Jakarta, Indonesia – Dr Erlina Burhan has been providing medical care for over 30 years – but now, for the first time in her career, she has been forced to turn away patients.
For the past six months, the intensive care unit (ICU) at his hospital in the Indonesian capital, Jakarta, has been operating at a capacity of 90-100% as coronavirus infections increase.
“We are rejecting patients every day because there is nothing we can do if the hospital is full,” said Burhan, the COVID-19 team leader at Persahabatan National Lung Hospital.
“Even though the patient is in a very bad condition and needs the ICU, if we don’t have space we can’t take it and we have to say, [we’re] Sorry.”
Confirmed cases of COVID-19 in Indonesia surpassed the million mark on Tuesday, but doctors warn the reality in their hospitals is much worse – especially on the islands of Java and Bali.
“There are some regions and cities with 90 percent bed occupancy – and there are cities with 100 percent occupancy. The consequence of the overflow of hospitals is that patients will not receive adequate treatment, ”said Hery Trianto, of the country’s COVID-19 task force.
Dr Atok Irawan, from Umum Sidoarjo Hospital in North Jakarta, said the facility had no choice but to use its general section to treat COVID-19 patients because the COVID-19 zone designated is already at full capacity.
“Last night we were really overwhelmed… almost all of the hospitals affected by COVID-19 are full,” he said. “We have many non-COVID patients who also need help… because of the rainy season there are patients with typhoid and diarrhea.”
In east Jakarta, Burhan Hospital has added ventilators and beds to emergency units, but it does not have enough staff to meet demand.
“We get so many requests and unfortunately we have to turn them down,” Burhan said. “I read the files of people referred to our hospital. It makes me so sad… A person who can barely breathe… but we can’t help them.
Sick and desperate
To date, Indonesia has recorded some 28,500 coronavirus-related deaths while more than 800,000 people have recovered. Among them, Gena Lysistrata, who suffered from body aches, eye pain, diarrhea, fever and difficulty breathing.
The Jakarta resident was fortunate enough to receive treatment at Wisma Atlet – formerly, the Athletes’ Village during the 2018 Asian Games, but now a fully functioning hospital for COVID-19 patients – relatively quickly, but she’s growing. is found in a desperate search for medical care for her elderly parents after also testing positive for the virus.
“My mom and dad started to have breathing problems and my dad was shaking and feeling weak,” Lysistrata said. We went to an emergency unit and it was full… there were a lot of people on the waiting list, ”she said. “In another hospital, the emergency unit was already full.”
Eventually, her parents were hospitalized because a nearby hospital was able to increase its patient capacity, and they have since recovered.
“I was panicked. I watched the news and saw that many health facilities are full. So I was scared, ”Lysistrata said.
In desperation, some families have turned to a local COVID-19 data agency to help them find a hospital that will accept their loved ones.
Since August of last year, Dr Irma Hidayana of Lapor COVID-19 has been responding to these calls.
“From the cases we are working on, four people have died – one died in a health center, one died in a taxi after being rejected by so many hospitals… another died in hospital because that the ICU was full … and [in] in another case the family had to rent a respirator but this person recently passed away, ”she said.
The person who died in the taxi had tried to seek treatment at 10 hospitals – and after being rejected by all, she died on the way to another.
“Many sick people cannot get treatment, they cannot even enter the intensive care unit,” Hidayana said. “It is important that the government respects people’s right to receive medical treatment.”
Contested working group
An archipelago of some 270 million people, Indonesia tests only about 40,000 to 50,000 people per day, with about 30 percent of those tested returning positive results.
It is the worst-affected country in Southeast Asia but, unlike its neighbors, it has never implemented a strict COVID-19 lockdown.
Meanwhile, many of the restrictions imposed at the start of the pandemic have already been watered down, despite evidence the crisis is worsening. Current restrictions include slightly reduced hours for shopping malls and restaurants and entry restrictions for most foreigners.
This week, President Joko Widodo praised his country’s handling of the pandemic.
“This has caused health and economic crises. We are grateful that Indonesia is one of the countries capable of controlling these crises well, ”he said during a presentation.
“The pandemic is still ongoing and we must remain vigilant.”
At the end of another long day at the hospital, Burhan said she hoped the government would do more to ease the strain on medical facilities.
“The hospitals are in a hectic state; health workers are tired. We are extremely exhausted… and frustrated, ”she said.
“I know the government has passed so many regulations, but the implementation is weak and inconsistent.”
She is now used to responding to complaints from patients and their families about the quality of care – but her options are limited.
“Health care will not collapse instantly… What we will see is the decline in the quality of services… because health workers are pushing their limits,” she said.
“Those who will suffer are the people of Indonesia.”