Detty Revolyatuti (63) still feels pain in the middle of her stomach. It has been four months since she underwent surgery at a hospital in North Jakarta. This woman, born in Banjarmasin, was diagnosed with an umbilical hernia in July 2022.

This condition occurs when part of the intestine protrudes through a hole in the abdominal muscles near the navel. Apart from that, Detty also had white spots on her lungs when she had an X-ray last year.

“The scar from the operation still hurts, and my movements are limited. I can’t work or lift anything heavy,” said Detty, pointing to the scar from the operation when Betahita met her at her residence in Cilincing, North Jakarta, last December.

From the medical explanation she received, Detty said the illness she suffered was caused by her holding back her coughs too often. Before seeking treatment, she often experienced shortness of breath and coughing for seven months.

The complaints started in November 2021 when coal dust pollution was intense at Rusunawa Marunda.

Detty lives on the first floor of Block D3 Rusunawa Marunda, Cilincing District, North Jakarta. She moved to the flat in 2017 when she was relocated from Kampung Bandan, Ancol, North Jakarta.

Rusunawa Marunda is located not far from the PT Kawasan Berikat Nusantara industrial area, which is situated on Jalan Raya Cakung-Cilincing. There are 104 processing customers (producers), 15 warehousing companies, and 34 other service businesses operating in this 176.6-hectare area.

In June 2022, the DKI Jakarta government revoked PT Karya Citra Nusantara (KCN)’s permit because it did not comply with administrative sanctions. This coal and sand loading and unloading company was proven to have polluted the environment in its business activities, resulting in coal dust pollution in residential areas in Marunda.

However, even though PT KCN has ceased operations, coal dust pollution is once again affecting residents’ homes. Detty, who is currently undergoing recovery for the next 12 months, is worried about this condition.

“Since September until now, (coal) dust has started to be felt again. I’m afraid because if I cough, it will aggravate the scar from the hernia operation. So now if I cough a little, I quickly buy medicine,” said Detty.

Sundari, who lives on the third floor of Block D, has a history of asthma. She admitted that in the last two years, her illness had worsened. Ndari, her nickname, often suffers from shortness of breath and coughing. The intensity increases when coal dust is high in the flat area.

This woman, born in 1978, admitted that as a housewife, she works all day at home and around the flat area. Ndari often feels itchy all over her body. “The current dust feels sharp and really itchy on the skin, and the smell is terrible, like the smell of burning,” she said.

Betahita interviewed ten other women, all of whom are housewives living in Rusunawa Marunda. On average, they complain of itching and headaches. Many of them showed various black dots and wounds on their feet and hands due to itching and scratching.

According to the Chair of the Marunda Flats Community Forum (FMRM) Didi Suwandi, coal dust pollution will still occur until February 2023. When pollution is thick, residents often complain of coughing, itching and shortness of breath, from the elderly, adults and children.

On January 9th to 11th, 2023, as many as 100 residents underwent examinations by health workers from the Cilincing Community Health Center. As a result, 63 people had itching, 16 people had coughs and colds, eight people had high blood pressure, three people had headaches, and six people complained of eye pain or body aches. There were also two people sick with measles and two other with digestive complaints.

“Many residents are experiencing itching, and many are coughing and short of breath. Well, we don’t know what it will be like in 10-15 years. Moreover, not all residents report it, because they still feel healthy,” said Didi.

Prof Budi Haryanto, Professor of Public Health at the University of Indonesia, said air pollution has short-term impacts on health, including coughing and skin irritation. However, if exposed continuously in the long term, the effects can be deadly. The illnesses suffered can include heart disease, lung cancer, and other chronic diseases.

According to Prof. Budi, people who live in areas with high levels of pollution such as Marunda are more vulnerable to the impacts of additional pollution. The types of disease can also increase, depending on the source of the pollutant. Coal, for example, contains heavy metals such as lead and mercury.

“What is more dangerous is what is inhaled into the lungs, such as PM2.5. This will manifest into chronic diseases such as heart disease,” said Budi.

According to Dr. Puji Lestari, lecturer in environmental engineering and Chair of the Air and Waste Management Expertise Group at the Bandung Institute of Technology (ITB), the distance between Rusunawa Marunda and the KBN industrial area is only 1 kilometer if a straight line is drawn. The proximity of this area is the main factor why the people of Marunda are exposed to coal dust pollution.

