Indonesia ignores sanitation, waterborne diseases loom: WB

Irawaty Wardany, The Jakarta Post, Denpasar, Bali

Despite the progress in economic development in Indonesia, sanitation has remained a major challenge facing the country, a World Bank executive says.

Almud Weitz, regional team leader of the Water and Sanitation Program for East Asia and the Pacific, told a media workshop here Monday the problem lay with the absence of investment in the sanitation sector.

Indonesia has the lowest percentage of urban sewage treatment among neighbors the Philippines, Vietnam and Cambodia.

The survey found only 2 percent of urban sewage in Indonesia was treated.

"The three other countries have invested much in sanitation. They have been really into it," Weitz said.

She added that around 60 percent or about 80 million people in Indonesian had no access to sanitation, inflicting US$6.3 billion in economic losses annually on the country.

Failure to act immediately would only cause the next generation to bear the consequences, she said.

"Bad sanitation leads to waterborne diseases such as diarrhea that claims over 100,000 lives of children every year," she said.

Head of the subdivision for drainage and garbage at the National Development Planning Agency Oswar Mungkasa acknowledged Indonesia had not yet developed a sound sanitation system.

"Statistically 68 percent of Indonesian people have access to sanitation systems, but it does not meet the standard of proper sanitation," he said.

He said 70 percent of wells in Jakarta were polluted by E. coli bacteria as many septic tanks were located too close to wells.

Oswar said the government was not the only one responsible for the sanitation problem.

"People need to take responsibility. How you can possibly expect the government to provide sanitation to all Indonesians?"

He said the government was only responsible for providing access to public sanitation facilities such as public toilets and sewage treatment systems.

Low public awareness of sanitation is one of the problems, with people in many places still defecating in rivers, the main source of water for their daily needs.

"They brush teeth, wash and bathe in the same river where they defecate. They do not realize (they're attempting to live a) healthy lifestyle in an unhealthy environment," Oswar said.

Director of environmental health at the Health Ministry Wan Alkadri said the ministry was organizing a community empowerment program called Community-Led Total Sanitation that had been used since 2005 in six provinces: South Sumatra, East Java, West Java, West Nusa Tenggara, West Kalimantan and Jambi.

"The program is quite successful in changing people's habits. There are 160 villages in those provinces (where people) no longer defecate (in unsuitable places)," he said.

Bandung Zoo immunizes birds

The Jakarta Post

BANDUNG, West Java: The Bandung Zoo on Tuesday vaccinated some 700 various species of poultry in its collection to prevent the spread of bird flu, especially to visitors.

The zoo's animal care head Fathul Bahri said the birds were vaccinated once every four months.

"This is the eighth time we have vaccinated the birds since 2005," Bahri told reporters in Bandung on Tuesday.

Bahri said the Bandung Agricultural Office provided the H5N1 virus vaccines, adding the zoo kept 105 species of birds which were placed in 10 different enclosures.

He added that thus far the vaccination program had proven effective because none of the birds had abruptly died or been detected with the virus.

Ten die of dengue in E. Kalimantan

Nurni Sulaiman, The Jakarta Post, Balikpapan

The East Kalimantan provincial government has called on people in the province to be alert to dengue high fever, after an outbreak caused the deaths of ten people in the past two months.

The provincial health office also asked hospitals and public health centers to remain open to those infected by the endemic disease regardless of their economic background.

"We have disseminated through local media, including TV and radio stations, necessary information on the disease and preventive actions to have the people be alert of its risks," provincial health office chief Dyah Muryani said here Tuesday.

She said many people knew little about the disease left it too late to come to the hospital.

"Since January, 372 patients with dengue fever have been treated in Balikpapan, 32 in East Kutai and 29 in Tarakan. Many died because they were brought too late and, therefore, all people, especially those living in urban areas, should enhance their alertnes by rushing to clinics or hospitals those with dengue symptoms and keeping a healthy and clean environment," she said, adding locals should know that the disease's symptoms included fluctuating body temperature and severe headaches.

Since last December, six have died in Balikpapapan, and two each in Tarakan and Sangatta, East Kutai regency.

Diyah said that after being infected, victims would suffer from a high fever for several days "and the high fever is usually on and off. After the three-day incubation period, hot spots appear on the victim's whole body and bleeding could happen in the higher phase depending on their body's immunity."

He said that dengue was a serious disease which was more ferocious than HIV/AIDS because it could kill within days.

"Residents should improve their alertness also because of the changing climate during the rainy season could affect their body's immunity. Therefore, those with a high fever that lasts than one day should be rushed to a hospital or clinic for observation and medication because the disease does not always shows its physical symptoms."

Dengue regularly kills people around the archipelago, including Jakarta during the rainy season.

Riau haze blamed for rise in health woes

Rizal Harahap, The Jakarta Post, Pekanbaru

The Riau Health Office announced Monday 1,547 people were suffering from a number of afflictions from the haze caused by forest fires in the province over the past two weeks.

Residents in a number of regencies have developed respiratory infections, skin irritations, conjunctivitis and diarrhea.

"The diseases are always imminent during the recurrent haze and dry seasons," said Burhanuddin Agung, head of nutrition and medical care at the health office.

Data gathered over the weekend from Rokan Hulu, Rokan Hilir, Indragiri Hulu and Bengkalis regencies, indicated 1,095 people have already contracted respiratory infections.

The most affected area is Rokan Hulu, where there are 702 cases. As many as 150 people have reported skin irritations in the regencies, 29 of them suffering from eye irritation and 19 from conjunctivitis.

"The number affected could be higher because seven other regencies have not sent in their reports, including Dumai, which is likely to be the worst hit area," said Burhanuddin.

Surging numbers of people seeking treatment in Pekanbaru's hospitals and community health centers show that respiratory disease has doubled in the area.

At the Arifin Achmad General Hospital, for instance, the number of respiratory disease patients seeking treatment reached 25 each day compared to around 10 before the fires.

"The conditions are like this every haze season. Patients not only come from Pekanbaru but also from outside the city. Their conditions are generally not too chronic and they can still be treated as outpatients. Only six patients are currently receiving in-patient treatment," said hospital spokesman Nuzeli.

