[Marinir] Indonesia Digest No: 34.05 ; 25-09-'05

[Yap Hong Gie]

INDONESIA DIGEST

Indonesia's complex Issues in a Nutshell
 By: Wuryastuti Sunario
Published by: TBSC-Strategic Communication
No.: 34.05 - Dated: 25 September 2005
In this issue:

MAIN FEATURE:

CATEGORY 3 - AVIAN FLU ALERT OVER INDONESIA

NEWS AND BACKGROUND:

1.      The Economy, Trade and Industry:

Ensuring smooth Supply-Demand flow is most important "key" to economic
recovery
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MAIN FEATURE:

CATEGORY 3 - AVIAN FLU ALERT OVER INDONESIA

Two more children died of suspected avian flu on Wednesday, 21 September,
bringing the total deaths to seven within three months since the first
suspected patient succumbed to the dreaded avian flu in the suburbs of
Jakarta last July.

But, as the public starts to panic, the "where, why and how" the disease is
spread can still not be pinpointed. World Health Organization, WHO,
officials have, nonetheless, confirmed that Indonesia is now at Category 3
alert. This is the category when the virus is spread from animals to humans
who were in direct contact with the infected animals. The spread, we are
assured, is not airborne, but the patient has usually been in direct contact
with infected birds or poultry, or their secretion has touched the patient's
skin. Eating well cooked chicken and eggs is safe, since the virus dies at
high temperatures or when exposed to the sun for two or three minutes.
The most dreaded category , however, is category 6,  when the virus mutates
and spreads from human to human. When this will actually happen is only a
matter of time, warn officials of the World Health Organization.

Investigations in Jakarta into how the first three victims (and confirmed to
have died of the bird flu in July), had in fact contracted the disease has
still not been resolved, for the wife and mother of the victims as well as
their neighbours and those who came into direct contact with the patients
have remained free from the H5N1 virus.

Up to today, Health Minister Siti Fadilah Supari assures, that the spread of
the virus has been limited from poultry, birds or pigs to humans. No known
case has been found in Indonesia of the virus having been transmitted from
human to human. "But this will only be a matter of time when the avian flu
virus mutates into human flu and the spread is transmitted through humans",
said the Minister quoting findings of the World Health Organization, WHO.
WHO tells us further that the virus has spread from northern China to many
parts of Asia, including Vietnam, and Thailand. A strain of bird flu known
as H5N1 has killed 63 people in South East Asia since 2003, the majority
of them in Vietnam. Health experts warn that a major and quick-spreading
pandemic internationally could kill millions. Therefore, discovering the
sources early and stemming the spread fast is of the utmost importance.
The H5N1 virus was first discovered among the poultry population in
Indonesia in January 2005. But how the virus has further spread to the
affected patients, and where patients have contracted the virus is not
clear.

On Monday, 19 September it was announced that a number of rare birds
inspected at the Ragunan Zoo in Jakarta were infected, among whom an eagle,
and rare cockatoos. The Ragunan  Zoo has now been closed to the public for
three weeks. Further investigations later revealed that one zoo worker and a
peddler selling food at the Zoo also showed symptoms. They were immediately
taken for isolation at the hospital of communicable diseases of the Sulianti
Saroso Hospital in North Jakarta.

On Friday 23 September, Health Minister Fadilah Supari confirmed that 28
suspected cases of avian flu have been found in the country, with 18
suspected patients having been treated at  the Sulianti Saroso hospital in
Jakarta. Three cases were confirmed infected with the H5N1 virus by the
WHO lab in Hong Kong and two cases related to the first victim (in a 
cluster).
This brings to five the total confirmed cases detected in Indonesia. Four
patients have succumbed and one is recovering.

