They oppose the Health Ministry's February announcement that the midwives currently working in rural areas must sit the civil servant enrollment test (CPNS) and must be a maximum 35 years old.

Indonesia PTT (non-permanent staff) Midwives Central Forum chairperson Lilik Dian Eka said the ministry's decision posed a serious threat to midwives who had dedicated their lives to helping women in rural areas for the best part of a decade.

Instead of insisting they sit enrollment tests, Lilik said, the ministry should simply carry out administrative procedures to verify the authenticity and tenure of midwives.

"Non-permanent midwives should be enrolled as civil servants. We shouldn’t be treated like new civil service candidates," Lilik told thejakartapost.com recently.

The forum demanded a presidential decree be issued to that end; the midwives hope to receive the decree from President Joko "Jokowi" Widodo at the State Palace on May 4, a day before International Day of the Midwife.

The last enrollment of non-permanent midwives as civil servants took place in 2005; around 26,000 midwives saw their rights ensured, with social security benefits.

Since then, 42,245 non-permanent midwives have been given three-year contracts that can only be renewed twice, until the midwives have reached nine years of working. They are then laid off, or must begin the process anew.

About 68.6 percent of births in Indonesia are still assisted by midwives who also serve on the frontline in reducing the country’s maternal mortality rate, the second highest in Asia, with about 200 mothers dying per 1000 births, Lilik said.

Midwives in rural areas do not only help women to give birth but also serve to provide health care for local people.

Regina, a non-permanent midwife in Cikuya, Tasikmalaya regency, said she worked in a rural area 100 kilometers from Tasikmalaya city, where the roads are still unpaved and there is no electricity.

Regina recounted how once, crossing a dark and thick forest with a patient on the verge of going into labor, the group was chased by three wild boars, causing them to panic and flee in disarray.

"Some patients also have to cross on boats to access the nearest health-care facilities," Lilik added.

Forum board member Eka Pangulimara Hutajulu said the group had been fighting for midwives' career certainty for four years, lobbying the House of Representatives, local governments and related ministries.

The forum also met Jokowi at Jakarta City Hall when he was still Jakarta governor in relation to the matter, Eka said.

In February, Administrative and Bureaucratic Reform Minister Yuddy Chrisnandi told the forum that the government would enroll the midwives as civil servants using funds provided by the Finance Ministry.

The important thing was that the midwives were below 35 years old when they were first recruited and had worked at least a year as midwives in rural areas, Yuddy said.

The forum, Eka said, will keep urging the government, particularly the Health Ministry and the President, to issue a concrete policy to ease the situation.

"The Kartinis of public health are in danger – they need help from the government." (dan)