Besides those being treated for respiratory diseases and irritation, the number of diarrhea patients is also on the rise. In the past week, the number of patients in the four regencies has reached 254.

"Based on our experience, the number of diarrhea patients usually goes up during each haze season. There is no correlation between diarrhea and forest fires. It's actually the rainfall because rural residents still depend on rain for their source of drinking water. During minimum rain, they are forced to seek other means of water, even if it is unsafe. This is believed to have triggered the rise in the number of diarrhea patients," said Burhanuddin.

The Riau Health Office has set up health posts in 11 regencies and cities across the province in a bid to monitor and overcome the impacts of forest fires.

It has distributed 30,000 masks in Siak, Bengkalis, Dumai and Rokan Hilir; areas it predicts will face the worst impacts of the haze.

The health office has also distributed 2,000 free masks in Pekanbaru. The provincial administration has also requested the central government provide an additional 100,000 masks to replenish its stock.

"Other logistics, such as medicine, are still adequate," said Burhanuddin.

Bird flu as biological weapon "nutty" idea, says Gates

JAKARTA (JP): United States Defense Secretary Robert Gates has denied allegations by Indonesia's Health Minister Siti Fadilah Supari that his country is developing biological weapons frombird flu strains found in Indonesia.

"I think it's the nuttiest idea I've ever heard," Gates said Monday after addressing his speech to the Indonesian Council on World Affairs at the Four Seasons Hotel, South Jakarta.

Siti's book, It's Time for the World to Change, Divine Hands Behind Bird Flu, alleges the U.S. and the World Health Organization are conspiring against developing countries by seizing control of bird flu samples.

The book says virus samples being sent to a laboratory in Los Alamos are under U.S military control.

After meeting with President Susilo Bambang Yudhoyono and Defense Minister Juwono Sudarsono at the State Palace, Gates said he did not discuss the issue with the President.

"I respectfully and strongly disagree with the minister, andit is not true that the United States offered military equipment if the book was withdrawn," he said in response to allegations that the U.S would provide military aid for Indonesia as long as the English version of the book was withdrawn.

Presidential spokesman Dino Pati Djalal said any claim the U.S designed the virus as a biological weapon was a personal view of the minister and not the President.

U.S State Department spokeswoman Susan Stahl recently denied Siti's claim.

Recently, Siti said she was pulling the English version of the book from distribution after less than a month, citing inaccurate translations as the main reason.

The book was launched on Feb. 6 and is a 182-page memoir recording Siti's struggle to change the allegedly unfair virus sample sharing.

She claimed the system was not transparent and did not accommodate the needs of developing nations.

The Indonesian government decided to stop sharing virus samples early last year following a perceived leakage in the GISNas vaccine makers in developed countries could obtain samples sent by Indonesia to produce bird flu vaccines.

However, the government resumed sharing last week and sent 12 samples to the Center for Disease Control and Protection in Atlanta, Georgia. (anw/dsy)

Red Cross organizes emergency drill

The Jakarta Post, Jakarta

Thousands of people in coastal Muara Baru, North Jakarta, took part Sunday morning in a two-hour disaster drill aimed at preparing residents and authorities to respond to a tidal wave.

Up to 2,000 Muara Baru residents were involved in the drill, which was organized by the Jakarta chapter of the Indonesian Red Cross.

Jakarta Deputy Governor Prijanto said good coordination and communication were important in responding to any disaster.

"Too often flood-affected residents refuse to move to shelters set up by the government, saying they want to stay close to their houses," he said.

The drill, the first ever in Indonesia to prepare residents and officials to respond to a tidal wave, was part of a Red Cross campaign to increase public awareness about the threat of tidal waves.

During the drill, residents were led to open and higher ground, in this case an unused field owned by a real estate company, where the Red Cross had set up a coordination post.

Residents were instructed to use the main road, instead of the narrow lanes of their densely packed neighborhoods, and head for the post, located about a kilometer from the coast.

The post included emergency medical assistance, a pharmacy, shelters and kitchens.

The drill also involved hundreds of personnel from the National Search and Rescue Agency, the provincial natural disaster coordinating unit, the Jakarta Military Command, the Jakarta Police and the Navy's Western Fleet.

Trained locals also participated by sounding an early warning to the tidal wave and then providing first aid.

Though usually a seasonal phenomenon, because of global warming and environmental degradation, high waves have caused losses to coastal residents over the past few months in the form of floods and by preventing fishermen from going to sea.

In early February, flood victims in Kampung Rawa, West Jakarta, built shelters on nearby railway tracks. They said the shelters provided by the government were too far from their homes.

Jeung Park, a representative of the International Federation of Red Cross and Red Crescent Societies, said the Indonesian Red Cross was measuring and evaluating its capacity to deal with a tidal wave disaster with Sunday's drill.

"Although there are weaknesses, like in the information system, it's a good thing that they can learn from the simulation," he said. (dre)

UNESCO workshop urges ICT use in HIV/AIDS awareness

Mohammad Reiza, President University - The Jakarta Post

The National Education Ministry, in collaboration with the Jakarta office of the United Nations Educational, Scientific and Cultural Organization (UNESCO), the Indonesian National Commission for UNESCO, Braillo Norway and ASPnet/iEARN organized a three-day national workshop on "Using ICT as a Tool to Get Updated Information about HIV & AIDS".

The workshop ran from Feb. 1-3 at the LabSchool-Rawamangun in East Jakarta, and was officially opened by Dr. Arief Rachman, executive director of the Indonesian National Commission of UNESCO.

Ngo Thanh Loan from the UNESCO office in Bangkok and Alexander Hauschild of Braillo Norway attended the workshop as observers.

Forty teachers, who represented 18 secondary schools, four universities and two government institutions, were invited from across Indonesia to participate in the workshop.

They were given updated and detailed information on the HIV/AIDS issue in Indonesia through a presentation by Mira Fajar of UNESCO Jakarta.

Meanwhile, the ASPnet/iEARN Indonesia team, led by national coordinator Hasnah Gasim, delivered presentations on Project Based Learning and iEARN Indonesia projects in relation to the nationwide HIV/AIDS epidemic.

