The Right to Health Care: Building on Traditional Self-Reliance in Village Java

Abstract

Some of the beliefs and practices in maternal and child health care among rural Javanese women are described and important changes which are occurring as new forms of medical care are introduced are reviewed. In terms of both specific practices and an underlying philosophy an understanding of the 2 approaches to health care is critical to the formulation of effective programs aimed at improving the health and welfare of women and their families. A health program which recognizes the right to effective self-care could be developed from a combination of the best features of modern and medicine. Overall the practices of health imvolve a considerable amount of self treatment support from family and the larger social group and in some instances healers who are also a part of the community. In Javanese society it is primarily the women who hold and apply knowledge of a wide range of home remedies to prevent and treat illnesses among family members. The wisdom in this form of health care lies in the principle of self help health care. The women are following a basic organized medical procedure i.e. identifying symptoms selecting the appropriate cure which has been shown to be effective previously and applying the remedy. There are also many harmful practices which are a part of tradition but these must be viewed in the context of the beliefs and knowledge upon which they are based. The important issue is that harmful practices are not based on irrational assumption but on reasons within the womens perceptions of risk and causality. Attempts to change such behavior could be more meaningful if they were based on an understanding of these reasons. Although the concept of traditional health care has been defined broadly there is considerable diversity within Javanese society according to social class. The Indonesian government under its 5-year plan ending in 1973-1974 established more than 2500 rural health centers and programs of expansion have continued under the 2nd plan. Most modern health care programs work toward removing health care from the responsibility of the woman and her family and placing it in the hands of professionals.