Saturday, December 21, 2002

57. NEIGHBOURHOOD CHIEF

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I was back in Indonesia, having endured the usual sixteen hour flight from London. I walked smartly through the glass-walled halls of Soekarno-Hatta Airport and hurried out into the warm balmy air to be met by my faithful driver. We travelled along the toll expressway towards Jakarta, city of over fourteen million souls. In spite of the recent riots, Jakarta looked no different from usual. I was looking forward to more explorations and adventures in the countryside around the city. But first I was desperate to see Min.

As I drove up to Min’s house, I could see that Min was standing at his front door staring out onto the street. Did he know I was going to arrive at that particular moment, or was it just coincidence? Did he normally stand there much of the day? He gave me a nervous, tight-faced smile as I patted him on the arm. His mum assured me that Min was in good health. For at least a year I had been making my meetings with Min less and less frequent, so as to condition him for the day when I would eventually have to leave Indonesia. I hoped the conditioning was working.

Min, his mum and I took a walk to the home of the little tubercular twins Sani and Indra. The twins had grown taller, but no fatter. We met little Saib, the boy who had had a stone removed from his bladder. Saib gave us a shy smile and assured us he was still attending school.

On my second evening back in Jakarta, tubercular Fajar and the little musicians, Ali and Dikin, arrived at my house. Fajar looked a little brighter in his eyes, but Ali was complaining of a headache and weariness. We took Ali to the hospital and it turned out that he was yet another victim of TB. He started to take his cocktail of medicines.

On a morning journey to Bogor I stopped off in Parung to see Nurul, the woman with lumps on her breasts. She was sitting on a mat at the front door of her wooden shack, her big-eyed little son at her side. I asked her if she had changed her mind about going to the hospital. She was still determined not to go. I asked her how much of the medicine she had left. She said that she had stopped taking the medicine as it made her feel sick. After failing to persuade her to change her mind about medical treatment, I left her some money, and motored on to Bogor to visit the family of Asep.



In Bogor Baru I walked through the fields of rice and tapioca until I came to the dark, damp hollow under the trees and the damp, earth-floor house where Asep had once lived, before dying of TB. Standing outside the house were Asep’s son, grinning and looking taller and less malnourished, and Asep’s daughter, still innocent and sweet in appearance. My driver had been coming to Asep’s house once a month to deliver a little money for the family. I confirmed with Asep’s smiling wife that she had been receiving the money and apparently making good use of it.

Near Asep’s house I spotted little Andi. He too was taller, but his swollen tummy suggested he still had worms.

At the mental hospital I was met with shrieks of joy by both Firdaus, the boy with the scars and lumps, and by the boy with the strange eyes. The female nurse who was in charge suggested we take the two children for a short run in my van, and stop off at a shop. We drove past the golf course, stopped at a little store, bought packets of noodles, tinned milk and biscuits and then returned to the hospital.

Near Bogor’s Jalan Pledeng, I called in at the simple red-roofed home of elfin schoolboy Dede, brother of gypsy-faced Rama.

"How are you and how is your sister?" I asked Dede who was sprawled out on the settee. I noted that his hair had grown long and that he was wearing dark glasses, an earring, a heavy-metal T-shirt, and ripped jeans. There was no sign of Rama or granny.

"Fine, mister," said Dede. "But I’ve had dysentery."

Now, what did I know about dysentery? There is bacillary dysentery caused by bacteria. There is amoebic dysentery caused by a tiny amoeba. And sometimes dysentery can be caused by parasitic worms. One study done on a sample of several hundred apparently healthy Indonesian schoolchildren showed that over 70% of them had some type of parasitic infection.

In some areas, 80% of Indonesians have had bacillary dysentery by the time they’re aged five. With bacillary dysentery, the disease strikes suddenly. At its worst there is abdominal pain, stools may become watery, there may be fever, nausea and vomiting, and there may be muscular pains, chills, backache and headache. After one or two days there can be pain in the rectum and lower abdomen and frequent small stools which may or may not contain mucus and blood. In severe cases there may be rapid weight loss and dehydration; the bug invades the lining of the large bowel and multiplies there, killing cells. Occasionally the bug invades the bowel beyond the surface lining. One form of bacillary dysentery produces a toxin, which causes additional tissue damage, and may lead to kidney failure. A doctor will prescribe antibiotics. Some strains of the bug are becoming resistant.

