Betting Lives for Vaccination on Small Island

ARSIP PUSKESMAS SEIRA

The Covid-19 vaccine is transported by speedboat to Seira Island, Tanimbar Islands Regency, Maluku, Wednesday (27/1/2021).

As the world’s largest archipelago with a total of 17,491 islands, it is not a simple matter for Indonesia to distribute Covid-19 vaccines to remote areas in the country. Challenges lie not only in limited infrastructure connecting islands, but also in health infrastructure and weather factors at sea.

On Wednesday afternoon (27/1/2021), the head of the Seira community health center (Puskesmas), Gerica Lenonduan, was preparing to depart from Seira Island for Yamdena Island in Tanimbar Islands regency, Maluku. Together with a nurse and Seira Security and Public Order (Bhabinkamtibmas) chief Brig. Donbosco Watkaat, Gerica was getting ready to deliver the shipment of Covid-19 vaccine.

Seeing tidal waves of up to 2 meters in the waters between Yamdena Island and Seira, they postponed their departure. The 40-horsepower speedboat they had rented for around Rp 150,000 for the round trip would not be able to withstand such high waves.

Also read: Sharing Antibodies to Fight Pandemic

The clock kept ticking, the cell phone ringing. Tanimbar Health Office officials kept contacting her, confirming the location of the vaccine collection point.

The tidal waves were still more than 1-meter high. They decided to go to Batu Putih, a village in Yamdena, 35 kilometers west of Saumlaki, the capital of Tanimbar. Even though the sea waves were quite high, Gerica was not afraid, because she had been facing similar conditions for decades. "This is normal," she said when contacted by Kompas on Thursday night (28/1).

KOMPAS/DOKUMENTASI SATUAN BRIMOB POLDA MALUKU

Brimob personnel escort the distribution of the Covid-19 vaccine to Seira Island, Tanimbar Islands Regency, Maluku, Wednesday (27/1/2021).

Many trees collapsed

An hour later, they arrived at Batu Putih. The car to transport the vaccines from Saumlaki was still on its way. Brig. Haeruddin, a member of the police’s Mobile Brigade (Brimob) who was securing the vaccine transportation from Saumlaki, said it was a hassle to drive along a road full of obstacles. There was rain and strong wind, and many fallen trees blocked the way.

The car could not go at high speed. They avoided bumpy roads that they feared could affect the vaccine.

"The speed of the car was only 30-35 kilometers per hour. The trip from Saumlaki to Batu Putih, which normally takes 30 minutes, took more than an hour," said Haeruddin.

Also read: Vaccines: Some Successful, Others still Awaiting Results

After receiving the vaccine on the beach, Gerica and her group returned to Seira. The sea waves were getting higher, and Gerica\'s burden was getting heavier. She was responsible for the vaccines. Inside the box, there were 88 vials of Covid-19 vaccine, which will be injected to 44 health workers at Puskesmas Seira. Each person would get two shots.

The speedboat cruised at low speed because of the high waves. Gerica\'s hands hugged the vaccine box so that it wouldn\'t be shaken hard. "This is state property. It must be kept [in good condition]," she said.

An hour later, they arrived at Seira safely. The small group could breathe a sigh of relief.

Meanwhile, on Wednesday (27/1), another team participated in distributing vaccines to Larat Island, north of Yamdena. The trip by road covered a distance of 110 kilometers. Chief Brig. Marthen Samar and First Brig. Ode Imran, who guarded the vaccines, were also having trouble with fallen trees on the streets.

KOMPAS/FRANSISKUS PATI HERIN

The car carrying the Covid-19 vaccine made by Sinovac in Ambon, Maluku, Wednesday (13/1/2021).

At a maximum speed of 30 kilometers per hour, the journey took four hours. After handing over the vaccine, they returned to Saumlaki and arrived the next day, Thursday, at 2 a.m. After a break, at 11 a.m., they were ready to guard the vaccine distribution to Selaru Island, south of Yamdena.

However, they were informed that morning that there would be bad weather, so the departure was postponed. The Meteorology, Climatology and Geophysics Agency of the Ambon Maritime Theoretical Station said the sea waves at Tanimbar were between 2.5 and 4 meters.

Also read: Covid-19 Vaccine Euphoria Deemed Dangerous

Ambon Maritime Meteorological Station forecaster Moch Zainuri Damayanto said the waves could even reach twice the forecasted height and high waves were common in February.

This is the state\'s duty, we must do it

Marthen and colleagues said they were ready if they were ordered to escort the vaccine to Selaru. "Even if we have to face the worst case [of the motorboat sinking], we have thought about it. There are life vests for our personal safety as well as the safety of the vaccines. This is the state\'s duty, we must do it,” he said.

High waves have become an obstacle for vaccine distribution in almost all areas of Maluku. The spokesperson for the Maluku Covid-19 task force, Adonia Rerung, said that if the high waves continued, the vaccine would be distributed using large vessels belonging to the Indonesian Navy.

KOMPAS/FRANSISKUS PATI HERIN

Jane Pakaila (51), an employee at the Maluku Provincial Health Office, received a vaccine injection at the Sirimau Community Health Center, Ambon City, Maluku, Friday (15/1/2021).

It\'s hard to come to town

Vaccine distribution is not the only problem. Another obstacle is the fact that not all Puskesmas in Maluku are able to conduct vaccinations. Health workers were asked to come to the nearest Puskesmas or to the regency capital for vaccination.

The procurement of floating health facilities is urgently needed.

"Issues relating to the accommodation of the health workers are the responsibility of the regency administration," said Adonia. However, getting health workers to come to the regency capital was also not easy during high waves.

Vaccinations in Maluku began on 15 January. About 1,600 health workers have been vaccinated, almost all of them are from Ambon. The total number of health personnel registered to receive the vaccine is 14,845.

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Authorities doubt the target for completing the vaccination of health workers in Maluku in April 2021 will be met, mostly because of the difficult geographical conditions and bad weather.

"The procurement of floating health facilities is urgently needed," said Thomas Matulessy (62), a retired official from the Maluku Health Office, who has 40 years of experience serving residents on the islands, including for vaccinations.

The hard challenges faced by health personnel and officials in vaccine distribution in remote islands should open the eyes of policymakers. There must be no more individuals risking their lives on the high waves with limited facilities.

This article was translated by Kurniawan H. Siswoko.