GENERAL APPEAL (Indonesia): Hundreds die due to government’s failure to control Cholera outbreak

Dear friends,

The Asian Human Rights Commission (AHRC) has received information regarding the death of hundreds of people in the Dogiyai District in Papua, Indonesia, due to a cholera epidemic. Despite requests to local and national authorities, the epidemic has not yet been prevented from spreading into neighbouring provinces. Local organisations report that 239 people had lost their lives from Cholera as of mid September. The AHRC is deeply concerned about the ongoing deaths due to the outbreak and the lack of sufficient response from state authorities.

CASE DETAILS:

The first cases of diarrhea in the Dogiyai District in Papua, Indonesia, were registered in April 2008, mainly in Ekemanida and Idakotu, as well as in surrounding villages. It has been confirmed that the Cholera Bacterium was the causing agent. So far, the provincial health office has officially confirmed 81 fatal cases in the districts of Dogiyai, out of 552 officially known cases of infection. Additionally the provincial health office has reported 23 cases of infections, resulting in 6 deaths in Obano, the neighboring sub-district.

Local organisations however (Médecins du Monde Papua; PRIMARI), have reported much higher figures of deaths than the official numbers indicate. The fatality number in mid July was 173 (Geraja KINGMI – Christian Evangelical KEmah Church, Please see the list), whilst a report from mid September stated that 239 people had lost their lives by then. There is a large discrepancy between the official numbers of fatalities provided by the provincial health office and those provided by the local NGO’s and churches

Although the ministry of health has stated that the outbreak is under control, suspected cholera cases in the areas around lake Tigi and Painai have surfaced in mid-August. The number of cases of diarrhea and the deaths resulting from the epidemic in Paniai has been increasing.

It is reported that the government has not taken appropriate action despite repeated requests from local groups asking for an intervention from health authorities.

To stop the further spread of the epidemic, proper disposal of faecal waste and disinfection is essential. A weekly surveillance system in the infected areas (suspected and confirmed) should be established. Appropriate medical tools and village-level training of community health workers should also be made available. This training should naturally be funded by the Government, and it is regrettable that such training has not already been initiated, given that cholera outbreaks in the recent past have shed many lives in the region (for example as recently as 2006 more than 200 people died in the Jayawijaya regency of Papua).  
 
Unfortunately, the required materials; personnel for the treatment of infected persons; and the prevention of the epidemic from further spreading into the neighbouring District of Paniai, have neither been provided nor initiated at this point in time.

BACKGROUND INFORMATION:

The health infrastructure in Papua is very poor. Papua is Indonesia’s most naturally abundant region, with resources such as timber and other minerals prevailing in the area. The revenue created by non-Papuan mining companies and the migration flows of Muslim traders from other regions of the country have not resulted in a visible upsurge in the living conditions of the predominantly Christian communities. Native Papuans blame past transmigration policies imposed by the government, as well as the exploitation of the natural resources, for undermining their livelihood, traditional culture, and way of life.

Under Indonesia’s domestic law 23/1992, the government is required to provide sufficient health facilities throughout the nation and take action to combat both infectious and non-infectious diseases in order to decrease mortality rates. Given that the Indonesian Government has ratified the International Covenant on Economic, Social and Cultural Rights (ICESCR) and has also incorporated it into domestic law with the implementation of Law number 11/2005, the government must recognize the right of everyone to enjoy the highest attainable standard of physical and mental health, and must maximize available resources to achieve full realization of this right.

ADDITIONAL COMMENTS:

Frustration among members of the indigenous community about the lack of government response has sparked riots in Moanemani. A history of harassment, torture and other forms of human rights violations directed against the indigenous population in Papua means that communities have a high level of distrust towards authorities of the central government. Some have even expressed suspicion that the delay in providing aid is a deliberate failure on the part of the government, intending to harm the indigenous people.

SUGGESTED ACTION:
Please write to the authorities listed below expressing your grave concern regarding the lack of facilities and the negligence of health institutions regarding this case. The authorities must employ all means necessary to ensure that the cholera epidemic is brought under control and that further unnecessary deaths are prevented.

Please be informed that the AHRC has also written to the UN Special Rapporteur on the right to health, the right of indigenous people, and on racism, calling for an intervention in this matter.

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