I often feel like my life here is a comedy of errors and that all of a sudden, the guy from Candid Camera is going to pop out and say, “Surprise, you’re on Candid Camera.” Sadly – or maybe not – that hasn’t happened yet. Karawang certainly started off that way. Midway through the week, we visited a village that was only about a km or 2 from the city, but down a terribly broken road that was jarring for the 10 minutes it too to ride down. In addition to that, the only way to cross the “river” that divided this village from the jarring road, was a small foot or moto bridge that I wasn’t too trusting of to walk across. When the midwife coordinator suggested that our hired car drive across the bridge, I immediately imagined the driver being unable to balance on the edges of the bridge and us in the water. Luckily, he had the foresight to say no. The one thing I love about the villages that we’ve visited is that they are little labyrinths. The roads are narrow, and there are so many streets jutting off from the main one. We arrived at a posyandu in progress with tons of women and children. The village health worker, who was weighing the babies, was actually a man. I had, until now, only seen female village health workers, so I was happy to see that men were engaged in the fight toward maternal and child health as well. We set up in the village health worker’s house and got to work right away. The interviews started off as usual, but as we got to the end of the group, this weird thing started happening. We ask all postpartum women this question:
Would you recommend to your friends and family to deliver at the same location where you delivered? Which of the following is the most important reason influencing your decision?
And then we provide this list for them to choose from:
1 Cost
2 Distance
3 Cleanliness
4 Transport available
5 Good supply of drugs and equipment
6 Type of health provider
7 Experience of health provider
8 Attitude of health provider
9 Relationship with health provider
10 Being treated with respect
11 Facility where usually go
12 Safety for mother and child
13 Health worker recommended
14 Referred by another facility
15 Other (specify)
98 Don’t Know
Not only were many women unclear about the list of choices – it is a bit cumbersome – but women’s response to the question about recommending was often, “I don’t want to recommend anything. What happens if that woman has a complication or problem, then it’s my fault because I recommended it.” Interesting theory. I can understand the guilt that women might have in this case, but the question doesn’t ask women to be so complex in their thinking and think of repercussions down the road. It made me think that maybe women don’t sit around and talk about this stuff like I thought. I thought that on any day, when pregnant and postpartum women were hanging out, a conversation might come up about where the women delivered or were planning to deliver, and each woman giving her (unsolicited) opinion about which location is the best. Does this happen? Does it not happen? Obviously, I don’t really know. I was also surprised that women would go to such lengths to think through the repercussions of this question, yet they were confused and often unable to answer the question associated with the list. After this roundabout with at least 5 women, it felt like one of those days that I just wanted to go back to the hotel, crank the AC and read my Steig Larson book. Unfortunately, our hotel was ridiculously far and inconvenient, taking us about an hour and half from the village to arrive at the hotel. With that distance, we should have just stayed in Jakarta.
