Indonesia faces unusual challenges as Covid cases climb — theft of corpses, smiling

A clash between culture and medical procedure is resulting in frequent reports of corpse stealing, where family members or, in extreme cases, local mobs take away bodies.

Passengers wearing protective face masks sit inside a train at a station in Jakarta on July 8 | Representation image | Photo via Bloomberg

Jakarta: Body stealing, island hopping and smiling are some of the latest challenges facing Indonesia as the virus spreads along the world’s largest archipelago, turning the Southeast Asian nation into the latest cautionary tale about how long the battle against the pandemic will last.

Like other large developing nations with a lot of people in low-income brackets and a medical infrastructure unprepared for such a rapid and complex emergency, Indonesia is caught between the need to contain the epidemic and the difficulty of enforcing isolation for millions who have to work to eat. Added to that are a mix of cultural, religious and geographical factors unique to the country of 17,000 islands that have made it almost impossible for the government to contain the disease.

In mid-February, Wiranto, chairman of Indonesia’s presidential advisory council, and World Health Organization representative Navaratnasamy Paranietharan held a join press conference to assure the public that the government was prepared for a potential outbreak. Hours earlier at a palace compound next door, Health Minister Terawan Agus Putranto, one of a few Christian ministers in the cabinet, told reporters people should not be ashamed of asking for God’s help should an epidemic come to Indonesia. “Ora et labora,” he said. Pray and work.

Within three weeks Indonesia reported its first case. Only then did the public learn that the country didn’t have enough reagent to test suspected cases, only had one laboratory in the capital capable of conducting the polymerase chain-reaction test, and was short of protective gear for medical workers, forcing some to resort to wearing green plastic raincoats.

“We have failed to manage this pandemic strategically,” said Pandu Riono, an epidemiologist at the University of Indonesia. “There are too many counterproductive narratives out there. Each of us has our own huge ego while we should have dealt with this with one voice.”

Indonesia’s failure to deal with the pandemic effectively could hand the economy its first recession since the Asian Financial Crisis in the late 1990s and send millions back into poverty. The missteps have dented the popularity of President Joko Widodo. More than half the participants in a May survey said they were unhappy with the government’s handling of the pandemic. Jokowi, as the president is popularly known, saw his personal approval rating slip to 66.5% in a May survey, from 69.5% in February.

It was months before the world’s fourth-most-populous nation was able to activate hundreds of facilities across the archipelago to allow local testing instead having to send samples thousands of kilometers to the capital.

Inspired by China’s success in building a makeshift hospital in a week, Jokowi instructed his ministers to build a similar facility. Indonesia’s hospital, initially designed to treat infected returning migrant workers, was constructed on Galang Island, near Singapore, but 826 kilometers (513 miles) from Jakarta, the nation’s virus hotspot in the first few months.

Cultural diversity

Indonesia’s archipelago is scattered across the equator, covering a distance equivalent to the span from New York to Alaska. Its people speak thousands of dialects and languages. Most of its 270 million people are Muslim, giving it the world’s largest Islamic population.

That geographic and cultural diversity helped it attract more than 16 million international tourists a year to beaches, temples and mountains from Bali to Borobudur and from the spice islands to the sprawling metropolis of Jakarta. With the pandemic, billions of tourist dollars are missing.

In addition, cultural norms in different parts of the country have played havoc with government attempts to curb infection.

For the nation’s Muslim population, formal burial rites would normally require the family to ensure the deceased is cleansed soon after death and buried in a cotton or linen cloth, not cremated or interred in a coffin. Special virus protocols require bodies of Covid-19 victims to be wrapped in plastic and buried in sealed coffins within 24 hours of death.

Newspapers and media publish frequent stories of corpse stealing, where family members or, in extreme cases, local mobs took bodies of people who died from the virus, sometimes by force. In one case, relatives of a patient who died at a hospital in Medan, North Sumatra, persuaded staff to take the body out of an ambulance so they could perform last rites and then made off with the corpse in a car, according to the Jakarta Globe.

