Ketare Village, Central Lombok
This article is a summary of a case study of an issue in reproductive health services and childbearing mothers. This case study is taken from one of seven Districts in Indramayu, Surakarta, Lampung Utara district, West Sumba district, East Lombok district, Jembrana district, and Lebak district. It is describing the life story of Kholifah who lives in Central Lombok, Ketare Village.
Kholifah was born 40 years ago in a hamlet by the name of Embung Rungkas which is located in Katare village, Pujut subdistrict, Central Lombok regency. She comes from a very poor family whose members work as temporary hired farmers and laborers. By working as hired farmers, Kholifah and her husband cannot earn money every day. Since most of the land in the southern part of Central Lombok is made up dry land, the rice harvest takes place only once a year. The remaining ground water is used to water corns, beans or watermelons. Other than this, the land cannot be planted with anything. Cosequently, Kholifah and her husband can only work during the planting season dan the harverst season.
When interviewed Kholifah had six children, the youngest of whom, 9 months, was still breastfed. Kholifah admitted to having been pregnant for eight times, where one of her children died at the age of 50 days, while the other died when still in the womb. Form the eight pregnancies, seven of them got medical checkups and assisted at the childbirth by the dukun in her hamlet. Only one of her children was born in the puskesmas. Although it was free of charge, other expenditures were much bigger than the cost spent for a dukun’s assistance. After that Kholifah never gave birth in the puskesmas.
When she was pregnant with the fourth child, Kholifah had a miscarriage. For one week it bled so heavily on her vagina, and for two days after that Kholifah could not walk because of a terrible pain on the upper part of the vagina. Her suffering did not make her from house chores. Still in such a sick condition, Kholifah had to wash her blood-stained clothes and cook for her husband and children.
When giving birth to her last child, Kholifah had a horrible colic for one day and one night, causing pain dan cramp on the stomach. The pain had made her think of not having more children, but her intention could not be materialized since she was not able to pay Rp. 15,000,- for the injection. She thought, it was better to use the money to provide food for her family.
A dukun was summoned to help the childbearing. Arriving at Kholifah’s house she told her to sit do contraction. The dukun said what while sitting it would be easier for a mother to give birth rather than lying down. After doing several times of contranctions the baby was able to be popped out and then by the dukun bare-haned, without gloves.
After the birth, Kholifah had an excessive bleeding that spilled over three pieces of sarongs for seven days. She also felt pain and cramps in her vagina causing her not able to walk for three days. More than that she had a fever with a high body terperature for two days, swelling in her breast and putrid smell on the vagina.
Solutions for recovery of Kholifah’s choice
There is no midwife in Ketare village. The only reachable health facility is Sengkol puskesmas that is located 7 kilometers from her house. The distance from her house to the highway is 3 kilometers through which one can walk or use an ojek with Rp. 5,000,- payment. From the highway to the puskesmas one has to take a public vehicle with a fare of Rp. 2,500,-. This means that in order for Kholifah to get to the puskesmas she has to spend Rp. 15,000,- for a roundtrip cost. This amount is much bigger than her payment as a hired farmer for one day as big as Rp. 10,000,-. Her husband earns the same amount as the roundtrip cost. So it is quite impossible just to have a medical checkup while abandoning the spending for food of the day.
Finally Kholifah chose the methods proposed by the dukun. As soon as the child was born, the dukun would cut the umbilical cord using a blade of bamboo outer part, taken from the framework of Kholifah’s house which in Sasak language is called adas-adas. After that the dukun would take a grain of pepper (Sasak: sabia tandan) to be put into the baby’s navel to speed up the cure. If the umbilical cord became infectious, the dukun would advise her to take wood ash from the fireplace to be put in baby’s umbilical cord. By doing this the sore would recover fast and dry up.
The dukun’s medication for Kholifah after the childbirth is as follows : First to bring the vagina back into shape, Kholifah is advised to burn a stone. After the stone was well heated, it was to be wrapped with the baby’s diapers, and it must be used as compress on the whole body as well as on the vagina. Second, to cure the vagina Kholifah was told to take a bath using water filled with spices. After taking a bath Kholifah was asked to sit upon on a heated stone that had been dried in the sun (from 11 to 12 am). When sitting the vagina should touch the heated stone. The heat induced by the heat into the vagina would accelerate the cure.
Third, to recover from sickness and to regain physical fitness, the dukun made a tonic consisting of palm sugar and pepper that must be consumed until the patient felt fit. There was no time limit to consume the tonic. Its bad effect is that it can cause a diarrhea if it does not match one’s physical condition. Fourth, to get rid of putrid smell form the vagina, Kholifah was told to boil water in a fairly big bowl. When the water was boiling on the stove and evaporated, the bowl must be placed under the vagina. Although it was smarting, the vapor of the water was very useful to purge the putrid smell from the vagina. Kholifah did this for several times until the smell disappeared. Sometimes just by once steaming, the smell faded away. She acknowledged this as an effective way to dispose of the unpleasant smell.
Besides these practices, Kholifah often heard of some prohibitions from the dukun to be followed after the childbirth. Her neighbors and even her mother had often reminded her of the proscriptions. Some of them are mentioned here. First, after giving birth, the mother is forbidden from eating leaves of creeping plants like sweet potato, kangkung (“water spinach”), and beans; also watery fruits and banana. Second, a childbearing mother is forbidden from eating chicken, fearing that the baby might get fever as the pountry usually have a high bodily temperature. A childbearing mother is advised not to consume chicken for the first six months postnatal period. Third, after giving birth the mother is advised not to use plates for eating. Instead a small palm-leafed handwoven bowl is recommended for the first month. Fourth, the baby’s umbilical cord must be hanged on the clothes line. This signifies that the baby would dress up appropriately and nice to see (Sasak: ”awak penyampek”) ***