Participants also were directed to join the iEARN teachers network and instructed in how to use a mailing group.

Loan shared her expertise on the HIV/AIDS Clearinghouse run by UNESCO Bangkok, while Braillo's Hauschild guided the participants in using the AVERT system and in creating lesson plans.

Pelita Ilmu Foundation, the first non-governmental organization in Indonesia to focus on HIV/AIDS, also took advantage of the occasion to present its ongoing projects DAKU! (Dunia Remajaku Seru) and Plan Indonesia, which provided an information session about the Indonesia Child Helpline, TESA 129.

What made the workshop distinctive was that participants were divided into groups to create lesson plans that could be entered in the lesson plan writing competition organized by UNESCO Bangkok.

On the last day, three groups from the Labschool, Al-Izhar and SMA 1 senior high school Karawang presented their lesson plans.

In their concluding remarks, Hauschild and Loan urged the participants to add another significant issue: changing the social stigma against people living with HIV/AIDS (PLWHA), underlining that PLWHA should not be subjects of social discrimination.

In closing, Dr. Arief Rachman hoped that the participants would share the information they had gained from the workshop with other teachers and transfer the knowledge to others, to spread awareness of HIV/AIDS.

Harm reduction -- Part II: Need for more realistic, compassionate public edu

Jane Raniati, Contributor The Jakarta Post, Gianyar, Bali

According to Octavery "Very" Kamil, head of the Injecting Drug Users Intervention Unit at Aksi Stop AIDS! (ASA) of Family Health International-Jakarta, a major challenge in the battle against the negative health and societal problems of drug abuse is the heavy stigma placed on users of any kind of illegal drug -- when in fact there are many different kinds of drugs, some of which are more likely to lead to addiction and other problems.

The National Police campaign, which uses slogans implying that any use of any kind of drug will ruin one's life, is neither accurate nor effective, according to Very.

For example, Very relates an interview with an injecting drug user (IDU): "In 2000, (the user) had already seen ads and posters about (the National Police campaign). But he had already tried ganja (marijuana) and ecstasy by then and felt no addiction or problem, so he didn't believe the message. So then he tried heroin, and eventually became an addict."

The issue of drug abuse thus concerns both the availability of the drugs and the dissemination of incomplete or inaccurate public education messages.

Asked for a better, alternative message, Very replied: "What is addiction? It doesn't happen in a moment. It's a process."

More realistic information is the key -- and people need to know about the different types of drugs available.

Heroin and shabu-shabu (methamphetamine), Very says, were more likely to leave one with withdrawal symptoms, and thus more likely to lead to addiction and associated problems. This includes HIV infection, due to the tendency to use these drugs by injection to get a faster and more cost-efficient hit.

Very suggested that more efficient approaches might include "life skills education" programs at schools or in youth groups that teach young people skills for making better decisions in life.

Overall, he says, drug prevention programs (the demand reduction side of the equation) in Indonesia are generally still weak. While some very good programs exist, including those implemented by Yayasan Cinta Anak Bangsa (YCAB) and Yayasan Kita (Yakita), their reach is not yet broad enough.

"Drug education for students and young people is important," he said, "but it must be non-stigmatizing, and it must not ignore the fact that many high school students have already used drugs."

A 2002 behavioral survey among high school students in Jakarta, implemented by the Health Ministry with technical and financial support from the ASA, reported that 34.2 percent of boys and 6.3 percent of girls had never used any drugs, while 2.5 percent and 0.6 percent, respectively, reported use by injecting. Surprisingly, alcohol use was lower, at 29.8 percent and 4.3 percent, respectively.

Very is emphatic that, despite campaign messages implying that anyone who tries drugs has ruined their life, "We must not give up on those people". Information must be given to young people about what to do if a friend or sibling is using and needs help.

He added that while in the United States, the old "Just Say No!" approach to drug education had been replaced by a more moderate "Safety First" approach, Indonesia's approach was still largely modeled on "Just Say No!".

Determining the success rate of supply reduction and demand reduction efforts here is difficult, since various indicators can be used to judge this. According to Very, however, these efforts are still very minimal.

"The fact is, drugs are still a big problem in Indonesia. Actually, internationally this is also the case," he said. "As yet, there has been no mainstream global policy on drugs that has demonstrated success."

It thus seems clear that harm reduction is an important and necessary component of efforts to tackle both the problem of drug abuse and the HIV/AIDS epidemic.

More information and help

* Family Health International (FHI) www.fhi.org
* National Narcotics Agency (Badan Narkotika Nasional) www.bnn.go.id
* Komunitas AIDS Indonesia www.aids-ina.org
* Yayasan Cinta Anak Bangsa (YCAB) www.ycab.org Hotline: 0-800-1-NO-DRUG (663784)
* Yayasan Harapan Permata Hati Kita (Yakita) www.yakita.or.id Hotlines: Jabodetabek (0251) 243069, 243077; Aceh (0651) 23213; Bali (0361) 465203; Bogor (women's center) (0251) 244375; Kupang (0380) 821425; Makassar (0411) 873658; Surabaya (031) 5039228

Related Article:

Harm reduction -- Part I: Combating drug abuse

Indonesia resumes sharing bird flu samples

Radio Netherlands

Published: Friday 22 February 2008 09:59 UTC

Jakarta - A spokesperson for the World Health Organisation (WHO) says Indonesia sent 12 bird flu samples to a WHO laboratory this week for the first time since August 2007. Jakarta stopped sharing its virus samples in December 2006 as it feared that they would be used to make vaccines that poor countries could not afford. Indonesia has not said what prompted the change in policy.

Last August, Indonesia did send two samples to the WHO to prove that the virus had not mutated after the organisation accused Jakarta of endangering world health by failing to share its samples. The WHO also said Indonesia was endangering its own population as any vaccine developed would not contain components of the variant prevalent in the country.

Bird flu is endemic in Indonesia and the country has been hardest hit by the H5N1 variant, which has a mortality rate in humans of more than 60 percent. So far, 105 Indonesians have died after being infected with H5N1, 11 of them this year alone. At present H5N1 is not easily transmissible between humans but scientists fear it could mutate into a transmissible form and spark a global pandemic and kill millions of people.

