RESEARCH REPORT : EVIDENCE BASED OF KATAJAGA IN IMPROVING HEALTH, ENVIRONMENT AND ECONOMIC OF VILLAGE BUDI LAKSONO

KEY FACT OF DIARHEA Key facts Diarrhoeal disease is the second leading cause of death in children under five years old. It is both preventable and treatable. Diarrhoeal disease kills 1.5 million children every year. Globally, there are about two billion cases of diarrhoeal disease every year. Diarrhoeal disease mainly affects children under two years old. Diarrhoea is a leading cause of malnutrition in children under five years old.

DIARRHOEA DEATH TO DAY http://who.org/diarrhoea/

DIARRHOEA CAUSE DEATH http: //www. pacinst DIARRHOEA CAUSE DEATH http: //www.pacinst.org/reports/water_related_deaths/water_related_deaths_report.pdf

DIARE DI INDONESIA Penyakit diare masih menjadi penyebab kematian balita (bayi dibawah lima tahun) terbesar di dunia. Menurut catatan Unicef, setiap detik satu balita meninggal karena diare (www.ampl.or.id). Diare seringkali dianggap sebagai penyakit sepele, padahal di tingkat global dan nasional fakta menunjukkan sebaliknya. (NEGLECTED DISEASES Menurut catatan WHO, diare membunuh dua juta anak di dunia setiap tahun, Di Indonesia, sekitar 162 ribu meninggal setiap tahun atau sekitar 460 setiap harinya Diare infeksi di negara berkembang, menyebabkan kematian sekitar 3 juta penduduk setiap tahun. Setiap anak di Indonesia mengalami episode diare sebanyak 1,6 – 2 kali per tahun. Dari hasil Survey Kesehatan Rumah Tangga (SKRT) di Indonesia, diare menempati urutan pertama dr preventasble diseases penyebab kematian bayi (Elemen Seng Mampu Atasi Penyakit Diare; Available from :  www.mediaindonesiaonline.com

10 THE MOST DEATH CAUSES IN CENTRAL JAVA PROVINCE DIARE 978 JANTUNG 827 STROKE 791 THYPOID 671 KECELAKAAN 366 BRONKHITIS 297 BBLR 292 ASFIKSI 287 DARAH TINGGI 264 TBC 263 PROFIL KESEHATAN JATENG 2004 – DINKES JTG

10 MOST ILLNESS CAUSES IN CENTRAL JAVE PROV. ISPA (UPPER TRACT DIARE KULIT DESENTRI INFEKSI USUS ANEMIA THIPOID PROFIL KESEHATAN JATENG 2004 – DINKES JTG

ECONOMIC HEALTH OF DIARRHOEA http://ieham

PREVENTABLE AND ECONOMIC Analysts say eliminating disease and death due to unclean water and poor sanitation would reap billions of dollars in health and productivity gains. They estimate that for every dollar spent, there would be an economic return of between $3 and $34, depending upon the country. Worldwide, over 2 billion people lack access to a safe water supply. It is estimated that over 2 million individuals, most of them children, die each year from preventable waterborne diseases. That's 14,000 deaths daily or one death every 15 seconds Ð from a completely preventable illness. Waterborne diseases are caused by infectious agents that can be present in the water, soil, or air. These agents include bacteria, viruses, and parasites. The most common way these diseases affect the body is by causing diarrhea, in addition to other symptoms. Infants, children, the elderly, and individuals with weakened immune systems (such as those with HIV or AIDS) are especially vulnerable to waterborne diseases.

NEGLECTED DIASEAS "This neglected disease area is devastating, not only because one in 200 children who contract infectious diarrhea will die from it, but for those who survive, it has a lifelong, generation-wide impact," stated Victoria Hale, Founder and CEO of OneWorld Health. She added that of all childhood infectious diseases, diarrhea is thought to have the greatest impact on fitness, cognitive function, and school performance. "We will find ways to change this, through the development of new treatments for the world's most vulnerable infants and children," Dr. Hale said.

The data of Latrine FORMAL DATA of Government : 50-70% . KASUS PATEMON: 55% --14% Gunugn pati villages : 70 – 90 % Recall survey by team : 20 – 80%.

