respondents (41,6%) spent more than 6 minutes for cleaning the place where they eat within one day altogether, a smaller share (28,1%) spent 3-6 minutes altogether per day, an even smaller share (16,9%) spent up to 2 minutes altogether per day and a considerable minority (13,5%) no time at all.
More than half of the respondents (53,4%) spent more than 6 minutes for cleaning their sanitary fittings (in case they possess any) within one day altogether, a smaller share (19,3%) spent 3-6 minutes altogether per day, an even smaller share (5,7%) spent up to 2 minutes per day and a considerable minority (21,6%) no time at all.
Food hygiene
A large majority of respondents regularly washed their hands before dealing with food, either always (55,4%) or often (26,6%), a smaller share (9,8%) did this sometimes or seldom and an even smaller share (8,2%) never.
A large majority of respondents regularly washed their hands before consuming food, either always (52,7%) or often (39,8%), a smaller share (7,5%) did this sometimes or seldom and none of the respondents never.
A large majority of respondents regularly boiled water before consuming it, either always (51,6%) or often (26,3%), a smaller share did this sometimes or seldom (13,4%) and an even smaller share (8,6%) never.
A large majority of respondents regularly washed food before consuming it, either always (66,3%) or often (28,3%), a small share (2,7%) did this sometimes or seldom and an evenly small share (2,7%) never.
A large majority of respondents regularly peeled food before consuming it, either always (54,7%) or often (27,1%), a smaller share (14,4%) did this sometimes or seldom and an even smaller share (3,9%) never.
A large majority of respondents regularly cooked food until done before consuming it, either always (59,5%) or often (27,0%), a smaller share (11,9%) did this sometimes or seldom and an even smaller share (1,6%) never.
Many respondents regularly kept food cool, either always (27,7%) or often (20,1%), a large share (33,7%) did this sometimes or seldom and a considerable minority (18,5%) never.
Many respondents regularly kept raw meat, poultry and fish/seafood separate from other food, either always (28,3%) or often (27,7%), a smaller share (25,5%) did this sometimes or seldom and a considerable minority (18,5%) never.
Use of water
For a major share of respondents (41,7%) the main source of water for drinking was water bottles/gallons from a shop, for a considerable share (32,2%) it was water piped from a neighbouring well (artesis), for a smaller share (15,6%) it was water piped from a private well in their house, for another smaller share (8,3%) it was water piped from a public supply, for an even smaller share (1,7%) it was water from a public well and for a very small minority (0,6%) it was water from other sources.
For more than half of the respondents (55,7%) the main source of water for cooking was water piped from a neighbouring well (artesis), for a considerable share (23,5%) it was water piped from a private well in their house, for a smaller share (13,1%) it was water piped from a public supply, for an even smaller share (5,5%) it was water bottles/gallons from a shop, for a small minority (1,1%) it was water from a public well and for another small minority (1,1%) it was water from other sources.
For more than half of the respondents (58,2%) the main source of water for washing their hands was water piped from a neighbouring well (artesis), for a considerable share (27,5%) it was water piped from a private well in their house, for a smaller share (12,1%) it was water piped from a public supply, for a small minority (1,1%) it was water from a public well, for a very small minority (0,5%) it was water bottles/gallons from a shop and for another very small minority (0,5%) it was water from other sources.
For more than half of the respondents (58,0%) the main source of water for washing their body was water piped from a neighbouring well (artesis), for a considerable share (28,2%) it was water piped from a private well in their house, for a smaller share (11,6%) it was water piped from a public supply, for a small minority (1,1%) it was water from a public well, for a very small minority (0,6%) it was water bottles/gallons from a shop and for another very small minority (0,6%) it was water from other sources.
For more than half of the respondents (58,3%) the main source of water for washing their clothes was water piped from a neighbouring well (artesis), for a considerable share (27,2%) it was water piped from a private well in their house, for a smaller share (11,7%) it was water piped from a public supply, for a small minority (1,1%) it was water from a public well, for a very small minority (0,6%) it was water bottles/gallons from a shop and for another small minority (1,1%) it was water from other sources.
For more than half of the respondents (59,7%) the main source of water for washing their dishes was water piped from a neighbouring well (artesis), for a considerable share (26,0%) it was water piped from a private well in their house, for a smaller share (12,2%) it was water piped from a public supply, for a small minority (1,1%) it was water from a public well, for a very small minority (0,6%) it was water bottles/gallons from a shop and for another very small minority (0,6%) it was water from other sources.
