Tuesday, January 19, 2016

Damp Spirits

Praise the Lord, for the rains have finally arrived.

And so we find ourselves moving and gathering momentum towards the festive period. Indeed, no less an authority than the Pope himself has just chimed in on the subject of this year’s yuletide, the official papal verdict being that it’s going to be a, “charade,” given recent world events. Certainly sounds like a few Christmases I’ve spent before. Well thanks for that, Francis my old mate. Why don’t you just stick to your job, eh? Just wish everybody a Happy Christmas, instead of bequeathing us an atmosphere as noxious as that left by a fat uncle who has polished off too many Brussels sprouts at Christmas lunch.

Thankfully though, here in Indonesia things are looking up somewhat as the daily likelihood of precipitation is finally above diddly-squat. Yes, the rains have arrived, and not a moment too soon, as the El Niño effect, coupled with unbridled avarice and stupidity, have conspired to ensure that a cloud of choking smoke the size of the former Soviet Union has been released over Southeast Asia.

Apparently however, according to the current (and alas also a previous) vice president, only half the country being on fire doesn’t actually constitute a national disaster. The half that was on fire not being the half that he lives in may also have been a factor here. Although you would be a fool and a communist to point out that if imperial Java had been blanketed in smoke, then we may have seen rather less foot dragging on the issue.

Thankfully, the apocalyptic flames are now finally being quenched and the country can reflect on a truly appalling year, even by its own dismally low standards. Indeed, Indonesia’s fires have pushed atmospheric carbon to levels not seen on this planet for over 2 million years (400 ppm to be precise) and ended up releasing some 1 billion tonnes of the stuff over poor old Borneo and Sumatra. Some even claim that this may have actually pushed the entire planet over a runaway global-warming tipping point. In this context, I’m not sure that even January’s inevitable torrents will be able to wash away a sin so apocalyptically awful.

And so Indonesia’s farmers try to pick up the pieces and tend to their cracked, blistered plots as the rain ramps up through the gears and the drought subsides. Here in the terminal urban terminus of the Indonesian capital, it’s been a bit of a novelty to use one’s umbrella again after nine long, hot months.

City dwellers generally have a somewhat ambivalent relationship with rain, and I’m sure that by the middle of January, the deluges will really start to grate once more. We’ll soon be arriving at work looking like drowned baboons, while the country’s notoriously porous ceilings spring leaks and turn to sodden cardboard, and clothes start smelling like an ojekdriver’s socks because it’s taken three days for them to dry.

And that’s without mentioning far more serious issues such as landslides and biblical flooding. God knows how the city’s putative, currently-under-construction subway stations will cope with all of this. It’ll be like SeaWorld down there.

One image from a previous year’s flooding is forever seared into my brain and involved the rather ludicrous tableau of a housemate and myself in our underpants at 3am frantically bailing rainwater out of our living room with empty Pizza Hut spaghetti trays. Indeed, previous wet seasons have seen my landlubber shipmates and our dodgy leaking ceilings recreating those scenes from World War II movies in which the German U-boat dives too deeply in order to escape the Allied depth charges and the rivets start popping out followed by jets of seawater and general Nazi sturm und drang.

In Jakarta, the rains can turn houses into sewage processing plants, half-hour journeys into Homerian odysseys and trips to the local market into mud-spattered trench warfare. Seasonal affective disorder may well be upon us folks, and that’s sad.

Hopefully though, having just gone through an El Niño/man-made environmental catastrophe, Indonesia will be spared serious flooding this year. Jakarta’s preparedness for such an eventuality, while still sketchy, has hopefully been booted a few rungs up the mission-critical ladder from previous efforts. A few years back, I recall the city administration proudly boasting of having purchased a whopping 10 rubber dinghies.

Thankfully, 26,000 infiltration wells are currently being dug across the capital for run-off water to drain into. Indeed it’s a false economy not to invest in these kinds of measures, as during the previous rainy season, Rp.3 trillion in losses were inflicted in a single week in Jakarta. Such losses, however, be they the result of forest fires or flooding, are to be born by the public, while investment designed to mitigate such disasters would have to come out of government budgets earmarked for palm grease and pied-à-terres.