Impact due to the illness PRODUCTIVE TIME LOST COST TO CARE POOR PEOPLE MORE AFFECTED. UNEQUITY DAN UNEQUALITY IN HEALTH

THE PREVIOUS FAIL OF FAMILY LATRINE CAMPAIGN FAMILY ELEMENT AND SYSTEMIC FACTORS LOW EDUCATION INCLUDE MORAL EDUCATION. LOW EXPERIENCES LOW AESTETEIC LOW ECONOMIC LOW HEALTH PROMOTION LOW ATTENTION FOR THE PROBLEM BY ALL BEAUROCRATS CLIMATE AND ENVIRONMENT DRY SEASON DRY AREA ALTERNATIVE PROVIDED (RIVER, BUSH) TECHNOLOGY EXPENSIVE SAMPLE OF LATRINE RIGID SAMPLE. SOCIAL CULTURE LACK OF REGULATION (PERDA,PERDES) ABOUT LATRINE/MOTION LACK SOCIAL AWARENESS SOCIAL CULTURES UPPORT. HABIT

MITOS OF THE LATRINE HARUS TEMBOK HARUS ADA SUMUR PERESAPAN TERSENDIRI HARUS KERAMIK HARUS MAHAL HARUS INDAH HARUS DIMILIKI ORANG KAYA DAN BERPENDIDIKAN SAJA HARUS BAGI KEL YANG ADA TAMU. ANAK TAK PERLU BERAK DIJAMBAN. BERAK DI KALI /BUANG KOTORAN DI SUNGAI TIDAK SEBABKAN KITA SAKIT JAMBAN PERLU TEMPAT YANG LUAS PUNYA JAMBAN DI RUMAH BIKIN BAU. JAMBAN ADL KEBUTUHAN SEMUA KELAURGA RUMAH SEHAT BILA ADA JAMBAN JAMBAN TAK HARUS KERAMIK ATAU INDAH JAMBAN BUKAN UNTUK TAMU TP UNTUK KITA JAMBAN ITU MURAH DAN MUDAH JAMBAN ITU NYAMAN MEMANG SUNGAI AKAN MENGALIR KE BAWAH, TP ORANG DI DESA ATS KIT JUG ALAKUKAN SAMA ANAK DN DEWASA SAMA SAMA BERESIKO TULARKAN PENYAKIT JAMBAN HANYA PERLU 1 METER PERSEGI JAMBAN TIDAK BAU BILA DIBERSIHKAN BAIK

PROMOTE 1. SIMPLE LATRINE. AMPHIBIAN LATRINE

MODIFIKASI MENJADI DISPOSAL BAMBOO AMPHIBIAN LATRINE UNTUK BANGKITKAN NEED AKAN JAMBAN BAGI KELAURGA DESA.

MODIFIKASI JAMBAN AMPHIBI UNTUK JAMBAN PENGUNGSI

PROMOTE 2. Kampung Total Jamban Keluarga (KATAJAGA) A strategy to provide latrine for all family in a certain area (kampoong/block area/ dusun/ kelurahan / kecamatan /kota/province) Some dusun/area have been provided as pilot Various kinds of latrine type used (masy memilih yang paling sesuai dengan dirinya yg penting sehat) Family latrine no public latrine.

Some methods of latrine

Various type of septic tank

Various type of latrines

Various type of the latrine wall

10. KATAJAGA STEP OF DEVELOPMENT. PENDEKATAN TOKOH MASYARAKAT PENYULUHAN DAN DISKUSI DNG MASYARAKAT KONSELING PRIBADI PADA TOKOH YG SULIT PEMBUATAN SAMPEL PENGIRIMAN STIMULAN SUPORTING PEMBANGUNAN SUPORTING PENGGUNAAN PERDES REWARD AND PUNISHMENT. EVALUATION

PATEMON

BENDOSARI

SUKOREJO

NGELOSARI

Rejosari mijen

Deliksari

TUNTANG

JUDUL RISET : ENVIRONMENT AND PUBLIC HEALTH IMPROVEMENT DUE TO DEVELOPMENT CHEAP, EASY, FAST LATRINE FOR ALL FAMILY (KATAJAGA) IN THE VILLAGES. TUJUAN RISET : MENUNJUKKAN BUKTI ILMIAH JAMBANISASI TOTAL KELAURGA DIDESA DENGAN JAMBAN MURAH,CEPAT,MUDAH MENINGKATKAN DERAJAT KESEHATAN MASYARAKAT DAN LINGKUNGAN. Menjadi bahan advokasi pembangunan jamban bagi semua rakyat yang mudah,murah cepat. MENJADI ISUE POLITIK KESEHATAN SEHINGGA PERHATIAN POLITIK KESEHATAN MENGARAH PADA PEMBANGUNAN KESEHATAN INFRASTRUKTUR DAN PENCEGAHAN PENYAKIT Menjadi dasar rasional untuk advokasi program KATAJAGA lokal dan NASIONAL.

