Health Behavior Models in Utilizing Water Resources to Tidal

Waters Community

Vieronica Varbi Sununianti, Tri Agus Susanto and Diana Dewi Sartika

Sociology Major, Faculty of Social and Political Science, Sriwijaya University, South Sumatera, Indonesia

vieronicavarbis@unsri.ac.id

Keywords: Health Behavior, Tidal Water Community.

Abstract: Water is a basic need of all living things, including human. However, living in tidal areas with large bodies

of water does not necessarily mean a society can fulfill their need for water. This happened in Maura

Padang sub-district, Indonesia. A large number of areas are peat bogs and deltas of the Musi river. The

water sources are acidic, smelly, sticky, and unfit for consumption. This attracted researcher to analyze

public health behavior based on water resource utilization in daily needs. It is descriptive qualitative

research through interviews, FGD, observations, and study documents. Researchers interviewed migrants,

natives, medical workers, communities, and religious leaders. The results found that migrant communities

can survive in this area. Nevertheless, part of them return to their hometown since they’re unable to adapt to

the physical environment. Government programs contribute artificial water reservoirs for families and

communities. Due to limitations of water resources, they use rainwater for household consumption and

ground water (river, well, and ditch water) to flush their yard, wash their food and clothes, and bathe.

Socioeconomic status and environment impact health behavior, including such treatment. This paper is

beneficial for residents in tidal areas, the Banyuasin District health office and the University in providing

socialization, promoting health living and help the fulfillment of clean water.

1 INTRODUCTION

A number of studies discuss the manifestation of

health behavior. The elements that form the

difference in social health behavior is a culture (Fox

and Alldred, 2016; Singer, 2016). According to Fox,

the nature and culture of human beings are a part of

the environment and health. The environment also

affects the interface between human and

environment. It constructs innovative healthcare

(Saidi, 2017) with emphasis on social practices,

structure, and material. Next, health behavior is also

related to lifestyles (Romano and Scott, 2014; Bure,

2016). The arrangement of health education and the

height of the intervention towards a healthier

lifestyle (Romano and Scott, 2014). Individual

lifestyle choices affect physical and emotional

health. (Bure, 2016). Furthermore, study of oral

health behavior using the Health Belief Models

(HBM) (Zetu, 2014) identified there is no significant

difference between genders. However, women are

known to have more perceived severity and self-

efficacy, but have lower perceived barriers. All of

these studies dicussed health behavior on social

aspects of the environment, culture, and lifestyle, but

paid less attention on adaptation and behavior

changes to survive. We deliver this gap by

explaining the tidal society behavior in utilizing

water resources to meet the daily needs.

Water is a basic need and a source of life. It is

useful to support all living beings, especially human.

Unfortunately, water supplies are unable to meet

increasing demand for water. The millennium

development goals (MDGs) 2010 report exposed the

percentage of sustainable access to drinking water in

urban areas is 49,82%, and in rural areas is 45,72%.

It has been predicted that there could be a global

water scarcity. (Shiva, 2002). Even though Indonesia

is an archipelago country, nevertheless it still faces

obstacles in providing clean water. What is unique in

Banyuasin district, is that a large part of the area is

comprised of inconsumable water. Together with the

increase of the development of tidal community’s

health behavior changes in the use of water

resources to meet their daily lives.

Sununianti, V., Susanto, T. and Sartika, D.

Health Behavior Models in Utilizing Water Resources to Tidal Waters Community.

In Proceedings of the 2nd International Conference on Sociology Education (ICSE 2017) - Volume 1, pages 277-280

ISBN: 978-989-758-316-2

277

2 CONCEPT

The World Health Organization (WHO) explains

health as a condition that covers one’s state in

complete physical, mental, and social well-being. It

is not only the limited absence of disease or

lethargy. In Indonesia, health legislation number 36

of 2009 states that health covers various health

conditions, such as physical, mental, spiritual, and

social conditions, which allows every person to have

a productive social and economic life.

In medical concepts, a disease is an abnormal

body condition that can be detected by certain

symptoms. But in social science, diseases are bio-

physiology symptoms that affect the human body.

Illness is a social symptom that accompanies disease

to the point where it disturbs feelings of health. In

this case, disease is related with a subjective

meaning.

