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Coronavirus: poor Indonesian families most at risk of sudden spike in infections

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South China Morning Post - March 15, 2020

Joe Cochrane – The most valuable possession that Hasib, 40, owns with his wife Khomsiah, 38, is their shop in a trash-strewn riverside slum near the centre of the Indonesian capital Jakarta.

The shop, hidden between a five-star hotel and a Marine Corps barracks, sells everything from instant coffee and tea packets, instant noodles, cold drinks and cigarettes, to cheap toys and bags of rice.

But it is the little things that the couple neither owns nor sells which could gravely affect them and their three children: face masks and hand sanitiser. Not that they could afford them.

As the novel coronavirus spreads around the world, with cases in Indonesia reaching 117 on Sunday, poor Indonesian families, such as Hasib and Khomsiah's, have no means to do anything but worry.

"We have nothing special, really, to help us," Hasib said. "We hope we will be OK."

Nonetheless, it appears miraculous that Indonesia has so few confirmed cases – and five deaths, including a British tourist in Bali on Wednesday – when its Southeast Asian neighbours are dealing with hundreds of cases in what the World Health Organisation (WHO) declared last week is a global pandemic.

Health officials, doctors and researchers are sceptical, believing that there must be many more cases that have not been detected in this sprawling archipelago of 260 million people.

If the infection rate spikes dramatically, the country's poor have few financial resources and health options to cushion themselves from a severe blow.

"I definitely think the poor will be more affected due to the lack of access to health care, and the lack of access to clean water and good diet, compared to the middle and upper classes," said Ariyo Irhamna, an economist specialising in poverty at the Institute for Development of Economics and Finance (INDEF) in Jakarta. "The conditions they are living in are very bad."

Officially, Indonesia's poverty rate is around 10 per cent, or 26 million people, but that is based on a controversial government-set poverty line of US$1.25 a day. However, international organisations have long said that nearly 100 million Indonesian families or individuals live on US$2 a day or less.

"From what I know, and from experience in the past, as long as they feel strong enough to, the poor will continue to work if they are sick to earn money in order to survive", even if they might be carrying the virus, said Wardah Hafidz, coordinator of the Urban Poor Consortium, an advocacy group.

Hasib and Khomsiah's shop, which doubles as their home, is in the slum area known as "Starling keliling", which is a play on Starbucks and the Indonesian word for mobile.

It is home to some of the many traditional street hawkers who peddle around on old-style, single-gear bicycles with packets of instant coffee, tea and milk, using hot water from a vacuum flask lodged in a holder on the back of the bicycle. Others use pushcarts that also enable them to sell water, canned drinks and cigarettes.

Those who live there are from the impoverished island of Madura, off the coast of East Java, and flocked to Jakarta in search of work, some more than 20 years ago.

Munidin, 32, has been peddling his bicycle around since 2011, working between 12pm and 1am on a side street between two mammoth upscale shopping malls. He said he usually earns around 50,000 rupiah (US$3.35) per shift to support his wife and three children.

"I really don't know much about corona, but if we were sick, we'd go to the Puskesmas," he said, referring to free community health clinics that treat poor Indonesians.

But such a clinic would be of little help to anyone who contracts the coronavirus. They do not have coronavirus testing kits or ventilation machines, and only some of them have inpatient beds.

"We have the tools to take temperatures, do an initial screening as a first step, and monitor symptoms, check their travel history," said Dr Arita Magdalena, head of one local health clinic. "If they have the criteria points like Corona symptoms, the Puskesmas will refer them to a larger hospital."

But that could be problematic if there is a sudden, massive spike in cases, as some fear is inevitable.

"They can be referred to state hospitals for free but the [bed] capacity is very, very limited, and for that matter the capacity at the local clinics is also very limited," Irhamna said.

Misliah, a 30-year-old mother of three, sells coffee, water, instant noodles and cigarettes off a pushcart outside a nearby mosque from 10pm until dawn most nights, to avoid the police or public order officers because street hawking is technically illegal. She earns about US$2.70 each night.

"I heard about the virus. I read about it. Yes, I'm worried, but I don't have a mask," she said.

Hafidz said national and local governments should be distributing free face masks in poor communities to give residents at least give some basic protection – and to thwart hoarders who later resell masks at double or triple the normal price.

"I also believe the government at all levels should be very active and serious in disseminating information using all means possible, and be open and transparent on the cases and treatment," she said. "Before, they were so secretive and issued stupid comments."

Across the small paved alley that runs through the middle of the slum, Fuzalih, 35, says his business is down because of the virus, as fewer people are going to the small shopping centre where he sets up his pushcart.

To make matters worse, he and probably many others, may not necessarily be getting the proper health advice about Covid-19. "The government said that if we are healthy, we don't need to wear a mask," Fuzalih said.

Behind him, one of his friends chimed in, jokingly but perhaps ominously saying: "Starling is the 'anti-corona city'."

Source: https://www.scmp.com/print/week-asia/people/article/3075175/coronavirus-poor-indonesian-families-most-risk-sudden-spike

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