A large majority of respondents (81,1%) boiled their drinking water before using it, whereas a considerable minority (18,9%) did not.
Sanitary fittings
A large majority of respondents (75,0%) had sanitary fittings (a toilet) in their homes, whereas a considerable minority (25,0%) did not.
Among those respondents who did not have sanitary fittings (a toilet) in their homes, the large majority (64,0%) lived in a close distance and a considerable share (14,0%) in a very close distance to such a facility, whereas another considerable share (20,0%) lived in a far distance and a small minority (2,0%) in a very far distance to such a facility (according to their individual perception).
For the large majority of respondents (71,6%), the usual place for bowel movements was at home, for a considerable share (17,5%) it was a public toilet, for a smaller share (8,7%) it was the river/sea and for an even smaller share (1,1%) elsewhere, namely the daughter’s/son’s house or a latrine.
C. Questionnaire results: Health
Health-related attitudes
A large majority of respondents (73,5%) strongly agreed with the statement “My health is very important” (Kesehatan saya sangat penting) and the rest (26,5%) simply agreed.
A large majority of respondents (64,7%) strongly agreed with the statement “I object to the consumption of alcohol” (Saya menolak konsumsi alkohol) and a smaller share (19,6%) simply agreed, whereas a considerable share (10,9%) disagreed and a small share (4,9%) strongly disagreed.
A major share of respondents (47,0%) strongly agreed with the statement “I object to the consumption of tobacco” (Saya menolak konsumsi tembakau) and a smaller share (25,1%) simply agreed, whereas a considerable share (15,3%) disagreed and a slightly smaller share (12,6%) strongly disagreed.
More than half of the respondents (57,1%) strongly agreed with the statement “Regular vaccination is important in order to protect myself against diseases” (Vaksinasi secara teratur penting untuk melindungi saya dari penyakit) and a smaller share (34,1%) simply agreed, whereas a small share (6,6%) disagreed and an even smaller share (2,2%) strongly disagreed.
A large majority of respondents (63,6%) strongly agreed with the statement “Regular handwashing is important” (Cuci tangan yang teratur sangat penting) and a smaller share (35,3%) simply agreed, whereas a small share (1,1%) disagreed and none of the respondents strongly disagreed.
A large majority of respondents (64,7%) strongly agreed with the statement “It is important for me that I can regularly wash my body” (Penting bagi saya untuk dapat membersihkan bagi secara teratur) and a smaller share (34,2%) simply agreed, whereas a very small share (0,5%) disagreed and another very small share (0,5%) strongly disagreed.
More than half of the respondents (59,6%) strongly agreed with the statement “I feel uncomfortable when I cannot brush my teeth regularly” (Saya merasa tidak nyaman apabila saya tidak bisa menggosok gigi secara teratur) and a smaller share (29,0%) simply agreed, whereas a small share (8,2%) disagreed and an even smaller share (3,3%) strongly disagreed.
A large majority of respondents (66,1%) strongly agreed with the statement “I prefer clean water for washing myself and for washing clothes” (Saya lebih memilih air yang bersih untuk mencuci diri dan mencuci baju) and a smaller share (32,8%) simply agreed, whereas a small share (1,1%) disagreed and none of the respondents strongly disagreed.
Preferences related to healthcare
Many respondents (31,9%) strongly agreed with the statement “When I am ill, I prefer a Puskesmas for treatment” (Apabila sakit, saya lebih memilih Puskesmas sebagai tempat berobat) and more than half of the respondents (54,1%) simply agreed, whereas a considerable share (10,8%) disagreed and a small share (3,2%) strongly disagreed.
A considerable share of respondents (12,5%) strongly agreed with the statement “I get treatment at a Puskesmas when a traditional shaman recommends it” (Saya akan berobat ke Puskesmas apabila seorang dukun tradisional menyarankan) and a slightly larger share (17,9%) simply agreed, whereas many respondents (23,4%) disagreed and a major share (46,2%) strongly disagreed.
A small share of respondents (3,3%) strongly agreed with the statement “When I have a mild or serious disease, I prefer to go to a traditional shaman rather than to a Puskesmas for treatment” (Apabila sakit baik ringan maupun berat, saya lebih memilih berobat ke dukun tradisional daripada Puskesmas) and a considerable share (13,1%) simply agreed, whereas many respondents (24,0%) disagreed and more than half of the respondents (59,6%) strongly disagreed.