Amoebic Dysentery is common in Indonesia. In some regions over half the population are carriers of amoebic cysts. This is partly because human excrement is used as fertiliser. The cyst is the inactive stage. When cysts enter the body with contaminated food or water they are changed inside the intestine into active amoebas and may cause dysentery. The symptoms usually begin gradually. Some people who have the amoeba show no symptoms. But if the amoeba gets through the intestinal wall, ulceration takes place and there is diarrhoea which may be mild or which may involve high fever and frequent watery stools with blood and mucus.

With chronic amoebic dysentery, the patient gets diarrhoea, lasting for 1 to 2 weeks, several times a year. This can be dangerous if the amoebae spread to the liver or brain, and form abscesses there. Destruction of liver tissue is the most frequent complication of amoebic dysentery. Infection by amoebas, whether of the intestine alone or of other parts of the body, is called amebiasis. To diagnose dysentery a hospital should take several fresh stool samples over a number of days. This is because some of the stool samples of infected people will show no signs of amoeba. The disease may be treated with a ten day course of a drug like metronidazole to remove the amoeba from the intestines, with a drug such as iodoquinol to make sure the bug is completely killed off, with an antibiotic to deal with any bacterial infection, and finally with a drug to deal with any infection of the liver.

"What kind of dysentery have you had?" I asked Dede.

"Don’t know," said Dede.

"Did the doctor do any tests? Did he take a sample of any diarrhoea?"

"No," said Dede, with an amused look on his face.

"What medicine did he give you?"

Dede showed me a small cheap plastic envelope which failed to list the name of the medicine it had once contained.

"The doctor told me to keep my finger nails clean," said Dede, holding up nails that looked cleaner than those of your average Indonesian.

"Are you better now?" I asked. I had noted that Dede showed no obvious signs of weight loss.

"I’m better now," said Dede.

I politely declined the offer of tea and cakes.

After lunch of cola and biscuits at the Internusa shopping centre, I went for a stroll. Outside a brightly painted Moslem school, a brick structure that appeared to consist of perhaps only one or two classrooms, a skinny young boy with skinny bare legs was selling cakes from a tray. Around the boy, tropical sunlight created Matisse-like blocks of brilliant colour: the blue of the school door, the green of the wall, the pink of the boy’s shirt. The boy’s eyes sparkled with joy and his smile was wide and almost saucy. I took a photo and gave the child a few coins. He told me his name was Chandra.

I continued my walk, ascending steep stone paths and following winding lanes. It was Bogor at its best: a jumble of house walls and flowering shrubs with different shapes and textures and smells, a host of happy children, and the sort of air of gaiety you might expect on a sunny day on Italy’s Amalfi coast.

After half an hour I found myself back near the Moslem school and sighted Chandra with a group of small friends.

"Give me some money," said Chandra, holding out his hand and not smiling.

"I’ve already given you some," I explained.

"I need money," said Chandra, scowling.

"I’m not giving you any more."

Chandra’s eyes looked moist. He turned his back on me and stomped off.



The following weekend, back once more in Bogor, I walked along the sun-dappled banks of the River Cisadane to the home of Melati, Dian, Tikus and the fruit bat. I was invited to have a seat in the front room. Only Dian and Tikus were at home. Dian gave me a strained smile and assured me that she was well. Tikus, sprawled on the settee, and didn’t bother to contain his yawns. I struggled to make conversation. I swiftly got the message that they were not in the mood for entertaining me, so made my excuses and went for a solitary walk.

After lunch near the Internusa Shopping Centre, I took a stroll through the nearby kampungs. Having passed a bungalow-sized mosque and a number of simple houses with gloomy interiors, I descended a steep lane and reached a dank, sunless quarter next the small and murky river Ciparigi. It was how the slummier parts of Venice might have been in a previous century. There was a smell of dampness, dead vegetation and waters polluted by human waste.

Outside a basic brick and concrete house, occupying a sloping site, stood a big-boned woman, a small girl, and Chandra, the boy with the skinny legs and pink shirt, the boy who had claimed he needed money. When he saw me coming, Chandra climbed the steps of his house and disappeared inside.

"Chandra lives here?" I asked the woman.

"Yes. His mother has just died."

"Died?" I felt an element of shock in my chest.

"She had TB."