Day care center gives family quality time

The Jakarta Post, Jakarta

For people working in a big city like Jakarta, a quality get-together with the children can be hard to afford. For many young mothers, leaving babies with nannies is not an option.

Susi, who works at the Forestry Ministry on Jl. Gatot Subroto, South Jakarta, has brought her daughter to the office since she was only 3 months old.

"The office provides a day care center ... it's very helpful," the Cipinang resident said.

Two-year-old Aliah is still breast-fed, Susi said.

"Knowing that my daughter is practically within reach, I can monitor her all the time," Susi told The Jakarta Post on Wednesday.

"During my lunch break, I always spend my time with her," she said.

Susi prefers to leave her only child with trained nurses at the center, instead of hiring a babysitter or a domestic worker to take care of her at home.

There have been many reports of housemaids and babysitters who failed to do their job. In some serious cases, they have abused employers' children physically and mentally, and have even abducted them.

Many parents, however, rely on maids or nannies and there are numerous employment agencies offering these services at affordable prices.

At the Forestry Ministry's Sylva Day Care Center, the monthly fee is Rp 300,000 for children of ministry employees or Rp 450,000 for the general public. Parents can pay on a daily basis, costing Rp 30,000 or Rp 45,000 for the public, or weekly at Rp 100,000 or Rp 170,000.

Built in 1993, the center receives children aged between three months and four years old.

"The main goal of establishing the center was to help the ministry's employees take care of their children. Working mothers can meet their children here anytime," assistant manager Ita Billy Hindra said.

Sylva Day Care has three nurses and can accommodate up to 20 children, Billy said.

It provides snacks and meals for children.

Deni, who works in a private company on Jl. Sudirman, entrusts his 14-month-old son, Nabil, to the center because it is near his home and workplace.

"I learned about the center from the Internet. My wife and I began bringing our child here one month ago because it is relatively close to home in West Jakarta," Deni said, adding that day care centers were good for his son's growth.

"Nabil was a shy boy but he's not anymore," he said.

"He also has many friends here."

Another facility, Makara Children's Development Center, was launched by the University of Indonesia School of Psychology last week.

Dean Dharmayati Utoyo Lubis and her colleague, Diennaryati Tjokrosuprihatono, inaugurated the center for UI lecturers' and employees' children, aged from one to four years.

"Many lecturers brought children to work because they didn't have a housekeeper or a nanny. Then we had the idea to help the mothers by establishing this center so parents could work peacefully without worrying about their children," Yati said at the opening of the center in the school compound.

To run the center, Yati said, the School of Psychology cooperated with the School of Medicine, the Dental School and the School of Nursing Sciences.

"Makara is different from nurseries because it also has a health clinic for children.

"We also provide two dentists, two doctors, two nurses and two psychologists to take care of them," Yati said, adding that parents could also monitor their children via the Internet.

The center can accommodate up to 20 children. The attendants teach children to brush their teeth, wash their hands before and after meals, and to go to the toilets by themselves.

Household products producer PT Unilever Indonesia has provided a nursery and a day care program for employees since 2002.

Unilever external communications manager Nurulita Novi Araida said the nursery was provided for breast-feeding employees and children under five years old.

"We provide a nursery room and a nurse for mothers who need assistance," Novi said, adding that the facility could accommodate up to five children.

The day care center only opens one week before Idul Fitri and two weeks after.

The center does not open daily because the company does not have proper facilities to care for children, Novi said.

"Many working parents need assistance at that time because maids or nannies go back to their hometowns," she said.

The center was open daily, before and after Idul Fitri, for up to 30 children aged below eight, Novi said.

"And it's free of charge," she added.

Indonesian Toilet Association raises stink over cleanliness

Adianto P. Simamora, The Jakarta Post, Jakarta

The lack of clean public facilities in the country attests to the apathy most people feel regarding the issue of toilet cleanliness, according to a concerned group.

"Most Indonesians still look down on toilets although they use them at least five times a day," said Naning Adisowo, chairwoman of the Indonesian Toilet Association.

"Sorry to say, most toilets in state buildings are badly designed, forcing the user to spray a lot of water," she said.

She estimated that on average, an Indonesian uses 21 liters of water in the toilet per day.

"There must be action from the government to promote clean toilets that use less water. It could be part of the effort to mitigate a potential water crisis due to climate change," she said.

"Clean toilets do not have to be luxurious. It is more important to have the design be eco-friendly and use less water and energy."

Naning pointed to several countries where toilet cleanliness is a top priority.

"Several countries, including Singapore, China and Thailand, are selling their clean toilets to attract tourists," she said.

The Chinese government has promoted the use of green toilets to welcome millions of athletes, officials and visitors to the 2008 Olympic Games in August.

Naning, who is an interior designer, began to realize the importance of clean toilets after being invited to the World Toilet Organization-sanctioned World Toilet Forum in 1999.

She set up the Indonesian Toilet Association in 2001.

"Since then, we have campaigned to change the public mind-set on clean toilets," she said.

The association travels to cities to inspect the quality of toilets both in private and state buildings.

"We have invited officials from state offices, including the Health Ministry and the State Ministry for the Environment, to discuss the issue but there has not been a positive response. They laugh at our program," she said.

"I say a nation without good toilets is a nation without culture. Dirty toilets are a national embarrassment."

Naning said the Jakarta administration pledged to set up green public toilets, but never followed through with action.

"I think it (dirty toilets) discourage tourists from visiting Jakarta," she said.

"We are now lobbying the administration of Yogyakarta to establish green public toilets and make it a selling point to attract tourists."

The association also visits schools and universities to teach students about proper toilet behavior and "ecological sanitation".

"We also plan to provide free-of-charge training to cleaning service staff on how to maintain toilets," she said.

The majority of Indonesia's 220 million citizens do not have access to proper sanitation, including toilets.

The National Development Planning Board said poor sanitation caused potential economic losses of US$6.34 million annually and led to the deaths of 100,000 toddlers every year.

There are a number of international forums on toilet issues, including the Singapore-based World Toilet Organization and the World Toilet Association in South Korea.

Currently, the WTO has 91 member organizations from 46 countries.

"But officials from the Indonesian government never attend the toilet forum," she said.

