Health costs due to exposure to air pollution are not only borne by affected residents. Those who have not been exposed pay the cost to protect themselves.

Istu Prayogi said that he never gets quality sleep anymore.

“Sleeping for an hour at most, then waking up, remaining awake for half an hour, we can’t sleep well. I could wake up 4-5 times only to spit phlegm out,” Prayogi said.

He has struggled to escape respiratory problems since 1995. Prayogi was diagnosed as susceptible to air pollution but lives in a city with high pollution levels, Jakarta.

Prayogi suffers from sudden and massive sleepiness during work while driving passengers as a taxi driver. That often forces him to ask permission to rest for a while.

“Many times too, people are bothered and wake me up. ‘Sir, how long do you want to sleep?’ Yes, let’s go. We can do it,” he said laughing a bit.

Prayogi realized that his income could very well decrease but there was nothing he could do about it. Job opportunities are limited due to his age and health problems.

Respiratory problems have also prevented him from participating in the General Election Commission (KPU) selection.

“When I started the test, my vision became blurry, then my head hurt, I was feverish. I was given medicine by the doctor. After fifteen minutes, I was sweating, but I was already half an hour late,” said Prayogi.

As an online taxi driver, his income continues to decline not only because of his health but because his competitors are numerous. He can only make about Rp. 5 million per month. In fact, with that budget, he also has to pay for medicines and masks.

“The budget for medicine and masks is Rp. 300,000 per month, just for that. Whether you like it or not, the food must be really nutritious,” he said.

Similarly, Detty Revolyatuti (66) has been burdened with extra expenses since 2019. The Marunda low-cost rental apartment in North Jakarta where she lives, has also been exposed to air pollution for years.

Valda Kustarini/KBR
Detty Revolyatuti (66) shows the results of her lung X-ray when KBR met her at Marunda Flat (30/11/2022). From the clinic, Detty was referred to different hospitals, before finally being diagnosed with a hernia at Cilincing Hospital, Central Jakarta.

The source of pollution, coal dust, comes from the coal loading and unloading activities of PT Karya Cipta Nusantara (KCN) at Marunda Port. To protect against coal dust, masks are essential.

“I buy 2-3 packs, 50 pieces in each box. At first, it was very expensive, but now it’s cheaper, only around Rp. 20,000 – 25,000,” Revaliastuti said.

In 2022, this 66-year-old woman suffered from coughing for 7 months. Revaliastuti also accidentally leaks when coughing, so she always wears a sanitary napkin.

“What’s more irritating is the cough, which is so painful that it stings. It is painful to cough for a long time. My chest hurts, it hurts,” she added.

It is suspected that the prolonged cough has also caused Revolyatuti to suffer from a hernia. She has to go back and forth to the hospital, which certainly adds to the costs. A widow, Revolyatuti depends on her children for her daily needs.

“Yes, it’s difficult. Like vitamin C, vitamin B. My children got me all of that. In addition to covering the hospital costs,” she added.

Multiple costs of air pollution

Budi Haryanto, a Professor at the Faculty of Public Health at the University of Indonesia, said that many people do not realize that this kind of additional expenditure is a loss arising from air pollution. People often think that economic losses only stop at medical expenses while in fact, there are multiple other additional costs to be calculated.

“For example, taking a taxi to the hospital, then eating while waiting. The costs incurred by a person who must be treated are therefore intangible costs,” Haryanto explained.

These costs are difficult to measure. Another term for this is indirect costs. If properly calculated, air pollution losses could actually double. Haryanto said that the total cost could double the treatment cost.

Intangible costs also include the cost of not being able to work. If he is paid Rp. 10 million per month, that’s Rp. 500,000 per day. If he does not attend two days a month, Rp. 1 million is already a loss for the company,” he explained.

Greenpeace Indonesia’s research illustrates air pollution’s layered impact. It is estimated that PM 2.5 in Jakarta increases the risk of premature death of 8,700 people in the period from January to August 2021. This resulted in economic losses reaching IDR 33.1 trillion.

Air pollution losses are not only suffered by residents with air pollution-related problems.

Young people like Debby Thalia have paid to prevent health problems due to polluted air.

Valda Kustarini/KBR
Debby Thalia (24) is challenging the state to take responsibility for poor air quality because she is a potential victim of air pollution.

“When I calculated my budget, I realized there were too many expenses,” Thalia said.

This 24-year-old woman spends up to IDR 1.5 million to ensure proper protection.

“Buying masks, air purifiers, filters. I have four people in my family and all of them are also active outside,” she said.

Working in a crowded area like Jakarta forces Thalia to think hard when engaging in activities outside her home. She looks for greener outdoor places to reduce pollution exposure.

State responsibility

Debby complains that it is difficult to get information about air quality daily. She believes that such information was very helpful for her to identify high-risk areas.

This motivated Debby to file a civil lawsuit in 2019 with 31 other residents, including Prayogi. They sued President Joko Widodo and his staff and the DKI Jakarta Provincial Government over poor air quality.

“The losses may not be in the form of illness and stuff, yeah, I haven’t checked with the relevant specialist doctor, but my position is as a potential victim,” she said.

In 2021, the Central Jakarta District Court ruled in favor of the citizen’s lawsuit and a higher court later upheld the verdict. The government was ordered to improve Jakarta’s air quality.

Anies Baswedan, the governor of DKI Jakarta at the time, promised to comply with the verdict.

“This year we are very serious about public transportation. One of the goals is to reduce emissions. The second one is the obligation to test (vehicle) emissions. One of them is to reduce the negative impact of motorbikes in Jakarta,” Anies said at the time.

The Jakarta Provincial Government has three strategies and 75 action plans that would be outlined in a governor’s regulation on air pollution control, which is currently being finalized.

Haryanto reminded the government that it plays a crucial role in controlling air pollution. The main sources of pollution, such as motorbikes and the coal power plants, must be eliminated or replaced.

The government remains the leader, providing electric cars, electric buses, and the MRT and LRT, all of which are powered by electricity. “Then carry out actions supported by regulations, legislation, facilities, infrastructure, etc.,” Haryanto explained.

If pollution sources can be suppressed, social-economic costs or losses can be reduced or curbed. In addition, the government should also help citizens mitigate air pollution risk, including by providing accurate information and other helpful access.

“The most critical thing is an early warning system. This means that there must be lots of air quality sensors that can be accessed quickly via mobile phones. This is so that when people want to travel, they can decide,” he concluded.

Listen to the podcast (in Bahasa Indonesia):

This story was produced with support from Internews’ Earth Journalism Network through the Clean Air Catalyst program, which is a flagship program launched by the U.S. Agency for International Development (USAID) and led by a global partnership of organizations including the World Resources Institute and Environmental Defense Fund and Internews. The story was first published in Indonesian on Spotify on January 10, 2023 and the online version on KBR on January 16, 2023.

About the writer

Valda Kustarini

Valda Kustarini is a journalist from Jakarta, Indonesia. She holds a master's degree in humanities from the University of Indonesia. She has been reporting on various topics including politics, economy,...

There are no comments yet. Leave a comment!

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.