Tsunamis, landslides, fires, haze, droughts, floods: has mother nature, so generous in blessing this country with so much bountiful fertility, now turned her back on her Indonesian progeny as a punishment for its rapaciously corrupt excesses and poor stewardship of its Edenic inheritance? Will we be able to pull together as a species and tackle these issues head-on? Or will the new Star Wars flick win out in the ongoing battle for hearts and minds?

As the writer Chris Isherwood once said, the rich world has “retired to live inside [its] own advertisements. Like hermits going into caves to contemplate.” And there’s a sense in which environmental concerns are now the preserve of Facebook feeds that we lap up before signing an online petition with brows suitably furrowed and chowing down on another bowl of palm oil-laced noodles. Clicktavism they call it.

So, will we be able to save Jakarta from being regularly waterboarded by the Almighty? Storming the ramparts of parliament in KPK-logoed combat fatigues and kicking the whole rotten bunch out on their exquisitely tailored arses would be a good start perhaps.

Maybe the future will look something like the one predicted by the late, legendary Kurt Vonnegut in the pages of his Darwinian prophecy of a novel Galapagos. In the book, the process of evolution by natural selection rounds decisively upon our capacious human brains. Brains which have brought so much suffering and environmental calamity to the world are depicted as having little intrinsic survival value, and are thus portrayed as an evolutionary dead-end in the book. In Vonnegut’s vision, homo-sapien grey matter thus starts to shrink and bodies begin to grow seal-like flippers as we return to the blissful ignorance of life’s oceanic cradle.

A little far-fetched? Perhaps, although just maybe the seemingly diminishing cerebral capacities of many power wielders are an early embodiment of the truth of Vonnegut’s thesis. Maybe their descendants will already be equipped with flippers during the Jakarta floods of the future. And there we were thinking that regional devolution referred to politics. Now pass me a bucket of fish please.

What's Up, Doc?

Bapaks in white coats continue to put the fear of God up Indonesia’s expats.

“Doctor, Doctor, I’m at death’s door!”

“Don’t worry, we’ll pull you through.”

This is not an exchange that I overheard in a Jakarta waiting-room, although Indonesia’s doctors, fine specimen of men and women that they most assuredly are, certainly come in for a fair amount of flak from the expatriate community. The general perception of the country’s professional bone-sawers held by those who hail from wealthier nations seems to bounce like a heart-rate monitor readout between patronizing ridicule and sheer terror at the prospect of ever falling into their clutches.

If they ply their trade at a more down-market hospital or medical centre, then local doctors are usually viewed as buffoons who offer diagnoses along the lines of “doctor, doctor” joke punchlines before pumping you full of the wrong drugs and amputating the wrong leg for good measure. However, if they work at a more salubrious house of medicine, then they will obviously try and hook you up to as many expensive machines that go ‘ping’ as possible, as the dollar signs revolve in their eyes like one-armed bandits (although American expatriates may be used to this kind of treatment as a result of their noble nation’s general disdain for socialized medicine).

One can head to the official statistics in search of a more sober analysis of the country’s medical system, however this may not help to dispel the negative aura that hangs over Indonesian hospitals like the smell of a full specimen jar.

Of Indonesia’s 1,800 hospitals, apparently only five are internationally accredited, and all of these are privately owned, although supposedly the health ministry is currently preparing another seven state-owned hospitals to qualify for international accreditation.

Ultimately, this may not make much of a dent, however, in the 100,000 or so locals who head abroad every year (mainly to Singapore, Malaysia and China) in search of decent medical treatment. And they are the lucky ones, of course. The vast majority of Indonesians, not in possession of a great deal more, asset-wise, than a bedpan, can either incur crippling debts when they require medical attention or instead opt for a judicious application of Tiger Balm whilst offering a few prayers to Him upstairs.

