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Endless first wave: How Indonesia failed to control coronavirus | Coronavirus pandemic News

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Only last week, Luhut Pandjaitan, Indonesia‘s maritime minister and close confidant of the country’s president, touted herbal mangosteen juice as a coronavirus remedy.

His suggestion was the latest in a string of unorthodox treatments put forward by members of Joko Widodo’s cabinet during the past six months, ranging from prayer to rice wrapped in banana leaf to eucalyptus necklaces.

The remedies reflect the unscientific approach to battling the coronavirus in the world’s fourth-most populous country, where the rate of testing is among the world’s lowest, contact tracing is minimal, and authorities have resisted lockdowns even as infections spiked.

Indonesia has officially reported 6,346 deaths from COVID-19, the disease caused by the new coronavirus, the highest overall toll in Southeast Asia. Including people who died with acute COVID-19 symptoms but were not tested, the death toll is three times higher.

Indonesia shows no signs of containing the virus. It now has the fastest infection spread in East Asia, with 17 percent of people tested turning out positive, rising close to 25 percent outside the capital, Jakarta. Figures above 5 percent mean an outbreak is not under control, according to the World Health Organization.

“This virus has already spread all over Indonesia. What we are doing is basically herd immunity,” said Prijo Sidipratomo, dean of the Faculty of Medicine at the National Veterans Development University in Jakarta. “So, we should just dig many, many graves.” Herd immunity describes a scenario where a large proportion of the population contracts the virus and then widespread immunity stops the disease from spreading.

Government spokesman Wiku Adisasmito did not respond to detailed questions from Reuters. He said the number of infections was “a warning for Indonesia to continuously improve its handling effort,” and that positive cases per capita in Indonesia were lower than most countries. President Joko Widodo’s office did not respond to questions sent by Reuters.

To be sure, Indonesia‘s confirmed 144,945 infections out of a population of 270 million are much less than the millions reported in the United States, Brazil and India, and below the neighbouring Philippines, which has less than half Indonesia‘s population. But the true scale of Indonesia‘s outbreak may still be hidden: India and the Philippines are testing four times more per capita, while the US is testing 30 times more.

Statistics from Our World in Data, a nonprofit research project based at the University of Oxford, show Indonesia ranked 83rd out of 86 countries surveyed for overall tests per capita.

“Our concern is that we have not reached the peak yet, that the peak may come around October and may not finish this year,” said Iwan Ariawan, an epidemiologist from the University of Indonesia. “Right now, we can’t say it is under control.”

‘Pure nonsense’

At the start of the pandemic, Indonesia‘s government was slow to respond and reluctant to reveal what it knew to the public, according to more than 20 government officials, test laboratory managers and public health experts who spoke to Reuters.

Despite surging cases in neighbouring countries and having 3,000 polymerase chain reaction (PCR) test kits – the WHO-approved test for detecting the coronavirus – ready by early February, the government said fewer than 160 tests had been conducted by March 2.

On March 13, Widodo said the government was withholding information so as not to “stir panic”. During the first two weeks of March, the government concealed at least half of the daily infections it was aware of, two people with access to the data told Reuters. The two people said they were later restricted from seeing the raw data.

A call by Widodo in March for a massive expansion of rapid diagnostic testing may have undermined the country’s testing regime, according to Alvin Lie, a commissioner in the office of the Indonesian Ombudsman, an official government watchdog.

Scientific studies have shown rapid tests, which test blood samples for antibodies, were found to be far less accurate than the PCR method, which tests swabs from the nose or throat for genetic material. Widodo’s push to use a less-reliable test diverted resources away from PCR tests, three lab managers told Reuters.

Lie told Reuters that importers of the rapid tests, including large state-owned enterprises and private companies, made “huge profits” by charging consumers up to one million rupiah ($68), even though each test costs only 50,000 rupiah ($3.50).

By mid-April, provincial governments said rapid testing in the provinces in West Java, Bali and Yogyakarta produced hundreds of false negatives and false positives.

But the tests continued to be widely used and it took until July for imports of rapid tests to be halted and for the government to introduce a price cap of 150,000 rupiah ($10). In July, Indonesia also formally advised provincial governments and others not to use rapid testing for diagnostic purposes in their updated guidelines for COVID-19 prevention and control.

