As They Save Lives, Healthcare Workers Struggle With Rejection From Society

This article originally appeared on VICE Indonesia.

This article is part 2 in a two-part series about the workers on the frontlines of the COVID-19 pandemic in Indonesia. Part 1 followed the daily routines of undertakers, hearse drivers, and gravediggers. Read it here .

Some hospitals, like the Sulianti Saroso Infectious Disease Hospital, have converted all rooms into isolation chambers. The building’s 150 beds and 60 rooms are operating at full capacity, forcing healthcare workers to make tough decisions and prioritise patients in critical condition. Patients with little to no symptoms are sent home and asked to self-isolate.

“A few times, we’ve had no choice but to turn patients away,” said Derpina Sinaga, a nurse in Jakarta said.

Derpina is a veteran healthcare worker, having served on the frontline during the Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) outbreak between 2012 and 2015.

Indonesia managed to avoid the MERS epidemic, but the government nevertheless prepared for the worst case scenario due to the high number of religious pilgrims travelling between Indonesia and the Middle East.

“But the COVID-19 pandemic is different from the MERS outbreak,” Derpina said. “We have no idea what we’re up against or when this will end.”

Indonesia’s COVID-19 cases are concentrated in the capital, which has over half of the 4,557 confirmed cases. Overall, Indonesia is known to have one of the world’s worst coronavirus testing rates at only 36 tests for every million people. With many Indonesians neglecting to practice social distancing, the lack of testing could be a recipe for disaster.

Many have criticised the Jakarta local government’s slow distribution of rapid test kits in the city of nearly 10 million people, as well as the national government’s lack of social distancing measures. Ministers have made conflicting statements about the extent of necessary social distancing, making it difficult for Indonesians to make judgement calls about acceptable behaviour during the pandemic.

The rapid spike in COVID-19 cases in Indonesia prompted the government to expand its healthcare network, increasing the number of hospitals dedicated to COVID-19 patients from two to eight.

The Jakarta government has designated eight locations for COVID-19 treatment, including a former athlete dormitory with a 4,000-person capacity. But nearly all designated hospitals are facing a shortage of staff, beds, and equipment.

The Indonesian government has not been transparent about the coronavirus situation in the country. In March, authorities still claimed that Indonesia was coronavirus-free, even as cases skyrocketed in other parts of Asia.

It wasn’t until March 2 that President Joko Widodo announced the nation’s first confirmed coronavirus cases. Since then, the government’s slow response and lack of preparation has been the subject of local and international scrutiny. Hospitals are overwhelmed and personal protective gear is in short supply.

But like many other healthcare workers, Derpina is conflicted between serving her fellow humans to save lives and prioritising her own health. Mentally and physically, her work has been a rollercoaster ride.

“There’s always the fear that I’ll bring the virus home with me,” said Derpina, who has a primary school-aged son. “But worrying about that kills my spirit. As long as I’m disciplined and follow all procedures, I’ll be fine.”

After each shift, Derpina carefully removes her personal protective equipment (PPE), cleans her body, and changes her clothes. She showers again and washes her clothes as soon as she returns home before tending to her son. The next day, she will battle uncertainty again for the chance to come home to her son.

“After I take a shower, I can hug my child with a clear conscience,” she said.

But what Derpina fears most is the stigma and discrimination. A number of Indonesian healthcare workers have been kicked out of their residences over fears that they might spread the virus. Some who die of the coronavirus are turned away from cemeteries and burial sites, like nurse Nuria Kurniasih was. She tested positive for COVID-19 and died at the age of 38 the week of April 6.

A mob of angry residents awaited Kurniasih’s family when they brought her body to a cemetery. They refused to have a coronavirus patient buried so close to their homes. Her family had to move Kurniasih’s body to a hospital cemetery. When the incident gained attention online and sparked backlash, the neighbourhood head who authorised the protest issued an apology.

When a coronavirus patient dies, the hospital calls a burial service right away. “We no longer bring deceased patients to the morgue. We bring them straight to the graveyard,” Derpina said. “We wrap their bodies in plastic.”

The bodies, along with the beds and rooms they occupied, are then decontaminated. That’s when organisations like the Black Cross take over, delivering bodies to their final resting places.

The Jakarta Provincial Government allocated hotel rooms to healthcare workers between April 1 and May 31 to ensure that they all have a safe place to stay. Derpina rejected the offer, saying she would rather stay home with her son.

Once at the hospital, Derpina heads to the emergency room clad in full PPE gear to survey patients. Under normal circumstances, one nurse would be assigned a single patient at a time, but now each nurse handles up to nine patients on their own.

Apart from her routine activities, like taking temperatures and administering medicine, Derpina prides herself in being someone patients can lean on during a stressful time.

“I also make myself available as a sort of counsellor,” Derpina said. “I can spare at least five minutes on a patient just chatting or praying so that they hang in there. It has a huge impact on the isolated patients. They’re alone.”

It’s no overstatement that healthcare workers risk their lives while on the job. So far, 30 doctors, nurses, and paramedics have died of COVID-19 in Indonesia. Healthcare workers are particularly vulnerable to infection as they remove their PPE.

Doctors in Bergamot, Italy, wrote in a medical journal that hospitals may become the biggest carriers of the coronavirus due to the comings and goings of infected patients. Derpina knows she is extremely vulnerable to infection, but still refuses to be tested. As Derpina continues to grapple with uncertainty, she hopes to see the pandemic through and return to a normal life.