Indonesia’s anti-leprosy fight paralyzed by COVID-19 challenges

Indonesia’s anti-leprosy fight paralyzed by COVID-19 challenges
A health worker, right administers COVID-19 vaccine in Surabaya. (AFP)
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Updated 01 February 2021

Indonesia’s anti-leprosy fight paralyzed by COVID-19 challenges

Indonesia’s anti-leprosy fight paralyzed by COVID-19 challenges
  • The prevalence of leprosy among Indonesian children is currently 9.14 percent, well above the government target of 5 percent

JAKARTA: Indonesia’s efforts to ensure an early screening of leprosy cases among children is being hampered by school closures due to the coronavirus disease (COVID-19) and a shift in focus to combating the pandemic.

The prevalence of leprosy among Indonesian children is currently 9.14 percent, well above the government target of 5 percent.

Failure of early detection and treatment in children could result in permanent disability and a lifetime of stigma and discrimination.

Al Qadri, a 49-year-old leprosy survivor from Makassar, South Sulawesi spoke with Arab News on Jan. 31, World Leprosy Day.

“I was expelled from school after I learned I suffered leprosy when I was six. It was a very painful experience. I never had a chance to graduate from elementary school, but when I was 12 I was taught how to read and write from a local school teacher,” said Qadri, who is the deputy chairman of Perhimpunan Mandiri Kusta, a nongovernmental organization advocating for leprosy sufferers.

He added that he did not receive treatment until he was 18.

When the six-month treatment finished, he underwent 13 surgeries to reconstruct his deformed fingers.

Although they could not return to their normal condition, Qadri said he could use his fingers for basic tasks such as typing.

Leprosy is an age-old infectious disease with a slow incubation period that takes an average of five years.

It is transmitted via droplets from the nose and mouth during close contact with untreated cases and is curable with multidrug therapy, but could cause permanent nerve damage to the skin if ignored.

Maxi Rein Rondonuwu, the acting director general of disease prevention at the Health Ministry, said in a press conference on Friday that eight of Indonesia’s 34 provinces still record the disease, with an average prevalence of 1 in every 10,000 people.

“We are focusing on efforts to treat new cases found in children since they could face discrimination and pose a risk to infect other children,” Rondonuwu said.

Siti Nadia Tarmizi, the ministry’s director for communicable disease prevention, said the national prevalence of leprosy cases has continuously declined since 2010, with the other 26 provinces having eliminated it. 

In 2020, the ministry recorded more than 16,000 new cases.

“But the declining figure does not mean that it was getting better since the COVID-19 pandemic has gotten in the way of active case- finding efforts through schools. In provinces where leprosy is not yet eliminated, infections remain very high, resulting in children being infected,” she said.

According to the World Health Organization (WHO), only Brazil and India have a higher prevalence of leprosy. 

The country’s 1 million COVID-19 cases and almost 30,000 deaths are the second-highest in Asia after India.

There are still some 200,000 new cases of leprosy diagnosed worldwide each year, and millions are living with some form of disability as a result of the disease, according to WHO Goodwill Ambassador for Leprosy Elimination Yohei Sasakawa.

“Leprosy cases detected in Indonesia are actually just the tip of an iceberg, especially when the public remains misinformed about the disease and stigmatizes those who suffer,” Qadri said, adding that awareness about early symptoms and treatment could prevent nerve damage and people being ostracized.

“I decided to leave my village in Wajo district when I was 19 after I was cured because of the marginalization. I am now married to a leprosy survivor and our two children, both in their 20s, are healthy, and there is no indication that they suffer from the disease like their parents,” he said.


Cooperate despite ‘genocide’? Biden tests ties with China, Russia

Cooperate despite ‘genocide’? Biden tests ties with China, Russia
Updated 10 min 8 sec ago

Cooperate despite ‘genocide’? Biden tests ties with China, Russia

Cooperate despite ‘genocide’? Biden tests ties with China, Russia
  • Climate envoy John Kerry issued a joint statement with China saying the two nations are “committed to cooperating with each other”

WASHINGTON: US President Joe Biden’s administration accuses China of genocide but reached a joint pledge to cooperate on climate. The White House is also working to arrange a summit with Russia, despite imposing harsh new sanctions.

