Understanding modifiable risk factors associated with childhood diarrhea in an eastern Indonesian urban setting

Life in a landfill slum, children's health, and the Millennium Development Goals

“…This results in direct exposure to fecal matter. Since mothers are primary caregivers for children, children were more likely to develop diarrhea, if mothers washed their hands without soap after defecation (Watson et al, 2015).…”

“…The landfill slum population has not been officially recorded, however the number of waste pickers working in the landfill was estimated to be approximately 300, according to a "PUSKESMAS" (Pusat Kesehatan Masyarakat or government operated community health clinic) staff member. A total of 113 people (approximately one third of the waste pickers) from the landfill slum and 1184 people from the general population participated in the survey in June of 2011 Watson et al, 2015). All interviews were conducted in Bahasa Indonesia (Indonesian) by trained research assistants from the Fakultas Kesehatan Masyarakat (School of Public Health) at Hasanuddin University (FKM-UNHAS).…”

“…Of note, $152/month is the threshold value for household poverty based on the international poverty line of $1.25 per day per person and assumes that the average household size was four in Makassar Watson et al, 2015). It should also be noted that the Indonesian definition for household poverty is based on a household meeting nine out of 14 poverty criteria with $60/month being just one of these criteria (MDHO, 2011).…”

“…Thus, shutting waste pickers out from the landfill would be a problematic option. Low household incomes link to other MDGs and are also a significant risk factor for childhood diarrhea in Indonesia (Watson et al, 2015). In order to improve the incomes of waste pickers and thereby their health status, local governments could formalize and regulate the waste recycling services these workers provide (Wilson et al, 2006;Nzeadibe, 2009).…”

“…Unfortunately, many people in the landfill slum lack primary education, because they need to work in order to support their families. An earlier study conducted at one general population site showed that mothers without primary education tended to think childhood diarrhea was not life threatening, and mothers with such a perception were more likely to wash their hands without soap after defecation (Watson et al, 2015). It must be noted that local people used wetted fingers of the left hand to clean their anal area after defecation instead of toilet paper.…”