Difficult to find paramedics Tegal Badeng Timur Village, Negara subdistrict, Jembrana Regency

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 Maimunah who lives in Jembrana, Tegal Badeng Timur Village, Negara subdistrict, Jembrana regency.

 

Maimunah and the Health of her Reproductive Organs

Maimunah related that she had been going through various forms of health problems relating to her reproductive organs. She had problems with menstruations, the gonorrhea, during the pregnancy and post-natal period, and troubles with the contraceptives from the Family Planning Agency.

 

The problem of menstruation experienced by Maimunah was the excessive pain on the belly. More than that Maimunah also got fainted and pale during the menstruation period. The pain was felt from the first day until the third or the fourth day. This condition remained the same even after she had a husband. For the last menstruation the bleeding was more than usual. She still experienced an untimely menstruation and excessive pain.

Beside the menstruation problem, Maimunah also had problems during the pregnancy. She was pregnant for the first time when she was just 16 years old, and the second when she was 19 years old. Maimunah’s pregnancies were categorized as highly risky. More than that Maimunah also underwent a longer period of pregnancy, more than other normal pregnancies, that are 10 months for the first pregnancy and 11 months for the second pregnancy. Other complications also occurred during the second pregnancy. She had a high fever.

 

Maimunah also had problems at parturitions. The first time she gave birth when she was 17, she felt afraid. She also felt pain and repeated colic’s. For the first childbirth she struggled for 2 hours. Actuality she admitted to undergoing complications and disturbance when she gave birth to the second child. On that day she went through many health problems in the form of repeated colic’s for one day and one night. In addition to that Maimunah had an excessive bleeding during the post-natal period. The bleeding was experienced for three times during the post-natal period. Sometimes she even fainted.

 

Beside those problems Maimunah also had troubles with the use of contraceptives. When she used the injection for three months period, Maimunah felt she gained weight. She also experienced slight bleedings, but those were really agonizing; they were even worse compared to pains during the menstruation. Maimunah then switched to 1 month injection. But another problem appeared. The milk in her breasts dried up. She was then given pills for breastfeeding. But she became dizzy from those pills.

 

Medications of Maimunah’s Choice

In her agonizing pain during the menstruation, Maimunah always overcame it by using traditional medications. She overcame it by drinking the jamu or traditional tonic made of turmeric and tamarind produced by Sido Muncul Company. The other jamu that she took was Kiranti.

 

According to her, the choice was proposed by her mother. According to Maimunah’s mother, in order for the menstruation not to stink, she had to drink water of boiled betel leaves. Another reason for choosing the traditional medication is her own experience in resolving personal reproduction-related problems. Maimunah also admitted to being reluctant to go to doctors or midwives because she used to do that but the problems remained. She also felt indolent because in her village she could not find any doctor or midwife; she had to go to a neighboring village for the purpose using an ojek, implying that she had to spend additional cost for transportation, while she herself is economically powerless.

 

Maimunah did the same thing to overcome her gonorrhea that she had. She overcame it by drinking jamu on regular basis. Other than that she is also diligent to clean her vagina using the betel leaves.

 

During her first pregnancy, Maimunah regularly had herself examined by a midwife for the midwife had suggested her to have her pregnancy checked. Besides following the midwife’s suggestion, Maimunah also drank jamu, made of turmeric and tamarind, twice a day. She consumed the jamu because of the suggestion from her neighbors and jamu-vendor. According to them, consuming the jamu could make Maimunah feel fresh.

For her second pregnancy, Maimunah said she rarely had herself checked up. She did that only sometimes. She chose a midwife to have her last pregnancy checked up. She chose the place because she felt suitable with the health services provided by the midwife. She acknowledged that she did not spend a single rupiah to pay the checkup because she had a JKJ card. Maimunah felt she was experienced with the first child. In her second pregnancy, Maimunah also took the jamu made of turmeric and tamarind.

 

When she was about to give birth, Maimunah chose to give birth at home. Maimunah chose to be attended by a dukun, or traditional midwife. The choice was made by Maimunah herself. She was afraid to ask for help from the midwife. Maimunah had a trauma relating to the way a midwife assisted her sister-in-law. When her sister-in-law was screaming painfully, the midwife stayed unmoved. The midwife just told her to wait despite the fact that her sister in law had suffered a great deal.

 

Other than this reason, Maimunah felt difficult to visit the midwife by herself when it was about time to give birth. It was different from the dukun. If she asked for help from the dukun, the dukun would come to her house. According to her, the dukun was also hospitable dan friendly. The dukun could make her feel more comfortable and it was important for a childbearing mother. Unlike the experience of her sister in law, the midwife kept grumbling making the mother feel uneasy. Finally, Maimunah’s sister in law silently went home using an ojek. Arriving home she right away gave birth.

 

In connection with the childbearing preparation, Maimunah also drank jamu to make her easily give birth. The jamu was made of yellow part of the egg to reduce the zise of placenta and in order for the child to stay calm and not rebellious during the birth giving process.

 

Maimunah’s Handicaps in Accessing Health Service Facilities

To overcome her health problems, Maimunah admitted to having come across some problems and handicaps. Those are:

1. Unavailability of midwives in her village of Tegal Badeng Timur. The unavailability of midwives and doctors had caused Maimunah to have additional spending for transportation. The cost had not included the snacks for her child who she took along for the check up. This had made Maimunah unable to routinely have her pregnancy checked up during her second pregnancy. She also opted for the dukun’s assistance enabling her to give birth at home.
2. Unavailability of transportation means other than the ojek. When Maimunah did not have money, she could not utilize her JKJ card for she could not pay transportation cost
3. Unavailability of midwives in her village had caused Maimunah to opt for the dukun to assist her childbirth. In the village where she lives there are three midwives.
4. There was a difference between having a medical treatment using the JKJ and not using it. Maimunah felt than when using the JKJ, it was not quite fast to recover from her illness. But if she did not use the JKJ card, she felt that she could recover faster. According to Maimunah, this was not her own experience. Some of her neighbors experienced the same thing if they used the JKJ. Based on this experience, Maimunah was suspicious that the medicines given to JKJ users are different from medicine given to non-JKJ users. ***