Indonesia’s pandemic policy: Pray and pay

Jan 31, 2021

Indonesia’s former health minister, a medical doctor, predicted the satanic infection would fly over the country because the people below were so pious. The world’s fourth most populous nation has a huge vaccination task ahead. 

A wall sign at Malang’s Lavallette public hospital advertises Covid-19 tests for Rp 250,000 – about AUD$23. That’s cheap; other Indonesian clinics are charging double or more.

To put the fee into perspective consider this: it takes two days for an Indonesian tradie to earn a quarter of a million rupiah, four for a factory hand.

The high charges for testing explain why the rate is so low, making a spittoon of stats about the spread of the plague and death rate, the essential info that shapes public health planning.

Late last year, Our World in Data, an Oxford University non-profit, reported Indonesia testing 16/1,000 suspects. The Philippines figure is 54/1,000.

Indonesia’s Health Ministry says the nation has more than 1 million cases and almost 30,000 deaths. Independent epidemiologists fear the figure is three or four times greater.

Yet President Joko Widodo has told his 270 million citizens the policy of balancing health and the economy has been successful.

CNN Indonesia reported him saying: ‘We are grateful. Indonesia is among the countries that can control these two crises well.’

As the police are getting keen on prosecuting critics of the administration during the President’s second five-year term, one had better not say his statement is untrue. Instead, we’ll suggest he may have been poorly advised.

Unfortunately, it’s not the first time. When the virus was already travelling well, the government offered A$10.4 million for web ‘influencers’ to promote tourism. The nutters who most likely sowed that idea would have been the Gen Z court whisperers hired to help old politicians plug into young voters’ thinking and behaviour. Fifty per cent of the population is under 40.

Fortunately, it was clobbered by public outrage led by medics and journos who read more than memes and understood the virus was real.

The standard Indonesian response – also favoured by some overseas leaders – has been to call on the Almighty.  That hasn’t worked either, as the Lowy Institute’s ranking of 94 countries’ handling of the pandemic shows: Indonesia is in position 85.

Business lobbyists, more worried about bottom lines than full hospitals, have had more success than their Oz colleagues in pushing for prioritising of the economy.

This became clear late last year when Widodo finally tossed out Health Minister Terawan Agus Putranto after 14 months of fumbling. He’s most infamous for predicting the satanic infection would fly over the world’s fourth most populous nation because the people below are so pious.

For all his faults (he let hospitals cry out for essential equipment), Putranto is a medical doctor.

His replacement is not. Budi Gunadi Sadikin has been running the task force for national economic recovery. Before his promotion, he led a state bank and a state aluminium company. In the Indonesian political system, ministers can be appointed who aren’t elected politicians.

A vaccination program using the Chinese Sinovac vaccine has started targeting medical workers. Unlike other countries, jabs aren’t being offered to the vulnerable elderly, only those under 60. Indonesia is the first state outside China to give the go-ahead.

So far it’s taken two weeks for 250,000 medical workers to get needle number one. Widodo, 59, got his second last Wednesday. The early queue includes the police, military and public servants.

The president told the media that about 30,000 inoculators are readying syringes in clinics and hospitals, each medic giving 30 jabs a shift. That should result in close to one million pricks a day.

The service is supposed to be free, though the government is pondering a parallel program for those prepared to pay. They’ll probably prefer one of the better-appraised vaccines from the West than the donated Beijing product, which has not undergone stringent testing.

Trials of Sinovac in Turkey reported efficacies of 91 per cent, 50 per cent in Brazil, then revised to 78 per cent, though only 65 per cent in Indonesia. The discrepancies are being blamed on different participation rates and data interpretation, creating more confusion.

The Widodo government claims two-thirds of the population will bare shoulders within a year. That figure is also being scrutinised. If the testing regime is so inefficient, why would delivering vaccines be any better?

To be fair the logistics are confronting. With about 6,000 occupied islands across an archipelago 5,245 kilometres wide, hampered by inadequate transport and inept bureaucracy, the task is immense.

It’s also expected many will reject the vaccine. Distrust of the government is widespread, partly because oldies remember the nation was ruled for 32 years last century by a dictator who ensured the only news read and heard came through his PR filters.

Then there’s the problem of scientists broadcasting a muddled message – an issue not confined to the Republic. The ABC reported University of Indonesia epidemiologist Dr Pandu Riono saying advice was often dismissed when the infection was getting into gear:

‘The denial of the Government at that time was extremely high.

‘Giving input to the Government is a big challenge for me, especially how to translate academic findings into policy. Officials tend to listen more to their expert staff, not academics from outside the bureaucracy like us. The Government should have involved all universities from the start.’

Australian journalist Duncan Graham writes from Indonesia.

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