Discharged and Going Home Quietly, in Secret

KOMPAS/KURNIA YUNITA RAHAYU

A number of Covid-19 patients sunbathe in the courtyard of Pademangan Athletes House, North Jakarta, Saturday (23/1/2021) morning. Within a day, patients may be active outside the room in the morning and evening.

As in previous days, Sawitem was in her room on the eighth floor of Tower 9 at the Wisma Atlet Pademangan Covid-19 emergency hospital in North Jakarta on Tuesday (26/1/2021), after her morning exercises.

That morning, the 50-year-old woman got together with four other isolating patients. They formed a large circle to sunbathe while chatting about their backgrounds and the early symptoms they experienced before they tested positive for the disease.

Also read: Public Spaces Put People at Risk for Covid-19 Infection

In the middle of their conversation, Sawitem suddenly stood up and yelled, "Hey, people out there! Staying here is [...] really nice.”

"We take hot water baths, you know!" she continued with a laugh, accompanied by laughter from the four patients sitting around her.

When I went to a food stall, no one would serve [me]. Even if there were, they refused to take my money. They were afraid of being infected with the virus.

Behind her laughter, however, Sawitem hopes that the public will hear her, because social stigma against virus carriers still prevails, even though it has been almost a year since the Covid-19 outbreak emerged in Indonesia, including in her neighborhood in Pulo Gadung, East Jakarta.

Sawitem and her husband both tested positive for Covid-19 in the second week of January. However, they had to wait several days at home for a referral letter from the local puskesmas (community health centers). During her self-isolation at home, the mother of two ran out of food. None of her neighbors would help her and her family.

"When I went to a food stall, no one would serve [me]. Even if there were, they refused to take my money. They were afraid of being infected with the virus,” she recalled.

KOMPAS/KURNIA YUNITA RAHAYU

Sawitem (50) (center), a Covid-19 patient from Pulo Gadung, East Jakarta, is talking with another patient on the 8th floor field, Tower 9 of Wisma Atlet Pademangan, North Jakarta, Tuesday (26/1/2021). He told how stigma was still developing in the neighborhood where he lived.

People were not only afraid of Covid-19 carriers, but also of getting a swab test. According to Sawitem, many residents in her area were sick and showed symptoms like hers, such as fever, cough, runny nose, and loss of smell.

"Pak RT [the neighborhood unit head] and his family had been suffering loss of smell for a week, but they didn’t want to take a test because they were worried about leaving their children alone at home," said Sawitem.

Although she could express her pain through humor, Sawitem did not want the stigma to occur in the isolation facility. She wanted to escape the stigma and harshness of life.

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Sawitem, who has mild symptoms, therefore makes sure to leave her isolation room in the mornings and evenings. She has gone to the three fields in the 24-storey apartment complex, greeting and chatting with everyone she meets. From these meetings, she has formed bonds with other patients.

Afraid to go home

But it seems that leading a life that is relatively safe from public stigma ends when an isolation patient leaves the emergency hospital. Imawati (40), a resident of Tanjung Priok, North Jakarta, was very worried on the last day of her isolation, even though she had kept her health a secret from her neighbors because she feared being shunned.

She traveled to Wisma Atlet in secret, and would also go home in secret. She asked her husband and two children, who remained at home, not to tell the neighbors about her release from the emergency hospital. Imawati, a housewife, would interact with her neighbors more frequently once she returned home.

Also read: Balance Vaccinations by Complying with Health Protocols

"Every time the neighbors where I was, my husband and kids told them that I was visiting my hometown,” said Imawati, who originally hails from Nias, North Sumatra.

KOMPAS/KURNIA YUNITA RAHAYU

A Covid-19 patient at Pademangan Athlete Village, North Jakarta, exercised with the nurses on Tuesday (26/1/2021) morning.

Niar (26), a resident of Cilincing, North Jakarta, had a similar experience. She was worried that the public stigma against Covid-19 carriers would hurt her family. When she and four other family members tested positive for Covid-19, none of the neighbors wanted to take care of her grandmother, who lived with them.

Niar’s grandmother fell ill after the entire family left her behind, alone at home, to go into isolation in separate locations. The grandmother experienced a relapse of her chronic asthma and hypertension.

"Help arrived only when Grandma had to be taken to the hospital. At the hospital, Grandma tested positive for Covid-19. Her symptoms were severe, and she fell into a coma. Her health worsened because of Covid-19," said Niar.

Hampering detection

The stigma against Covid-19 carriers emerged when the first cases were detected in March 2020 and has continued to grow, even a year since the pandemic was declared.

According to a LaporCovid-19 survey conducted in August 2020, not only Covid-19 patients, but also survivors, their families and health workers all experienced stigmatization.

Ede Surya Darmawan, who chairs the Indonesia Public Health Experts Association (IAKMI), said social stigma against people with or people who had recovered from Covid-19 continued to grow among the public, mostly among people who had a low level of education. Widespread fake news and inconsistent information from public officials during the Covid-19 pandemic had resulted in misunderstandings about the disease, which shaped personal perceptions and led them to react inappropriately.

According to Ede, social stigma against Covid-19 also made it difficult to detect new cases. If people with Covid-19 concealed their health condition, testing and contact tracing could not proceed.

KOMPAS/KURNIA YUNITA RAHAYU

A boy with Covid-19 who are undergoing independent isolation at Tower 9 of Pademangan Athlete House, North Jakarta, have a chat with an ambulance driver, Saturday (30/1/2021).

Ideally, close contacts of Covid-19 cases should be found within 72 hours. "Because of [social] stigma, detecting new cases has become difficult. When they are discovered, these people already show moderate to severe symptoms. This causes overwhelm in health services,” said Ede.

Aulia Nursyafitri, a tracing officer at the Puskesmas Kelapa Dua Wetan in Ciracas, East Jakarta, said that stigmatization hindered the detection of new cases. Many residents refused to be tested, even though they had close contact with Covid-19 cases. Health workers also found that the residents they contacted ended up blocking their phone numbers, she said.

"There are still many rumors that the swab tests at the Puskesmas are set up to produce positive results," she said.

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Puskesmas cannot force anyone to take a test against their will. Health workers usually recommend that people get a swab test at a laboratory they trusted.

Policy director Olivia Herlinda at the Center for Indonesia\'s Strategic Development Initiatives (CISDI), said that the pandemic response should be carried out closer to people’s daily lives in order to remove the social stigma against Covid-19.

"Setting up community-based isolation facilities should be an option if hospitals and other public health facilities are full. This could people be more open and stigma can be avoided,” she said.

There are still many rumors that the swab tests at the Puskesmas are set up to produce positive results.

In a society that was open and fully understood Covid-19, Sawitem and her fellow patients would not need to experience trauma. Covid-19 prevention and control measures of should be more effective.

This article was translated by Hendarsyah Tarmizi.