Dengue infects 74, killing one in C Java`s Karanganyar

Karanganyar (ANTARA News) - The outbreak of dengue fever in Karanganyar district, Central Java, has infected 74 people and killed one suffer since January this year, said Warsito of the local health service office here on Wednesday.

He said that a total of 400 people were infected with dengue in 2007, three of the patients died.

In Central Java, at least 37 people died of dengue fever last month. According to the record of the Central Java provincial administration, there were 2,347 cases of dengue fever in January 2008.

"But this figure shows a decrease compared with that of the same period last year when it stood at 2,518 cases with 62 fatalities," Hartanto, the head of the Central Java health service, said here over the weekend.

The dengue fever cases in Central Java were found among others in the districts of Jepara (548 cases), Kudus (212), Tegal (118), and Grobogan (104), he said. During the first two weeks of February 2008, at least 57 local people were infected with the dengue fever virus.

The total number of dengue sufferers in Central Java in 2007 was 20,361 including 327 fatalities. It increased two-folds from that of 2006 when the figure was recorded at 10,924 cases with 337 dead toll.

Bird flu kills 3-year-old boy in Indonesia, second case reported in one day

The Jakarta Post

JAKARTA (AP): Bird flu killed a 3-year-old boy and ateenager in Indonesia, the health ministry announced, bringing the country's death toll from the disease to 105.

The latest victim was identified only as Han, a 3-year-old boy from the capital, Jakarta, who died Friday at a hospital in the city, radio El-Shinta reported Saturday.

Nyoman Kandun, a senior Health Ministry official, confirmed the report but did not provide details.

Laboratory tests confirmed the boy had the dangerous H5N1 strain of the bird flu virus, Kandun said. It was not clear how he was infected.

Earlier Saturday, the Health Ministry said a 16-year-old Indonesian boy from Central Java province died of bird flu. The boy, whose name was not disclosed, became ill on Feb. 3 with a cough and other respiratory symptoms, according to the Health Ministry's Web other respiratory symptoms, according to the Health Ministry's Web site.

He died a week later in a hospital in the city of Solo, about 450 kilometers southeast of Jakarta, said Sumardi, a ministry spokesman. Like many Indonesians, he goes by one name.

Tests confirmed the teenager had been infected by the H5N1 virus, the ministry's Web site said.

Bird flu kills 16-year-old boy in Indonesia, bringing nation's toll from illness to 104

Herald Tribune, Published: February 16, 2008

JAKARTA, Indonesia (AP): A 16-year-old Indonesian boy has died of bird flu, bringing the nation's death toll from the illness to 104, the Health Ministry said Saturday.

The boy became ill on Feb. 3 with a cough and other respiratory symptoms, according to the Health Ministry's Web site.

He died a week later in a hospital in the city of Solo, about 280 miles southeast of the capital, Jakarta, said Sumardi, a ministry spokesman. Like he many Indonesians, Sumardi goes by one name.

Tests confirmed the boy had been infected with the dangerous H5N1 strain of the bird flu virus, the ministry's Web site said.

The victim's neighbors had sick chickens on their property and the boy apparently slaughtered some of them before he became ill, the ministry said.

Indonesia has regularly recorded human deaths from bird flu since the virus began ravaging poultry stocks across Asia in 2003.

Bird flu remains hard for people to catch, but health experts worry the virus could mutate into a form that passes easily among humans, sparking a pandemic. So far, most human cases have been linked to contact with infected birds.

Scientists have warned that Indonesia, which has millions of backyard chickens and poor medical facilities, is a potential hot spot for a global bird flu pandemic.

More than 225 people have died worldwide from the virus, according to the World Health Organization.

Indonesian girl contracts bird flu in new family cluster: WHO

The Jakarta Post

JAKARTA (AP): The daughter of an Indonesian women whotested positive for bird flu has also contracted the virus, the World Health Organization said Wednesday, in what could be a case of human-to-human transmission.

The 14-year-old girl was in critical condition at a Jakarta hospital, the WHO said on its Web site. The girl's 38-year-old mother has been hospitalized with the bird flu virus since Jan. 26.

"She was exposed to her sick mother... and spent time in a neighborhood where chickens and other birds were found," the WHO statement said, adding the source of infection was still under investigation.

Further tests will be needed to establish whether the daughter contracted the virus from contact with her mother or from an infected chicken or its droppings - the source of most of Indonesia's 103 fatal cases.

New health scheme goes ahead

The Jakarta Post, Jakarta

State health insurance company PT Askes said Tuesday it was ready to continue partnership with the government under a new health insurance scheme proposed by the Health Ministry.

Company director I Gede Sumbawa said his team had confirmed with the ministry its commitment to the cooperation.

However, he said, the two parties needed to discuss the scheme further, as some items in the government's proposal did not fit with the company's responsibilities.

"The new scheme requires us to do the financial reporting, while in fact, that job is not part of our responsibility. We can't report something we don't do," he said after a discussion here.

Health Minister Siti Fadilah Supari said the company's concerns would not affect the new scheme.

"If they refuse to do the financial reporting, we can ask other institutions to do it," she said after delivering a speech at the same discussion.

The new scheme was proposed in response to the frequent overdue payments from PT Askes.

Siti also accused the company of lacking transparency when it came to hospital insurance claims.

Under the new scheme, the Finance Ministry will disburse funds to the appointed bank accounts of hospitals treating low income patients, instead of the money being channeled through Askes.

PT Askes' new responsibility will only include identifying patients entitled to the program, distributing insurance cards and preparing monitoring and financial reporting.

The director general of medical services at the ministry, Farid W. Husain, earlier said that to prevent possible insurance claim markups, the government would place 2,650 independent auditors in appointed hospitals.

"The verification team will be monitored by our internal auditor (the ministry's Inspectorate General and the Supervision of Finance and Development Agency), as well as by the Supreme Audit Agency," he said.

Despite massive promotional efforts for the new scheme, hospitals appointed for the program said they had received no formal notice about it.

Head of the Indonesian Regional Hospital Association, Hanna Permana, said none of its 438 members had been informed about the scheme.

"I have received many reports saying the new scheme has confused hospital managements," he told The Jakarta Post.

