Hepatitis Jumpee

(from Monday)

I was back in Jakarta over the weekend and pretty much dreaded going back. What’s to like about a big city with almost zero charm? But from the moment I arrived in Jakarta this second time around, everything was just a bit better. This time, there was someone at the airport holding a sign with my name on it, and what’s not to like about that? And the Saturday night traffic back into town was minimal. When I got to my mediocre hotel, it was still mediocre, but the wireless was working upstairs, and somehow the crap food at the restaurant was just the crap that my body wanted. The real highlight came the next day, on Sunday, when I got to spend a good chunk of the day with Hope Worldwide (www.hopeww.org), and to visit their programs in three of Jakarta’s slums. They’re doing some wonderful TB eradication work, and run both a clinic and a pretty aggressive outreach/community education program. We visited several families, both with people who were still patients and others who had completed their treatment and who were now peer health advisors. For me, it was great to get see part of this city that I might never see on my own: several of these slums were tucked away behind seemingly middle class communities. Turn left into an alley and right across a makeshift footbridge and there you are, into a maze of tenement housing. But what activity lay in store, at least on a Sunday. Most of the three communities had small stores, a bustling informal economy, and most services outside of basic sanitation. Most of the residents in the smaller slums are new migrants to the city, living semi-illegally in places that might soon be torn down. One man reported that he makes about 60-80 dollars a month as a bicycle taxi driver, and pays $16 for “rent” and electricity. Toilet and water facilities are extra, and are pay per usage. His particular slum was clearly built on landfill—and with a dump right next to it—and walking just about anywhere outside of the “houses” felt like navigating a jumpee. At first, I feared that my legs would fall through into the goo, but later learned that it was as sturdy as your typical North American jumpee and was more about sloshing around playfully than being swallowed into the hepatitis morass below. This is what happens when far too many people flock to anyplace where work can be found. People live where they can, they make due with what they can find, and the city’s health resources are left to catch up. But outside of the poor sanitation services (many of the poopers looked a lot like they were straight from the latrine scene in Slumdog Millionaire), these slums were not as depressing or desperate as many I have seen in the past. In fact, the happiness quotient was quite high, and for many, they may see their future chances as being better in the big city than what they were before. Here there are jobs, or at least the hope of jobs. Here there is electricity and activity around the clock. Here there might be TB brought on by the overcrowding (and other diseases tied to the close quarters and lack of sanitation services), but at least there are also the health-care services to address the looming health crises. So why shouldn’t there be happiness? Even I’m a bit happier in Jakarta this second time around. I’m starting to see this city in a new light, which is good since I might have to pass through it two or three more times before this trip is over.