Water Pollution In Indonesia: Health Impact Analysis

Indonesia is the world's fourth most populous country, with 275 million people. However, it has lower levels of access to basic sanitation than would be expected based on its GDP. This has resulted in water pollution, which affects the majority of the population. The main sources of water pollution in Indonesia include untreated municipal wastewater, industrial discharges, agricultural runoff, and mismanaged solid waste. This has significant impacts on health, including acute illnesses such as diarrhea and cholera, and chronic diseases such as cancer and other degenerative diseases, organ damage, and embryo defects.

Poor sanitation and open defecation

Indonesia's water pollution crisis is a significant issue, with up to three-quarters of the population living in areas where water quality is not monitored. The majority of Indonesia's population is exposed to contaminated water, with about 85% of water sources containing faecal coliform pollution. This has led to severe health issues, including acute illnesses like diarrhoea and chronic diseases such as cancer, organ damage, and embryo defects.

Open defecation contaminates water sources with human waste, facilitating the spread of diarrhoeal diseases such as cholera. This is a significant health concern, as a quarter of children under five in Indonesia suffer from diarrhoea, the leading cause of child mortality in the country. The lack of proper sanitation also contributes to the spread of other diseases, including soil-transmitted helminth, schistosomiasis, and trachoma infection. Additionally, poor sanitation has been linked to stunting, cognitive development issues, and lower educational outcomes.

The Indonesian government has recognised the urgency of this situation and has set ambitious targets for universal access to safe water and sanitation by 2024. UNICEF and other organisations are working closely with the government to accelerate progress through high-level advocacy, peer-to-peer learning, and social mobilisation in marginalised communities. They are also promoting behaviour change through initiatives like the Sanitation and Water for All partnership and by improving hygiene practices in primary schools and surrounding communities.

While progress is being made, significant challenges remain. Indonesia's decentralised government structure, with responsibilities devolved to provinces, regencies, and cities, makes coordinated action more complex. Additionally, changing behaviours and creating a national social norm around safe sanitation is a critical but difficult task. Finally, there are disparities in access to sanitation across different socioeconomic groups, with the poorest Indonesians often lacking safe sanitation facilities and being left behind in terms of access to improved sanitation infrastructure.

Industrial and agricultural wastewater

Indonesia is the world's fourth most populous country, with a population of around 270-275 million people. With such a large population, the country faces significant challenges in providing access to safe water and sanitation for all its residents. Domestic wastewater is a major contributor to water pollution in Indonesia, with untreated grey water being particularly problematic due to its high volume and lack of treatment.

Industrial wastewater is another significant source of water pollution in Indonesia. Various industries, such as food and beverages, automotive, textiles, chemicals, and pharmaceuticals, generate large volumes of wastewater that can contain harmful substances if not properly treated. To address this issue, Indonesia has seen the development of numerous wastewater treatment plants by companies such as PT. Amrita Enviro Energi (AEE). These plants employ advanced technologies, including aerobic and anaerobic treatments, to remove pollutants and contaminants from industrial wastewater before it is released back into the environment.

Agricultural activities also contribute to water pollution in Indonesia. Livestock farming and fisheries, for example, can introduce high concentrations of nitrogen and phosphorus into water bodies, leading to eutrophication. This issue is particularly prominent in rivers like the Upper Citarum River in Java, where domestic wastewater and agricultural activities combine to degrade water quality.

The inadequate treatment of wastewater has severe health implications for Indonesians, especially children. Open defecation and untreated wastewater contaminate water supplies, facilitating the spread of diarrhoeal diseases such as cholera. A quarter of all children under five in Indonesia suffer from diarrhoea, making it the leading cause of child mortality in the country.

To improve the situation, Indonesia has set national targets for universal access to safe water and sanitation by 2024. Efforts are being made to integrate clean water supply and wastewater treatment systems, and organizations like Water.org are working with the government to support these goals.

Solid waste and household sewage

Indonesia is the fourth most populous country in the world, with a population of 270-275 million people. As a result, domestic wastewater is a major contributor to water pollution in the country. In particular, the large quantity of untreated greywater, which is produced 1-4 times more than black water, is a significant source of water pollution.

Greywater refers to wastewater from sources such as sinks, showers, and laundry, while black water refers to wastewater from toilets. The high volume of untreated greywater is due to the lack of treatment facilities and inadequate on-site treatment methods, such as inadequate quality control and maintenance. This untreated wastewater, along with open defecation, contaminates water sources and facilitates the spread of diarrheal diseases, such as cholera.

A 2017 survey of drinking water in Yogyakarta, an urban area in Java, revealed that 89% of water sources and 67% of household drinking water were contaminated by fecal bacteria. This issue is not limited to socio-economic conditions, as even well-off areas face similar problems. Furthermore, only 7% of Indonesia's wastewater is treated, and less than 8% of households have a toilet connected to a sealed septic tank.

To address these issues, UNICEF has launched campaigns like #DihantuiTai, which aims to educate households about safe sanitation practices and the health risks associated with fecal contamination in water sources. Additionally, the Indonesian government is developing a roadmap to improve access to safely managed sanitation with support from UNICEF and other partners. These efforts are crucial in reducing water pollution and improving the health and well-being of Indonesia's population, especially children, who are vulnerable to waterborne diseases.