"They also complained the new scheme was already in place even though they hadn't received last year's overdue payment of hospital claims."

The government has allocated Rp 4.6 trillion (around US$497 million) to cover health insurance for 76.4 million low income people this year. (dia)

Dengue fever outbreak hits Yogyakarta

YOGYAKARTA (The Jakarta Post): At least 124 people were treated at Sardjito Hospital in Yogyakarta for dengue fever from January to Feb. 10, with one death.

Hospital spokesman Trisno Heru Nugroho said the number of patients was expected to continue rising, a situation he blamed on poor sanitation in the city.

Heru said the hospital had treated 78 dengue fever patients as of last week, but the number jumped to 124 within days.

"Within one week there were 46 additional dengue fever patients being treated at the hospital," he said.

Despite the surge in the number of patients, the hospital has been able to cope, he said.

He said last year the number of dengue patients treated at the hospital was 475, or 39 per month.

To avoid more patients, he said, joint sanitation efforts had to be launched.

"If part of the population of a village does not want to join the sanitation program, all of the residents will be at risk of infection," he said.

Two dies of rabies in Flores

KUPANG, East Nusa Tenggara (The Jakarta Post) : Two of the 40 people infected with rabies over the last two weeks in West Manggarai regency, East Nusa Tenggara, have died, an official said Tuesday.

All of the infections resulted from the victims being bitten by dogs.

IG Ngurah Harijaya, head of the West Manggarai Health Office, said in a report to East Nusa Tenggara Governor Piet A Tallo the regency's death toll from rabies was now four this year.

Ngurah said the 40 rabies cases were recorded in five districts: Komodo with 15 cases, Sanonggoang (2), Lembor (15), Kuwus (5) and Macang (2).

"There was an increase in the number of infections in nearly each district," he said.

According to data from the East Nusa Tenggara administration, of about 200,000 dogs in Fores and Lembata, 50,000 have not been vaccinated.

The data also show 134 out of 647 peopled infected with rabies over the past 10 years have died.

Some 165 people hospitalized

Andi Hajramurni, The Jakarta Post, Makassar

At least 165 people were admitted to hospitals and clinics with suspected food poisoning in Makassar, South Sulawesi, on Saturday after eating together at a neighbor's home after prayers.

Dozens were still being medically treated on Sunday.

The victims said they were poisoned "after eating at Yuddon's house" -- one of their neighbors, on Jalan Abubakar in Lambogo, Makassar.

Head of Makassar Health Agency Naisyah Tun Azikin said 165 people had received treated across 10 hospitals and clinics in Makassar and nearby Takalar regency.

"Initially the victims were treated at Bara-Baraya clinic, but were then transferred to hospitals to get better and more intensive treatment," Naisyah said.

More than 50 people were treated at Labuang Baji hospital. Others were admitted to hospitals including Wahidin Sudirohusodo, Faisal, Ibnu Sina, Stella Maris and Bhayangkara, Naisyah said.

Some patients admitted to Labuan Baji hospital received treatment while they waited in corridors due to the limited number of rooms at the hospital, she said.

All the patients reportedly suffered similar symptoms including dizziness, vomiting, diarrhea and stomach aches.

"At first, I just thought I was a little dizzy, but after vomiting several times, I suspected I was being poisoned," Samaria, one of the victims, said.

Naisyah said she believed meals offered at the prayer meeting contained a poisonous substance.

She said her office had sent samples to the forensic laboratory of South Sulawesi Police Office and to the Food and Drug Monitoring Agency for analysis.

West Makassar Police said they had questioned Yuddin and his wife, Rahmatia, and the chef about the food they served during the event.

The police had yet to determine any suspects in the case.

"We just asked them several questions in connection with the incident," head of the West Makassar police criminal unit, Adj. Comr. Ronald Sumigar said.

"Now, we are waiting for the result of investigations and examination from the forensic laboratory and the agency," he said.

Harm reduction -- Part I: Combating drug abuse

Jane Raniati, Contributor The Jakarta Post, Gianyar, Bali

While drug abuse is a broad problem encompassing many potential causes and consequences, both personal and societal, the problem of associated HIV infection is becoming one of the primary concerns due to the rapidly rising proportion of HIV/AIDS cases that are linked to injecting drug use.

According to a 2005 study by the National Narcotics Board (BNN) and the University of Indonesia, approximately 1.5 percent of Indonesia's population (3.2 million people) abuse drugs; 25 percent of them by injecting. Furthermore, 60 percent of these injecting drug users (IDUs) are estimated to be infected with HIV.

In the same study, the Communication and Information Technology Ministry estimated that 15,000 people die each year in Indonesia due to drug abuse, either from overdose or from AIDS. In addition, according to an article on the BNN website (www.bnn.go.id), 2006 saw more than 15,000 cases of secondary school students who were "victims of illegal drugs", with over 4,000 among junior hih school students and over 11,000 among senior high school students.

The first case of HIV due to injecting drug use (IDU) was reported in 1993. According to the Health Ministry, only 1.1 percent of all known HIV/AIDS cases by December 1995 were due to IDU, but by December 2000 this figure had risen to 6.4 percent; by December 2005, it reached 38.9 percent.

In 2006, IDU surpassed heterosexual transmission as the most common mode of transmission among all cumulative reported cases of HIV/AIDS in Indonesia. The latest data, compiled through September 2007, indicates that 49.5 percent of the 10,384 known AIDS cases in Indonesia (cumulative, not including HIV) are due to IDU.

Harm reduction

Harm reduction has become quite a global buzzword in recent years. It refers to interventions aimed at minimizing the medical and social problems associated with drug use, such as methadone maintenance and needle exchange programs. It is not exclusively concerned with IDUs or with HIV, but with all kinds of drug use and all kinds of harmful consequences.

In other parts of the world, HR has become a major thrust of government and community efforts to combat the problems of drug abuse, within the context of frustrated efforts at controlling drug trafficking and dissuading people from using drugs.

Despite being recently embraced by the office of the Coordinating Minister for People's Welfare, HR remains somewhat controversial in Indonesia, mainly due to its different approach from the more popular demand reduction and supply reduction programs (see Part II-sidebar).