According to Marshall Becker, health behavior

has three variations, which are healthy life behavior,

illness behavior, and sick role behavior

(Notoadmodjo, 2003; Weitz, 2007). Healthy life

behavior is the effort by someone to maintain and

improve their health. Illness behavior is a someone’s

response towards illness, disease perception, causes

and symptom knowledge, treatment, etc. Meanwhile,

sick role behavior is related to the rights and

obligations of sick individuals which are known by

themselves and by others. According to sociologist

Talcott Parsons, roles and social functions are

interconnected. Consequently, someone is

considered healthy if they have the maximum

capacity to do roles and tasks which are learned

through the process of socialization (Sunarto, 2002).

Thus, sociology’s understanding of health is relative,

and is based on the social role of society.

3 METHODS

This paper is constructed on descriptive qualitative

research (Denzin, 1994; Creswell, 2003; Neuman,

2007) in Maura Padang sub-district, Banyuasin

district, South Sumatera province, Indonesia

(Susanto et al., 2016). This location had been

selected due to their lack of clean water despite their

abundant water resources.

Research sources are sourced from primary and

secondary data. The primary data used unstructured

guidelines when conducting interviews and focus

group discussion (FGD) in five villages. The social

categories are migrants, natives, medical workers,

village officials, religious and community leaders

who have lived at least for five years and have a

family. Analysis was conducted from collecting,

coding, and connecting between data and concepts.

Data validation was conducted internally and

externally.

4 ANALYSIS AND DISCUSSION

Maura Padang sub-district is spread over a wide

area, around 944,60Km

in total. Overall, their area

consists of low land, marshes, and peats. The

marshes found are categorized as brackish water. It

is a result of the meeting between fresh water from

the Musi River and salt water from the Bangka sea.

Tidal wave soaks almost all of the marshes. This

result is tidal groundwater is usually salty, acidic,

and brackish, and the color of the water ranges from

brownish to black. This water condition near inland

or low land depends on tidal water from the sea.

This natural water becomes very poor and unfeasible

for consumption. The tropic areas have the most

precipitation in December until January. Meanwhile,

rainfall also affects the quality of ground water.

Generally, the groundwater will be taste saltier than

usual in the dry season. This area also faces tides

which causes the land to be drowned in water from

the tides. This tide also had an impact on

transportation. In the morning, the tides are high,

which means speed boat becomes the popular choice

for transportation. However, ever since road

infrastructure was build in 2000, the resident’s

mobility no longer depends on the tide.

The transmigration program in this area was

implemented by the Indonesian New Order

Government in the 1980s. Most of the inhabitants in

this sub-district originated from Java. These

migrants occupy 12 villages, while native

inhabitants from Palembang occupy a mere three

river-side villages. Migrants make a living by

becoming tidal farmers, while natives usually

become fisherman and freelance plantation workers.

Unlike migrant inhabitant, natives build their houses

on stilt structures, which also influences the culture

and the communal patterns of utilizing water

resources and fulfilling their daily needs.

In the beginning, migrant communities gained

their knowledge about rainwater utilization from the

government. They collected rainwater and used it

carefully. This happened due to the significant

difference topographical areas between Java and

Sumatera. In Sumatera, especially in the Banyuasin

district, ground water is usually impossible to

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consume. Meanwhile, rain water supply exists in

limited quantities. The effect of these geographical

situation is that many migrants that failed to adapt to

the environment moved back to their hometowns.

The limited supply of fresh water has been the

center of attention for many stakeholders. For the

first time, the nation’s government gave each family

an artificial water resevoirs. Furthermore, the local

government built water deposits with artificial water

reservoirs for the whole community to access in the

central village and drilled a well in order to access

ground water. Some universities also contributed by

making ground water filters. However, this effort

has yet to be successful.

The community also has local traditions that they

follow in the pursuit of fresh water. They try to find

fresh water by looking for it as far as the deep end of

ricefields, where rain water puddles form. They also

try to make reservoirs for both river water and well

water by using chlorine. They even use religious and

cultural ritual to find water such as fasting, praying

at outdoor villages, and putting many of their fruit

and food near the river in the central villages.

Cultural values and societal norms protect the rivers

and ditch from becoming garbage dumpsters.

We’ve constructed that they’ve divided the water

functions in order to meet their daily necessities

(Table 1.). The water difference function influences

health behavior in the communities living in the tidal

areas. The behavior patterns aim to maintain and

improve the health conditions of the individual and

their family.