The sharp increase in the number of suspected patients admitted to the
hospital does not mean that the situation is worsening, said Minister
Supari, as also confirmed by WHO. It means that the public, through
intensive and widespread information issued by the media, has become more
aware of the dangers of the avian flu and are reporting their sickness at an
early stage. Door-to-door surveillance by health officials have also
intensified.  The Indonesian government is resolved, that should a worldwide
pandemic emerge, Indonesia is prepared to face such problems, says the
Minister.

Symptoms, Treatment and Preventive Measures

Avian flu symptoms are very similar to those of the ordinary flu, says the
Health Minister. This starts with very sore throat and running nose, and
continues with high temperatures of over 38 degrees Celsius for more than
three days. Further the patient will find difficulty in breathing, usually
associated with acute pneumonia. In the case of the avian flu, however, the
patient's health will deteriorate very fast and may lead to death within
days.
When treated early with Tamiflu, the disease may be cured. But when Tamiflu,
an antiviral medication, is applied at an advanced stage of the disease, it
is no longer effective. Therefore, the government urges those suffering from
the above symptoms to immediately report to the nearest hospital. Today with
the assistance of WHO, that has supplied 10,000 capsules to Indonesia, the
government has a total stock of 12,000 Tamiflu capsules to be distributed to
hospitals. The government has also assigned specific hospitals around the
country able to treat avian flu, should it grow to epidemic proportions.
>From Bandung to Bali, hospitals have readied special teams to handle avian
flu patients, and have prepared isolation rooms to handle such patients.
As further precaution, and to further stem the spread of the virus, and, so
that the government can handle the case more effectively, Minister of Health
on Sunday, 19 September proclaimed Jakarta as "extraordinary infected area",
and the next day, Sunday 20 September, the whole country was proclaimed as
"infected area". This does not mean, however, that an epidemic has spread
over the entire country, Minister Supari said.

Her decision to do so, nonetheless, has reaped strong protests from the
Jakarta governor, Sutyoso, who felt that he was not earlier informed of the
decision, and that this action would disturb the tourism and investment
drive underway, thus affecting economic growth of the province. Another
protest came from poultry farmers of South Sulawesi, who aver that their
farms are absolutely clear of the virus.

But, to prevent further spread of bird flu disease, Indonesia takes firm
measures.
Immediately upon his return from the United States, where he attended the
World Summit, President Susilo Bambang Yudhoyono instructed relevant
authorities to take immediate and firm measures to prevent the lethal virus
from spreading, Coordinating Minister for People Welfare and Poverty
Alleviation Alwi Shihab said after meeting with the president at the
presidential office: "We are instructed to take immediate and accurate
actions to handle birds and humans, who have been infected," said Alwi at
a joint press conference.
He said the president has instructed that authorities stem the outbreak from
further spreading by conducting isolation and quarantine measures or take
further preventive actions at liable infected places, such as bird markets,
animal husbandry and poultry farms.
The President has also asked that the public be made aware of the threats;
socialize to the community what government efforts have been taken,
strengthen coordination among authorities and enhance cooperation with
international communities, he added.
So far, sick poultry found at farms have been killed, and the  farms
disinfected, but poultry have not been culled at random.

On Saturday, 24 September, Minister Supari further detailed that 22 of
Indonesia's 44 provinces are in danger of being infected. These areas cover
the entire island of Java (home to around 130 million people), South
Sulawesi, North Sumatra, parts of Kalimantan and Bali

Which animals are vectors of the dreaded virus?

Several theories have been put forward on how avian flue has spread around
the world. The first expounded was that the avian flu virus now threatening
to spread into pandemic proportion, is carried by migrating birds. And, in
their trek from north to south and vice-versa, they make, among others,
Indonesia their favourite stopover. One of these is the island called Pulau
Dua, off the coast of Banten. Experts on migrating birds, however, say that
the spread of the virus does not follow the pattern of the migration of
birds. Furthermore, if the vectors of the virus are migrating birds, how did
the virus spread to the rare birds that are kept in cages in the zoo?
Nonetheless, as a further precaution, now, the Jakarta Government has
ordered all doves at the National Monument plaza be vaccinated.