METODE PENELITIAN CROSS SECTIONAL AND EXPERIMENTAL DIPIIH 3 DESA, DESA YANG DIJABANI, KONTROL DAN DESA YANG SUDAH DIJAMBANI 1 THN LEBIH. ALUR PENELITIAN : JAMBANI DESA TARGET BASELINE DATA : PENGAMBILAN SAMPEL TINJA , AIR DAN TANAH PADA 3 DESA PENELITIAN DEWORMING ( PENGOBATAN CACING DAN KLORINISASI AIR). 5 BLN DARI DEWORMING 1, DI TEST TINJA, TANAH DAN AIR KEDUA

DEVELOPMENT LATRINE START IN JUNE CHOSEN THE VILLAGES DATA COLLECTION

Juli 16 juli 18 juli. Sampel jetis

Agusutus – September Mundingan

Field Supervision by Prof. Suharyo and Undip team.

ACARA PERESMIAN : PENYERAHAN SERTIFIKAT KATAJAGA ROTARY CLUB SEMARANG

Penyerahan rekor MURI

PERESMIAN & KOMITMENT WALIKOTA

Etape 2. penelitian. Data baseline BASELINE RESEARCH IN VIL PRE VIL CON VIL FAECES TEST 400 400 400. MEDICATION 400 400 400 WELL TEST 50 50 50 SOIL TEST 200 200 200 IN VIL : INTERVENTION VILLAGES PREVIL : PREVIOUS PROGRAM KATAJAGA VILLAGES CONVIL : CONTROL VILLAGES

TRAINING OF SURVEYOR.

Pemeriksaan di PARASITOLOGI

Pengambilan tanah sampel

RESULT AND DISCUSSION

RESULT

EDUCATION OF THE RESPONDES

JOB OF THE RESPONDENS

TAKE HOME PAY

HOME : WALL OF THE HOUSE

HABIT : Before have latrine, where motion?

9. Reason haven’t latrine

11. Water for family cleaning (utensil, clooth)

12. Water TO DRINKING

13. DO BOIL THE DRINKING WATER?

16. SICKNESS HISTORY

16. 18. GE ILLNESS AND DAY LOST

TOTAL LOSS DAY A DAN C AVERAGE: 261 DAYS TOTAL LOSS DAY B ;55. ADVANTAGE : 261- 55 = 206 PERDAY POTENSITAL MONEY : 50.000 3 MONTHS : 10.300.000 PERYEAR : 41.200.000 …THIS IS MONEY OF THE POOR PEOPLE!!!!!! INVERTASI JAMBAN PERDESA 40 JUTA BISA DIPAKAI 10 THN.  INVESTASI JAMBAN : 400 JUTA/DESA.

18. WORK ABSENCE COS’ ILLNESS

19. WHY people got GE ?

20.How can people got diare and GE.

22. DO YOU KNOW THE KIND OF WORM?

22. HOW TO PREVENT

31. Are bactery and worm’s egg contained in human faeses?

32. Does motion in bush and water ways spread the diseases?

33. Is the faeses from healthy person still contain the diseases?

34. Is it good to motion in the river and bush?

35. Do you thing that motion is regulated by your religion?

40. Do you clean your hand before eat?

44. LALAT

45. MAKANAN TERTUTUP

47. HAND EXAMINATION

1. Feeling of having latrine

4. SUDAH DIPAKAI?

5. WHEN YOU START TO USE LATRINE

6. STILL USE RIVER?

HELMINTH LAB. RESULT

PERSENTAGE WORM INFECTION

THE KIND OF THE WORM NEW KIND OF EPIDEMILOGY CONDITION IN THE COMMUNITY.