Health behaviour socialization is carried out by

health workers, government, or private institutions.

One of the socialization methods conducted by

government is the promotion of a clean and healthy

lifestyle (“Perilaku Hidup Bersih dan Sehat”). In

fact, many people, especially native residents, still

bathe, wash, and defecate in the river water. As a

result, water-related diseases are often suffered this

community, such as diarrhea, dengue fever, typhus,

vomiting, coughs, lung diseases, and respiratory

diseases. Other diseases are sweet pea, uric acid, and

high blood pressure which are caused by dietary

habits and lifestyle choices. Based on past

experience, some of the residents feel sore when

they consume too much rain water, however there is

still a gap among individual manner in symptoms

that appear in response to diseases.

Table 1: Sources and function water in tidal community.

Water

function

Water sources

rain

well

river

ditch

gallon

Cooking and

consumption

√

Washing food

√

Washing

clothes

√

Bathing

√

Flushing yard

√

Worship

(‘Wuhu’)

√

Transportation

√

Health service

√

Source: (Sununianti, 2015)

The variance of knowledge and experience affect

the community’s efforts to deal with disease.

Different disease management methods are also

based on social and economic status. If children are

ailed with illness, seeking treatment is usually a high

priority for parents, compared to when adults are

ailed with similar illnesses. When adults are ailed

with illness, they will only look for treatment if they

can no longer fulfill their societal role, such as

working. The treatment provided by health services

also differ between lower and upper class

communities. Upper class communities usually have

direct access to health services when they are

diagnosed with symptoms of diseases. Lower and

middle class communities that are ailed with illness

usually postpone their search for health services

until their illness reaches a critical condition. Part of

the lower class communities still use “dukun” or

traditional medicine to cure their diseases before

they attempt to go to Public Health Services

(“Puskesmas”), clinics, or hospitals.

Efforts to achieve health have been conducted

through a variety of strategies. Researchers found a

combination of health behavioral model that

emerged in Maura Padang’s tidal community that

was in line with Health Belief Models (HBM)

(Weitz, 2007; Sudarma, 2008; Solhi, 2010; White,

2012; Romano and Scott, 2014). It is based on

experiences, culture, and social structures with the

environment of the residents having an influence on

individual and societal health behaviour.

Communities residing in tidal areas were perceived

to be in a susceptible and severe situation. They face

many difficulties in accessing fresh water and are

susceptible to a wide array of water related diseases.

These communities must get treatment of diseases

caused by ground water, due to the unfeasible

consumption, dire health conditions, and the need

Health Behavior Models in Utilizing Water Resources to Tidal Waters Community

279

for medical assistance. They have felt direcly the

benefits and barriers of shifting from ground water

to rain water. Health behavior changes are through

the form of using rain and gallon water for washing

and consumption, a practice that has been utilized by

many parts of the community except the lower class

society. They also require regular maintainince to

keep, close, and clean reservoir rainwater.

Furthermore, there is an extra expense that needs to

paid for chemical treatment to prevent mosquito

larvae, and for using gallons and packaged water,

which is relatively expensive. In this case, health

behavior towards illness treatment differs from

social status, economic situation, and societal

culture. Meanwhile, sick role behavior is still

relatively dependant on an individual’s role in

society.

Tidal communities have their own medical

system. This medical system includes faith healing

and efforts to improve general health. The health

behavior in this study is formed due to societal

culture and beliefs on susceptibility to illness,

malignant diseases, and general societal costs.

Geographical conditions affect the behavior of the

tidal community in preventing and healing of

disease, as well as in improving their health.

5 CONCLUSIONS

This paper discusses the limited access to clean

water in areas with abundant water resources.

Communities in this areas use different strategies to

fulfill their daily need of water. The obstacles they

face in accessing various water sources will

influence the health behaviour of the community as

a whole. The point is that individual and familial

health behaviors in tidal communities are related to

environmental, social, economic, and cultural

conditions.

ACKNOWLEDGEMENTS

The authors are grateful to anonymous reviewers

that spent their time providing constructive input to

improve this article. The authors also appreciate all

the informants who contributed to this paper. We’d

also like to extend our gratitude to the Ministry of

Research and Technology, Directorate of Higher

Education, Indonesia, and Sriwijaya University, that

funded this fundamental research. We hope this

research will be useful for others in the future.

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