Now I knew why Chandra had wanted money. I left the scene but returned one week later to persuade the boy’s emaciated-looking father that he and his children should have a hospital check-up. It transpired that one daughter, a girl in her late teens who looked quite plump and healthy, had TB in the form of a lump on the top of her shoulder. This was non-pulmonary TB, evidently quite common in parts of Asia. Some patients with tubercular lumps can appear otherwise healthy, with no weight loss and no cough. She began receiving medicine and had recovered within a year. Chandra always kept his distance on the rare occasions I visited the daughter to check that she was taking her pills.



Out for some Sunday morning exercise, in an area only five minutes from my local supermarket, I walked through sun-drenched meadows with happily grazing goats, kampungs with red-and-green-roofed houses, fields of tapioca, and patches of tall fruit trees. Beside a small stream stood a group of boys, one of whom, aged about thirteen, had a cheeky grin on his rather plain face and a nasty abscess on his bare leg. This boy told me that his name was Novi, and he had not had any medical treatment for his wound. I gave him some money to pay for a visit to the doctor and he promised to provide me with a receipt, should I bump into him again.

Next afternoon, Novi arrived at my front door, with a doctor’s receipt.

"How did you find my house?" I asked.

"My father is a neighbourhood chief," said Novi, "and he asked the other local neighbourhood chiefs, the other RT’s, if they knew of a white man living nearby, someone who likes wandering through kampungs. Your own neighbourhood chief, your own RT, lives in the very small house at the end of your road and he’s seen you going for walks."

"I’m amazed," I said. I had never met my neighbourhood chief and it had not really occurred to me that, as one of the tiny handful of expats in the area, I must stand out like a sore thumb.

"My father hopes you’ll come and visit him," said Novi.

I loved visiting Indonesians’ houses and let Novi take me straight away to visit his family.

The home of Pak RT, or Mr RT, stood on the edge of a hamlet and was larger than average, big enough to house an extended family. It had that home-made, slightly dishevelled look of kampung houses. Some of the musty green-brown roof tiles looked loose; water was provided by a well; chickens ran about in front of the open front door.

The cavernous living room, into which I was invited, had a bare concrete floor, well-worn furniture, but a larger than normal TV. Pak RT came forward to shake my hand. He looked as if he was in his late fifties; he was tall and his hands were big and muscular; his manner seemed placid and amiable, like that of a simple farm worker.

"I am a retired soldier," he said, as he sat back in his chair.

"And you are the elected neighbourhood chief," I said. "I want to learn all about that."

He proceeded to tell me that he was elected by the thirty households in his area. Elections were held every three years. He helped his neighbours with government form filling; he organised kerja bakti, voluntary work, such as ditch clearing or celebrations of Independence Day; he settled neighbourhood disputes; he had helped to raise money for the building of a musholla, a small mosque.

"Are you a rich man?" I asked.

Pak RT’s wife, who had been hovering in the background, gave out a laugh.

"We are poor," she said.

Pak RT’s wife was much younger than her husband; she wore a well-cut trouser suit and a gold watch; she looked sharp, self-confident and alert. She would not have looked out of place in a smart shopping mall.

"Does Pak RT get paid for his work," I asked.

"It’s not like being a civil servant," she said. "No big cars. All we get is a small monthly contribution from the local people. This is a poor neighbourhood."

"Do soldiers get well paid?" I asked.

"No," said Pak RT, unsmiling. "I wasn’t an officer. I couldn’t become an officer because I didn’t have the money."

"You have to pay to become an officer?" I asked.

Pak RT shrugged his shoulders; he seemed to have decided to keep quiet on the subject.

"My husband had to have two jobs," said Pak RT’s wife, breaking the silence. "While he was a soldier, he also had to do private work as a guard."

There were two teenage girls standing shyly at the far end of the room; and there were four young boys, perhaps cousins or friends, who had joined Novi and who were now standing beside Pak RT. The boys were not shy. One boy, with a cheeky-monkey face, held up three fingers, then one finger, and whispered some rude words in English while staring in my direction. Pak RT ignored this.



The following afternoon, Novi arrived at my front gate with a letter from his mother. It was a request for a sum of money to help pay for Novi’s schooling. I explained to Novi that I only helped very poor people and he was not one of the very poor. I politely got rid of Novi and put the letter in the bin. Another letter arrived the following day and I wrote a courteous reply, repeating what I had already said to Novi. Next came a series of telephone calls from Novi, begging for money. Eventually he gave up.




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