Eliza Borrello and Phil Hemingway in West Java – After some coaxing, Siti Dalfa stands against a height chart in her family's modest living room in Cipanas, West Java. She comes in at the recommended measurement for a 15-month-old.
But Dalfa is 21 months old and the discrepancy means, like nearly one in every three Indonesian children, she is stunted.
According to the World Health Organisation, stunting is the "impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation".
Dalfa's 21-year-old mum, Windy, was upset her daughter had not grown properly.
"She often gets sick. She was sick [a] few months ago," she said. "There was even a month when she didn't grow. I'm really sad."
Windy's next-door neighbour, Papat Fatimah has a three-year-old daughter, Alilah Tulhaniah, who stands just 78 centimetres tall. She is the height children half her age are supposed to be.
Papat Fatimah isn't as concerned as Windy, saying stunting is normal in their kampong, or village. "This kid is OK... my feeling is OK, nothing different," she said.
Stunting is about more than height, though. Other consequences include impaired brain development and an estimated 20 per cent reduction in earning capacity over a lifetime. Stunting cannot be reversed once a child reaches the age of two.
Why is stunting still a problem in Indonesia?
Dalfa and Alilah were measured by Valerie Krisni, who works for 1,000 Days, a non-government organisation trying to eradicate stunting in Indonesia by 2030.
The country is classified as middle income by the World Bank, but its stunting rate is higher than those in South Sudan and Somalia.
"I find it very upsetting that Indonesia, as South-East Asia's biggest power, as a G20 country, that our stunting prevalence is almost on par with some sub-Saharan African countries," she said. "It's definitely a heartbreaking situation with stunting in Indonesia."
Ms Krisni's NGO got its name because of the 1,000 days between conception and the age of two, when 80 per cent of human brain growth happens.
Stunting is caused by poor maternal health and nutrition. Feeding a child nothing but breastmilk for their first six months of life is one way to prevent it.
But Ms Krisni said in some outlying Indonesian areas mothers substituted breastmilk for the water in which they washed and cooked rice.
"I think a lot of people see the colour of it resembles breastmilk so they think that they can substitute rice water with breastmilk," she said.
Some women who cannot afford formula or are not producing enough breastmilk will supplement their baby's diet with the run-off.
"Another cause could be a misconception about how much breastmilk a child actually needs," she said. "When a child is about one day old, you only need maybe a teaspoon or a tablespoon of breastmilk, but a lot of mums don't know that."
Constant infections and bouts of diarrhoea resulting from poor hygiene are among the biggest contributors to stunting.
Like villages across Indonesia, there were no flushing toilets in the one Ms Krisni visited, and women cook and wash in dirty water.
Are cigarettes causing stunting?
Indonesia's Health Ministry hopes it can halve the country's stunting rate in four years. The Health Minister, Terawan Agus Putranto, is a controversial former military doctor.
One risk factor for stunting is having a parent who buys cigarettes, because it reduces the amount of money a family can spend on food.
But when asked if Indonesia had plans to reduce the consumption of cigarettes, Dr Terawan simply said education was the key. "We cannot violate human rights, therefore education is done to build awareness," he said.
Before visiting the Kampong in Cipinas, Ms Krisni spent the morning training volunteers about how to prevent stunting.
At the back of the class sat the only man in attendance, 50-year-old Dedi Supardi, who used to be a village chief.
He signed up for the stunting class in a bid to improve health conditions in his nearby village. "If it was not me, who else?" he said.
Mr Supardi condemned parents for wasting money on cigarettes. "For me, kids' health is more important than smoking. If the money is tight, one should reduce buying cigarettes," he said.
Source: https://www.abc.net.au/news/2019-12-24/indonesias-economy-grows-but-babies-are-stunted/1180939