Many respondents (28,1%) strongly agreed with the statement “When I have a serious disease, I prefer a Puskesmas for treatment” (Apabila sakit berat, saya lebih memilih Puskesmas sebagai tempat berobat) and a major share (40,5%) simply agreed, whereas a considerable share (18,4%) disagreed and a smaller share (13,0%) strongly disagreed.
A small share of respondents (3,8%) strongly agreed with the statement “I do not go to a Puskesmas for treatment because I object to modern/scientific medicine” (Saya tidak berobat ke Puskesmas karena saya menolak pengobatan modern/akademis) and a considerable share (16,5%) simply agreed, whereas many respondents (28,6%) disagreed and more than half of the respondents (51,1%) strongly disagreed.
A considerable share of respondents (11,4%) strongly agreed with the statement “In my opinion traditional medicine is not effective” (Menurut saya pengobatan tradisional tidak efektif/ampuh) and a larger share (25,0%) simply agreed, whereas a major share (39,7%) disagreed and many (23,9%) strongly disagreed.
A considerable share of respondents (12,0%) strongly agreed with the statement “When I am ill, I prefer self-medication without medical advice” (Apabila sakit, saya lebih memilih memakai obat-obatan tanpa saran medis) and a larger share (26,8%) simply agreed, whereas a major share (33,3%) disagreed and many (27,9%) strongly disagreed.
Many respondents (33,2%) strongly agreed with the statement “When I am ill, I prefer the closest hospital for treatment” (Apabila sakit, saya lebih memilih rumah sakit terdekat sebagai tempat berobat) and a major share (47,8%) simply agreed, whereas a considerable share (14,1%) disagreed and a small share (4,9%) strongly disagreed.
A considerable share of respondents (18,0%) strongly agreed with the statement “When I am ill, I prefer to go to a Puskesmas for treatment even though a hospital or another, better healthcare facility is easier to reach” (Apabila sakit, saya lebih memilih untuk berobat ke Puskesmas, meskipun ada rumah sakit atau tempat pengobatan medis lebih baik lainnya yang lebih mudah terjangkau secara lokasi) and a major share (40,4%) simply agreed, whereas many (26,2%) disagreed and a considerable share (15,3%) strongly disagreed.
A small share of respondents (8,7%) strongly agreed with the statement “I object to go to a Puskesmas for treatment because I do not have the money required for the treatment” (Saya menolak untuk berobat ke Puskesmas karena tidak ada uang untuk biaya pengobatan) and a considerable share (23,9%) simply agreed, whereas many respondents (28,3%) disagreed and a major share (39,1%) strongly disagreed.
Health condition and medical treatment
On average, the respondents had been ill 2,2 times during the previous three months (ranging from 0 to 20 times).
On average, the respondents had drawn on advice from a traditional shaman (dukun) 0,1 times during the previous three months (ranging from 0 to 3 times).
On average, the respondents had drawn on advice from a Puskesmas 1,2 times during the previous three months (ranging from 0 to 15 times).
On average, the respondents had drawn on advice from a public hospital 0,5 times during the previous three months (ranging from 0 to 10 times).
On average, the respondents had drawn on advice from a private hospital 0,1 times during the previous three months (ranging from 0 to 3 times).
On average, the respondents had drawn on advice from a doctor’s practice 0,6 times during the previous three months (ranging from 0 to 7 times).
On average, the respondents had used self-medication without medical advice 1,4 times during the previous three months (ranging from 0 to 20 times).
On average, the respondents had not done anything in spite of some kind of health suffering 0,7 times during the previous three months (ranging from 0 to 15 times).
A large majority of respondents (85,2%) suffered from diarrhoea only once a month or less frequently, whereas a small share (5,7%) suffered 2-3 times a month, another small share (5,1%) about once a week, an even smaller share (2,3%) several times a week and the smallest share (1,7%) every day.
D. Questionnaire results: Waste disposal
A large majority of respondents (67,2%) indicated that there is an organised system of waste disposal in the place where they live, whereas a considerable share (25,0%) indicated that there is none and some (7,8%) indicated that they did not know.
A major share of respondents (43,3%) disposed of their waste at a public drop-off point or dump every day, a considerable share (20,8%) did this several times a week, a small share (6,7%) once a week, a very small share (1,1%) several times a month, another small share (4,5%) less frequently than that and a considerable share (23,6%) never.
