An upcoming seminar in Jakarta will discuss aspects of stunting, which affects one in three children in Indonesia. 

Stunting was thrust into the spotlight during a debate between two then-vice-presidential candidates, Ma’aruf Amin and Sandiaga Uno. 

That moment in the televised debate brought attention to the issue. However, stunting prevention activist Zack Petersen says that most Indonesians do not realize how far-reaching the problem is in the country.

“Indonesia’s best-kept secret is not its pristine beaches, rugged volcanoes or picturesque island getaways but its stunting rates, which sit on par with sub-Saharan Africa,” Petersen said, referring to Ethiopia, Rwanda and Zambia.

Petersen and his team at the 1000 Hari (1000 Days) initiative have been working to educate the public on stunting, which impacts one in three children in the country.

The impacts of stunting, as Petersen noted, goes beyond just health issues.

Given their poor cognitive abilities, stunted children will very likely go on to earn a wage more than one-fifth lower than their peers in adulthood. This costs Indonesia’s economy more than US$20 billion per year.

To raise awareness on this chronic health problem, Facebook’s Ruang Komunal at One Pacific Place in Jakarta will host the “Stunting: Costs, Causes and Courses of Action” seminar on Sunday. It will feature a keynote address by Dr. Brian Sri Prahastuti, a senior advisor at the Executive Office of the President.

Petersen, the operations director of the 1000 Hari initiative, has expressed hope that such talks will encourage discussion and action in the battle against stunting. 

Collaboration: The 1000 Hari initiative works hand-in-hand with local experts on the ground in an effort to develop effective stunting prevention programs. (Photo by Ade Ansori)

The World Health Organization (WHO) defines stunting as the impaired growth and development that children experience as a result of poor nutrition, repeated infection and inadequate psychosocial stimulation. Undernourishment is the leading cause of stunting.

Once a child is stunted, passing the 1,000-day threshold, “There is not a lot you can do to reverse course,” Petersen explained.

“Much of the damage incurred through neglect during the first 1,000 days of life is irreversible. For example, by the time a child is 2 years old, the brain weighs almost 80 percent that of an adult brain — and by that point, considerable structural damage will have been done.”

He voiced hope that the attendees would come out of the seminar understanding that tackling stunting means putting the focus back on integrated health posts (Posyandu), which provide vaccinations and nutritional supplements for children and pregnant women.

“Indonesia has over 300,000 Posyandu, which amounts to some 2 million kader [volunteers]. Most of those kader have never received proper training. How can we expect to slash stunting rates if we don’t focus on the core issues, like support to the heart of the village?” Petersen stressed.

Aside from addressing the immediate causes of stunting, Petersen also pointed out the need to pay attention to hygiene and sanitation in the effort to protect children, including those suffering from stunting, from life-threatening illnesses.

A number of studies suggests that stunting is responsible for death from illnesses like pneumonia, diarrhea, meningitis, tuberculosis and hepatitis. In part, this is because stunted children have poor immune systems, making them 10 times more susceptible to illness than their healthy peers.

Health check: A woman carrying her baby consults counselors at an integrated health post (Posyandu) in Pontianak, West Kalimantan. (JP/Severianus Endi)

According to the 2017 Indonesian Health and Demography Survey, 24 babies per 1,000 live births die before their first birthday. The mortality prevalence among children aged under five is 32 per 1,000 live births.

“Almost half of preventable infant deaths is related to malnutrition. That’s as many as 70,000 child deaths in Indonesia every single year,” Petersen explained.

Meanwhile, Brian said she expected the seminar would amplify the message on stunting prevention. She noted that the government, through various efforts, had managed to reduce the number of stunting cases in Indonesia.

“On several occasions, the President described stunting as a serious threat to national development and expressed the need for immediate action to solve the problem through cross-sector collaboration between government, communities and the private sector. In the past five years, we have saved roughly 1.7 million infants and young children,” she explained.

Petersen said he hoped the seminar would inspire the attendees to take an active role in stunting prevention efforts.

“We can all do something,” he said.

“You can adopt a Posyandu. You can use your birthday for good and raise money to support any number of amazing local NGOs working on stunting across the country. You can connect with us and volunteer to install height charts. We have 1,000 height charts to give away, we want to install 10,000 height charts across Indonesia by 2020.”

Petersen foresees a day when Indonesian children will no longer be affected by the devastating effects of stunting. Petersen said that initiatives such as 1000 Hari would work until that day came.