Lost Livelihoods, Lost Lives in a Jakarta Neighborhood During the Pandemic

Editor:
Pandemi dan Kampung
A woman scatters flower petals over a loved one’s grave as workers lower a coffin, at Tegal Alur Public Cemetery in West Jakarta. The urban poor in Indonesia’s capital face an increasing number of hardships from the spread of Covid-19 and subsequent public activity restrictions (PPKM) that have been imposed without government support of their basic needs. (Project M/Ricky Yudhistira)

The Covid-19 pandemic has been out of control in Indonesia. Poor urban communities are facing worse conditions compared to the start of the pandemic. Many have lost their jobs, and thousands have lost their lives due to a lack of access to public healthcare, medication or oxygen supplies, while promised government social aid has yet to materialize.

In one case, the driver of a three-wheel taxi, or bajaj, collapsed as he parked his vehicle. Passersby discovered that he was already dead. A few days earlier, the man had complained of fever and chills. Elsewhere, a woman was doing laundry at home when she suddenly fainted and died. She had no prior symptoms or complaints.

Since June, deaths, possibly linked to Covid-19, have spiked in the 18 urban kampungs that partner with the JRMK. “Every day, I get about three to four reports of fatalities,” Eny said, adding that she has been struggling to fathom the deaths.

Although the pandemic has continued for more than a year, Eny said that she did not anticipate the sudden surge in cases after kampung dwellers went back to work and their daily routines.

“At some point, the situation subsided. There was no [Covid-19] news. Suddenly, [infections] escalated again,” said Eny. “Death announcements are coming from every kampung that we assist, including from my own area and from my own friends.”

A friend of Eny’s in Penjaringan, North Jakarta, had been short of breath for days. With a history of acute respiratory infections, the friend had attended the funeral of a co-worker, who had died after 10 days of suffering from headaches, stomach pains and breathing difficulties.

In need of oxygen, the co-worker went to the hospital, but was taken to a tent, as there were no available beds. After waiting for medical assistance, their family decided to bring the co-worker home. The co-worker died on the way back.

Eny said her friend called on the morning of July 8 to report that they could barely hold on. “It’s too hard to breathe,” they said. Eny contacted friends, searching for any information on where to find oxygen. Her friend had tried several sources, including the Penjaringan Puskesmas (community health center), Husada Hospital and Duta Indah Hospital — all in vain.

By 11 a.m. Eny had finagled an oxygen tank from Patungan Rakyat, a crowdfunding initiative initiated by humanitarian activist Sandyawan Sumardi. However, it would not be available until evening, as a volunteer was still queuing for a refill in Pancoran, South Jakarta. “The oxygen was initially intended for another patient in Rawa Barat who also experienced difficulty breathing and could not get oxygen anywhere else. However, the condition of the patient in Penjaringan was more worrisome,” Eny said.

Bahrun, the neighborhood head of Kampung Muka in Ancol, North Jakarta, shared a similar experience. He said 43 of his residents had been diagnosed with Covid-19 between June 2021 and July 7. Fifteen died.

Pandemi dan Kampung
A man sleeping in a temporary shelter in Sunda Kelapa, North Jakarta. Apart from lack of public access to information and healthcare, inadequate self-isolation space has worsened the spread of Covid-19 in crowded neighborhoods. (Project M/Seto Wardhana)

Like Eny, he hadn’t anticipated the surge in Covid-19 cases. Kampung Muka had been known for its strict adherence to health protocols. Bahrun, who also heads the neighborhood Covid-19 task force, leads nightly patrols to remind residents of health protocols. People are told to avoid crowds. Anyone seen without a mask is rebuked.

However, the Delta variant of the SARS-CoV-2 virus has accelerated the rate of Covid-19 infections. The current situation has clearly been more alarming than the beginning of the pandemic, says Bahrun. The virus currently infects anyone, regardless of age — including three children, aged 10, 4 and 2, in Bahrun’s area.

The 10 year old had a medical history of lung disease when they were diagnosed with Covid-19. No hospital would admit the child, who was barely able to breathe. The parents visited five healthcare facilities: The Pademangan Puskesmas; RSUD Pademangan, RSUD Taman Sari, and RSUD Koja general hospitals; and a clinic in Mangga Dua downtown, Bahrun said.