A considerable share of respondents (17,3%) disposed of their waste at a garbage bank in exchange for a reward (financial or else) every day, an almost equal share (16,2%) did this several times a week, a small share (5,2%) once a week, an almost equal share (5,8%) several times a month, a slightly larger share (8,1%) less frequently than that and a major share (47,4%) never.
A considerable share of respondents (11,6%) disposed of their waste in the surrounding environment/nature every day, a slightly smaller share (9,9%) did this several times a week, a smaller share (7,0%) once a week, a very small share (1,2%) several times a month, a considerable share (10,5%) less frequently than that and more than half of the respondents (59,9%) never.
A considerable share of respondents (9,9%) disposed of their waste in the water every day, a small share (2,9%) did this several times a week, another small share (3,5%) once a week, another small share (4,1%) several times a month, a considerable share (9,9%) less frequently than that and a large majority (69,8%) never.
A small share of respondents (3,5%) disposed of their waste by burning it every day, another small share (2,9%) did this several times a week, another small share (1,8%) once a week, another small share (2,9%) several times a month, a considerable share (13,5%) less frequently than that and a large majority (75,4%) never.
A small share of respondents (2,4%) disposed of their waste by burying it every day, an equally small share (2,4%) did this several times a week, an even smaller share (1,2%) once a week, another small share (2,4%) several times a month, a larger share (7,7%) less frequently than that and a large majority (84,0%) never.
A few respondents (0,1%) added that they also disposed of their waste in another way (namely by having it collected by an RW/RT assistant or by throwing it in a special garbage container or water channel) several times a week.
E. Qualitative interview results
In addition to the quantitative survey, the qualitative interviews convey individual perceptions and experiences of 20 randomly selected residents. The interview results reflect their perspectives on a variety of topics related to health, hygiene and sanitation. The interviewees were asked about their perception of the healthiness of their housing and living conditions, about health services and facilities around Tambak Lorok, about their individual health behaviour, about reproductive health issues and about their individual experience with information and education about health. The interviews were conducted for explorative purposes. It is important to note that the sample of interviewees is not representative of the whole population of Tambak Lorok and that the content of the interviews may neither be proportionately quantified nor generalised.
Housing and living conditions
Several respondents referred to the littering of public spaces, insufficient waste management and frequent flooding due to the gradual subsidence of the whole Tambak Lorok area below sea level as the major issues they were concerned about. Some emphasised a good social cohesion within the local community, e.g., gatherings for social matters and for studying the Koran, collective cleaning activities carried out by the youth organisation Karang Taruna every weekend and a mutual responsibility to help each other with health-related issues.
Health services and facilities, sanitary infrastructure
Many respondents were quite content with the existing healthcare facilities around Tambak Lorok, even though some mentioned that queues of patients waiting to be served were rather long at times or that in their opinion the equipment in certain facilities was improvable. Among the facilities that respondents were familiar with were the Posyandu in Tambak Lorok, the Puskesmas in Bandarharjo and several hospitals. Some respondents also mentioned a local medical service occasionally offered free of charge by university students and a small local health centre in Tambak Lorok that served patients for a fee of 5.000 Rp. including medicine. Some said the distance to Bandarharjo made it complicated and/or expensive for them to get to the Puskesmas.
Many respondents reported about their usage of industrially produced herbal medicine (Tolak Angin, Antangin), which they used to buy without prescription. Some said they preferred traditional remedies like jamu or kerokan in general or only in particular cases, e.g. mild diseases, or after having tried modern medicine without effect. Some reported they would occasionally see a shaman (dukun) rather than a doctor, whereas others rejected the idea of seeing a shaman, some explaining that it was forbidden by religion. One respondent said traditional medicine was less reliable and more expensive than modern medicine, the latter providing proper diagnoses and medication free of charge when using the national health insurance.
Many respondents shared their views about the usefulness of the Jamkesmas health insurance for the poor or of the new national health insurance for all (JKN/BPJS), whereas some said they rarely or never made use of that and preferred to pay fees for a high quality of medical service and an easy access to it. Others claimed that the quality of the medical treatment itself was equally good either way.
As for drinking water supply, many respondents said their house was connected via pipes to one of the wells in private houses in the neighbourhood (artesis/artetis) whose owners charged their clients according to their consumption (e.g., 3.500 Rp. or 4.000 Rp. per cubic metre) or at a flat rate (e.g., 20.000 Rp. per week). Some mentioned that the public water supply system (PDAM) did not cover their housing area or that it was often defective or that the quality of PDAM water in Tambak Lorok was poor in terms of bad smell and taste. Some respondents said that they used tap water for all domestic purposes, including drinking, and that they always boiled it before drinking. Others said they only used bottled or galloned water from a shop for drinking. One respondent emphasised the good quality of well water in Tambak Lorok compared to well water in nearby Demak. Another one said galloned water was preferable because its taste was better than that of tap water, but both were equally healthy. Another respondent mentioned two different types of galloned water, the more expensive one (17.000 Rp.) being drinkable without boiling, in contrast to the cheaper one (4.000 Rp.).
