An Irony in the Urban Scene

KOMPAS/SEKAR GANDHAWANGI

Nurjanah carries her 15-month-old child to check her height and weight at her home, West Cakung Village, Cakung District, East Jakarta, Saturday (8/4/2023). Her son was diagnosed with stunting and tuberculosis (TB).

Nurjanah led her 15-month-old child by the hand into the nutrition consultant’s room at the West Cakung Community Health Center (Puskesmas) in Cakung district, East Jakarta. The 16-year-old mother was having a routine consultation on the health of her child, Rafka, who within the last six months had been diagnosed with both stunting and tuberculosis (TB).

The nutritionist receiving them then conducted a physical examination on Rafka. The body of the child was weighed and his height measured. The measurements showed that Rafka weighed 7.9 kilograms and he was 75 centimeters tall.

“Last month he weighed 8.1 kg. Now he is 7.9 kg. His height is increasing little by little,” said Hanna Claudia, the nutritionist who has been treating Rafka from the beginning on Tuesday (4/4/2023).

Also read:

> ‘Sebar Cinta Jakarta’ Tackles Stunting

> Involve All Parties to Overcome Stunting

For Hanna, the measurements still left some notes. Rafka should have gained weight from the previous month, even if the ideal weight for babies his age, 10 kg to 11 kg, was out of reach. Meanwhile, his increase in height was a step in the right direction but too small to be significant.

Nurjanah, who has her child routinely examined at the health center, found out that her child’s weight had fallen below the standard range when he was 9 months old. At that age, Rafka only weighed 5 kg, far from the ideal weight of 7 kg to 10 kg for male babies.

Meanwhile, Faradila Ayu, 3, was born weighing a normal 2.9 kg. Her mother, Nasihatul Karomah, 26, was also declared healthy while pregnant, which helped Ayu grow healthily. But nonetheless, Ayu is now listed as one of 11 stunted children in community unit (RW) 009 in West Cakung subdistrict, Cakung district, East Jakarta.

KOMPAS/SEKAR GANDHAWANGI

Nasihatul Karomah (26) gave a bottle of milk to her daughter aged 3 years and 11 months, Saturday (8/4/2023) at her home in West Cakung Village, Cakung District, East Jakarta. Her daughter was diagnosed with stunting six months ago after she continued to lose weight.

An employee of the West Cakung integrated healthcare center (posyandu), Martini, suspects that Ayu is stunted because she has frequently eaten snacks from food stalls, candy and junk food. These filler her up and stop her from consuming enough nutritious food. At her posyandu examinations, Ayu’s body weight fell progressively to a level below the red line, an indicator of moderate to severe undernourishment, according to the Kartu Menuju Sehat(KMS/Health Card).

“Ayu became a participant [in the stunting treatment program] in November 2022. At the time she weighed 9.6 kg,” said Nasihatul on Saturday (8/4/2023).

Also read:

> Specific Interventions Needed to Address Stunting

> Strengthen Collaboration to Overcome Stunting

Now Ayu weights 11.4 kg and is 89 centimeters tall. Her growth has improved after being provided with additional food in the form of abon ayam (fried shredded chicken), milk and zinc. Extra food and vitamins are part of the stunting treatment program implemented by the district.

Nasihatul was at first reluctant to have her child join the stunting treatment program. She felt inferior and feared that other people might be gossiping about her undernourished child. After some encouragement from posyandu workers, she decided to join this program. They also promised to help dispel any gossip spread by neighbors.

KOMPAS/SEKAR GANDHAWANGI

A 3.5 year old child with "stunting" or tengkes plays in his home area in West Cakung Village, Cakung District, East Jakarta, Saturday (8/4/2023). Stunting is a condition of failure to develop in children due to malnutrition which results in disruption of the child's brain, physical and metabolic development.

Poverty

Stunting is deeply connected to poverty. Economic constraints have made it difficult for some people to access nutritionally balanced food for children. Nurjanah, for instance, has an average budget of Rp 30,000 per day for her and Rafka’s consumption. If she is unlucky, she may have no money for food at all.

Nurjanah’s husband is the family’s breadwinner. Her husband is typically paid Rp 185,000 per day as a chauffeur. But his salary was recently cut by Rp 60,000-Rp 100,000 per day to pay back his boss for crashing his car at work. With an estimated Rp 125,000 left per day and Rp 30,000 allotted for Nurjanah, her spouse keeps Rp 95,000 per day.

“He spends the total on meals, coffee, cigarettes, electricity bills and the Rp 600,000 rent per month of the leased house,” said Nurjanah. “My husband is a heavy smoker. He can spend Rp 30,000 [on cigarettes],” she added.

Nurjanah once protested against the budget for household needs and cigarettes, but her husband ignored her protest.

Stunting is deeply connected to poverty.

Nurjanah also needs money for the purchase of nutritious food for Rafka to help with his stunting and TB.

A researcher from the Urban Development Study Program of the School of Strategic and Global Studies at the University of Indonesia, Renny Nurhasana, holds the view that in order to help families escape from poverty and elevate their living standards, interventions can be made in education and skill training to support new job opportunities, as well as interventions in the provision of economic aid for families.

“But economic aid will not progress appropriately if their basic behavior has not yet changed,” she said when contacted in Jakarta.

The basic behavior as meant above is, for example, smoking. The smoking habit among adults, based on various studies, has direct relationship with the transmission of TB. Budgeting for cigarettes also reduces families’ ability to buy healthy food. Consequently, stunting appears.

(ERK/SKA/BRO/JUM/IDO/AIN/Z08)

This article was translated by Aris Prawira.