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SINGAPORE: Imagine being a healthcare worker at the forefront of the fight against the deadly pandemic in a hospital, working endless days to help nearly 100 patients each day on your own.
Imagine also fighting your own fears of contracting the virus, in a country with one of the highest death rates from COVID-19 among healthcare workers.
And then imagine coming home to discover that other neighborhood kids refused to play with yours, because you work in hospitals and treat COVID-19 patients, and you hear parents tell their kids that their family has been exposed. and that it will transmit the virus to the community.
These stories are common, according to nurses at North Jakarta’s Sulianti Saroso Infectious Disease Hospital, who revealed their ordeal to local media in April.
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In Semarang, Central Java, that same month, the family of a health worker who died of COVID-19 had difficulty burying his body.
The communities living around the cemetery rejected the burial for fear of contracting the disease.
The fact that this nurse died as a result of treating COVID-19 patients did not move them from this puzzling stance.
In Solo, Central Java, some landlords refused to rent houses and rooms to nurses working in hospitals treating COVID-19 patients. This rejection has also occurred in various places in Indonesia and has happened not only to nurses but also to doctors.
Farther afield, in Bali, news reports highlight the public’s backlash against returning Indonesian migrant workers who have lost their jobs.
Government workers wearing protective suits carry a mock-up of a coffin of a coronavirus disease (COVID-19) victim on a main road to warn people of the dangers of the disease as the outbreak continues in Jakarta, Indonesia , August 28, 2020. REUTERS / Willy Kurniawan
While the Indonesian government made quarantine arrangements at hotels, crowds of residents living near their surroundings gathered near transport buses in an attempt to turn them away, after concerns grew that they could carry the virus with they.
THE COSTS OF STIGMA
While these incidents that stigmatize Indonesians believed to have contracted the virus and those who treat them were stories from April, many more have persisted five months later across Indonesia.
Public fatigue with the avalanche of stories showing problematic attitudes about COVID-19 has caused this issue to disappear from the national agenda, even as such sentiments continue to fester in Indonesian society.
While experts and government officials hope that over time this stigmatization will diminish as people gain more knowledge about COVID-19 with ongoing public education efforts, such hopes seem unrealistically optimistic.
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A survey conducted in August by LaporCovid-19, a civil society group that aims to improve the transparency of information about this virus, showed that the majority (55.8 percent) of the COVID-19 survivors surveyed revealed They experienced various types of stigmatization, including social exclusion and even harassment on social media, where they were called by names such as “virus carriers” or “super-spreaders.”
The survey is particularly puzzling when more than half of the respondents were healthcare workers whose courage, determination and experience are urgently needed in one of the most urgent periods in the country’s fight against a dangerous infectious disease. Indonesia has seen more than 3,000 new cases a day in the past week.
Meanwhile, more than 100 Indonesian doctors have succumbed to COVID-19, according to the Indonesian Doctors Association, one of the highest in the world.
SHAME OF THE COMMUNITIES
The targets of this shame extend beyond individuals to their families and even to their community.
A worker at an incineration company in a protective suit prepares bags of medical waste for loading onto a truck in Jakarta, Indonesia, on August 12, 2020 (Photo: Reuters / Willy Kurniawan).
In Jakarta, I met a neighborhood association (a rukun tetangga) whose members were not allowed to visit other neighborhood association areas because a member had contracted the virus.
Part of this fear is motivated by the prohibitive financial cost of contracting the virus. If someone is infected, he or she and their close contacts must be in isolation for 14 days, a cumbersome period of isolation few can afford when many lives depend on daily work.
People also point to the cost of testing, which many times exceeds an Indonesian worker’s daily wage of Rs 375,000 (US $ 25.70) per person, when entire families will have to be tested when one person contracts it.
This economic threat has created a crisis in society, facilitating the “otherness” of coronavirus patients when precautionary behavior that aims to separate the healthy from the infected incites suspicion and sows divisions.
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THE HIGH BETS
What is also at stake is the risk that such public sentiments will fuel a national health emergency.
While it is deeply troubling that prejudice, even discrimination, has come to characterize how Indonesians view heroic COVID-19 victims, the concern is whether such attitudes discourage people with symptoms from getting tested and allow them to remain. large stocks of undiscovered infections.
With around 200,000 cases in total, one of the highest in the region, experts warned that Indonesia’s testing rate of less than 8,000 per million residents remains one of the lowest in the world.
Its positive rate continues to persist at figures “well above” the World Health Organization standard of 5% for countries that have flattened the curve and are ready to enter a “new normal” of 14%, according to the spokesperson for the COVID-19 working group. Dr. Wiku Adisasmito.
Passengers wearing protective masks and face shields queue for a public bus, following the COVID-19 outbreak, at a central bus point in Jakarta, Indonesia, on July 27, 2020 (Photo: REUTERS / Willy Kurniawan).
Breaking this stigmatization will require proactive government intervention and social change.
It appears that a long time ago the Indonesian government had initially administered free tests targeting essential workers, when both the central government and regional authorities worked hand in hand to act together to standardize the tests.
The Bali provincial authorities had provided free testing for drivers transporting goods to this region, but discontinued this practice due to high costs reportedly amounting to Rs 2 billion per day.
In that vacuum, some logistics companies have reluctantly stepped in to bear the costs, which unfortunately can be reflected in higher consumer prices, but enforcement against companies that disobey health measures has been half-hearted and spotty.
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This also points to the problem of moral hazard in which companies left to their own devices in worker testing may be incentivized to avoid reporting cases entirely, where the rules require that workers who have come into contact with a case must be evaluated and operations must be closed completely. cleaning.
The problem is also that the Indonesian government appears to be hesitant in its overall national response to address the pandemic, which is seen in the patchy testing arrangements and inadequate contact tracing.
This tepid reaction only adds to the uncertainty gripping the nation, fuels the notion that only individual action and self-reliance can counter the spread of the coronavirus, and inadvertently reinforces the sense of stigma Indonesians bestow on the sick.
Another way to overcome fear is to encourage civil society to come together. Some villages, such as Cempluk in East Java, have developed mutual self-help systems to cope with this pandemic.
A student, wearing a mask and face shield, writes at school amid the coronavirus pandemic in Tegal, Central Java province, Indonesia, on July 13, 2020 (Photo: Antara Photo / Oky Lukmansyah via REUTERS).
Volunteers help distribute food and essential items so families can stay home.
Rather than alienating community members who contracted the virus, village leaders and community members abandoned those old mindsets to set good examples to care for villagers’ families, rice fields, gardens. and cattle.
To be fair, resilience like this can only be built because some communities in Indonesia already have strong ties and a certain level of social capital.
But in a country that is staring at the coronavirus at a tipping point in its fight, it is also small gestures of leadership like these that can make a big difference in bringing communities together and ending stigma.
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Made Supriatma is a Visiting Fellow, ISEAS – Yusof Ishak Institute, Singapore.
