Jenny Lei Ravelo, Manila – Recently, Indonesian President Joko Widodo expressed hopes of a novel coronavirus vaccine being available to the Indonesian population by 2021. The Indonesian leader isn't alone in pinning hope on a vaccine to end the pandemic, but grassroots groups worry over the implications of this kind of messaging to the public.
The narrative that a vaccine could be available soon could create a false sense of security among the Indonesian public, according to Elina Ciptadi, co-founder of KawalCOVID19, an online information hub on COVID-19 that was set up in March, just before the government reported the first COVID-19 case in Indonesia.
"We have no problem with putting a positive narrative out there, if there's a balance between that and reminding people that the risk is still out there, and what are those risks and where are those risks... for balance," Ciptadi told Devex in late July.
But there are gaps in the government's risk communication, that the KawalCOVID19 team of volunteers have been trying to fill for months now, along with other civil society and nongovernmental groups.
Indonesia has one of the highest COVID-19 cases in Southeast Asia – at 155,412 – second only to the Philippines. But it registers the highest COVID-19 death rate in the region, at 6,759, as of Aug. 24.
The testing rate in the country is one of the lowest globally, at 7.2 tests per 1,000, as of Aug. 20, according to Our World in Data, leading many to believe that the real number of cases are higher. The government has received criticism for its handling of the pandemic, from downplaying its risks early on to prioritizing the economy over public health.
The challenge of muddled messaging
Issues such as child death rates from COVID-19, for instance, aren't often highlighted by the government, Ciptadi said. There's also limited child-friendly messages, and specific risk communication materials for people with disabilities, said Save the Children Indonesia's Merry Ivana Saragih, the organization's head of evidence and impact.
The Indonesian Pediatric Society identified 51 COVID-19 deaths among 2,712 children confirmed to have COVID-19 between March and July, but estimated the real number could be over 300, according to Straits Times. The World Health Organization Indonesia's latest situation report meanwhile revealed that children aged 5-14 years old account for 6.8% of total recorded cases in Indonesia, above the global average of 2.5%.
"Things like that are just mentioned in passing, with the risk of not alerting people of the real risk and the real scale of the pandemic," Ciptadi said.
Issues on risk communication is one of the many reasons Indonesia has failed to reduce the spread of COVID-19 in the country, according to civil society groups.
An open letter published by CSOs last month called on the government to maintain its large-scale social restriction strategy, commit to data transparency, and increase polymerase chain reaction-based testing and stop the use of rapid tests. The letter also asked the president to appoint a new health minister. Group representatives later clarified to Devex that this is not meant to be specific but instead highlight the "absence of leadership" in the ongoing pandemic response.
"We've been trying to push forward for them to prioritize the public health policies over the economic policies. But we haven't been listened [to] by the government," said Olivia Herlinda, policy director at the Center for Indonesia's Strategic Development Initiatives.
"It's very confusing, the policies they're trying to implement, because one day they will try to be more strict about the social restriction policy... [and] the next day they will talk about different policies, like to reopen the economy and to lift the social restriction," she said, adding that "it's very confusing and exhausting for all of us."
The government narrative
Government officials are the third most trusted source of information on COVID-19, according to a survey in Jakarta carried out in June by LaporCOVID-19, a crowdsourcing platform for citizen reporting on COVID-19, and the Social Resilience Lab of Nanyang Technological University in Singapore, and shared with Devex. The first are medical doctors and health experts, and second are religious leaders. Celebrities and influencers come last in the list.
"So the bottom line here is that the message from the government is very effective, but the problem is the message from the government is not always accurate. – Sulfikar Amir, associate professor, Nanyang Technological University
Despite this, 77% of survey respondents think the chances of them getting infected with COVID-19 is small or very slim, and 76% had similar thoughts when asked on the probability of people around them to get infected.
Sulfikar Amir, an associate professor at NTU who worked with LaporCOVID-19 on the survey, thinks this perception is influenced by people's knowledge and experience.
"We asked how many people you know that are infected by COVID-19? 94% said no, no one.... So they have not seen anyone who got infected by COVID-19. And these shaped their perceptions that the chances are slim for them to be infected," Amir told Devex.
A separate survey done by Save the Children Indonesia in mid-April showed similar results. It revealed that 70% of respondents believe they are not at risk of getting infected, and 90% are confident that they have a strong immune system to fend off the virus, said Save's Saragih.
Amir believes the government plays a central role in people's understanding of the pandemic, but the challenge is that messaging from the government is not consistent, and not always accurate.
Part of the question they asked survey respondents in Jakarta was whether they think Indonesia is safe from COVID-19 because of its tropical climate. Those who answered "yes" were also the ones who trusted the government.
"So the bottom line here is that the message from the government is very effective, but the problem is the message from the government is not always accurate. It's not always valid. And sometimes it misleads the people. So this is a problem here," Amir said.
Indonesian government officials have been quoted by local and national media making or amplifying unproven claims on COVID-19, a scenario also familiar in other countries. In the early days of the pandemic, Widodo himself promoted the use of chloroquine as a cure for COVID-19.
That has an impact on how people perceive the severity of the disease, and has a domino effect on the work of civil society. A number of CSOs and NGOs have told Devex of challenges in planning and implementing their programs with the changing government policies, limited risk communication, and weak surveillance. Gaps on testing and data make it challenging for them to understand the true scale and depth of the problem.
While civil society has tried to fill information gaps, they don't have the same bandwidth and resources the government has to lead and raise awareness. KawalCOVID19, for instance, helps share information on social media. But they don't have the same reach in many of Indonesia's villages, where television is a main source of information and a medium the government has huge access to.
In July, the government halted daily press briefings on COVID-19.
"We at KawalCovid19 know that this doesn't mean the end of the pandemic, but what about the people out there who without that daily presence telling them, 'you know... this is the daily statistics, and these are where the outbreak is most concerning.' Without that daily presence, what do they think about the status of the pandemic? Is it over now because they're not on TV anymore?" she said.
Devex reached out to the Indonesian health ministry for comment, but has yet to receive a response.