Biden’s strategy is not about easing tensions, so often the stated goal of diplomacy, but identifying narrow areas to work together — especially on climate change — while acknowledging that much of the relationship will remain hostile.

Biden alluded to America’s Cold War relationship with the Soviet Union last week after he ordered sanctions and the expulsion of Russian diplomats as a way to impose costs over Moscow’s alleged interference in US elections and a major hacking operation.

“We want a stable, predictable relationship,” said Biden, who proposed a summit in a neutral country during a telephone call with Russian President Vladimir Putin even while pressing him over the health of jailed dissident Alexei Navalny.

“Throughout our long history of competition, our two countries have been able to find ways to manage tensions and to keep them from escalating out of control,” he said.

Biden’s relationship with China is guided by a similar philosophy — described, in a colloquial phrase popular in his White House, as being able to walk and chew gum at the same time.

Secretary of State Antony Blinken, in a speech Monday, defended the approach from expected criticism by saying that no nation’s climate efforts would “excuse bad behavior.”

“Climate is not a trading card; it is our future,” Blinken said.

Climate envoy John Kerry, after a visit to Shanghai last week, issued a joint statement with China saying the two nations are “committed to cooperating with each other.”

However general in tone, it marked a stark contrast to a testy first meeting between top officials in March in Alaska, where Blinken raised concerns on a host of Chinese actions including what Washington has described as “genocide” against Uyghurs and other mostly Muslim Turkic-speaking people.

Biden has invited Putin and Chinese President Xi Jinping to a climate summit this week, with Kerry saying it would be tantamount to “killing yourself” not to work together on climate despite other disagreements.

Biden’s cool approach follows the highly personalized diplomacy of his predecessor Donald Trump, who voiced admiration for Putin and in his last year in office incessantly berated Beijing, which he blamed for the devastating Covid-19 pandemic.

Ryan Hass, a senior fellow at the Brookings Institution who advised former president Barack Obama on China, detected a “gradual but significant shift” in the stance toward Beijing under Biden.

“His administration has dialed down the rhetorical heat and focused purposefully on concrete areas of the relationship where American interests are impacted by Chinese actions,” Hass said.

“Both sides also have slowly begun restoring direct functioning channels of diplomatic communication to address areas of concern and explore opportunities for coordination.”

China and the United States are the world’s top two economies and together account for half of global emissions responsible for climate change. Russia is the fourth biggest emitter and Putin has accepted an invitation to speak at the climate summit.

Putin’s decision to participate “signals that he, too, is interested in preserving some space in the fraught US-Russian relationship,” said Heather Conley, a senior vice president at the Center for Strategic and International Studies.

But, Conley said: “Speaking at a virtual summit and mitigating climate impacts are two very different things.”

“What is striking to me is that while both Beijing and Moscow are speaking the language of climate change before international audiences, at home, they are putting their foot on the accelerator to increase global carbon emissions,” she said, pointing to Russia’s fossil-fuel industry and China’s reliance on coal plants.

In a recent essay, Andrew Erickson, a China expert at the US Naval War College, and Gabriel Collins of Rice University argued that the United States should look to compete rather than coordinate with China on climate. They said the United States could champion a carbon tax on exports — already backed by the European Union — to force China to cut back on coal.

“Xi’s bullish talk of combating climate change is a smokescreen for a more calculated agenda,” they wrote in Foreign Affairs.

“Chinese policymakers know their country is critical to any comprehensive international effort to curb greenhouse gas emissions, and they are trying to use that leverage to advance Chinese interests in other areas.”