But Lie said there is a huge stockpile and rapid tests are still being broadly deployed, including for screening office workers and travellers to allow them to move freely for 14 days.

“That is like saying for the next 14 days after the rapid test they are free from the virus. That’s pure nonsense. All it indicates, and not very accurately, is they were free from the virus when the sample was taken,” said Lie.

Adisasmito declined to comment on whether the president’s call for rapid testing undermined its overall testing efforts. He did acknowledge the inaccuracies of rapid testing but said it was still useful in some situations where the capacity to use PCR tests is limited, including screening travellers. He did not directly answer questions about companies making large profits from tests.

The central government does not disclose the level of national rapid testing. But data from West Java, Indonesia‘s largest province with 50 million people, shows that it has conducted 50 percent more rapid tests than PCR tests.

Government officials say 269 labs with PCR machines are now operating. However, the labs are increasingly unable to meet demand as infections rise. The number of suspected cases – those with COVID-19 symptoms who have not been tested – has doubled to 79,000 in the past month, according to government data.

Part of the problem is that lab capacity is far from being fully utilised, according to four health officials. One senior health ministry official, Achmad Yurianto, told Reuters Indonesia was able to test 30,000 people per day, more than twice the daily average of 12,650 people tested during the past month.

Five lab managers and consultants contacted by Reuters said the failure to use the country’s testing capacity was due to government mismanagement that had led to shortages of staff and reagents, chemicals needed for the tests.

Adisasmito did not respond to questions about the government’s management of testing. Last week, explaining the shortfall in testing, Yurianto said labs did not have enough time to check all specimens, with some labs working limited days and hours.

Minimal contact tracing 

Widespread PCR testing and quick results are essential for tracing the contacts of those infected by the coronavirus. According to national guidelines released by Indonesia‘s health ministry on July 13, contact tracing is “the main key in breaking the COVID-19 transmission chain”.

Reuters spoke to 12 health workers across Indonesia who described the country’s contact tracing effort as bungled and ineffective.

Passengers queue to board a commuter train during the morning rush hour on the outskirts of Jakarta on July 27. Doctors say the country is still battling an endless first wave of the coronavirus [Fakhri Hermansyah/Antara Foto via Reuters]

Rahmat Januar Nor, a health official in the city of Banjarmasin in Indonesian Borneo, said information about new coronavirus cases often came into his office in varying states of disorder, with incomplete names, inactive phone numbers or outdated addresses for patients and their contacts, problems seen by healthcare workers across the country.

“We asked the village leaders for help,” Nor told Reuters. “But in the end, we didn’t find them (the contacts) most of the time.”

When they did reach contacts, many refused to be tested, fearful they would lose their jobs or be ostracised in the community, Nor and other health officials said.

Unpublished data from the government COVID-19 task force, reviewed by Reuters, shows only 53.7 percent of people identified as confirmed or suspected carriers of the disease were subjected to contact tracing by June 6.

Adisasmito did not provide more recent contract tracing data but acknowledged it “remains low” and said the government aimed to track 30 people per positive case. That is still low compared with other Asian countries. South Korea said in May it traced and tested almost 8,000 people after a man with the virus visited a nightclub.

According to five people familiar with the matter, the WHO advised Indonesian authorities that contact tracing should involve at least 20 people tracked per confirmed and suspected case. But Indonesia is only averaging about two traced contacts per case, according to provincial officials and data reviewed by Reuters.

In Jakarta, where the epidemic first took hold in the country, the data shows fewer than two contacts traced, on average, for each confirmed and suspected case in July.

In East Java, another hotspot, tracing rates are 2.8 contacts per each confirmed and suspected patient, according to researchers from Airlangga University.

A WHO spokesperson said Indonesia began following its contact tracing recommendations in mid-July.

‘Always on the first wave’ 

Indonesia‘s decision to reject full lockdowns was driven by economic and security concerns, said government advisers.

Instead, it has urged Indonesians to wear masks, wash their hands and practise social distancing while working, travelling and socialising.

Firefighters Indonesia coronavirus

Firefighters wearing protective suits spray disinfectant at the National Monument area to prevent the spread of the coronavirus disease (COVID-19) in Jakarta in June [Wahyu Putro/Antara Foto via Reuters]

“The argument was that we could not [afford it],” Soewarta Kosen, a health economist who consulted the government on its coronavirus response, told Reuters. “We were afraid that there would be social unrest.”

