Alarming rise in Malaria outbreaks in Indonesia

Alarming rise in Malaria outbreaks in Indonesia

JAKARTA (JP): There has been an alarming increase in malaria
outbreaks in Indonesia in the past few years, with some areas
showing a 200 percent rise in the number of reported cases.

Officials attribute the rise to, among other things,
environmental changes, relatively high population mobility and
refugees.

The Ministry of Health and Social Welfare reported on Tuesday
that between 1997 and 1999 there was a more than 200 percent
increase in malaria cases in Java and Bali.

Outside of Java and Bali there was an increase of 56.25
percent.

The number of malaria cases in Java and Bali -- except for
Jakarta -- increased from 12 cases per 100,000 people in 1997 to
38 cases per 100,000 in 1999, with the most occurrences in
Yogyakarta with 35 cases per 10,000 persons.

Outside of Java and Bali, from the 1,600 malaria cases per
100,000 in 1997, the figure increased to 2,500 cases in 1999,
with the highest in East Nusa Tenggara with 16,290 cases per
100,000.

That amounts to a total of about 15 million people who have
suffered malaria in this country with a mortality rate of 30,000
people.

The ministry's Director General of Communicable Disease
Control and Environmental Health Umar Fahmi Achmadi highlighted
environmental changes as the cause.

"For example in Cilacap, Central Java, where farming land has
been converted into fish ponds, or neglected shrimp ponds which
have become potential breeding grounds," he told reporters on
Tuesday on the sidelines of a partnership meeting to eradicate
malaria with the World Health Organization (WHO).

Yogyakarta, he said, especially Kulon Progo, is prone to
malaria due to its natural soil condition which contains a lot of
rocks.

According to Umar, the clearing of mangrove forests, global
climatic changes and the economic crisis also contributed to the
increase of malaria cases.

He added that the number of malaria cases was expected to rise
this year due to the increasing number of refugee camps.

"Malaria is rampant in the camps," he said.

Umar once mentioned that based on a brief survey, some 80
percent to 90 percent of refugees suffer from malaria.

There is an estimated 800,000 refugees in the country who have
been displaced due to conflicts or natural disasters.

Most of the refugees are in Aceh, North Sumatra, West
Kalimantan, East Nusa Tenggara, South Sulawesi, Southeast
Sulawesi and Maluku.

Umar also said that malaria patients had a tendency not to
finish the full course of medication.

"They are usually reluctant to take medicine. The patients
stop taking medicine when they feel a little better, while in
fact they have to take it until they are really cured," he said.

Such reluctance, he added, increases the medical cost tenfold.

According to Umar, although malaria is an acute disease, it
claims fewer lives compared to dengue hemorrhagic fever.

"But while it doesn't cause immediate death, it decreases
people's productivity. It actually results in a higher economic
cost. That is why malaria is called the silent killer," he said.

Therefore, Umar said, regional administrations should not
hesitate in investing money for medicine in treat malaria.

The government, he added, launched the Malaria Eradication
Movement (Gebrak Malaria) in April last year, particularly
targeting susceptible areas including Central Java, West Java,
South Sumatra, South Kalimantan, Southeast Sulawesi and East Nusa
Tenggara.

"Eradicating malaria is one of our priorities this year," Umar
said.

The strategy includes surveillance, proper diagnosis and
treatment, prevention, research and development, and increasing
health services.

"Hopefully in 2010, we can at least reduce malaria prevalence
by 50 percent," Umar said. (hdn)