Russian military build-up near Ukraine numbers more than 100,000 troops, EU says

Russian military build-up near Ukraine numbers more than 100,000 troops, EU says
Updated 14 min 26 sec ago

Russian military build-up near Ukraine numbers more than 100,000 troops, EU says

Russian military build-up near Ukraine numbers more than 100,000 troops, EU says

BRUSSELS: More than 100,000 Russian troops have massed on Ukraine’s border and in annexed Crimea, the office of the EU’s top diplomat Josep Borrell said after EU foreign ministers were briefed by Ukraine’s foreign minister.
In a press conference on Monday, Borrell had originally spoken of more than 150,000 troops, and declined to give a source for the figure.
His office later corrected the number to more than 100,000 troops without giving a reason for the change.
Borrell said no new economic sanctions or expulsions of Russian diplomats were planned for the time being, despite saying that the military build-up on Ukraine’s borders was the largest ever.
In Washington, the Pentagon said the Russian military build-up was larger than that in 2014 and it was not clear that it was for training purposes.
A US official, speaking on the condition of anonymity, said the Russian build-up numbered in the tens of thousands but was not aware of intelligence that pointed to more than 150,000 Russian troops.
The United States also expressed its “deep concern” over Russia’s plans to block foreign naval ships and other vessels in parts of the Black Sea, State Department spokesman Ned Price said in a statement.
“This represents yet another unprovoked escalation in Moscow’s ongoing campaign to undermine and destabilize Ukraine,” Price said.
Russia has temporarily restricted the movement of foreign warships and what it called “other state ships” near Crimea.
Ukrainian Foreign Minister Dmytro Kuleba, after addressing EU foreign ministers, called on the EU to impose new sanctions on Russia.
Tensions between Moscow and Kyiv have been rising amid the military build-up and clashes in eastern Ukraine between the army and pro-Russian separatists.
The US Federal Aviation Administration on Monday urged airlines to exercise “extreme caution” when flying near the Ukraine-Russian border, citing potential flight safety risks.


US on alert as jury deliberates in trial of Derek Chauvin

US on alert as jury deliberates in trial of Derek Chauvin
Updated 20 April 2021

US on alert as jury deliberates in trial of Derek Chauvin

US on alert as jury deliberates in trial of Derek Chauvin
  • Chauvin, a White Minneapolis police officer, is accused of killing African American George Floyd while restraining him
  • There are fears that Arab American businesses could be targeted if the verdict triggers violent protests

