Catalog

Fighting Ignorance

MDGs
4	Child Mortality
5	Maternal Health

ADB Review [ May - June 2004 ]

Traditional medicine women are key to promoting cleanliness and better health

CHANGING TIMES A young woman (left) receives contraceptive pills from the health center; A midwife making her rounds (below)

In the war against malnutrition and disease among Indonesia’s rural women and young children, the midwives are the frontline troops in a two-pronged campaign against ignorance and traditional practices. For years, Indonesian women have depended largely on untrained traditional medicine women, known as dukun, for their maternity and child-rearing needs, sometimes with disastrous consequences.

“When people are sick, they often go to the traditional healers, the dukun,” says Dr. Taufiqurrahman, in charge of the Kurau health center. “For a case such as diarrhea, the dukun might administer herbs or just give water accompanied by a special prayer. Building on the belief that sickness is caused by bad spirits, some dukun will take a gulp full of water and spray it at the patient with their mouth.”

Yet for many women having babies, the dukun provide an affordable, highly convenient, and seemingly more comprehensive service than midwives, who receive formal training following high school and are paid about $60–$90 per month.

“Dukun are willing to wait for days for a baby to be delivered, while the midwife will come only when it is time for the birth,” says Ms. Fahrinawati, a midwife at Kurau. “Also, women are afraid to get stitches and injections that the midwives might administer. Plus the dukun are often willing to take care of

She said the quality of dukun has been improving, as they now receive training from local districts in three basics—cleanliness in the area where the delivery takes place, clean equipment, and clean hands.

But some of the traditional nutritional practices can be damaging to babies and mothers. For instance, Ms. Fahrinawati says, dukun commonly instruct the mother to give honey to the newborn baby in the belief it will stimulate them to suck. “Sometimes, the babies are even prescribed crushed banana to try to settle the stomachs,” she says. “The result is a bloated stomach and chronic constipation as the baby can’t digest the food.” Ms. Fahrinawati remembers that before ADB’s Family Health and Nutrition Project, a baby in her area died from such chronic constipation.

“But that would not happen now,” she adds. “People are so much better informed about health and nutrition. Now there is more knowledge, so it is easier to work in the local community.”

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