Coping with Covid-19: Indonesia

Coronavirus: Amid fear, sadness Indonesians look out for one another

As the coronavirus cuts a swathe through Asia, The Straits Times bureaus report on how governments, hospitals and the man in the street are rising to the battle. In the second of a five-part series, Regional Correspondent Arlina Arshad and Indonesia Correspondents Linda Yulisman and Wahyudi Soeriaatmadja find the traditional community spirit to be a great help when resources are scarce.

A woman wearing a mask washing her hands at a portable sink outside an office building in Jakarta, Indonesia. PHOTO: BLOOMBERG Workers from PT Pan Brothers Tbk & Group, the largest garment manufacturer in Indonesia with multiple factories across Java
Workers from PT Pan Brothers Tbk & Group, the largest garment manufacturer in Indonesia with multiple factories across Java, are producing washable and waterproof jumpsuits at its factory in Banten province to address the shortage of personal protective equipment. PHOTO: PT PAN BROTHERS TBK & GROUP
A woman wearing a mask washing her hands at a portable sink outside an office building in Jakarta, Indonesia. PHOTO: BLOOMBERG Workers from PT Pan Brothers Tbk & Group, the largest garment manufacturer in Indonesia with multiple factories across Java
A woman wearing a mask washing her hands at a portable sink outside an office building in Jakarta, Indonesia. PHOTO: BLOOMBERG

After weeks nursing a migraine, and suffering bouts of nausea and shortness of breath that would not go away with antibiotics, Indonesian housewife Ratna Khairani, who is in her 40s, had a chest X-ray and found out she had pneumonia.

She was shocked, and then feared for her life. After all, the coronavirus has infected nearly 2,500 people in the country and killed more than 200, mostly in the capital, Jakarta, where she lives.

"Is it Covid-19?" she asked the doctor, referring to the disease caused by the coronavirus. The doctor did not rule it out, but rejected Ms Ratna's plea for a throat or nasal swab as she was an outpatient. Two other hospitals refused to get her admitted. "All wards are full. No beds," they said.

Ms Ratna rushed to Wisma Atlet, a residence for athletes which has been turned into an emergency hospital for coronavirus cases, to get a blood test but was made to wait for hours by soldiers at the entrance. The test would not confirm a coronavirus infection, but she hoped it would shed light on what was wrong with her.

However, she has given up trying for a test. Now, she isolates herself in her room, away from her husband and two teenage sons. She has not cooked for them, hugged or touched them. She wears a surgical face mask like a second skin, even when she sleeps.

"Not knowing whether you really have the virus may be a good thing. It gives you some room to be in denial and not to feel too down," she told The Straits Times.

Nobody knows how many Indonesians are unwitting carriers of the virus as the disease takes a toll on the country's stretched healthcare system.

President Joko Widodo declared a public health emergency on March 31, and ordered large-scale social distancing measures which Dr Pandu Riono, an epidemiologist from University of Indonesia, described as "between mild and moderate intervention".

The university's public health expert team has projected the outbreak will peak in late May to early June, with between 1.25 million and 1.75 million cases of infections, and 47,984 to 144,266 deaths.

Indonesia's health facilities could only cope with fewer than 50,000 patients a day, Dr Pandu told The Straits Times. "We are buying time because our health facilities cannot accommodate all patients," he said.

"We could end up like Italy or Iran," he added, referring to the countries where the virus is spreading uncontrollably.

  • COVID-19 CASES

  • 2,491 Total number of infections in Indonesia, as of yesterday.

    209 Total number of deaths.

As it is now, cases have largely gone unreported and undetected in the world's fourth-most populous country of 270 million people. Its 48 laboratories have so far tested only around 11,000 samples.

Indonesia's virus fatalities now rank the highest in South-east Asia.

DEAD DOCTORS, OVERWHELMED HOSPITALS

Outside a hospital in central Jakarta, healthcare workers in blue uniforms and face masks waved sombrely as a van carrying the sealed coffin of their dead coworker drove past.

"Till we meet again, till we meet again, God is with you," they sang.

At least 11 doctors have died from the virus and another from exhaustion, according to the Indonesian Medical Association, in a sign of poor infection controls in hospitals and clinics.

The association has threatened to stop treating cases if the government does not replenish dwindling supplies of personal protective equipment (PPE) such as hazmat suits and N95 masks.

Yet, a sense of duty has kept many doctors working, even without protective gear.

Since early March, pulmonologist Eva Sri Diana has been shuttling between two hospitals in Jakarta to tend to dozens of suspected cases.

As both were not among the 132 referral hospitals designated to treat Covid-19 patients, PPE was not provided for.

