Combatting Malnutrition

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  • TEMPO.CO, Jakarta

    ILHAM Rusting wakes up, works and goes back to sleep at a community health center (puskesmas) at Entikong, West Kalimantan, on the border area between Indonesia and Malaysia. The 25-year-old nutritionist who graduated from the Ternate Health Polytechnic has been stationed there for one year.

    When he and his four teammates first arrived in December 2015, they conducted a survey in five villages in Entikong. "It was not easy, because there were no roads yet. We had to travel on a sampan (small boat) and walk very far to reach the villages," he said.

    Ilham had his first encounter with people two, at first affected with malnutrition at Entikong. He had no idea malnutrition was a problem. He and his teammates set out to address the matter. 

    Ilham immediately treated the two individuals with malnutrition, both in their 20s, providing them with nutrient-rich meals and counseling. The team also introduced innovative methods to the local puskesmas, to anticipate and deal with future cases of malnutrition at Entikong.

    They held community-based counseling every month to educate villagers on nutrition, and advise mothers to keep watch over the height and weight of their toddlers. After the initial survey, Ilham and his team conducted another survey involving more participants, and discovered five other individuals suffering from malnutrition. 

    "One of them even had a heart complication caused by severe malnutrition," said Ilham. With every case they discovered, they had the patient undergo rehabilitation for 30 days to gain more weight.

    Ilham and his teammates are participants in the Nusantara Sehat (Healthy Archipelago) program initiated by the health ministry. The program dispatches healthcare professionals to the remote corners of the country for a two-year term. 

    Wahyu Manggala Putra in Enggano, an island southwest of Bengkulu, came across several cases of malnutrition at the puskesmas where he and six others are stationed. "Nine children are suffering from malnutrition, though not too severely. We reported it to the provincial health office," he said. 

    The team facilitates and gives assistance to new mothers in the area, to ensure that newborns and toddlers receive the proper nutrients. They also distribute complementary biscuits provided by the health ministry as supplemental food for toddlers with malnutrition. Additionally, with funding from the local health office, Wahyu and his team buy highly nutritious products, including milk, for the children at Enggano.

    Wahyu said the people at Enggano today also have better sanitation because of their efforts to build more toilets. "Before, in my estimation, only about 40 percent of the villagers had access to clean toilets. Now, after one year, I think around 50 percent have clean toilets," he said, adding that many people had now abandoned their old practice of defecating in the forest or on the beach.

    Ilham and Wahyu will end their two-year term with the Nusantara Sehat program this year. Both said they would like to return and continue the work if given the chance. "I think I can still do much more to help people in remote areas. If not in Enggano, I'd still be happy to be assigned somewhere else," said Wahyu.

    The Nusantara Sehat program was initiated in 2015. This is a replication of the Pencerah Nusantara program run by the office of the president's special envoy for the millennium development goals (KUKPRI-MDGs).

    Like its sister program, Nusantara Sehat is aimed at improving the quality of primary healthcare services in Indonesia, namely at the puskesmas and integrated healthcare posts (posyandu). Diah Saminarsih, special staff at the health ministry, said the program is expected to reach out to between 1,000 to 1,500 puskesmas by the end of 2019. 

    "We recruit young individuals and place them in a location for two years. They all have the same goals: to empower communities and help the puskesmas provide better services," Diah said. Applicants to the Nusantara Sehat program have to be under 35 years old and unmarried.

    Like the previous program, which aimed at pushing Indonesia to achieve the MDGs, Nusantara Sehat is designed to support the national sustainable development goals (SDGs) comprising 17 targets, among them achieving good health and well-being for our citizenry, as well as eliminating starvation and providing better nutrition. (*)

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