Interview/Professor Saparinah Sadli: Maternal health is a matter of gender equality

IN her advanced age, Saparinah Sadli, 83, continues her staunch struggle for women’s rights, as outlined in her book Berbeda tapi Setara (Different but Equal) launched on April 21 coinciding with Kartini Day. Consistent in her efforts at promoting women’s life almost throughout her life, the professor has never ceased her activities at, among others, the University of Indonesia’s Center for Women’s Studies, National Human Rights Commission (Komnas HAM), and National Commission on Violence Against Women (Komnas Perempuan). Saparinah is very concerned about the high rate of maternal deaths in Indonesia-in fact, it is the highest in Asia. On Wednesday last week, she received Sadika Hamid and Farida Senjaya of Tempo English Edition for an exclusive interview. Excerpts:

The National Development Planning Board (Bappenas) recently stated it seems that the target of the Millennium Development Goals (MDGs) for maternal health cannot be achieved.

Bappenas says that out of eight MDG targets, some are on track while others are not. One of those off-track is MDG 5, improving maternal health.

What factors do you think affect this?

In my opinion, until now it seems that the Health Department is the only one responsible for this. The Health Minister is not the only one to handle this problem. For instance, some regions have poor transportation means. The rate of maternal deaths there tends to be high as people live in the mountains or in other inaccessible places. So, it is not just a matter of health, it must be supported by other factors. Anothee matter is tradition. Until now, in Java for example, there is a tradition or a myth that a woman who dies during labor will go directly to heaven. Then there is a custom where the husband can determine whether or not his wife can be taken to the clinic in case of
complications during childbirth. So, basically this is a matter of gender inequality.

So the basic problem is inequality in gender?

As a matter of fact, all the MDG targets are a new paradigm of how to reduce global poverty. This should be seen from the viewpoint of gender perspectives, that is, how to improve the living conditions of women so as to reduce the number of poor women. Then there is the need to reduce the rates of maternal deaths. If, for example, the mother dies-usually a poor one-according to a survey, normally the child left by its mother will also have short life expectancy. Usually the child cannot last more than two years as it has not received breast milk, cannot get nutritious food. Therefore, this has to do with the rates of maternal deaths and infant mortalities.

Which parts of the country have the highest number of maternal deaths?

I think Papua and East Nusa Tenggara (NTT) since it is very hard to get health services over there. This is a geographic as well as traditional problem. Women in Papua are accustomed to giving birth in the jungle. Education for women is also very low. So, not every region will reach the MDGs easily.

What needs to be done to overcome these problems, for instance, in eastern Indonesia?

The regions there are widely scattered, so transportation should be a contributing factor. Because, even if the health attendants are available, maybe the midwives are only to be found in villages, while in remote areas there are only dukun (traditional midwives) who may not be skilled in dealing with birth complications. The government already initiated a partnership program for traditional and modern midwives. Nevertheless, Indonesia’s maternal deaths remain the highest in Asia.

In your opinion, how many health centers and medical attendants are available, especially for mothers in labor?

There are doctors but only at community health centers (Puskesmas). Puskesmas are not to be found in remote areas. So, there have got to be more midwives, that is obvious. But midwives alone are not adequate. There should be transportation which enables the midwives to go there, for instance. Or there is a means whereby to take a sick person to the clinic easily. So, the important thing is the existence of a quality health service which every woman can get to.

Source: Tempo Magazine, No. 36/X, May 05-11, 2010

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