SitRep 2: Indonesia

As of Monday,  April 6, 2020, Indonesia has opened two emergency hospitals for COVID-19 patients. The first is the Kemayoran Athletes Village in central Jakarta which can accept 3,000 persons, and the second is on Galang Island with a capacity of 360.

Athletes Village opened on March 23, 2020. Able to house 24,000 during the 2018 Asian Games, four of the ten towers are now equipped for about 3,000 COVID-19 patients. Asymptomatic cases and those with mild symptoms are being sent home for self-isolation, so that those requiring hospitalization can being housed and treated in the Athletes Village.

Near Singapore and part of the Riau Islands, Galang Island is the former site of a United Nations refugee camp that had hosted 250,000 Vietnamese refugees beginning in the 1970s and operating until 1996. Today, the island is inhabited by  approximately 17,000 residents. The Indonesian military (TNI) and National Police inspected the site before its opening.  TNI commander Air Chief Marshal Hadi Tjahjanto led the inspection and insists that residents “welcome” the plan, and says he conducted a “social call” in which residents of Sijantung Village on Galang Island expressed support. Residents were previously opposed to the plan, citing discrimination and stigma. 

The Galang Island COVID-19 Specialist Hospital has 340 beds for patients under observation, and an isolation ward of 20 beds for intensive care. Another zone is designated for medical workers, containing 158 beds. The grounds also house land designated for a cemetery. When the hospital was conceived in early March, it was designated for migrant workers returning from Malaysia and Singapore, especially as Muslims prepare for mudik, the traditional visit home prior to the Idul Fitri (Eid) in late May. President Joko Widodo was first ready to call off the mudik, but now is reluctant to do so. As needs have changed, the purpose of the hospital has been expanded to receive patients from other hospitals across Indonesia, but plans for how patients will be transferred have not been revealed.

Displaying his distance from the reality of the virus spread in Indonesia, President Joko Widodo stated, “Hopefully, we will never have to use [the Galang Island hospital] to treat COVID-19 patients,” and that after the pandemic, the site will be used as an infectious disease research and treatment facility.

The reality is that 3,360 beds are far too few. Even combined with various plans such as the 190 military-owned hospitals being used for isolation rooms, state-owned enterprises converted for medical purposes, hotels opened up for medical staff, and religious dormitories being offered for use, Indonesia cannot keep up with the virus spread under current conditions. Officially reporting 2,956 cases, 240 deaths, and 222 recoveries as of April 8, 2020, lack of testing, treatment centered in the largest metropolitan areas, and other observable data indicate the virus is more widespread. The government has distributed 400,000 rapid-test kits, but positive cases from these kits are not included in the daily count. As for PCR tests, only 8,000 have been used in Indonesia. Other evidence includes 42 out of 76 passengers on a flight from Indonesia to Thailand on April 6, 2020, were found to have tested positive for COVID-19. And burial statistics in Jakarta indicate a 40% increase in deaths in March compared to the previous two years.

Policy recommendations:

  1. Disseminate clear and comprehensive public health information about the extent and severity of the outbreak, including virus prevention measures.  
  2. Restrict domestic travel and nonessential gatherings, including religious gatherings and travel.
  3. Ensure all citizens have access to COVID-19 medical care, regardless of geographic location; open more COVID-19 hospitals across the country to anticipate future needs.  
  4. Implement entire household isolation for those with household members who test positive or are suspected cases, regardless of presentation of symptoms or severity of the illness.

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