CHICAGO: Police in cities across America were on alert Monday night as a jury began its deliberations in the trial of White Minneapolis police officer Derek Chauvin, who is accused of causing the death of African American George Floyd while he was restraining him.
Floyd, 46, died on May 25 last year after Chauvin knelt on his neck for more than nine minutes to hold him down. Floyd’s death sparked widespread protests across the US by members of the Black Lives Matter movement, some of which turned violent.
Chauvin is charged with second-degree unintentional murder, third-degree murder and second-degree manslaughter. The jury could convict him on a murder charge or they could find him innocent. Many believe a verdict of innocence could spark more violent demonstrations.
During the protests last year, which raged for more than two months, some people looted, damaged and even burnt down businesses, not only in Minneapolis but across the country. Several dozen people died in the violence and hundreds were injured.
Arab American stores in particular were targeted and looted because Floyd was arrested in front of one, called Cup Foods, owned by Mahmoud Abumayyaleh. An employee at the store had called police to report Floyd for trying, for a second time, to pass a counterfeit $20 bill.
In Chicago, for example, more than a dozen stores owned by Arab Americans or Muslims were looted. Two of them were burnt down.
Hassan Nijem, president of the Arab American Chamber of Commerce of Chicagoland said he hopes that protesters will not resort to violence if the jury returns a not guilty verdict against Chauvin.
“Last summer more than a dozen Arab American businesses were among the hundreds of businesses in Chicagoland that were damaged and looted by some of the protesters,” he said.
“This happened across the country, with many Arab American businesses being targeted by rage and anger. The protesters have a right to protest, whatever the jury decision, but we urge them not to damage any businesses and not to target Arab or Muslim businesses.”
Tensions are running high and were further inflamed by California Congresswoman Maxine Waters on Saturday. During an appearance at a Black Lives Matter rally at the Brooklyn Center in Minnesota she told the crowd: “Well, we’ve got to stay on the street. And we’ve got to get more active. We’ve got to get more confrontational. We’ve got to make sure that they know that we mean business.”
Minneapolis Judge Peter Cahill, who is presiding over the Chauvin trial, described public comments about the case by elected officials, such as the congresswoman’s, as “abhorrent” but refused to grant a motion for a mistrial, which had been requested by Chauvin’s lawyers.
However he said: “I’ll give you that Congresswoman Waters may have given you something on appeal that may result in this whole trial being overturned.”
Fearing violence, police in many communities across the country are on high alert to protect business districts if the verdict does not meet the expectations of activists.
Minutes after Cahill directed the jury to begin their deliberations on Monday afternoon, Illinois Gov. J. B. Pritzker announced he was activating the Illinois National Guard. He said this was a response to a request from Chicago Mayor Lori Lightfoot to supplement the police presence.
“At the request of the City of Chicago, Gov. J. B. Pritzker is activating 125 personnel from the Illinois National Guard to stand by to support the Chicago Police Department, with a verdict expected in the trial of Derek Chauvin,” according to an official statement. The deployment will begin on Tuesday morning. The guardsmen will engage in “a limited mission to help manage street closures and will not interfere with peaceful protesters exercising their First Amendment rights.”
Pritzker has also directed Illinois State Police to support the Chicago Police Department by providing additional troopers “to keep the community safe.”
“It is critical that those who wish to peacefully protest against the systemic racism and injustice that holds back too many of our communities continue to be able to do so,” he said. “Members of the Guard and the Illinois State Police will support the City of Chicago’s efforts to protect the rights of peaceful protesters and keep our families safe.”
Lightfoot said the request for support was critical.
“Our greatest priority at all times is ensuring the safety and security of the public,” she added. “While there is no actionable intelligence at this time, we want to be fully prepared out of an abundance of caution. Our city has a long history of peacefully expressing its First Amendment rights and I encourage residents to exercise their rights to free speech this coming week thoughtfully, respectfully and peacefully.”


Philippine hospitals fight surge in COVID-19 cases

Philippine hospitals fight surge in COVID-19 cases
Updated 20 April 2021

Philippine hospitals fight surge in COVID-19 cases

Philippine hospitals fight surge in COVID-19 cases
  • Capital region and four surrounding provinces in lockdown

MANILA: The Philippines on Monday continued to record a spike in COVID-19 infections, with officials at a state-run hospital in Quezon City comparing the crisis to a “war zone” as health facilities across the country struggled to deal with an influx of patients.

The country registered 9,628 new infections on Monday, despite the government placing its capital Metro Manila region and four surrounding provinces under one of the strictest lockdown levels in March to tackle the surge.

“It’s like a war zone now,” healthcare worker John M. told Arab News on Monday, as he described scenes at his hospital of patients on a stretcher or a folding bed and lying in the hallway.

“This has never happened before. It’s because of an influx of COVID patients. Also, we do not refuse patients that are brought to the facility,” said John, who asked for his name to be changed as he was not authorized to speak to the media.

The Department of Health said that Monday’s infections brought the nationwide tally to 945,745. 

It reported 88 further coronavirus fatalities, raising the death toll to 16,048, with 788,322 recoveries and 141,375 active cases.

Since the March spike, several hospitals said they had been running at full capacity for COVID-19 patients, some of whom had to wait for several days to be admitted or drive from one hospital to another to seek treatment.

The state-run Philippine General Hospital (PGH), the largest COVID-19 referral facility in the country, had “a lot” of patients on the waiting list.

