Sunday, September 19

Fears for Indonesian provinces as delta variant spreads from Java | Global health

The scenes that for months have plagued hospitals on the island of Java in Indonesia are appearing across the country, as the Delta variant spreads to new provinces, causing shortages of beds and oxygen.

Images of overloaded hospitals in both Papua and Kalimantan have circulated on social media. A video shows a patient lying inside an ambulance., with two of his relatives sitting next to him. “People need help. [I] I have taken them to hospitals but they all turned us down. [The hospitals] He said there is no oxygen. How come the government can’t provide oxygen? “The ambulance driver can be heard, who recorded the video. The Twitter account reported that the patient eventually passed away.

On another image That has been widely shared, patients are treated on the terrace of a hospital in Jayapura, Papua, apparently for lack of space. A letter from one of the largest hospitals. in the city, which also circulated online, urged the mayor of Jayapura city and the head of the police station to provide more oxygen supply.

“This is a very difficult situation for us and this could put patients’ lives at risk,” wrote Fansca Titaheluw, director of the hospital, in the July 19 letter.

Indonesia’s daily infections have been among the highest in the world for the past week, with the majority of cases recorded in Java, which is home to 60% of the population. Medical facilities in the island’s big cities have been under immense pressure for months, unable to cope with the influx of patients. Many people have died in their homes, unable to find treatment.

According to data from the Health Ministry, the more aggressive Delta variant, which has been partly blamed for the crisis in Java, has spread to 11 provinces elsewhere. Health experts fear that those areas, which have weaker health systems, may face an even deeper crisis.

“From what I see, provinces outside of Java will not be able to deal with this. [surge]”Said Trubus Rahadiansyah, a public policy expert at Trisakti University.

Limited budget for regional quarantine, severe lack of medical staff, and limited health facilities are just three of the serious obstacles facing provinces, especially those in rural areas.

“Even before the pandemic, they have been struggling with a shortage of medical personnel and health facilities,” Trubus said.

Pandu Riono, an epidemiologist at the University of Indonesia, fears that if there is an increase similar to the wave experienced by Java, the death rate could be higher, because there are fewer resources. “People will suffer greatly if [there are] cases on the rise, like in the Java and Bali areas… The problem is that it is very difficult to scale the health facilities in those areas, ”said Pandu.

“The local government cannot do it by itself. They can receive help from the central government or international organizations. They should send the equipment (ventilators, oxygen) not only to the island of Java, but also to the outskirts of the island of Java. “

Only 1.1% of the country’s doctors and nurses – some 1,787 people – work outside of Java, according to a 2020 survey by Kompas’ Research and Development Department.

The number of physicians, including general practitioners, pulmonology specialists and internal medicine specialists, in Indonesia stands at 19,649 people. However, only 893 people, or 4.5%, provide services outside of Java.

The same inequality is also observed among the 140,071 Indonesian nurses. Only 894 nurses, or 0.6%, are outside of Java.

Pandu said the hiring process for doctors who have recently graduated must also be sped up, so that more staff can be deployed urgently.

Outside of Jakarta and Yogyakarta, the provinces with the highest number of cases per 100,000 include East Kalimantan, North Kalimantan, Riau Islands and West Papua. In each of these areas, at least a third of the tests performed are positive; in West Papua, this is the case for 40.2% of the tests.

On Tuesday, Papua Governor Lukas Enembe said people in the province should prepare for a shutdown throughout the month of August. The plan, which is still awaiting approval from President Joko Widodo, would include shutting down all transportation in and out of the province.

“Papua has not only human resource shortages, but also a shortage of medicines and health facilities,” said Adib Khumaidi, head of the risk mitigation team at the Indonesian Medical Association, who said he was aware of the proposal. .

Doctors from other provinces, such as South Kalimantan, South Sumatra, the Riau Islands and Lampung, have also reported an increase in cases, he said. “Some reported that their hospitals are full. Many of his medical workers were also infected with the virus. “

Trubus said the government needed to streamline its communications and deliver clear public health messages, and to work with religious and community leaders to raise awareness of the dangers Covid poses.

“This is a war with a very strong enemy, so we have to face it together,” he said.

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