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Water for all, health for all
While only 6 percent of people in Jakarta lack access to proper sanitation, in rural Papua the number reaches 98 percent, as cited by the World Bank in 2016.
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A child is bathed at an evacuation camp in Sentani, Papua, on Thursday, five days after a flash flood hit the region. Some 10,000 people have reportedly left their homes. (Antara/Zabur Karuru )
T
his year’s World Water Day of March 22, themed “water for all”, took place just five days after the third electoral debate that covered health issues. Thus it is timely to evaluate our task ahead on ensuring water is accessible and safe for all.
As we witnessed in the March 17 presidential debate, the discourse on health raised the question on balancing the quality of health services for all with the cumulative high costs borne by the nation. The answers of both vice-presidential candidates Ma’ruf Amin, running with President Joko “Jokowi” Widodo, and Sandiaga Uno, running with Prabowo Subianto, focused on more efficient governance of the healthcare system as well as disease prevention. Unfortunately, no one touched on the environmental factors that cause a large number of diseases of which the treatment is covered by our universal healthcare system.
Poor health is strongly associated with water pollution. The Global Burden of Diseases study in 2015 found that 1.8 million premature deaths across the world were related to water pollution. According to a study in Indonesia led by former health minister Nafsiah Mboi in 2016, skin and diarrheal diseases were significant causes of reduced life expectancy.
Diarrheal diseases are still prevalent among children living in poor environments in Indonesia according to other studies. Unimproved latrines and untreated drinking water are strongly associated with rural communities and urban slums. While only 6 percent of people in Jakarta lack access to proper sanitation, in rural Papua the number reaches 98 percent, as cited by the World Bank in 2016.
Stunting, an example used by Ma’ruf in the debate, has also been associated with inadequate sanitation and water supply. Consistent with the Lancet’s Commission on Pollution and Health finding in its 2018 report, pollution-related health problems disproportionately hit the poor and vulnerable, especially children affected by pollution before birth.
Improvements in the distribution of safe drinking water and sanitation have progressed slowly despite the economic growth in recent decades. Twenty-seven million people in Indonesia lack access to clean water and 51 million lack proper sanitation. Public Works and Housing Ministry reports state that progress has only reached 62 percent for proper sanitation projects and 72 percent for drinking water projects. This rate is slower than other infrastructure projects entrusted to the ministry. Achieving the target would cost the state Rp 275 trillion (US$19.38 billion).
Even when piped water is available, some surveys show worrying water quality. In Yogyakarta, two of three drinking water samples were contaminated with fecal bacteria. Pollution of shallow groundwater is reported in all large cities across Java, while in Jakarta one of two samples were contaminated by fecal coliform and 4 of 5 samples by E. coli.