In other cases, fear of contagion has caused riots and civil protests. Last month in a small town in East Java a group of people threatened to set fire to an ambulance carrying the body of a suspected Covid-19 case, according to Detik.com.

Throughout the country, many people don’t wear face masks, even in crowds. On a visit to East Java last month, Jokowi warned local officials to step up measures to contain the highest infection rate for any province, saying 70% of its population refused to wear a mask.

Airline PT Garuda Indonesia, the nation’s flag carrier, was considering substituting masks with face shields as long as it didn’t affect the wellbeing of the crew, President Director SIrfan Setiaputra told reporters in June.

“This industry is about happiness,” Setiaputra said. “You shouldn’t have to enter our cabin and be greeted by a steward and stewardess and wonder whether you are boarding a plane or entering a hospital ICU. If someone has a mask on, you can’t tell if the person is smiling or not.”

Back to normal?

Rather than demanding a national lockdown, Jokowi chose less punishing distancing rules such as shutting down malls, restaurants and encouraging people to work from home. He cited the economic impact of such a move on the large number of informal workers who had no financial safety net.

Within weeks, even those limits were being partially rolled back as the government worried about the economic damage to industries such as tourism, manufacturing and small businesses. Factories where many staff had been infected were allowed to reopen if they implemented special measures.

“He wants to revive the economy, which will most likely shrink in the second quarter,” Achmad Sukarsono, lead analyst for Indonesia at Control Risks, wrote in a report. “While this is good for businesses eager to go full steam ahead and resume activities, it also brings a raft of operational challenges. The ‘new normal’ requires businesses to be ready for sudden closures and public outrage if anyone is infected on their premises.”

Cases of infection soared. Since the end of May, the number of people in the country diagnosed with Covid-19 has tripled to at least 88,000, overtaking China. More than 4,200 have died.

“The massive testing being undertaken now shows that the virus is still spreading,” said Laura Navika Yamani, an epidemiologist at Airlangga University in Surabaya. “People are not obeying health protocols while in public. The easing of strict social distancing rules has further exacerbated this crisis.”

Part of the problem was communication. As the government moved to ease restrictions, it urged citizens to accept the “new normal,” an English term borrowed from abroad to indicate changes in behavior like mask-wearing and social distancing. But most people in the country speak little or no English and many took the term to mean life should carry on as normal, said Riono at the University of Indonesia.

“We should have said that Indonesia is abnormal,” Riono said in a phone interview. He said the country needs to intensify tracing, testing and isolation, and encourage people to wear masks, keep their distance and wash their hands frequently. “Too many people are hoping for a magic solution.”

But, as in many countries, people desperate for a way to ward off the disease or find a home cure are turning to alternative remedies and unproven treatments.

Agriculture Minister Syahrul Yasin Limpo said that he had discovered an anti-viral necklace made from eucalyptus leaves, remarks that brought a flood of criticism on social media that forced his ministry to hold a press conference to clarify his comment.

Saving economy

With the population spread over thousands of islands, air travel is often the only way to deliver logistics, personnel and medical supplies quickly — increasing infection risks and hampering the ability to combat the spread of the disease. In remote parts of Papua or the Moluccas, even travel within an island is only feasible by air.

With the virus continuing to spread from city to city and island to island, the government continues to walk the balancing act between the devastation of the pathogen and the damage to the economy. On July 16, Jakarta Governor Anies Baswedan said the last phase of reopening the capital would be delayed for at least two weeks because of the spike in infections.

“At this juncture, it’s difficult to say when Indonesia will get this pandemic under control,” said Gerry Soejatman, an aviation analyst who has been monitoring the virus’s effect on the industry and the reaction of neighboring countries. “How the international community treats us will depend on how the government communicates the reality on the ground, and that has been a major challenge for the administration.”- Bloomberg