e. Coli Water contamination

SOIL LABORATOIUM EXAMINTATION

RESULT ALMOST ALL HAPPY IN RESEARCH PARTICIPATION. HOWEVER, SOME DID NOT SENT THE FAECES SAMPLE. EDUCATION OF THE RESPONDENS : MAJORITY ARE LOW (SD/SMP) ECONOMIC LEVEL ARE LOW. MAJORITY ARE BURUH AND NO WORK. TAKE HOME PAY NO MORE 1 JUTA ($100) FOR A FAMILY./ MONTH THEY WHO HAVE NO LATRINE MOTION IN RIVER AND FIELD. REASON OF HAVE NOT LATRINE ARE MONEY. THEY USE WELL THAT ARE CONTAMINATED E.COLI TO CLEAN UTENSIL HOWEVER, THEY BOILED WATER TO DRINK. THE PEOPLE LIVE IN KATAJAGA VILLAGE LOST 55 DAYS DUE TO GE AND NO KATAJAGA IS 261. IT MEANS THEY LOST MORE 40 MILLION/YEAR. THE MAJORITY OF YOUNG AND SENIOR KNOW THAT THE GE AND HELMINTHIASIS CAUSED BY BACTERIA. BECAUSE OF CONTAMINATED FOOD AND WATER. ALSO HOW TO PREVENT.

RESULT MAJORITY OF THEM DID NOT KNOW THAT THEIR FAESES CONTAN WORM EGG AND BACTERIA. HOWEVER, ALMOST ALL OF THEM KNOW THATMOTION IN RIVER IS NOT GOOD ALMOST ALL AVOID THE FOOD FROM FLY AND CLEAN THEIR HAND AND NAILS ALMOST ALL FEEL HAPPIER WHEN HAVING LATRINE HOWEVER, 28 PERSON IN INTERVENTION VILLAGE AND 10 PERSON IN EXISTING VILLAGE NEED MORE 3 MONTH TO ADAPTATION TIME TO USE LATRINE BEFORE LEFT THE RIVER. AND 9 PERSON IN INTERVENTION VAILLAGE AND 7 PERSON IN EXIXTING SOME TIME STILL USE RIVER. LAB RESULT INDICATE THAT IN THE EXISTING (KATAJAGA) VILLAGE HELNTIHT PREVALENCE IS ONLY 7,2 COMPAE TO THE INTEVENTION ND CONTROL 24,1 AND 21,3. THE KIND OF WORM ARE HOOK WORM THE KATAJAGA VILLAGES’S WELL ARE LOWERCONTAMINATED TO THE E.COLI ALSO THE EGG WORM CONTAMINTIN TO THE SOIL (3,3 % : 12,3 %)

CONCLUSION IT IS SHOWED THAT VILLAGERS IN THE COMTEMPLATION STAGE IN LATRINE USE. BECAUSE OF THE LIMITATION (MONEY, LEADERSHIP) THEY FAIL TO BROKE THE EGG COVER. EDUCATION AND STIMULATION IS BEST WAY TO PROMOTE THEM THE KATAJAGA LATRINE PROGRAM WAS FULLY ACCEPTED BY COMMUNITY LABORATOY RESULT INDICATE THAT KATAJAGA PROGRAM DECREASE THE HELNTIH INFECTION FROM 24 % TO 7%. (3 TIMES) DECREASE E.COLI CONTAMINATION IN THE WELL DECREASE EGG WORM CONTAMITION IN SOIL FROM 12% TO 3 % (4 TIMES) RETAIN THE MONEY TO THE POORPEOPLE MORE 40 MILLION / YEAR / VILLAGE NO DROP OUT USE

RECOMENDATION THE LATRINE IS IMPROTANT TO EVERY FAMILY,HOWEVER 30- 40% THEY HAVE NOT . NEED TO CHEAP, FAST & SYSTEMIC PROGRAM TO THEY ALL KATAJAGA IS CHEAPEST , EASIEST, FASTEST WAY TO SOLVE THE PROBLEM OF FOOD AND WATER BORNE DISEASES. KATAJAGA BROKE THE CYCLIC OF DISEASE, HEALTH AND POVERTY KATAJAGA SHOULD BE SCALE UP TO ALL FAMILY IN ALL INDONESIAN

NEW ACHIEVEMENT SEMARANG WILL ADOPT THE KATAJAGA WAY TO SCALE UPTO ALL SEMARANG FAMILY IN 2013. KUDUS WILL BE DONATED BY A COMPANY TO SCALE UP. DIY WILL ADOPT THIS PROGRAM TOO AS PROVINCIAL TOTAL FAMILY LATRINE. 20 SEPT WE ARE ACCEPTED BY SULTAN JOGJA TO PRESENT THE KATAJAGA PROGRAM. COMBINATION : APPLIED TECH, HEALTH PROMOTION, ATTENTION TO THE COMMUNITY, INTENATIONAL COLLBORATION INCREASE THE BEHAVIOUS CHANGE TO ACHIEVE MDGS

TERIMA KASIH