Impact of COVID-19 on children rings alarm bells in Indonesia

By Taryn Wilson

Bangkok Desk, Jul 22 (efe-epa).- The impact of the COVID-19 pandemic on Indonesia’s children is causing alarm in the world’s fourth most populous country, while cases and deaths accelerate during the easing of restrictions.

A dangerous cocktail of factors – from pre-existing health conditions before the virus took hold in the country, disrupting health and education services, to a lack of community awareness – has meant that not only are the young being severely affected by a virus thought to pose little danger to this age group, but they also face long-term risks and challenges.

“Indonesia is the highest country (in Southeast Asia) with children infected by COVID-19,” Dr. Wahdini Hakim, head of health program impact and policy at Save the Children in Indonesia, tells EFE.

The country reported its first case of COVID-19 on Mar. 2, about a month and a half after the first case outside of China was reported in Thailand on Jan. 13. Now it has the most infections in all of Southeast Asia with over 89,869 confirmed cases and more than 4,320 deaths, according to government data on Tuesday.

It is believed that more than 200 Indonesian children have died due to the infectious disease. At least 1,543 children have tested positive for COVID-19 and 36 have died, while 204 out of more than 6,000 under surveillance (suspected cases) have died, the Jakarta Post reported, citing Indonesian Pediatric Society data from June 25.

The latest government data says that those aged 17 and under made up 1.7 percent of total deaths in confirmed Indonesian cases, suggesting that at least 73 children who have tested positive for COVID-19 have died as of Tuesday. Data is not publicly available for suspected cases.

By comparison, the region’s second hardest hit country, the Philippines on Sunday reported 47 deaths so far in the 0-19 age group, even though it has more total deaths per 1 million of the population at 17, compared to Indonesia’s 16, according to Worldometer.

PRE-PANDEMIC PROBLEMS

Early global reports that the virus posed the greatest threat to the elderly and little danger to the young may have put some countries on the back foot when it came to protecting children.

But high rates of child malnutrition, stunting, wasting and anemia, among other conditions, meant that many Indonesian children were in precarious states of health even before the pandemic swept through all provinces of the country.

“Indonesia has numerous pre-existing vulnerabilities that increase risks and impact of the coronavirus epidemic,” Save the Children said in its Rapid Needs Assessment (RNA) report in April.

Those suffering from wasting have weakened immune systems and face nearly 12 times the increased risk of death compared to well-nourished children, according to the United Nations’ children’s agency (UNICEF), which said more than 2 million children in the country suffer from the condition, and more than 7 million aged under 5 are stunted.

In addition, child mortality in Indonesia “is relatively high compared to its neighboring countries,” Dr. Hakim says, citing data stating that 10 children under 5 years of age die every 7 minutes in the country (2,000 per day), and 1 out of 3 sick children are not taken to health facilities.

At a health center in Medan, Sumatra island, Dr. Ester Sitompul tells EFE that “coronavirus has a greater effect on children” because their bodily defenses are “still weak.”

“In children, body immunity hasn’t fully developed. The nutritional status of children depends on various factors, such as social, economic, cultural and parental education. The lower the nutritional status of the child, the more vulnerable it is to COVID-19,” Sitompul says.

Dr. Hakim says other factors leading to children in the country being highly affected by the epidemic include a gap in basic immunization, poor hygiene and sanitation increasing the risk of children contracting infectious diseases, challenges in referral systems meaning delays in bringing children to health centers, and parents hesitant to take their child to clinics due to fear to COVID-19 infection.

COMMUNITY CHALLENGES

Both doctors point to cultural issues that can increase the risk of contagion.

There are challenges to imposing social distancing due to social, religious and cultural practices such as greetings with handshakes, hand kissing or nose kissing, and working and gathering in close proximity, Save the Children said in its RNA.