“They’re already full, and we have a lot of wait-listed patients,” Dr. Joel Santiaguel, a fellow at the PGH pulmonary department, told Arab News.

Santiaguel said that, compared to last year when a patient referred to the PGH could get easily admitted, patients now needed to wait for several days or be moved to the ER in case of an emergency. “But that too takes time.”

FASTFACT

Several hospitals said they had been running at full capacity for COVID-19 patients, some of whom had to wait for several days to be admitted or drive from one hospital to another to seek treatment.

He also cited how ambulances were working overtime to rush critical patients to hospitals, with a long queue of them parked outside PGH.

Santiaguel traced the crisis back to the second or third week of March, saying the PGH was never crowded with COVID-19 patients before then. He had also heard about some patients desperately searching for bed space to get admission into the ER.

“We used to see around 20 patients per day, but starting from March until now, we are attending to 70 patients per day. There are no beds available, so patients go to at least six to eight hospitals to find space in the ER or wait at the tent of the ER (for space to open up).”

Some patients died while waiting for their turn.

John said such stories were not limited to patients, with a nurse at his facility who tested positive for coronavirus also forced to wait on a “folding bed in the hallway of the hospital for a vacant room or bed.”

The hospital where he works has two five-story buildings for COVID-19 patients, with each floor able to accommodate 50 patients.

“All the rooms are currently occupied. Earlier, we would admit one person per room. Now we are forced to take two per room.”

According to the Department of Health, the utilization rate of COVID-19 beds remains high in the Metro Manila region, with beds in 700 of its intensive care units (ICU) reporting 84 percent occupancy, while 3,800 isolation beds were at a 63 percent occupancy rate, 2,200 ward beds at 70 percent, and ventilators at 61 percent.

Meanwhile, 66 percent of 1,900 ICU beds, 49 percent of 13,600 isolation beds, 56 percent of 6,000 ward beds, and 47 percent of 2,000 ventilators are currently in use nationwide.

In his televised address to the nation last week, President Rodrigo Duterte warned of more COVID-19 deaths due to the lack of vaccine supply.

“Until now, the word is unavailable. Unavailable because there’s no sufficient supply to inoculate the world. This will take long. I tell you, many more will die because of this. I just can’t say who.”

On Monday, however, Duterte’s spokesperson Harry Roque said the number of COVID-19 cases in a few Metro Manila cities had started to go down in recent days, partly due to the intensified implementation of the Prevent-Detect-Isolate-Treat-Reintegrate (PDITR) strategy.

He said that while there was only a slight decrease it was “still proof” that the PDTIR initiative was working. 

He added that the results of the lockdown in Manila and its surrounding provinces would be seen after three to four weeks.

In a press briefing at the weekend, Health Undersecretary Maria Rosario Vergeire said the department was stepping up its efforts to expand the health system.

“The most important thing for us now is, even though numbers will rise, to have enough healthcare capacity to accommodate patients, especially those who need hospital care or who need quarantine care. We are expanding (the number of) beds, talking with our local governments to intensify our response.” 

She also expressed hope that cases would decline in the coming days and that hospitals in Metro Manila would be decongested.


New Delhi placed under lockdown as hospitals reach ‘breaking point’

New Delhi placed under lockdown as hospitals reach ‘breaking point’
Updated 20 April 2021

New Delhi placed under lockdown as hospitals reach ‘breaking point’

New Delhi placed under lockdown as hospitals reach ‘breaking point’
  • New Delhi recorded 26,000 coronavirus cases on Monday, a record jump since April 1

NEW DELHI: India’s government on Monday announced a week-long lockdown in the national capital, New Delhi, after its health system reached “breaking point” due to a scarcity of hospital beds and oxygen tanks for coronavirus patients.

On Monday, India witnessed an unprecedented spike in coronavirus infections, with 273,810 cases reported in a single day.

At least 1,620 people were killed by the virus, creating another record on Monday and bringing the country’s death toll to 178,769.