“Specifically, Marunda is next to a source of high pollution, and this makes it possible that (air quality) could be worse than other areas. This is because there is a specific issue. If meteorological conditions are favorable, it could be worse or worse,” explained Puji to Betahita.

A study states that there are three main sources of air pollution in Jakarta, namely land transportation, manufacturing industry and power plants. Cilincing, North Jakarta itself has the largest number of companies after West Jakarta, namely 439 companies.

Not only that, this region has the Muara Karang-Pluit PLTGU with a capacity of 2,100 MW and the Tanjung Priok PLTGU with a capacity of 2,723 MW.

This condition, said Puji, makes Marunda experience a double burden of air pollution, because it receives pollutant sources from transportation as well as the manufacturing industry and the energy sector (power plants).

Puji said, from a physical perspective, coal fly ash has a very sharp shape. This form is dangerous because it can cause abrasives if it enters the lungs. Apart from fine particles, the chemical composition may also contain heavy metals such as lead and mercury.

“The most important thing to look at is the concentration, such as PM2.5. Is it high enough to pass the quality standards set by the government? “If it’s more than that, you have to be careful because it has already passed the ambient air quality standards in Indonesia,” he explained.

Particulates (PM2.5) are air particles smaller than 2.5 microns. Because it is very fine in size, this pollutant is able to penetrate lung tissue and blood vessels.

When exposed over a long period of time, these pollutants increase the risk of death through stroke, ischemic heart disease, lung cancer, asthma, lung disease, lower respiratory tract infections, chronic obstructive pulmonary disease (COPD), and type 2 diabetes mellitus.

According to data from the World Resources Institute (WRI) Indonesia, deaths are due to continuous exposure to PM2.5 air pollution also increase the number of deaths, especially in the elderly group with an average of 3,840 people per year in Indonesia.

The life expectancy of people in Jakarta has decreased by 4.54 years due to continuous exposure to PM2.5.

Government Regulation Number 22 of 2021 sets the safe air quality limit for daily PM2.5 at the level of 55 µg/m3 and annually 15 µg/m3. This figure is far from the WHO guideline standard of 15 µg/m3 (daily) and 5 µg/m3 (annual).

Jakarta’s air quality often exceeds both of these thresholds. On June 15 2022, for example, the PM2.5 concentration in Jakarta was in the unhealthy category, namely 148 µg/m3. Then on September 1, the DKI Jakarta Environmental Service (DLH) recorded PM2.5 at 130 µg/m3.

DKI Jakarta DLH data shows that over the last three years (2019-2021) the average PM2.5 exceeded the annual threshold set by the central government, namely >15 ug/m3.

In particular, PM2.5 at the air quality monitoring station (SPKU) Kelapa Gading, North Jakarta was recorded as the highest in 2019, namely 43.32 µg/m3. In 2020, the figure decreased to 33.38 µg/m3, then rose to 37.27 µg/m3 in 2020 or an increase of 11.66%.

If based on these two threshold standards, PM2.5 pollution in the Marunda area is very high. Referring to Ventusky data, a real-time web application that focuses on monitoring weather forecasts and visualization of meteorological data from the Czech Republic, recorded that the PM2.5 parameter in Marunda, North Jakarta, on February 1-9 was in the very unhealthy category, on average at above 200 µg/m3 at 1 – 4 am.

The highest PM2.5 parameter was recorded on February 9, namely 490 µg/m3. Meanwhile, the lowest PM2.5 parameter occurred on February 6, which was 53 µg/m3 at the same hour.

Chairman of the Indonesian Lung Doctors Association (PDPI) Dr Agus Dwi Sutanto said that exposure to coal dust containing fine particles PM10 and PM2.5 in the long term reduces the quality of human life. The diseases caused are dangerous and deadly, including decreased lung function, risk of chronic bronchitis, lung and heart cancer.

“Of the 300 lung cancer cases treated at Persahabatan Hospital in 2012-2013, 4% were related to air pollution,” said Agus, who also serves as the main director of the hospital.

There is also a risk of black lung disease or pneumoconiosis. This disease often occurs in coal mine workers, where sufferers experience disorders due to the accumulation of coal dust in the lungs due to continuous inhalation of coal dust for 20-30 years.

