Diarrhoeal problems and infant & child mortality in Indonesia.

An estimated 50 million episodes of diarrhea occur per year in Indonesia 70% of which involve children under 5 years of age. In 1974 there were 600000-900000 diarrhea-related child deaths. Diarrheal diseases accounted for 10-20% of hospital pediatric admissions in Indonesia in 1971-80 with mortality ranging from 2.5-10%. Children under 5 years of age average 2 episodes of diarrhea/year whereas infants experience an average of 2.8 episodes. A trend toward a national decrease in mortality from diarrhea is encouraging. By 1983 diarrhea-related mortality had decreased to 200000-300000--a fall of almost 2/3. Through promotion of integrated programs the Government of Indonesia hopes to reduce mortality due to diarrheal disease to under 2% in the next 5 years. Key to the success of this effort is the promotion of oral rehydration therapy. A recent survey indicated that use of oral rehydration solution occurs in under 35% of diarrhea episodes. Several studies have shown however that use of this solution can reduce diarrhea mortality by more than 40%. This effort has been hindered by Western style medical systems that are inappropriate for meeting the health needs of the populations of developing countries. Rather emphasis should be placed on community involvement in health care demystification of medical technology and the appropriate use of health care products.