Widodo’s emphasis on the economy is popular, polling shows. The Indonesian economy only shrank 5.3 percent in the second quarter of 2020, much less than many other regional economies. But epidemiologists said they fear the decision will cost Indonesia more in the long term, especially as its health system is poorly equipped to cope if positive cases continue to surge.

Dr Bambang Pujo, an avid runner and anaesthetist at the main COVID-19 referral hospital in Indonesia‘s second-largest city of Surabaya, said mortality rates in his ward are between 50 percent and 80 percent and there are not enough beds.

“Ten hours inside a hazmat suit is like running a marathon twice,” he said, describing the long hours he spends in protective gear inside the intensive care unit. “Imagine how we feel. It is like playing God. We hope that we don’t make mistakes and, if we do, we are forgiven.”

Indonesia has only 2.5 intensive care beds per 100,000 people, according to the country’s national disaster agency, which leads the COVID-19 task force. That compares with 6.9 per 100,000 people in India, according to an April report from Princeton University. Adisasmito said the healthcare system is being continuously improved.

“We must know that our infrastructure is not ready for a pandemic like this,” said Pujo. “Other countries have heard of second waves. We’re always on the first wave.”



Source – www.aljazeera.com

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Charles Mbire gains $1.2 million as stake in MTN Uganda rises above $51 million

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Ugandan businessman and MTN Uganda Chairman Charles Mbire has seen the market value of his stake in MTN Uganda surge above $51 million in just two days, as the share price in the leading teleco company increased by a single digit.

The single-digit bump in the share price caused the market value of Mbire’s stake to gain UGX4.42 billion ($1.24 million) in less than two days.

The million-dollar increase in the value of his stake came after Uganda’s largest telecom company delivered the country’s largest-ever IPO through the listing of 22.4 billion ordinary shares on the Uganda Securities Exchange (USE).

Upon completing the largest IPO in Uganda’s history, MTN Uganda raised a record UGX535 billion ($150.4 million) from the applications that it received for a total of 2.9 billion shares, including incentive shares.

As of press time, Dec. 7, shares in the company were trading at UGX204.95 ($0.0574), down six basis points from their opening price this morning.

Data gathered by Billionaires.Africa revealed that since the telecom company registered its shares on the Ugandan bourse on Mon., Dec. 6, its share price has increased by 2.5 percent from UGX200 ($0.056) to UGX204.95 ($0.0574) as of the time of writing, as retail investors sustained buying interest long after the public offering.

The increase in the company’s share price caused the market value of Mbire’s 3.98-percent stake to rise from UGX178.45 billion ($49.96 million) to UGX182.86 billion ($51.2 million).

In less than two days, his stake gained more than UGX4.42 billion ($1.24 million).

In a statement after the successful listing of MTN Uganda’s shares, Mbire said the IPO shows the confidence that Ugandans and other investors have in the company, its brand and strategic intent.

“We commend all the regulators for their support in our work to become a USE-listed company and to comply in a timely manner with the listing provisions of the national telecommunications operators’ license,” he said.

Steady but sure-MBIRE who is the biggest investor on Ugandas Stock exchange with stocks valued at more than $55 million is laughing all the way to the bank after MTN declared the latest dividend payout.He has steadily grown his business empire which is believed to be more that $350 million (debt free).

Steady but sure-MBIRE who is the biggest investor on Ugandas Stock exchange with stocks valued at more than $55 million is laughing all the way to the bank after MTN declared the latest dividend payout.He has steadily grown his business empire which is believed to be more that $350. ( debt free).

He is into communications-revenue assurance-cement-distribution-oil services-real estate-oil exploration and logistics.

Source: Billionaires Africa

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2-year-old dies at Arua hospital as nurse demands Shs 210,000 bribe

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A two-year-old child died at Arua Regional Referral hospital after a nurse, Paul Wamala demanded a bribe amounting to Shs 210,000 before carrying out an operation. 

The incident happened on Saturday, after Aron Nabil, a two-year-old child was referred to the hospital for an operation after he was diagnosed with intestinal obstruction, a medical emergency caused by a blockage that keeps food or liquid from passing through the small intestine or large intestine.

