HEALTH: Indonesia Grapples with Polio Resurgence as Neighbours Watch

By IPS Correspondents Reprint | | Print |

Richel Dursin

JAKARTA, Jul 13 2005 (IPS) - It was a TV news report on children dying after being vaccinated against polio, the crippling paediatric disease, that 40- year-old Sius decided that he would not allow his youngest child to be given a dose during a vaccination round late June.

I was scared that my daughter, Indrawati would die like the children I saw on TV if she was vaccinated against polio,” said Sius, who plies a motorcycle taxi in the capital.

To indicate that three-year-old Indrawati, was not immunised, health workers did not place a sticker, recording that she had been covered by a Jun 28 second round of polio vaccination, on the front door of Sius’ house in Central Jakarta.

Indrawati is one of 792,469 children under the age of five in the provinces of Banten and West Java and the capital Jakarta who were not vaccinated against polio last month mainly because their parents were afraid that the polio vaccine was harmful.

“We are very much worried that a lot of Indonesian children have not been vaccinated against polio,” Minister of Health, Siti Fadilah Supari said.

Supari and other health officials blamed lowered vaccination rates on sensational media reportage of the deaths and hospitalisation that parents like Sius associated with free polio vaccines given during an earlier round on May 31.

While a total 6,548,515 children in Banten, West Java and Jakarta had taken part in the first round the numbers had dramatically declined by 12.5 percent in the second.

”Reports by local media suggesting that some children had fallen seriously ill and died after the first polio vaccination sowed fear among parents – the whole nation is losing because the media misinterpreted the message,” Supari lamented.

It is not only Indonesia but its neighbours in the Western Pacific that are watching the resurgence of polio in the country which in March suffered its first outbreak of polio in a decade.

Australia, for example, was concerned enough to pledge donations that underwrote half the costs of covering children in areas affected by the outbreak in March besides offering expertise and support for efforts mounted by WHO.

Since 1995, Indonesia had been polio-free, but the disease re-emerged in March, the first outbreak hitting villages near the West Java city of Sukabumi, about 60 kilometres south of Jakarta before spreading to the populated provinces of Java and Sumatra.

The number of children suffering from polio continues to rise. As of Jul 7, the Ministry of Health recorded 122 children infected with polio in nine regencies spread across West Java, Banten, Central Java and South Sumatra.

Authorities said the cause of the polio outbreak in Indonesia remains unclear, but believed that the virus could have been brought in by workers shuttling to Yemen and back or Muslim pilgrims returning from Mecca.

Around 24,300,000 children in the country were targeted in the massive nationwide immunization programme including those who took the May 31 and June 28 polio vaccinations.

The government acknowledges that the polio outbreak in Indonesia is causing polio-free nations in the Western Pacific region, including China, Japan, Malaysia, Philippines and Vietnam, which have been polio- free for eight years now, to worry.

”By protecting our children from polio, we are reducing the risk of transmitting the virus to other countries,” said I Nyoman Kandun, director-general for disease control and environmental health in the Ministry of Health in an interview.

Kandun, who went to Manila in 1995 to learn how the Philippines government eradicated the disease told IPS that the vaccine used in the drive was ”safe and will prevent children from paralysis.”

The Ministry of Health has investigated the post-immunisation deaths of five toddlers and hospitalisation of seven others and concluded that these were unconnected with the polio vaccinations.

”There are 2,000 children who die each day in Indonesia and it is natural that when you are immunising, some of those children who would die normally would die,” Dr. David Heymann, WHO senior advisor for polio eradication, explained.

Realising that children missed in the vaccination campaign means plenty of holes in the net this vast country is trying to throw over the disease, the government will conduct polio inoculations throughout the archipelago on Aug. 30 and Sep. 27.

”The challenge is to get rid of polio in Indonesia by the end of this year,” Heymann said, adding that WHO also hopes that polio would be totally eradicated in Asian countries like Egypt, Niger, Nigeria, Afghanistan, Pakistan and India by the end of 2005.

”The polio virus is still present in the world and as long as it is present, it can spread from one country to another,” Heymann said. Last year, Sudan had a polio outbreak and the virus, crossed the Red Sea into Saudi Arabia and Yemen before leaping into Muslim-dominated Indonesia.

When the polio virus appeared in Indonesia, it found a weak point because routine immunisation services had not been able to maintain the protection level high enough among young children,” Heymann said.

The country’s annual immunisation rate after 1995 has dropped for lack of funding. Of the estimated 4.5 million babies born annually 450,000 or 10 percent are not vaccinated. ”We could not vaccinate all the children born every year and due to pockets of unvaccinated kids, the virus returned to Indonesia,” Kandun said.

Apart from insufficient funding, the vastness of Indonesia, which has a population of 216 million, presents a logistics problem.

More than 23 million dollars were allocated for the countrywide polio vaccinations. The government committed over 10 million dollars for free vaccinations while WHO, UNICEF, Rotary International and other donor agencies also pledged more than 13 million dollars for the programme.

”Please bring your children to the polio immunisation posts prepared by the government and don’t be afraid to have your kids vaccinated,” Supari appealed, hoping that Indonesia would be free from polio again by 2008.