Octavery "Very" Kamil is head of the Injecting Drug Users Intervention Unit at the Aksi Stop AIDS! (ASA) project, run by the Jakarta-based Family Health International (FHI). He has worked for ASA since its inception in 2001.

ASA is funded mainly by the U.S. Agency for International Development (USAID), but also by The Global Fund to fight AIDS, Tuberculosis and Malaria and the HIV/AIDS Indonesian Partnership Fund (IPF) of the UK Department for International Development (DFID). The IDUs Intervention Unit was created in 2005, and it manages 22 non-governmental organizations (NGOs) and two Health Ministry programs in six provinces -- the latter covering 40 districts and cities.

"The goal of ASA's IDUs unit is to reduce the spread of HIV among IDUs," said Very, "thus all of the unit's work is concerned with harm reduction (HR)."

The organizations and programs supported by ASA's IDUs Intervention Unit work on preventing the spread of HIV and sexually transmitted infections, assisting with health issues related to HIV infection, and assisting on addiction problems through rehabilitation programs, counseling and family intervention.

HR programs include outreach work, needle and syringe programs (NSP), counseling and testing for HIV, case management and support groups.

Rise of heroin in Indonesia

Although Very's unit deals mainly with HR among people already injecting drugs, he and his team also make it their business, he said, to learn about the drug problem in Indonesia from every angle.

As Very explained, Indonesia's response to the spread of HIV began in 1991, when the reported cases of HIV or AIDS began reaching the double-digits, but before the emergence of cases linked to IDU.

"Around 1995 to 2000, the availability and use of heroin in Indonesia increased greatly," he said.

The monetary crisis in 1998, with its attendant lawlessness and loosening of social controls at the community level, exacerbated these already growing problems.

During this period, Very estimates that about 70 percent of high school students in major cities had access to heroin and other drugs, regardless of social or economic status; at the same time, the number of HIV/AIDS cases linked to IDU began to increase dramatically.

But by 2001, Very continued, the country saw a substantial restoration of law and order.

"The socio-economic profile of IDUs in Indonesia varies from city to city," noted Very, "and they come from widely varying backgrounds."

Initially, heroin users were from the upper classes, but during the heroin boom throughout the 1990s, its use spread toward greater variation among users.

According to Very, many users from affluent families were thrown out, and some middle-class families were cast into poverty due to the heroin addiction of a family member.

In major cities like Jakarta, Bandung and Surabaya, he said, many IDUs were youth from middle- and lower-class families. According to a survey in late 2006 among clients of the Kios Atmajaya IDU program in Jakarta, 20 percent of the sample group were below the age of 23, and 38 percent had never reached high school.IDUs who drop out of school due to drug use never complete their education," said Very.

Indonesia rock concert stampede kills 10

Sat Feb 9, 2008 9:48pm EST

JAKARTA (Reuters) - A stampede at a rock concert in Indonesia's West Java province killed 10 people and injured several, police said on Sunday.

Hundreds of fans had packed a hall to watch a performance by a little known punk rock band in the city of Bandung when the stampede began on Saturday night, said Brigadier Nano Kartono, a local police officer.

Most of the dead were teenagers, he said.

Bandung city police chief Bambang Suparsono said 15 concert organizers had been questioned, the state-run news agency Antara reported.

"We received information that before the crush that ended with deaths, concert organizers distributed free drinks. There was a smell of alcohol," Antara quoted him as saying.

Indonesia has seen a number of deadly stampede at concerts in recent years.

(Reporting by Ahmad Pathoni; Editing by Bill Tarrant)

Tangerang to open crisis center to coordinate fight against bird flu

Multa Fidrus, The Jakarta Post, Tangerang

The recently reelected Tangerang Regent Ismet Iskandar has ordered officials to open a crisis center in a bid to curb the spread of avian influenza in the regency.

Ismet said the center would enhance coordination among agencies, and would be managed by a cross-agency team.

"Cooperation is the key. The regency's Asset and Wealth Management board must provide the required funding while the Spatial Layout and Building Agency must build a laboratory for research at Tangerang Hospital," Ismet said recently in a meeting before top officials in Tangerang.

He appointed administrative assistant Deden Sughandi to head the crisis center.

He also ordered the administration's legal department to compose a bylaw on poultry trade and industry.

"There must be the good will of all related agencies to fight avian influenza, otherwise Tangerang will remain one of the hardest hit areas in the country," he said.

The central government declared Tangerang a "red zone" for bird flu following the deaths of Iwan Siswara, an official at the Supreme Audit Agency (BPK), and his two young daughters in July 2005.

The red zone labeling has had a negative impact on poultry breeders and chicken meat traders, who have seen slumping sales ever since.

Public concern escalated again over the spread of bird flu in Tangerang after the recent deaths of two Tangerang residents at Sulianto Saroso Hospital in North Jakarta and Persahabatan Hospital in East Jakarta last month.

Head of the regency health agency Hani Heriyanto admitted that related agencies under the administration had yet to achieve coordination and cooperation on how to protect the area.

"It seems the health and husbandry agency is the only one that worries about the virus transmission here, while other agency officials remain undisturbed even though many have died of the virus," he said.

Since 2005, 16 local people have been infected in the regency, resulting in 14 deaths.

The bird flu anticipation effort would be among the first jobs for Ismet, who has started to resume his second term this month.

Together with actor-cum-politician Rano Karno of the Indonesian Democratic Party of Struggle (PDI-P), Ismet won the first direct election in the regency last January.

Group works to help street children

JAKARTA (Jakarta Post) : A community of young professionals and university students will introduce Jakarta residents to street children in an event on Feb. 17 in Senayan, Central Jakarta.

"The event is being held to introduce people to street children in the hope they will offer them support. It could be a solution to this social problem," Sahabat Anak (Friends of Children) executive Benyamin Lumy said Wednesday, as quoted by Antara.

The organization was formed in 1997 after several young professionals and students organized a jamboree for street children.

It now runs seven educational shelters for more than 300 street children across Jakarta.

The organization offers street children support and an education, and sometimes even reunites children with their parents.

"We feel we have to do something to help these marginalized children rather than staying silent," Benyamin said.