“In the end, the child was brought to a […] midwife in one of the communities. Steam inhalation was provided there, and the child was treated for about an hour. The child was saved,” Bahrun said.

Self-Isolation is Impossible

As healthcare facilities reach capacity, most people suffering from Covid-19 in the city’s kampungs must self-isolate in their own homes. As head of the local Covid-19 task force, Bahrun regularly monitors their condition while tracing their contacts.

He said his team records when residents have positive PCR tests. After 10 days of self-isolation, Bahrun asks them to get a second PCR test. If the results are negative, the certified results are sent to the local community health center to meet data collection requirements.

However, proper self-isolation is next to impossible for residents of Kampung Muka, one of the capital’s most densely populated areas, with a population of some 10,000 people. Tiny houses jostle side by side. It’s not unusual for four family members, or more, to share spaces as small as 16 square meters. “[Couples] with only two children are the very minimum. There are families with three to four children,” said Bahrun. “We fight for air just to breathe.”

Such circumstances have led to clusters of family infections. Bahrun reported a case where eight family members were infected with Covid-19. “There are cases where only one or two family members are exposed; in some, three out of four members, in others, all of them are infected.”

When monitoring self-isolation, Bahrun stresses the basics: every family member must wear a mask, every family member testing positive must refrain from physical contact with those testing negative, and no one should eat or drink with those testing positive.

He also reminds them to maintain a healthy lifestyle, take their vitamins and medication, sunbathe in the morning and limit their activities. Each house  in isolation and the surrounding area are routinely doused with disinfectant liquid.

“Frankly, monitoring the ones who are self-isolating is the hardest part,” said Bahrun.

Several days earlier his teammates were shocked to find a homeless man dead inside a makeshift hut. Residents who recognized the man found him unconscious on a sidewalk around Mangga Dua and carried him home. Although the homeless man had difficulty breathing, a doctor was consulted and advised him to rest. The locals left the hut at midnight. He died shortly later.

“We are worried that such things can happen again, which is why we are keeping an eye on people,” Bahrun said.

Economic and Information Inequality

It cannot be confirmed whether all the deaths in the 18 urban kampungs that partner with JRMK were due to Covid-19. Several Kampung Muka residents died without taking PCR tests. Warno, a coordinator of street hawkers in West Ancol, recounted the story of his peer, who died after 10 days of headaches and stomach pains.

“He did have an underlying lung condition. I asked him how he was, he said he was ill. I advised him to see a doctor, but he said he was too weak to stand up. His children were working and could not bring him to a doctor. Not long after, in around 4-5 days, I heard  he had passed away in his home,” Warno said.

Tight budgets are the main reason behind people’s reluctance to take PCR tests. Fees range from Rp 600,000 [US$41.77] to Rp 1.5 million.  “We are already struggling to eat,” Eny said. “Many people feel it’s better to bear the pain rather than spend money” for uncertain PCR results.

Under the current restrictions, getting a PCR test is even more unrealistic, including for members of Eny’s own family who have lost their jobs.

“My husband works at the port. With the [restrictions], he cannot work. Luckily, one of my children still works at the sub-district office, although it’s not enough.  I still need about Rp 1.5 million for the family to get by for a month,” Eny’s relative said.

Eny said community health centers only cover the cost of positive PCR tests. “So, if it’s negative, we still have to pay,” she said.

Bahrun also cited the loss of income throughout the government’s so-called micro-lockdowns (PPKM), which are extended based on official judgment of the pandemic situation in a given area.

Pandemi dan Kampung
A peddler serving residents of Kampung Bayam, North Jakarta. The current enforcement of public restrictions discriminates against the poor, who have lost their incomes while receiving no assistance to meet their basic  needs. (Project M/Tubagus Rachmat)

Although community health centers say they cover the cost of positive PCR tests, Bahrun said one resident complained that his PCR results were positive after spending more than 10 days in self-isolation. “He ranted. ‘I have paid for [PCR tests] twice. I have spent more than Rp 1 million, but the results remained the same. What should I do?’” said Bahrun. “We want it to be free. But that’s not the reality.”

A Project Multatuli reporter sought comment from the head of the Jakarta Health Agency, Widyastuti, on PCR fees, but has yet to receive a response. We also reached out to other officials: disease control and prevention unit head Lies Dwi Oktavia, health resources unit heads Ani Ruspitawati and Wening, as well as the spokesman for the national Covid-19 task force, Wiku Adisasmito. As of publication, no comment has been received.

