Indonesia’s Geography Holding Back Immunizations: Doctors

The Jakarta Globe

Jakarta. The Health Ministry’s mandatory immunization program for children has been successfully introduced in the majority of provinces, but has yet to take hold in the underdeveloped east of the country, doctors say.

Under the program, all Indonesians must have received 13 different vaccinations before the age of 18, eight of which are available for free at community health centers and general hospitals.

However, health officials meeting in Jakarta at the 2nd National Symposium on Immunization say the program is not reaching enough people in the provinces of Papua, West Papua and West Sulawesi.

“Immunization is very important because it’s an investment in future health,” Dr. Prima Yosephine, an immunization official at the Health Ministry, said during the symposium on Friday.

“Unfortunately, though, we face geographic challenges in implementing the immunization program for all of Indonesia.

“The central government has actually already provided all the vaccines to all 33 provinces across the country, with the provincial administrations expected to manage the distribution down to the district and municipal level,” she said.

“So while we expect the vaccines will be distributed properly, we understand that there are several challenges such as the tough mountainous terrain in West Papua.”

Another obstacle to the success of the program concerns religious belief.

In 2002 and 2005, the Indonesian Council of Ulema (MUI), the country’s highest authority on Islamic affairs, declared that the IPV and OPV polio vaccines were haram , or forbidden under Islam, because they were developed using strains of the virus.

While the MUI’s edicts are not legally binding, they carry substantial weight among the country’s majority Muslim population.

“But even if there are a couple of vaccinations that we’ve declared forbidden, that doesn’t mean we’ve closed our eyes to the importance of human health,” said Saleh Daulay, from the MUI.

“Islam allows its followers to use forbidden substances in emergency situations.”

He added that as long as there were no alternatives to the IPV and OPV vaccines in their current form, then it was allowed for Muslims to be immunized with the existing vaccines.

Of Indonesia’s 237 million people, 30 percent, or 71 million, are under the age of 18 and eligible for immunizations under the Health Ministry’s program.

As of this month, the country has immunized 90 percent of minors against measles.

However, the country is still in the top 10 worldwide for the fewest number of children below the age of 5 who have never been vaccinated for any disease.

“According to the WHO, approximately 1.4 million children under 5 years old die in Indonesia every year from diseases that could have been prevented by immunization, such as measles or tetanus,” said Dr. Toto Wisnu Hendarto, the chairman of the symposium.

“In addition, Unicef also recorded that 30,000 to 340,000 Indonesian children die every year from measles.”

The 13 mandatory vaccinations include DPT (for diphtheria, whooping cough and tetanus); HIB (for haemophilus influenza); PCV (for streptococcal pneumonia); and MMR (for measles, mumps and rubella).

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