Sejak 2009, inisiator Cerita Anak Pulau terlibat dalam penanganan bayi gizi buruk di Pulau Kei Besar, Maluku Tenggara. Berdasarkan riset, pengamatan, dan belajar dari pengalaman langsung, masalah malnutrisi di Pulau Kei Besar hanyalah akibat dari akar masalah yang lebih besar.

Beberapa dari bayi dan balita yang sukses kami tangani di pusat perawatan, kembali sakit bahkan meninggal saat pulang ke rumah. Kami mampu memberikan nutrisi cukup dengan sayur-mayur yang kami beli di pasar, tapi keluarga anak itu tidak sanggup membeli karena alasan harga dan jarak tempuh ke pasar. Ketika kami memperlajari lebih jauh, pengetahuan tentang nutrisi keluarga sangat rendah, dan harga bahan pangan sangat tinggi di pulau Kei karena hampir semua “impor” dari luar pulau. Contoh kasus ini ternyata memperlihatkan pola antara masalah sosial dan perubahan produksi dan konsumsi di tataran masyarakat Kei Besar, Maluku Tenggara.

Perubahan ini dikombinasikan dengan faktor eksternal seperti perubahan iklim, kondisi alam, dinamika sosial-politik, telah menempatkan masyarakat di Indonesia Timur -termasuk Kei Besar- mengalami kerentanan daya pulih. Kerentanan inilah yang berujung pada tingginya kasus malnutrisi, kematian ibu dan bayi, HIV/Aids, laju pertumbuhan minus, dan tingkat ketergantungan (dependency ratio) lebih dari 300%.

Sebagaimana timeline diagram di atas, Indonesia Timur yang secara geografis tidak menumbuhkan tanaman pangan beras, mengalami kampanye makan beras di era Politik Swasembada Pangan. Akibatnya muncul generasi pengkonsumsi beras yang meninggalkan makanan pokok lokal umbi-umbian, embal, dan sagu. Dengan menurunnya konsumsi panganan lokal, pasar terpengaruh dan mengakibatkan pertanian umbi lokal tidak bergairah. Muncul anggapan pengkonsumsi umbi adalah kelas kedua yang miskin, sementara beras adalah makanan kaum elite. Akibatnya generasi pengkonsumsi beras ini pun meninggalkan pertanian sehingga saat ini pertanian didominasi oleh senior dan masyarakat miskin tak terampil.

Masalah muncul saat Indonesia tidak lagi mampu berswasembada beras. Ditambah dengan pengaruh perubahan iklim yang menyebabkan el nino, maka di tahun 1997 terjadi krisis pangan yang berujung pada krisis moneter, ekonomi, dan akhirnya sosial-politik di 1998-2001. Di tahun yang sama, yaitu 2001, Indonesia menjadi negara pengimpor beras tertinggi di dunia, bersanding dengan tingkat partisipasi konsumsi beras penduduk Maluku yang telah mencapai 100%.

Dengan mulai diimpornya beras, terjadi lonjakan harga beras yang tinggi, apalagi di wilayah Timur yang jauh dari Jawa. Pemerintah Indonesia mulai memberlakukan Operasi Pasar Khusus yang kini menjadi Kebijakan Beras Miskin (raskin) untuk mendistribusikan beras mutu rendah-harga murah kepada penduduk yang “memenuhi persyaratan miskin”. Permasalahan diperkeruh dengan pola produksi yang selalu menutupi kekurangan dengan impor bahan pangan tunggal (beras), ketimbang mendukung produksi pertanian panganan lokal beragam dalam negeri (jagung, singkong, sorgum, ubi-ubian, dan sagu).

Di sisi lain, mulai berkembang produksi panganan instan berbasis terigu dengan harga murah. Hal ini tentu mempengaruhi pola konsumsi masyarakat yang tercermin pada grafik di atas, dimana peningkatan konsumsi mie instan melonjak dari 0.78 di tahun 1999 menjadi 43 di tahun 2014. Tahun 2014, Indonesia pun resmi menjadi negara kedua pengkonsumsi mie instan tertinggi di dunia dengan tingkat konsumsi 400 bungkus per detik atau 13 milyar bungkus per tahun (data World Instant Noodles Association); tanpa menyadari bahwa bahan dasar mie instan adalah terigu yang 100% impor.

Perubahan pola konsumsi-produksi ini berakibat jangka panjang di tingkat masyarakat, terutama mereka dengan penghasilan dan pendidikan rendah. Balita dan ibu hamil mengkonsumsi bubur raskin dicampur mie instan, mengakibatkan kasus malnutrisi dan zat besi rendah yang membuat kehamilan risiko tinggi. Mereka tidak sanggup mengakses pasar dengan harga pangan tinggi.

Generasi muda tidak lagi piawai bertani, dan tidak sanggup memenuhi kebutuhan dapur dari ladangnya sendiri. Mereka eksodus ke luar pulau mengadu nasib, yang menjelaskan mengapa tingkat pertumbuhan penduduk minus dan dependency ratio mencapai 300%. Kasus HIV/AIDSs masuk melalui generasi perantau rendah edukasi.