Health behaviour
The diseases that the respondents perceived as most prevalent around Tambak Lorok were common cold, flu, dengue fever, diabetes, stroke, gout, vertigo, diarrhoea, angina pectoris and hypertension. Some respondents said that in case of an illness, the decision about what to do was usually taken by the head of their household or that the decision was influenced by their parents. Some reported they had health checks at the Puskesmas on a regular basis.
Many respondents explained their practices of using traditional herbal remedies (jamu), which they bought from sellers around Tambak Lorok, e.g., rhizomes, leaves and blooms for tea. Several respondents said their Muslim beliefs did not impact their health behaviour, e.g., not preventing them from turning to Christian doctors, organisations or hospitals for medical assistance. Others, however, said medical treatment must not collide with sharia and herbal medicine must not be haram.
Many respondents reported about routine vaccinations given free of charge at the Posyandu and later at school. Vaccines against measles, rubella, diphtheria, pertussis, tetanus, polio, tuberculosis, hepatitis and chickenpox were mentioned. Most respondents held the view that immunisation was important. Some stated that they themselves had never been vaccinated or that they did not know anything about vaccination.
Some respondents expressed concerns that the waste littering public spaces attracted mosquitoes, ants, flies and rodents, which could contaminate food and harm people’s health. Some of them said waste disposal practices had already improved compared to previous years, which some attributed to a collection service organised by PKK for a weekly fee of 3.500 Rp. Others mentioned their habit of burning their waste in order to combat mosquitoes, putting up with the irritating effect of the smoke on their eyes and nose, and the common practice of throwing waste into the surrounding bodies of water in order to keep the dry land clean. Some also explained that rubbish was commonly used as a cheap form of backfill for the reconstruction of houses on subsided land.
Reproductive health
Many respondents described experiences they or their wives had with pregnancy and birth, e.g., getting advice from the local administrative divisions (RT/RW), PKK cadres, Posyandu staff and midwives, having ultrasound check-ups at a midwife’s place (every three months), having pregnancy massage and getting help from the husband, relatives or neighbours.
Several respondents said health conditions of pregnant women, new mothers and children in Tambak Lorok were altogether good. Some of them attributed this to the services for pregnant women and babies (KIA) and for children under age five (BALITA) at the Posyandu. Some respondents said the service hours at the Posyandu were publicly announced via musholla loudspeakers.
Some respondents said that cases of maternal mortality were happening every few years in Tambak Lorok and that in the past (1970s/1980s) many children under age five died. One female respondent talked about the difficulties she had faced in getting access to a hospital for an emergency birth before the national health insurance was introduced.
One female respondent reported that she used to see a traditional midwife (dukun beranak) with her baby for check-ups during the first seven months after birth, adding that the traditional midwives that still lived around Tambak Lorok had all retired since then and would directly refer to a modern midwife or doctor. A male respondent, however, stated that there still was a traditional midwife practicing in Tambak Lorok but it was common to go to a hospital rather than to her.
Many respondents also reported about using the family planning service (KB) offered at the Posyandu, free of charge when using Jamkesmas. One respondent said that doctors advised people to use the KB service.
Information and education about health
Several respondents reported that health education was offered in Tambak Lorok on a regular basis by the Puskesmas and Posyandu staff and occasionally by a university. Some said their main sources of information about health issues (e.g., cholesterol) were social media, websites (retrieved by search engines) and television (e.g., “The Dr. Oz Show”).
F. Final remarks
All respondents were assured the data collected would be used for scientific purposes only, which applies to every party involved in the project. The raw data and the content of this report may not be used, reproduced or repurposed by third parties. Once again, it should be emphasised that this report merely intends to give a brief overview of fieldwork results without judging them. Likewise, it is beyond the scope of this report to draw any conclusions, which the people of Tambak Lorok themselves, however, are free to do.
Hannover, 31.03.2020
Andreas Kurschat, M.A.
Lecturer in charge and fieldwork coordinator, ISH/LUH
Project leader, KED