Dr Eva wore a raincoat, safety goggles, surgical mask and face shield made of headbands and plastic sheets. "It's minimal, but still better than no protection at all," she told The Straits Times.

She paused to cough, as she did numerous times throughout the interview, but assured that she had tested negative for the virus.

Seeing fellow doctors die one by one sends chills down her spine. Every day, she counts her blessings that she is still alive, she said.

"When I go to work, my husband and children will try to stop me," said the 46-year-old. "I am so scared and I feel dejected every time I hear that my fellow doctors have died. My feelings are mixed... sad, afraid and helpless. But after seeing my patients, I no longer think about death," she added.

In Banda Aceh, Sumatra, doctors at Dr Zainoel Abidin General Hospital have found a way to save 600,000 rupiah (S$52) on the "expensive" full set of PPE, said hospital director Dr Azharuddin.

"To save money and supplies, each doctor handling Covid-19 patients will try to wear (the PPE) for his entire eight-hour-long shift, not eating, drinking or taking toilet breaks," he said.

After public criticism over its slow response in handling the pandemic, which included a nudge from the World Health Organisation to pull up its socks, the Indonesian government seems to have picked up pace.

It has prepared 1,000 beds in a quarantine centre built on Galang Island, near Batam. The facility, which opened yesterday, will also have isolation wards, intensive care units, pharmaceutical laboratories as well as a mortuary.

Exports of surgical masks and hand sanitisers have been banned, while supplies of test kits, N95 and surgical masks, protective gear and portable ventilators have flowed in from China.

To curb the contagion, rapid blood testing to detect symptoms is being carried out in zones with a high number of cases in Jakarta and its surrounding districts. The government aims to test a million people, with priority given to close contacts of positive cases, medical workers and migrant workers.

Mr Joko Hariyanto, a social affairs ministry officer who is helping to coordinate social distancing measures in the field, said he was relieved when his test was negative.

"I have had coughs, but these days, who knows if this cough is really due to an allergy or Covid-19," he said.

CLOTH MASKS, POCONG AND SMACKDOWNS

With frontline workers stretched to the limit, Indonesians are doing their part to keep infections at bay.

Jakarta city lawmaker Ima Mahdiah said she quarantined herself for 10 days after meeting someone who later tested positive for the virus. "I am afraid of infecting others and becoming a virus carrier," she told The Straits Times, adding that she drank lots of water, rested well and sunbathed.

Even though the government has not ordered a total lockdown, many people have chosen to stay at home and cancel various social activities - from religious congregations and weddings to popular lottery gatherings known as arisan.

Schools have closed and food stall owners have gone online, taking orders via WhatsApp messages and getting ride-hailing company drivers to deliver them.

Across the sprawling archipelago, from large cities to small villages, many volunteers are out in full force distributing masks and hand sanitisers. Others stand at village entrances to stop residents from sneaking out and bar strangers from entering, with some dressing up as pocong, or mummy-like ghosts in white shrouds, as a scare tactic.

Spray-painted "no entry" banners and empty cartons and bamboo poles serve as temporary road blockades. "Lockdown!! If stubborn, smackdown!" screams one banner, borrowing the title of a US professional wrestling television programme.

Mr Ali Imran, a resident of Kebon Kacang neighbourhood in Central Jakarta, said: "Better be cautious than sorry."

Sewing machines are humming away as housewives, renowned designers and companies begin to make protective suits and masks to address shortages.

Well-known kebaya designer Anne Avantie has begun churning out protective gear through her foundation. PT Pan Brothers Tbk & Group, the largest garment manufacturer in Indonesia with multiple factories across Java, has also produced anti-microbial and water-repellent washable masks and washable and waterproof jumpsuits.

Mrs Anne Patricia Sutanto, the group's vice-chief executive, told The Straits Times: "This is also for humanity. It was challenging at first for us since this is not our main business but we need to ensure our strong commitment and support for Indonesians. It's Indonesia One versus Covid-19."

And as the government struggles to keep its citizens and economy breathing, the worst is yet to come.

Already, hundreds of thousands of informal workers in the cities have returned to their villages after losing their jobs. Hari Raya next month will see millions more on the move, travelling home in an annual tradition called mudik, which could lead to an exponential rise in the number of infections.

Ms Iswanti Suparma, a 51-year-old women's rights activist who lives in Yogyakarta, the capital of Central Java, said: "It's hard for Indonesians to practise social distancing. Our society is typically communal and loves to chit-chat.

"I do worry about mudik. It will be unfortunate if villagers too become exposed to the virus."

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A version of this article appeared in the print edition of The Straits Times on April 07, 2020, with the headline Coronavirus: Amid fear, sadness Indonesians look out for one another. Subscribe