“People who live around industrial areas (with exposure to coal dust) have the same risk. However, for the case in Jakarta, until now there is no data because there are no specific studies regarding this matter,” said Agus.

Women have additional disease risks because they have different reproductive systems. According to Budi, exposure to PM2.5 can also penetrate to the fetus. When this happens, the fetus can be exposed to poisoning.

“The impact can be abortion or difficulty in giving birth, death, or giving birth to a baby with lower birth weight. “If the baby survives, there is a risk of autism,” explained Prof Budi.

The relationship between air pollution and disorders of the female reproductive system has been studied in several studies. Research in 2019 conducted in Beijing, for example, found that high concentrations of air pollution can increase the risk of miscarriage, fetal death in the first trimester, prematurity, low baby weight, and other health risks for pregnant women.

Double burden on women due to air pollution

For women in Rusunawa Marunda, the impact of air pollution does not stop at just health. When the coal dust was really bad, they have to work hard to clean the house.

In a day, Desi Natalia Sianturi can sweep and mop five to six times. When washing clothes, the 33 year old woman was also anxious and rushed to lift the clothesline.

“Basically, I just want the laundry to hang overnight on the balcony. Moreover, coal dust can stick. If you rub it, it will get stickier and it will itch when you use it. So I have to wash again,” said Desi.

Desi admitted that air pollution affected her mental health. She often felt annoyed and frustrated with the living conditions at Rusunawa Marunda. As a housewife, household chores are her daily routine.

However, now domestic tasks have become much more tiring and mentally draining. Moreover, she often felt itchy all over her skin.

Ndari felt the same way. Due to mopping more often, household expenses increase to buy detergent and mop equipment. “In the past, two bottles of mop fluid were enough for a month. Now it’s finished in two weeks,” she said.

For Eni, a resident who was relocated from Kampung Lodan, Ancol, there were economic losses in addition to the health impacts experienced, such as coughing and itching. At her previous neighbourhood, Eni sold fried rice. In one day, the profit can reach IDR 300,000 – IDR 500,000.

When coal dust pollution got worse in Marunda, Eni was forced to stop selling. Now the cooking equipment is left abandoned in front of her house. “Since I found out that the black dust was coal, I stopped selling it. Many buyers also say that the rice is sometimes black. My income has gone,” she said.

World Resources Indonesia (WRI) Gender Researcher Cynthia Maharani said that air pollution is very closely related to women’s lives. According to her, the gender role for care is one of the cultural elements that makes the impact of air pollution borne differently by men and women.

Household work related to ‘taking care’ is usually assigned more to women, including caring for sick family members, especially children.

“The burden and responsibilities multiply, especially when combined with other domestic work such as cooking and cleaning, which culturally is still the domain of women,” said Cynthia.

According to Cynthia, housewives generally do a lot of activities in residential areas. In the context of the Rusunawa Marunda area, exposure to coal dust is expected to be higher.

“This exacerbates the gender gap and can also have an impact on the increased work they have to do even though they are also ‘survivors’ of poor air quality,” she added.

Apart from causing fatigue from cleaning up dust deposits, housewives will also be mentally affected by excessive worry about the dust being inhaled by other family members.

Didi said that his party had submitted complaints and held hearings with the government, including the DKI Jakarta Environmental Service.

“We ask the government to immediately investigate the causes of air pollution in Marunda, as well as carry out strict monitoring and guidance of companies,” said Didi. “We also hope to create a scheme or regulation so that pollution does not happen again.”

Puji said the government must be firm in breaking the chain of causes of coal dust pollution in Marunda with preventive measures. Companies are obliged to carry out pollution control and must meet existing air quality standards. She said this because the community is the one who suffers the most.

Dr Agus encouraged the public to always wear masks when air pollution concentrations are high. “Apart from that, there must be regulations governing coal management and mitigation,” he said.

Air pollution is often referred to as the silent killer, and claims around 7 million lives worldwide. In Marunda, residents can see its form and feel it in their throats, skin and eyes.

In Detty’s case, the impact of coal dust pollution had brought him to the operating table. Even though she is worried that her illness will recur, Detty has no plans to move, like many other residents.

“Where do you want to move? This is my only home. I just hope that (the government) will pay attention to us. We all just want a clean environment and healthy air.”

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