In Jakarta's northern Muara Angke coastal area, a lack of access to piped water has forced people to bathe and wash clothes using murky grey water from fish ponds.
"I don't feel disgusted at all. I've gotten used to it," Ibu Nunung, who shells mussels for a living, told IRIN outside her house in Muara Angke Blok Empang, a slum in the area.
Nunung said residents, many of whom live on less than US$2 a day, had to fork out the equivalent of up to $1 daily to buy clean water for drinking and cooking from vendors transporting water in jugs.
She admitted that itchy skin was a common problem among locals.
Jakarta, a city of 10 million people, is dotted with slums like the one in Muara Angke
Many people live without running water in shanty towns built in the shadow of gleaming skyscrapers, and gutters are clogged with rubbish, causing foul smells.
"Poor sanitation, lack of access to clean water, overcrowding and poor nutrition are among [the] major problems in Jakarta, and the government's commitment is needed to address these problems," said Erlyn Sulistyaningsih, a project manager with Mercy Corps Indonesia.
Less than 50 percent of Jakarta's residents have access to piped water, according to the NGO, which runs water, sanitation and health programmes in the city.
More than 75 percent of the city's residents rely on shallow groundwater, but an official study found that 90 percent of shallow wells are contaminated with coliform bacteria or heavy metals, Mercy Corps said in a 2008 publication entitled Urban Poverty Reduction Strategy.
Jakarta produces 6,000 tons of waste each day, but can only manage 50 percent of it, it said.
Sulistyaningsih heads a project aimed at increasing access to sanitary facilities, including toilets, providing access to clean water, and educating child caregivers about nutrition in several villages in Jakarta and neighbouring Bekasi District.
"Our programme seeks to prevent diseases which are spread by the faeces-to-mouth route, and we hope it can be replicated by other communities," she told IRIN.
A study released by the World Bank's Water and Sanitation Programme in 2008 revealed that only 57 percent of Indonesian households had easy access to a private and safe place to urinate and defecate in 2004.
Poor sanitation, including poor hygiene, causes at least 120 million disease episodes and 50,000 premature deaths annually, the report said.
The study also found that poor sanitation costs the Indonesian economy $6.3 billion per year, or equal to 2.3 percent of the country's gross domestic product.
Nugroho Tri Utomo, head of the subdirectorate of drinking water and waste water at the National Development Planning Agency, said part of the problem was a lack of funding, with spending on sanitation accounting for only 1 percent of the city's budget.
"Both the general public and authorities have yet to realize the importance of sanitation, not only to health but also to the economy," he said.
Improvement plans under way
The government last month launched a programme to provide access to adequate sanitation to 80 percent of urban households by 2014.
The Settlement Sanitation Development Programme, estimated to cost $5.5 billion, aims to develop waste water services in 226 cities, build sanitary landfills serving 240 urban areas, and stop inundations in strategic urban locations covering 22,500 hectares.
Under a separate programme called the National Strategy for Community-Based Total Sanitation, launched in 2008, the government aims to provide access to sanitation and introduce more effective water treatment methods in 10,000 villages by 2012.
Source: the humanitarian news and analysis service, IRIN http://www.irinnews.org