Another more likely carrier is the poultry population, which in Asia,
including on Java and in Jakarta, are reared not only on farms, but are very
often kept in the backyards of homes. In many parts of the city one can see
chicken roaming around freely in crowded neighbourhoods. Therefore,
contamination can occur almost anywhere. A third theory put forward by the
University of Gajah Mada in Yogyakarta, is that vectors are flies. Clinical
investigations of flies in infected areas have been found carrying the H5N1
virus. This latter theory as well as the previous one are both quite likely.

So, how does one make sure not to become infected?

First of all, experts tell us, keep the environment clean. Vaccinate likely
infected poultry and keep farms and cages clean by spraying disinfectants.
Workers who are forced to come into close contact with birds and poultry
should make sure that all parts of the body are securely covered. Cover the
hair with a shower cap; cover the eyes with large transparent goggles; cover
the mouth with a mask; cover the body with a plastic coat; wear elbow-length
rubber gloves, and wear long rubber boots. Make sure to take a shower each
time after coming into contact with poultry and birds. Throw away items that
are disposable, and make sure that boots and gloves are washed and
thoroughly disinfected.

For the rest of us, keep fit by taking lots of Vitamin C and make sure to
stay healthy.

(Sources: SCTV, Media Indonesia, Kompas daily)
(Tuti Sunario)
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NEWS AND BACKGROUND:

1.      The Economy, Trade and Industry:

Ensuring smooth Supply-Demand flow is most important "key" to economic
recovery

The view expressed by many world economists as though increased investment
is the only key to economic recovery may be very misleading, for, if
investments is not done in the correct context then it will have no effect
whatsoever on economic recovery, least of all on the real sector, said Huber
Schmitz, economist at the Institute of Development Studies of the University
of Sussex recently in Jakarta.

There are in fact many "keys" to recovery, he continued, but these must be
discussed in specifics. For the automotive industry, for example,
investments is truly the key to growth, but where raw materials are
available in abundance, as is the case in Indonesia, then this needs to be
looked into deeper, said Schmitz, as reported by Bisnis Indonesia.

In the case involving raw materials, the key to growth lies in the creation
of a supply system that ensures the continued and smooth flow between supply
and demand. For that reason the correct treatment here is to ensure that
tight coordination is kept within the supply system, and not merely to
increase investments.  Huber Schmitz presented his paper entitled "Asian
Drivers of Global Change" before the Minister for Trade Mari Elka Pangestu
and Minister for Industry, Andung Natamihardja and invited guests.

It is, in fact not difficult to find the proper keys to economic
development, since any bureaucratic machinery could do it. An excellent
example is China, he continued.

During the past 25 years, China has initiated activities that were at the
time thought of as trivial. However, now these are showing results in the
country's phenomenal economic growth of 9%, multiplied income, and the
highest export-import volume expected by 2010.  At the same time, China has
opened up 75% of its economic activities, and, with a population of 1.3
million, - six times the population of Indonesia - China has become the
basis of production for 70% of the world's shoes, toys, photocopy machines,
and DVD drives.

A number of trivial-seeming actions that were taken by China included adding
trade attaches abroad, strengthen experts in specific sectors, and cooperate
with key players in the supply system of the world market.  They further
strengthened international cooperation with players in market access as well
as in investments, then promoted capital investments, as well as empower
provincial governments to develop their own economies.

"These are very simple actions, but these need consistency and hard work.
China has successfully captured the shift of the world economy from Europe
and America to Asia, and has entered into new sectors, as well as succeeded
to transform their production ability into innovation capacity", said
Schmitz

In response, Trade Minister Mari Pangestu commented that Indonesia is still
in the learning curve, while at the same time the country steps up
international cooperation, in particular with China.

For your comments or further inquiries, please e-mail to:
tbsc-strategy at indo.net.id