In the throes of the current Covid-19 crisis, world leaders are juggling a range of complex issues concerning the balance between public health and economic health, making decisive choices daily about a contagion that is still not fully understood.
Just six weeks ago, senior politicians were claiming that Indonesia was Covid-19 free (to the scepticism of many an epidemiologist), possibly because of Indonesian immune systems, the humid climate, or the power of prayer.
Fast forward to today, there are now more than 2,200 confirmed cases of Covid-19 in Indonesia, the majority of which are concentrated in Jakarta and its neighbouring provinces of Banten and West Java. Indonesia’s Covid-19 death toll is the second highest in Asia, surpassed only by China. And the future looks grim – recent modelling by the National Agency for Development Planning (Bappenas) and the University of Indonesia projected that without intervention, there could be as many as 240,000 deaths due to Covid-19 in Indonesia by the end of April.
As Indonesia is a Muslim majority nation, with the largest Muslim population globally, the end of April is a particularly significant time. Ramadan begins on 23 April this year, and will be followed by Eid celebrations, also known as Lebaran, from 23 May. During Lebaran, many working Indonesians of all faiths have access to an extended period of leave, giving them the opportunity to travel, and usually gather with extended family.
From the beginning of Ramadan through to the end of Lebaran, there is a large-scale exodus (known as mudik) away from large cities, to families and villages of origin. In 2019, more than 18 million people took part in mudik, the majority travelling from the large cities of Java, such as Jakarta, Bandung and Surabaya.
But this year, thousands of people have started travelling much earlier than usual. As the news of Indonesia’s first cases of Covid-19 began circulating in early March, reports emerged of busloads of people leaving Jakarta for the regions. In an eight-day period, almost 900 buses carrying more than 14,000 passengers arrived in Wonogiri, Central Java, from the Greater Jakarta area. Similar numbers have made the journey to regional areas of West Java.
In the small window of time remaining before 23 April, it will be vital for Indonesian leaders to collaborate on a pragmatic and clearly articulated response to deal with travellers, and for this plan to be implemented effectively. The current response has been far from clearly articulated, with different institutions and levels of government issuing different and at times conflicting advice.
From a public health perspective, the ideal scenario would be for nobody else to mudik this year. The majority typically make the journey on packed buses, trains and ferries; private vehicles and plane tickets are simply too expensive. Banning mudik would prevent Covid-19 spreading to communities that lack the resources to treat Covid-19 patients and in which medical personnel are already scarce.
Scientists from the Indonesian Young Scientist Forum called for a lockdown on 16 March. Days later the Indonesian Doctors’ Association released a call for volunteer specialists and general practitioners to contribute to management of the Covid-19 emergency. Those working within the health system have foresight that policy makers do not. They are acutely aware of the resource constraints they are facing and their limited ability to respond to Covid-19. The more mobility in the population at this critical point, the graver the outcome. In just five weeks, at least 24 Indonesian doctors have lost their lives in the front lines of the Covid-19 battle, an indication of the extent to which the health system is already struggling to cope.
On the other hand, considering the way that much of the urban poor migrant population in Jakarta lives, without a safety net and in overcrowded living conditions in which hygiene is compromised, remaining in Jakarta could just as likely be a death sentence for them.
Many street vendors, domestic workers, nannies and gardeners have difficulty accessing the public health insurance scheme and have no certainty that they will not lose their jobs (and possibly homes) if they become unwell. For these Indonesians living in economic precarity, being in the epicentre of Covid-19 must be incredibly unsettling and uncertain – it is no wonder so many have made the decision to mudik earlier this year.
Many also have children of their own who are in the care of their grandparents and extended family. Unless these Indonesians can be guaranteed a safety net in the form of government support, they will understandably feel compelled to mudik.
Middle-class Indonesians face different shades of suffering. Consider the university students living in cramped accommodation (kos) with shared bathrooms, or the families who live in (and are now attempting to work or home-school children from) cramped apartments. To be able mudik at this time would allow them to refresh and disconnect from Jakarta’s hustle and bustle.
Speaking about the possibility of a stricter lockdown on 24 March, Jokowi said that “Every country has its own character, culture, and discipline level. With this in mind, facing this COVID-19, we don’t opt for lockdown”. Since then, the governors of both Jakarta and West Java have called on the central government to mandate a lockdown. The mayor of Tegal in Central Java decided to take matters into his own hands, announcing that nobody would be able to enter Tegal between 30 March to 30 June, and that he would prefer citizens hated him rather than they face premature death.
At the time of writing, the central government remains fixed on avoiding a lockdown. Despite increasing calls from regional leaders to ban mudik, last week, after much vacillation, Jokowi said mudik will be allowed, but those who do make the journey home will be required to self-isolate for 14 days. Physical distancing principles will be applied to those who chose to travel, with buses only able to carry half the number of passengers (tickets will also be more expensive, which may dissuade some), and motorcycles prevented from taking passengers. At the same time as Jokowi was announcing mudik would be permitted to go ahead, his deputy Ma’ruf Amin said he would urge the Indonesian Council of Ulama (MUI) to issue a religious ruling, or fatwa, advising against mudik during the coronavirus pandemic. Although it is too late for those who have already made the journey, the government has announced it will provide “social assistance” payments to Jakarta residents who decide to stay put.
Mudik provides a safety net for many Indonesians, but it also provides the ideal conditions to exacerbate the Covid-19 public health disaster in Indonesia. If a lockdown cannot be enforced by the central government, in the coming weeks appropriate action plans must be put into place in each province to ensure that those people who return are adhering to self-isolation to stem the spread of Covid-19 in vulnerable communities.