Badong is a poor Melanau village in the Rejang delta near the South China Sea. When I was there, an elderly woman bicycled quietly by on the dirt road raised above the tidal swamp. She wore a frayed sun hat, tattered clothes, and was barefoot. In her bike basket were a few leafy vegetables. She smiled at the sunshine all around her, revealing that she had only four teeth in her pink gums. On the bridge over a tidal creek, a young village man was chatting with me. He sat astride his shiny motorcycle and knew he looked fashionable in his citified “biker” outfit. Does this rural scene personify the old versus the new in Sarawak? If so, is there anything wrong with this picture?

This chapter looks at women's health in the kaleidoscope world of Sarawak today. With the rapid transformation of the state, women are beset with both social and cultural forces affecting their health. It is not fanciful that structures such as roads, cities, dams, airstrips, plantations, and resorts impinge on health. Nor must we forget the effects of centralized policies and plans, or of bureaucracies, on people's lives and health in particular. All this is to say that women's health status is far more than the diagnosis and treatment of disease. It is also far more than nutrition, reproduction, and childcare. While reproduction and workloads map closely on health, urbanization and other changes may leave indelible marks. In fact, we must look at women's health embedded in a flux of familiar and alien, close and distant forces. To do so, information from fieldwork is combined with published reports here. This snapshot of women's health can then provide a perspective with some breadth and depth, even though research in this area is sparse.

Many health problems of Sarawak women echo regional situations, according to many reports on illnesses in Southeast Asia. In contrast, the good-health situations in Sarawak seem more home grown. This is because Sarawak is not as poor as many nation states in the region and once had less gender inequality, economic inequality, or political heavy-handedness. Not having the over-population of Java and being far from a political hotspot have also helped. But in today's interlocked world, Sarawak's advantages are tenuous and its health problems may be growing, despite dedicated efforts to solve them.