People living in slums can be considered left behind with regard to national successes in achieving Millennium
Development Goals (MDGs). The objective of this study was to evaluate the living and working conditions of
waste pickers and their children in a landfill slum located in the largest city in eastern Indonesia. A total of 113
people from the landfill slum and 1184 people from the general population participated in face-to-face interviews.
Municipal solid waste (MSW) was analyzed for metals, metalloids and fecal indicator bacteria. Ambient
air quality including particulate matter was measured in the landfill. Households in the landfill slum were 5.73
(p = 0.04) times more likely to be below the international poverty line (MDG 1: Poverty) and 15.6 times
(p b 0.01) more likely to have no one in the household possessing a primary education (MDG 2: Universal Education),
and 107 times (p b 0.01) more likely not to have improved sanitation facilities (MDG 7: Environmental
Sustainability) when compared to the general population. Diarrhea is one of the leading causes of death in children
under five in Indonesia. Young children living in the landfill slumwere 2.87 times (p=0.02)more likely to
develop diarrhea than their general population counterparts. Other survey results and environmental measurements
suggest that landfill slum children have additional adverse health effects (e.g. infections and poisoning).
Poverty underlies severalMDG issues that directly or indirectly affect child health. Therefore, eradicating extreme
poverty will continue to be the most critical challenge for the MDGs beyond 2015.