There have, however, been more recent signs of change. Both President Jokowi and his comrade-in-arms, Jakarta Governor Ahok, in a break with five decades of elite politics, actually seem to acknowledge that not all Indonesians drive BMWs and have pushed through medical insurance schemes, amidst much huffing and puffing from the trustees of the nation’s better-equipped hospitals.

Clearly though, this may well be like trying to fix a fractured skull with a Handiplast. Doctors here often work in a number of hospitals or health centres, and even hospitals that occupy fancy high-rise buildings may not be able to provide adequate or sufficiently professional consultation, as their doctors work long into the night with large numbers of patients. It seems that often here, high-end technology is not complemented by a similarly high-end level of professionalism among the nation’s 50,000 doctors and 2.5 million nurses.

The problem, as with so many things, lies with education, which in this country is about as bad as it gets. This is not a knowledge-based culture; it is a highly corrupt, consumption-based culture. Intellectually speaking, a complete disaster then includes the sale of places in med school (the lower your grades, the more you have to pay to get in; up to hundreds of millions of rupiah). Plus, of course, more payments will ensure that even the most chuckle-headed of potential quacks are able to pass their regular exams, whilst connections and the old-boy network also help, which is why medical care can seem so ‘dynastic’ here.

And all of this comes on top of Indonesia’s politically-motivated system of educational indoctrination, which is based around rote learning, and which seems to actively discourage the kind of critical thinking that is so valuable for the decent practice of medicine. Apparently, even nurses and midwives often have to buy their way into jobs. This can be as much as US$5,000 for a job that pays about US$300 per month. No wonder the nurses and doctors work for the government in the mornings and engage in private practice in the late afternoons and evenings.

Having said all this, my own experiences in Indonesian hospitals haven’t been too bad. Most seriously, I once rode my motorcycle into a bajaj that was seemingly being driven by some prototype Google software at the time. In any case, after being tossed in the air like a rag doll and landing in a big bone heap on the ground, I found myself being transported to Pertamina Hospital in South Jakarta having sustained several fractures.

After having various titanium plates and screws inserted into me, I was packed off home to recuperate and was also regularly visited by a nurse (alas, a male one) for the following two weeks. Both my inpatient and outpatient care were pretty decent, although all of this came at a price that was thankfully covered by my health insurance policy. Coincidentally, ex-President Suharto entered the very same hospital about a year later and, unlike myself, did not emerge alive. Perhaps the former strong man had been neglecting his health insurance payments (although I was always under the impression that the inscrutable old fascist was a collector, as opposed to a payer of premiums).

There was, alas, one dark cloud which cast a shadow over my otherwise delightful weeklong stay in hospital, and this was the nurses – angels of mercy that they were – who insisted upon waking me up at the very Indonesian hour of 5am every morning to administer nothing more than a vitamin pill and the most appalling breakfasts that I’d had since that time I went camping. After four days of this, I have to confess that I did offload some technical medical jargon in their direction.

“But we only trying to help you, Mr!”

“Aha, that’s very good, now here’s what I want you not to do…”

The great Benjamin Franklin supposedly claimed that “Early to bed, early to rise, makes a man healthy, wealthy and wise.” Well, he’d clearly never sailed around the Dutch East Indies, in my view.

Meanwhile, Indonesia’s poor may now be crowding hospital receptions the length and breadth of the nation clutching Jokowi Smart Cards, however many will still be unable to afford the fancy prescriptions dished out by doctors with a tendency towards polypharmacy (i.e. prescribing five or more drugs, many of which are non-essential but expensive if you’re on two dollars a day).

The quick fix offered by traditional jamu and over-the-counter energy pills and drinks is thus likely to remain a medical staple for the republic’s proletariat, who suffer the consequences of the fine line between commercial exploitation and medical science being gleefully trampled over. A quick fix of caffeine, taurine, sugar and paracetamol it is then, which should temporarily mask the negative effects of poverty, poor diet, lack of sleep, pollution, disease and parasites. Soviet Russia, now there was an efficient health system. As soon as you were ill, they’d kill you. No messing about with cures there…