Dozens hospitalized for poisoning

DENPASAR (Jakarta Post) : Dozens of PT Super Tuna Saku employers were taken to Surya Husadha Hospital in Denpasar on Thursday with carbon monoxide poisoning.

A doctor at the hospital, Doni Susanto, said 15 employees arrived at the hospital around 10.30 a.m., and four more employees arrived several minutes later.

"They were all suffering from carbon monoxide poisoning. Thirteen of them have been put in the nursing ward and six others are still receiving intensive care in the emergency room," he said Thursday, as quoted by Antara newswire.

He said the patients would be monitored for at least 24 hours before being discharged.

One of the victims, Ni Luh Sayani, 27, said she was working in her office and did not notice anything unusual before she passed out.

"I only regained consciousness when I was already in the hospital," she said.

W.H.O. and Bloomberg Open Global Antismoking Project

By Donald G. McNeil Jr., The New York Times

Published: February 8, 2008

Tobacco could kill up to a billion people during the 21st century, as cigarette sales soar in poor and middle-income countries even as they drop in wealthier ones, says a report issued Thursday by the World Health Organization.

The report, financed by Mayor Michael R. Bloomberg’s foundation, suggests a six-point program for fighting the tobacco industry’s influence.

“The W.H.O. is described by the tobacco industry as its biggest enemy,” Dr. Margaret Chan, the organization’s director general, said at a news conference introducing the report. “Today we intend to enhance that reputation.”

Nicknamed Mpower and based on a partly successful program for fighting drug-resistant tuberculosis, the report suggests raising cigarette taxes, banning smoking in public places, enforcing laws against giving or advertising tobacco to children, monitoring tobacco use, warning people about the dangers and offering free or inexpensive help to smokers trying to quit.

The report, to which Bloomberg Philanthropies contributed $2 million, is the first to compile global data on how many smokers or tobacco chewers each country has, how much they pay in tobacco taxes, and how antismoking efforts are faring.

Among its conclusions: poor and middle-income countries collect 5,000 times as much in tax revenue from tobacco as they spend in fighting its use. Only 5 percent of the world has no-smoking laws like those in New York City. Uruguay does more than any other country to reduce smoking.

Mayor Bloomberg, who is well known for his antipathy to smoking, said in presenting the report that it would be re-issued annually and would grade countries. “The United States would get a C or D,” he said, New York, an A or a B.

His statement puts him at odds with W.H.O. The agency has traditionally been cautious about offending members, and in interviews, officials from its Tobacco Free Initiative specifically said countries would not be graded.

Perhaps the oddest aspect was that the report itself was presented as if it were a campaign for menthol cigarettes, full of pictures of happy children and mottos like “fresh and alive.” It even came with what appeared to be a pack of Mpower-brand cigarettes, with a cheerful blue bubbles logo and a mock warning on the box — which actually contained a pad and pens.

That also seemed to fly in the face of the sort of harsh ads that Mayor Bloomberg endorsed, like those showing dying smokers croaking through tracheotomy tubes.

After the presentation, officials hastened to explain that the “cigarette pack” was not meant for the public, but to catch the eyes of health and finance ministers in poor countries.

“We’re co-opting the tobacco industry’s branding strategies to capture the attention of government officials,” said Sandra Mullin, a spokeswoman for the World Lung Foundation, which contributed to the report. “We want to show that they don’t own those mottos — freshness and fun and health.”

Minister asks for end to city poultry farming

Mustaqim Adamrah, The Jakarta Post, Jakarta

Health Minister Siti Fadilah Supari said Tuesday she expected poultry farming in Jakarta to stop in order to halt the spread of bird flu.

"If possible, both collective and backyard poultry farming must be restricted to curb the spread of the bird flu virus," she said at City Hall after a meeting.

"(It will enable us to) prevent the number of patients contracting bird flu from increasing," she said.

In a meeting presided over by President Susilo Bambang Yudhoyono, senior Cabinet members and government officials discussed efforts to curb bird flu in the three hot-spot provinces of Jakarta, Banten and West Java; flood mitigation in the capital and supply stability for commodities like cooking oil, soy bean and flour.

The meeting was attended by Jakarta Governor Fauzi Bowo and a number of city and state officials, including Transportation Minister Jusman Syafii Djamal, Trade Minister Mari Elka Pangestu and Public Works Minister Djoko Kirmanto.

Also present at the meeting were Meteorological and Geophysics Agency head Sri Woro B. Harijono, National Police chief Gen. Sutanto, Indonesian Military chief Gen. Djoko Santoso and the Health Ministry's Drug and Food Monitoring Agency head Husniah Rubiana Thamrin Akib.

In response to Siti's statement, Fauzi said the move was unnecessary, saying zoning regulations were more than enough to make sure poultry farming was under control and that the spread of the virus could be limited.

"The President hopes there will be no more deaths caused by bird flu in Jakarta, Banten and West Java this year," he said.

The three provinces have been centers for the H5N1 virus, with a combined 71 fatalities having been recorded out of 103 reported bird flu deaths nationwide.

Jakarta has been the hardest hit, with 25 deaths from 29 reported cases.

"Therefore, Jakarta will set aside special zones for the poultry industry as soon as possible," Fauzi said. "The zones must be far from residences."

He said such special zones would enable the administration to control the poultry industry.

"It will be easier for us to disinfect poultry as well," he said.

Earlier, the government urged the three provinces' administrations to strengthen their enforcement of bird flu regulations following a string of avian influenza deaths.

The most recent deaths were reported in Bekasi, Tangerang and Jakarta.

The call was made during a meeting at the Coordinating Ministry for the People's Welfare. The meeting was presided over by the coordinating minister, Aburizal Bakrie, and attended by Home Minister Mardiyanto and Siti.

The meeting discussed special zones and traditional markets' obligation not to sell live chickens.

Apart from the zoning regulations, Fauzi previously said he would strengthen restrictions on poultry in the capital, citing weak enforcement of a 2007 ordinance banning backyard poultry and regulating the poultry industry.

He said his administration would find a way to punish those violating the ordinance.

Offenders of the bylaw are currently only required to register their pet birds or have their backyard poultry culled.