Umar discloses malaria rampant in refugee camps

JAKARTA (JP): Last year saw a marked increase in the number of malaria cases, with health experts predicting continued high numbers if there large concentrations of refugees remain.

The Ministry of Health and Social Welfare's director general for Contagious Disease Eradication and Environmental Sanitation Umar Fahmi Achmadi described malaria as one of the major health problems in 2000.

"It is especially rampant in refugee camps," he told reporters.

"Unfortunately, we do not know the exact number of people stricken with malaria but based on a brief survey, some 80 percent to 90 percent of the refugees are suffering from malaria," he claimed.

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

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

Other health problems prevalent in refugee camps, particularly those in Atambua and East Nusa Tenggara, are respiratory infections, diarrhea and measles.

Umar pointed out that malaria is also rife in less developed provinces such as Irian Jaya and in small and isolated islands.

"In small islands, such as those in East Nusa Tenggara, Maluku and Riau, the increase in malaria was also caused by the clearing of the mangroves. The mangroves not only prevented land erosion, but they are also habitats for mosquitoes that spread the disease," Umar said.

According to Umar, one of the government's major concerns the past year was improving community health in Irian Jaya and small islands.

The ministry launched an intensive health care program in Irian Jaya last year as the people's health here were poorer than in other regions.

The poor health conditions were mainly due to a lack of qualified health workers and medical facilities, and limited accessibility to health services due to the province's rugged terrain.

Irian Jaya has an area of 421,981 square kilometers or three times the size of Java. 85 percent of its 2.1 million population live in rural areas.

"There is no electricity in the rural areas to refrigerate vaccines," Umar said.

"So we use solar cells. But solar cells need batteries, and to charge the batteries, we sometimes have to travel for weeks by boat," he cited.

There are also diseases that are peculiar to Irian Jaya, he said, like a species of worm that attacks the brain.

"In short, Irian is indeed a challenge for us," Umar said.

As for the small islands, Umar said, the problem is mainly providing adequate health service.

"It's impossible to establish one health center for every island," he said.

The directorate last year also recorded an extraordinarily high number of rabies cases in Flores Island, East Nusa Tenggara.

"We recorded some 1,200 dog bites there last year. Twenty percent to 30 percent of the bites resulted in rabies, with 100 to 120 fatalities," Umar said.

He added that many fishermen who have migrated from other islands come with their dogs.

According to Umar controlling the spread of contagious diseases will remain a major challenge for a country like Indonesia.

Umar said that besides malaria, other diseases that would have to be controlled are tuberculosis, HIV (Human Immuno- Deficiency Virus), AIDS (Acquired Immune Deficiency Syndrome), leprosy, and dengue fever .

"We've succeeded in eradicating polio through immunization, but we had to delay the immunization program in Ambon due to the conflict in the region," he said.

This year, he said, Indonesia will also embark on a program to eradicate leprosy by 2005. (hdn)