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Jakarta Post

Coronavirus stigma runs deep and dangerous in Indonesia

As the coronavirus rippled across the world's fourth most populous country, it also carried a stigma that public health experts say has stopped people from getting tested in fear of being shunned, and complicated the response to the pandemic.

Kate Lamb and Stanley Widianto (Reuters)
Thu, September 17, 2020

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Coronavirus stigma runs deep and dangerous in Indonesia Employees work in an office in Kuningan, South Jakarta on Sept. 11, 2020. Nonessential workplaces and government offices are only allowed to have no more than 25 percent of their employees to work in the office at the same time during the new large-scale social restrictions (PSBB) period in Jakarta. (Antara/Akbar Nugroho Gumay)

W

hen Ari Harifin Hendriyawan's mother tested positive for the coronavirus, their neighbors brought a hammer and nails and boarded up the lane.

From his home in the lush foothills of Indonesia's West Java, the 23-year-old told Reuters the barricade appeared days after he received a negative test result and was at home self-isolating.

“I was angry of course," he said, "If I had not been restrained [by relatives], I don’t know what could’ve happened."

As the coronavirus rippled across the world's fourth most populous country, it also carried a stigma that public health experts say has stopped people from getting tested in fear of being shunned, and complicated the response to the pandemic.

For months Indonesia has struggled to stem a rise in transmission, with nearly 229,000 cases and a death toll of 9,100, the second highest in Asia after India. It also has one of the world’s lowest testing rates.

Indonesia’s COVID-19 taskforce spokesperson Wiku Adisasmito said the stigma those infected face remains a problem. He said the government was doing what it could to counter that.

“Stigma can only be erased by tirelessly promoting health to increase awareness about infections and empathy to help those in need,” he said.

Indonesia has drawn criticism from public health experts for its relative lack of testing, its patchwork social restrictions to contain the spread of the disease and a list of unscientific treatments praised by cabinet ministers. At least two ministers had also caught the virus.

From across Indonesia, more than a dozen healthcare workers told Reuters how the stigma around coronavirus had complicated their work or, in some cases, increased risks.

In the riverside city of Banjarmasin on Borneo, hazmat-suited civil servants told Reuters of how their arrival caused panic in the streets. They now ask contacts to visit the health center to avoid unwanted attention - even though that could increase the risk of contact and transmission.

From Medan, North Sumatra, nurses recounted how they were expelled from a village in March and told the virus was fake news, while others have received abusive phone calls from parents, perplexed as to why their child, but not another, had contracted the disease.

Night-time convoys

In remote West Papua, so deep is the fear that nurses have on several occasions escorted patients into quarantine in the dead of night – pre-arranged convoys of motorbikes snaking along jungle roads.

“The patients themselves requested this,” nurse Yunita Renyaana, told Reuters via Zoom. "They would say, ‘Sister, not tomorrow, come tonight so nobody knows... They were afraid of the stigma, of being seen as a disgrace, or a source of contagion."

A survey by Lapor COVID-19, an independent coronavirus data initiative, and researchers at the University of Indonesia last month found that 33 percent of 181 respondents reported having been ostracized after contracting the coronavirus.

“This stigma phenomenon is costing people’s health and also their mental health,” said Dicky Pelupessy, a psychologist involved in the survey. “There are cases where people just don’t want to be tested, don’t want to be seen as having contracted the virus.”

On the islands of Java, Sulawesi and Bali, bereaved families have also barged into hospitals to claim bodies of COVID-19 victims, fearing their relatives might not be given a burial in line with religious beliefs.

Dozens were subsequently infected.

“The government is not doing enough to really educate the people,” said Sulfikar Amir, a disaster sociologist at Nanyang Technological University in Singapore, “That’s one of the reasons we have seen extreme reactions.”

Among various Indonesian government initiatives is one with the Johns Hopkins Center for Communication Programs and some 25,000 field workers to help share information about the coronavirus, including through Facebook, to help improve awareness and counter fake news and stigma.

But months into the pandemic, many still feel isolated.

Ari's mother was asymptomatic and stayed isolated for over a month, he said, but he still feels shunned by neighbors.

Reflecting on the experience, Ari, now unemployed after the cafe he worked in closed due to the virus, said the response lacked empathy, and logic.

“I think they’re afraid," Ari told Reuters, "Maybe for them the coronavirus is as big as an elephant."

 

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