Waterborne diseases and health complications

Water pollution is a pressing issue in Indonesia, with far-reaching health implications for its people. The country's water sources are contaminated by various pollutants, including heavy metals, microplastics, pesticides, and endocrine-disrupting chemicals (EDCs). The existing water and wastewater treatment plants are inadequate in completely removing these pollutants, including disease-causing bacteria. This situation has led to a range of waterborne diseases and health complications, which pose a significant risk to the well-being of Indonesians, especially children.

Waterborne Diseases

Waterborne diseases are a leading cause of mortality in developing countries like Indonesia, and they arise primarily from freshwater pollution. The lack of proper sanitation facilities, such as toilets and latrines, is prevalent in both rural and peri-urban regions of the country. This insufficiency leads to open defecation, which, along with untreated wastewater, contaminates water supplies. Fecal contamination of water sources is widespread, with a report by the World Bank indicating that about 85% of the population is exposed to fecal coliform pollution. This type of contamination facilitates the spread of diarrhoeal diseases, with a quarter of all children under five in Indonesia suffering from diarrhea, the leading cause of child mortality in the country.

Contaminated water also spreads other waterborne diseases, including cholera, dysentery, typhus, and other infectious diseases. These diseases are caused by the high levels of germs and pathogens present in water contaminated by human feces. The dirty aquatic environment resulting from water pollution also provides a suitable habitat for disease vectors such as mosquitoes, flies, and cockroaches, further exacerbating the health risks.

Health Complications

In addition to the immediate threat of waterborne diseases, water pollution in Indonesia has been linked to various chronic health complications. These include cancer and other degenerative diseases, organ damage, embryo defects, and stunting in children. Indonesia has a severe child stunting problem, with 35% of children under five affected, and this issue is partly attributed to water pollution and poor sanitation. Maternal health complications have also been associated with insufficient sanitation, underscoring the broad impact of water pollution on the health of Indonesians across all ages.

Access to Safe Water

The lack of access to safe water is a significant challenge in Indonesia. Despite being the fourth most populous country in the world and boasting Southeast Asia's largest economy, Indonesia struggles with water infrastructure. Many families, particularly in rural areas and informal urban settlements, face difficulties due to distant, contaminated, or expensive water sources, and household sanitation remains unaffordable for many. Approximately 192 million Indonesians lack access to safe water, and 14 million lack access to safe toilets. This situation has led to a reliance on unimproved water sources, such as river water, and further contributes to the prevalence of waterborne diseases and health complications.

Efforts to Improve the Situation

Recognizing the urgency of the situation, the Indonesian government, in collaboration with organizations like UNICEF and Water.org, has set targets to achieve universal access to basic water and sanitation by 2024. These efforts include improving sanitation infrastructure, promoting behavior change through advocacy and engagement, and providing financial solutions to increase access to safe water and sanitation for low-income households. While progress is being made, Indonesia continues to grapple with the challenges of water pollution and its impact on the health of its citizens.

Water infrastructure and management

Indonesia's water infrastructure has been continuously developed since 1969 to meet the growing demands for water for irrigation, domestic use, and other purposes. The country has undertaken a decentralized approach to governance, transferring responsibilities for public works, health, environment, and other sectors to provincial and local governments, while the central government provides monitoring and guidance. This decentralization aims to improve the efficiency of water infrastructure development and management.

One of the main challenges facing Indonesia's water infrastructure and management is the lack of access to safe water and basic sanitation for a significant portion of the population. Despite being the fourth most populous country in the world and having a large economy, Indonesia has lower levels of access to basic sanitation than would be expected based on its GDP. Approximately 192 million Indonesians lack access to safe water, and 14 million lack access to safe toilets. Open defecation is still practised by about 10% of the population, contaminating water sources and leading to the spread of diarrhoeal diseases.

To address these issues, Indonesia has set ambitious targets for universal access to safe water and sanitation. The National Medium-Term Development Plan aims for 100% access to drinking water and sanitation services, with interim targets of 72.04% and 76.92%, respectively, by 2017. The government is working with organizations like UNICEF and Water.org to accelerate progress through advocacy, behaviour change, and the development of water infrastructure projects.

Several water infrastructure projects are underway or planned in Indonesia, with significant budgets allocated. These include the Karian Dam-Serpong Water Conveyance System, the Drinking Water Development Program, the Development of Wastewater Management Program, the Regional Water Supply System in Wosusokas, the Jenelata Dam Construction Project, the Riam Kiwa Multipurpose Dam Construction Project, and the Lambakan Dam Project. These projects aim to improve access to safe water, reduce flood risks, and enhance water management capabilities.

In conclusion, water infrastructure and management in Indonesia are critical areas of focus to address the health issues caused by water pollution. While challenges remain, the country is making significant strides towards improving access to safe water and sanitation, particularly through decentralized governance, public-private partnerships, and the implementation of various water infrastructure projects. These efforts are essential to ensuring the health and well-being of Indonesia's vast population.

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