New Delhi recorded 26,000 coronavirus cases on Monday, a record jump since April 1, when daily case numbers hovered around the 1,000 mark. The city also recorded 161 coronavirus-related deaths in the past 24 hours.

New Delhi Chief Minister Arvind Kejriwal described the situation as “pretty critical,” adding that imposing the lockdown was “the only option left to avoid a bigger disaster.”

He said in a televised address: “Delhi’s health system is at a breaking point. I will not say it has collapsed, but the situation is pretty critical.”

Kejriwal added that the decision to impose a lockdown was “not an easy one to take.”

He said: “I have always been against a lockdown, but it will reduce the transmission rate and give us time to boost our infrastructure. We will use this week-long lockdown to improve our healthcare.”

Kejriwal acknowledged that Delhi was facing an acute shortage of hospital beds and oxygen supply, highlighting the issue in a letter to Indian Prime Minister Narendra Modi on Sunday while seeking help from the federal government to avert the crisis.

A majority of hospitals in Delhi reported chaotic scenes on Monday with patients desperately searching for bed space in coronavirus wards.

All of the 18,933 beds reserved for coronavirus patients were reportedly full on Monday, including 1,436 intensive care unit (ICU) beds and 2,881 ICU beds without ventilators.

However, residents are warning that existing facilities cannot accommodate the surge in infections, with several losing relatives due to a lack of oxygen supply and medical support.

“I lost my wife on Sunday because she could not get ventilator support on time,” Dr. Anwar Sadat, a Delhi resident, told Arab News.

“We never thought that such a tragedy would strike us and that our whole life would become disoriented within a matter of days. We desperately looked for beds in the hospital for her, but by the time she got ventilator support, my wife had collapsed,” Sadat said.

Besides New Delhi, the central Indian state of Madhya Pradesh (MP) also posted a grim picture, with medical infrastructure in its capital city Bhopal “overstretched” amid reports of residents suffering due to a lack of medical attention.

MP has also imposed a lockdown until April 26 in several cities, including Bhopal. 

On Monday, it reported almost 12,500 coronavirus infections across the state.

However, media reports alleged that government figures do not reflect the reality on the ground in crematoriums and burial grounds.

“There was hardly any space to burn the dead bodies in the crematorium ground. We had to wait eight hours,” Santosh Mishra, who lost his uncle to coronavirus, told Arab News about the situation at the Bhadbhada crematorium in Bhopal.

Doctors, too, said they were struggling to cope with the massive influx of patients.

“The situation is grim,” Dr. Sarman Singh, director of Bhopal’s premium medical institution, the All India Institute of Medical Science, told Arab News.

“We are facing a scarcity of beds and oxygen like everywhere in the world, and the patient load is increasing,” he added.

Arab News on Sunday reported similar events in the northern Indian state of Uttar Pradesh and the western state of Gujarat, Prime Minister Narendra Modi’s home state.

Experts said they were unsure how long the spike in coronavirus infections would continue, but blamed ongoing regional election campaigns and an ongoing Hindu festival, the Kumbh Mela — where millions converge to sacred sites for a ritual dip in holy waters — for “adding to the existing trouble.”

Dorairaj Prabhakaran, general secretary of the Public Health Foundation of India, said: “It will take another two to three weeks before the cases peak in major cities.”

He said that imposing the lockdown was “one of the options to contain the virus,” adding: “Lockdown is an important option right now. At least a decentralized lockdown is a better option than a countrywide lockdown. This keeps the mobility going.”

However, Dr. Jayesh Lele, general secretary of the Indian Medical Association, blamed the “pathetic management” of the government for the crisis.

“Why is the government going ahead with the election campaigning and not stopping mass gatherings? It’s a pathetic management of affairs,” Lele told Arab News.

“The government should have done some preparation. Today, cities across India have collapsed. In rural areas, the situation is probably grimmer,” he added.