According to the relatives of the child, Wamala allegedly asked them to initially give him Shs 30,000 to buy medicines to commence the procedure. He however returned shortly asking for an additional Shs 180,000 from the relatives.

Emily Adiru, a resident of Osu cell, in Bazar Ward, Central Division, and a relative of the child says although they paid money to Wamala, he abandoned the child without carrying out the operation. According to Adiru, Wamala later refunded Shs 200,000 through mobile money, after she threatened to report him to the police.

“They told us this boy needs an operation which was supposed to be done in the morning on Sunday at around 7 am. They took him inside there, some doctor came from the theatre, he called one of us and said, we should pay Shs 70,000 for buying medicine to start the operation. We paid the Shs 30,000 [but] after paying the Shs 30,000, after some minutes, the same man came and opened the door and called us again, and told us we should pay another Shs 100,000. We also paid the Shs 100,000 and we thought it is finished. We were outside there waiting for our patient to come out [but] then this man came back again and said we should pay another Shs 80,000,” said Adiru.

Although the operation was later carried out after a 7-hour delay, the child didn’t make it, and relatives attribute the death to negligence. Miria Ahmed, a concerned resident wonders why such incidents have persisted at the facility which is supposed to service the citizens.

“Is the problem the hospital, is it the management or it is the human resource that is the problem in the hospital? A small child like this you demand Shs 210,000 for the operation? Well, if the money was taken and the operation is done, I would say anything bad but this money was taken and the small boy was abandoned in the theatre,” she said. 

When contacted Wamala refused to comment on the allegations. Dr Gilbert Aniku, the acting hospital director says that the hospital will issue an official statement later since consultations about the matter are ongoing.

Arua City resident district commissioner, Alice Akello has condemned the actions of the nurse saying she has ordered his arrest so as to set an example to the rest. The case has been reported to Arua regional referral hospital police post under SD reference No:05/30/05/2022.



Source – observer.ug

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Mexican president’s Mayan Train dealt new legal setback | Tourism News

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Activists say the planned tourist train will harm the wildlife and natural features of the Yucatan Peninsula.

Mexican President Andres Manuel Lopez Obrador has been dealt the latest setback to an ambitious plan to create a tourist train to connect the country’s southern Yucatan Peninsula.

On Monday, a judge indefinitely suspended construction on a portion of the project, known as the Mayan Train, saying the plans currently do not comply “with the proceedings of the environmental impact evaluation”.

The ruling follows a legal challenge by activists who said they were concerned the 60km (37 mile) portion of the train that would connect the resorts of Playa del Carmen and Tulum would adversely affect the area’s wildlife, as well as its caves and water-filled sinkholes known as cenotes.

The original plan for the disputed section was for an overpass over a highway, but the route was modified early this year to go through jungle at ground level.

The federal judge cited the “imminent danger” of causing “irreversible damage” to ecosystems, according to one of the plaintiffs, the non-governmental group Defending the Right to a Healthy Environment. In a statement, the group said that authorities had failed to carry out the necessary environmental impact studies before starting construction of the section.

Lopez Obrador had announced the ambitious project in 2018, with construction beginning in 2020. The roughly 1,500km (930 mile) cargo and passenger rail loop was presented as a cornerstone of a wider plan to develop the poorer states and remote towns throughout the about 181,000sq km (70,000sq mile) Yucatan Peninsula.

The railway is set to connect Caribbean beach resorts with Mayan archaeological ruins, with authorities aiming to complete the project by the end of 2023. The plan is estimated to cost about $16bn.

The project has split communities across the region, with some welcoming the economic development and connectivity it would bring. Others, including some local Indigenous communities, have challenged the project, saying it could not only disrupt the migratory routes of endangered species, including jaguars, tapirs and ocelots, but could also potentially damage centuries-old Mayan archaeological sites.

The National Fund for the Promotion of Tourism, the government agency overseeing the project, has said that it expects to “overcome” the latest challenge and that work should continue after an environmental impact statement is finalised. It said the Environment Ministry was currently reviewing its environmental application for the project.

For his part, Lopez Obrador has insisted the railway will not have a significant environmental effect and has accused activists of being infiltrated by “impostors”.



Source – www.aljazeera.com

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