Published: 30/07/2008

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 Agustin who lives in West Sumba, Gaura Village, Lamboya subdistrict.


Difficulties to access Health Facilities and Health Personnel

Agustin was born on October 5, 1984, in Gaura village, Lamboya subdistrict, West Sumba Regency. In a relatively young age she had had four children, one of whom had died a neonatal death. Agustin admitted to getting married at a very young age because her family’s poverty had forced her to get married quickly. Her husband works as a farmer, and Agustin, after taking good care of her family and her children, helps her husband plant vegetables in their garden. It is the produces of their garden like the vegetables and the tubers that have become the income resources for their family.


When interviewed Agustin disclosed some problems relating to her reproductive organs. Her genitals have often suffered from pains, especially after having sex with her husband. Sometimes it bled after having sex. There is also the feeling of itching and inflammation in the vagina and there is a throbbing and aching on the lower part of the belly.


It is already quite long for Agustin to undergo problems on her reproductive organs. Every time she wanted to have it medically checked, the midwife in her village did not pay her attention to Agustin’s complaints. The midwife just gave her some pain-killers that she had to take every other day. After that the pain flared up again, so that Agustin had to yield to her evil fate, saying, “Lazy midwife, if we want to have a medical check up, she does not want to do it, if it is her family, she will giver her best service”. Finally Agustin just submits to her fate and she does not tell it to anybody, even to her husband. She bears the disease herself, because Agustin does not know what kind disease she has been suffering. She is afraid to reveal it to her husband or other relatives.


When giving birth to her youngest child, Agustin just summoned a dukun in her village. She did not want to ask for the midwife’s help. However, beyond her prediction, the childbearing was very difficult. The convulsion and stomachache had lasted for almost two days. When she was dying, she remembered that similar incident had fallen upon her adjacent neighbor who had to die because of excessive bleeding. Not able to bear the pain, Agustin told her husband to summon the midwife. Before the midwife arrived the baby had been safely born, but the bleeding on the oviduct did not seem to stop. Her head was dizzy, her body became so feeble and the last thing she could remember was the hysterical screaming of the dukun from seeing the bleeding.


The midwife came not long afterwards. After giving some injections she told Agustin’s husband to find a vehicle that could take Agustin to the puskesmas. It was very difficult to find a vehicle. Gaura village is located on a mountainous area. It takes two hours to reach the puskesmas through damaged and steep roads. The only means of transportation is a truck that operates just once a day. Other than the truck people can use ojek (two-wheel taxi ride) with a fare of Rp. 100,000. It was quite impossible to take a dying patient with an ojek that would run through horrendous shocks. In some referral cases of bleeding women, some of them died on the way to hospital because of the bad condition of the roads and length of time.


Still in Agustin’s very feeble condition, the midwife had some other midwives in the vicinities picked up to give help. Almost for four hours the midwifes struggled to stop the bleeding. Slowly could Agustin who almost ran out of blood recover from her frightening condition and her life could be saved. ***