Another factor contributing to test-taking reluctance is a fear that a positive result will separate people from their families. “If we are declared positive and become quarantined, well, it would be the last day to meet our family if our condition deteriorates and we die. The family would not be able to attend the funeral process, let alone join the ritual of bathing the dead,” Eny said. “That is why many people who know they have Covid-19 symptoms choose not to report it.”

Gugun Muhammad, an activist and the advocacy coordinator for the Urban Poor Consortium (UPC), said unequal access to information had led to misunderstandings of Covid-19 in the city’s kampungs. Continuous death notices are frightening people yet they are at a loss what to do. “The government has failed in raising awareness about the threat of Covid-19,” Gugun said.

He cited the Presidential Chief of Staff, Moeldoko, who said in October 2020 that “Hospitals should not ‘Covid-ify’ (meng-Covid-kan) patients.” The statement appeared to confirm widespread rumors that patients were diagnosed with Covid-19, regardless of their ailments, leading to protest against  the health workers tasked with transporting family members to hospitals, even though they tested positive for the virus. Some grieving families have stolen the bodies of their deceased relatives from ambulances to avoid Covid-19 protocol burials.

Moeldoko’s widely reported statement “corroborated people’s theories that those admitted to the hospital would be designated to have Covid,” Gugun said. “The responsibility to provide information is in the hands of the government.”

Discriminatory Emergency Restrictions

Urban kampung residents are torn between losing their livelihoods or losing their lives. Bahrun is afraid that crime will spike in his neighborhood as people lose their jobs. “The social impact is actually more fatal,” he said. “In the end, I understand. I never ban the residents who still venture outside from busking or from becoming ‘silver humans’ . It’s their means to survive.”

Warno said that there’s been a lack of government information on how to handle self-isolation. “We don’t understand what kind of disease this is. The medications are also so hard to get,” he said. “I mean, if any information was available, [then] if another friend or a colleague was exposed to Covid-19, I would know who to contact, where to take them, what medication to take and how to care for them.”

Eny also said the current emergency restrictions deny people their basic rights. “Last year during the PSBB [large-scale social restrictions], we still received basic food aid–even though it did not solve the problems of how we were going to pay rent [or] how we would cover the needs of babies and toddlers. And what about residents whose names aren’t registered for social aid?” said Eny. “At least, there was some aid. Now, absolutely nothing.”

So, how are residents surviving?

“Well, I don’t know,” Eny said. “The final solution? Borrow money.”

Eny cited a network member who is still ill in Penjaringan. “She is the family breadwinner. Her husband is unemployed. She has two toddlers and a baby grandchild. Now that she is ill, the family is economically crippled.”

The activist Gugun said the current restrictions discriminate against the poor. “People with a monthly salary may have no problem. But in the kampung, people get their income by directly meeting customers [and] selling their wares – not to mention freelance daily laborers, who won’t be paid if they don’t work.”

Gugun said the government should impose a formal quarantine in accordance with Law No. 6/2018 on Health Quarantines, which would oblige the government to meet the people’s basic rights to healthcare, food and other daily needs during a lockdown.

Meanwhile, the urban poor continue to face the worst of the pandemic. “The worst. Worse than last year,” Gugun said.

An economist, Faisal Basri, said the pandemic could further impoverish the country’s lower middle class. “The concern is that this pandemic will create a K-shaped recovery. The established upper middle class, with their adequate resources, will have a quick recovery. Meanwhile, our lower middle class peers, the ones with daily expenses of Rp 25,000, will become impoverished, or will get closer to the poverty line,” Faisal told Project Multatuli.

“They are about 134 million people or 52.8% of the population. They do not fall into the poor category, but live very sparingly. It will take a long time for them to recover.”

 


Editor: Mawa Kresna, Ati Nurbaiti, Christian Razukas

This article is originally published in Indonesian as part of the report series to portray inequality in Covid-19 handling. The series is supported by Kurawal Foundation. You can support Jakarta’s kampung residents through Patungan Rakyat via kitabisa.com and help Indonesia deal with oxygen shortage through #OxygenForIndonesia.

The translation of this article from Indonesian to English is made possible through the generosity of our readers, Tintin Wulia, Christie Santara, and AIYA translation team.

Related Coverage