Masyarakat Pulau Kei yang dulunya mampu menghasilkan hasil tani bergizi kini kehilangan daya pulihnya saat krisis menerpa. Sayur di Pasar Elat berasal dari luar pulau, yaitu Ambon, Jawa, bahkan Tiongkok. Hal ini mengakibatkan kota Tual (ibukota Maluku Tenggara) berulang kali meraih predikat kota dengan inflasi tertinggi di Indonesia.

Perbandingan harga bahan makanan terlihat pada diagram di atas, menyebabkan keluarga miskin tidak lagi mampu membeli sayur-mayur.

Dengan hilangnya kemampuan mereka bertani lokal dan mengakses pasar, tidak mengherankan status gizi keluarga menjadi rendah di tengah tanah yang sesungguhnya dianugerahi Tuhan dengan kesuburan yang mampu menyejahterakan penduduknya.

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Since 2009, the initiator of Cerita Anak Pulau Innitiative had involved in handling infant malnourishment problems in Kei Besar Island, Southeast Maluku. Based on the research, observations, and learning from direct experiences, the problem of malnutrition in Kei Besar Island is only a result of underlying larger problems.

Some of infants and toddlers who were successfully treated in a feeding center, got sick again and even passed away after several weeks they returned home. We were able to provide full of nutritious food we bought in the market while they were treated, but the children’s family could not afford the same food because of the price and distance to market. When we study the further, their families didn’t have enough knowledge about nutrition and food prices were rising up so high because almost everything were “imported” from outside the island. These examples shows changes pattern between production and consumption and its contribution on social problems to Kei Besar communities.

These changes -combined with external factors such as climate change, natural conditions, social-political dynamics- has put people in eastern parts of Indonesia including Kei Besar, vulnerable and loosing their resilience. These what led to the high rates of under-five malnourishment, maternal mortality, HIV / AIDS, declining population growth, and more than 300% dependency ratio.

As the timeline diagram shows above, East Indonesia, which is geographically not cultivating rice as food crops, experienced rice campaign in “food self-sufficiency” political era. This had resulted in new generation consuming rice who slowly left local staple food such as yams, cassava, and sago. The market then became affected as local food demand declining. Local food productions were also decreasing and affected the farmers. Local foods such as yams and sago are considered second class food for poor people, while rice is the food of the elites. As a result, the young from this rice-consuming generation left their land and farming and aim for other sources of income. Farming is currently dominated by unskilled and poor seniors.

Problems worsen when Indonesia was no longer be self-sufficient in rice production. Coupled with the effects of climate change that was causing el nino, in 1997 food crisis led to the financial, economic and social-political crisis which resulted in riots back in 1998-2001. In the same year, on 2001, Indonesia became the highest rice importer in the world, while Moluccas’s participation rate of rice consumption had reached 100%.

As imported rice started filling the markets, a surge in rice prices turned high, especially in the eastern region, which are far from Java. The Indonesian government began to enact the Special Market Operation for Rice which now is well-known as Rice for the Poor Policy (Raskin) to distribute low-quality rice at low prices to people who “meet the requirements of the poor”. The problems are worsen by the decision to cover shortfall of internal production with with a single food imports (rice), rather than supporting local diverse agricultural production (yams, cassava, sorghum, corn, etc).

On the other hand, the production of flour-based instant snacks at low prices started to develop. This certainly affects consumption patterns which are reflected in the chart above, where increased consumption of instant noodles jumped from 0.78 in 1999 to 43 in 2014. In 2014, Indonesia was officially become the second highest consumer of instant noodles in the world with a consumption rate of 400 packets per second or 13 billion packs per year (data from the World Instant Noodles Association); without realizing that the basic ingredients of instant noodles is wheat, which is 100% imported.

Changes in this consumption patterns had a long-term effect, especially for those with low income and low educational background. Toddlers and pregnant women eat instant noodles porridge mixed “raskin”, resulting in malnourishment and iron deficiences that contributing high-risk pregnancies. They can’t access the market with high food prices.

The younger generation who are no longer good at farming, and is unable to meet the needs of nutrition from their own land. They prefer to work outside the island, which explains why the rate of population growth was minus and the dependency ratio reaches 300%. HIV/AIDS victims were infected from Kei people worked outside the island with low educational background.

Kei Island people that were once capable of producing nutritious food for hundred of years, now slowly losing is ability to recover when the crisis hit. Vegetables at Elat’s market comes from outside the island, such as Tual, Ambon, Java, and even China. Tual (Maluku Tenggara capital) even repeatedly marked as city with the highest inflation in Indonesia several times.

With declining ability to farm locally and accessing markets, not surprisingly, poor families with low educational background can’t afford to buy vegetables and other nutritious food. They fall into the consumption trap to eat unhealthy foods while living in fertile land that actually is able to meet their nutrition needs.