Yohana Tiko, Bernard Marbun, and Fathul Huda Wiyashadi at first insisted that they did not want to be taken to Abdul Moeis Hospital, Samarinda, East Kalimantan on Friday night, July 31, 2020. However, some residents who had gathered at the Wahana Lingkungan Hidup office ( Walhi) East Kalimantan made this activist of the environment and human rights (HAM) soften to undergo Covid-19 quarantine at the hospital. According to Yohana, the pickup that occurred at the end of last July was carried out by the Samarinda City Covid-19 Handling Task Force together with the Health Service, Regional Disaster Management Agency (BPBD), Police, Civil Service Police (Satpol PP), and a number of village officials.
On arrival at the hospital, the officers instead left the three of them in the hospital parking lot. Meanwhile, the hospital did not immediately carry out a quarantine process.
"We ask for results swab to the officers who brought them to the hospital, but they could not show (swab results). One by one (they) left us in the hospital. We were abandoned in the parking lot, "said the Director of Walhi Kaltim, Yohana Tiko in a press statement on Saturday, August 1, 2020.
Yohana and two other people decided to return home for self-quarantine. This step is in accordance with the Decree of the Minister of Health of the Republic of Indonesia Number Hk.01.07 / Menkes / 413/2020 concerning Guidelines for the Prevention and Control of Coronavirus Disease 2019. Referring to this regulation, people exposed to Covid-19 without symptoms (OTG) can carry out independent isolation.
"We feel healthy and fine, not in a sick condition, and have no flu symptoms," said Yohana.
Three days earlier, namely Wednesday, July 28, the Samarinda City Health Office visited two offices of environmental activists, namely Walhi Kaltim and Working Group 30 (Pokja 30), which contained the Samarinda Legal Aid Institute (LBH) Secretariat and the Mining Advocacy Network (Jatam). East Kalimantan. They received reports from residents about the lack of application of health protocols in that location. In fact, the two offices which are only separated by a wall on Guitar Street, Dadi Mulya Village, Samarinda Ulu District are often visited by many people and are in the highest corona infection area.
Therefore, officers from the Samarinda City Health Office requested that a number of people at the Walhi office have their mucus samples taken by rubbing them. At least more than 10 lower respiratory tract mucus samples were taken. In less than 24 hours, the health team returned to deliver the results of the examination stated in the notification letter.
Of the dozens of people examined, three tested positive, so quarantine was necessary at the hospital. However, the request was denied. Both Yohana, Bernard and Fathul — the three people who tested positive for Covid-19 — asked officers to attach laboratory examination results in addition to the notification letter.
"Personally I support efforts to prevent the spread of Covid-19 which are carried out in accordance with procedures, but don't let the enforcement of the rules be done by violating the rules," said Fathul Huda.
Fathul said, when taking mucus samples, the officers promised that the results would be completed within 2-4 days. However, he was taken aback when the health workers returned the next day.
"There are many irregularities, including when delivering the results swab. When asked, he said the results were 2-4 days after completion, it turned out that the next day it was tested positive and there was no written result signed by the lab officer, "said Fathul.
Later, the Samarinda City Health Office said that the three activists tested positive after testing mucus samples through the molecular rapid test (TCM) method, not the swab test as previously stated. TCM is a method of examination commonly performed on tuberculosis (TB) patients and only takes less than two hours to get results.
In East Kalimantan, TCM is operated in a number of hospitals such as the Kanudjoso Djatiwibowo Regional General Hospital (RSUD) Balikpapan, Abdul Rivai Berau Regional Hospital, Kudungga Sangatta Hospital, East Kutai, Abdul Wahab Sjahranie Hospital Samarinda, Parikesit Hospital Kutai Kertanegara and Harapan Insan Sedawar Hospital. Spokesperson for the Task Force for the Acceleration of Handling Covid-19 in East Kalimantan, Andi M Ishak, from the start the TCM was intended to evaluate urgent cases and cases. The diagnosis for new samples will be sent to the Polymerase Chain Reaction (PCR) Laboratory.
"Evaluation of cases that are already positive is to ensure recovery, if an urgent case is for example a case with symptoms such as covid and has comorbidities that are worsening, or surgery will be carried out so it is necessary to confirm the patient's condition quickly before further action is taken," he told Jaring.id , Friday, August 14, 2020.
In addition to the examination method that was not in accordance with the directions, mucus sampling was accompanied by an examination of the entire work space. The officers went around and took pictures using cell phones.
"They messed up. They walked into the office wearing shoes. Grumpy. He says don't hide people. Even though we have nothing to hide. It seems that they are looking for something, as if they are looking for mistakes, ”said Fathul.
Pradarma Rupang, East Kalimantan's East Kalimantan dynamist — one of the dozens of people who was tested, highlighted the lack of equipment from the officers. According to him, when picking up three people who tested positive, some of the officers did not wear complete protective clothing (PPE). They only wear medical masks, face shields and rubber gloves.
In addition, the ambulance officers' PPE was inappropriate with the Technical Instructions for Using PPE in the Face of the Covid Outbreak 19 issued by the Ministry of Health. The regulation states that ambulance officers who pick up positive suspects must be equipped with standard PPE such as masks, special clothing, gloves, wearing eye and head protection, and wearing protective shoes. Meanwhile, the ambulance officers who picked up the three positive patients at the Walhi and Pokja 30 offices did not wear eye protection.
Rupang was also surprised by the Health Office who insisted on isolating his colleagues at the hospital. Though they have no symptoms that require medical care. If at the request of residents, the Health Office should try to ensure that there are other patients who need more care at the hospital.
"Pick-up is based on the request of the RT (neighborhood unit). The RT's objection letter came before the Friday prayers. Not long, at around 17.00 the officer arrived, ”said Rupang.
The RT letter that Rupang refers to is a letter of rejection from RT 33 Kelurahan Dady Mulya residents signed by Tarmiji. According to him, residents refused to use the Walhi office and Pokja 33 as a place for quarantine for corona patients.
"Residents are restless. We don't see this disease. Why is isolation in place, while there is a hospital, ”said Tarmiji when contacted by Jaring.id on Friday, August 7, 2020.
The initiative for making the letter was carried out by Tarmiji after receiving information about three positive people for Covid-19 in his area. This information was obtained by Tarmiji from the Head of Dadi Mulya Urban Village, Muhammad Yansyah. The letter which was copied to a number of agencies such as the Covid-19 Task Force, Dadi Mulya Village, Bhayangkara Community Security and Order, and the Village Guidance Officer contained residents' refusal to use the office as a quarantine place.
Contacted separately, Head of Dadi Mulya Urban Village, Muhammad Yansyah, admitted that he was not aware of any swab tests in his area until a notification letter from the Health Office landed on his device via a WhatsApp message. He said, the examination of the activists was purely initiated by the Samarinda City Covid-19 Task Force.
"According to the Health Office, there are people who report that many people come in and out of there and not residents without health protocols. As far as I know there are indeed many and not our citizens, all outsiders, ”he said when contacted by Jaring.id on Friday, August 7, 2020.
Pokja 30 activist, Buyung Marajo, denied the accusations that were addressed to his institution. According to him, the health protocol has been in place since last June. However, as a civil society-based institution, it cannot limit citizens who wish to report cases and carry out legal consultations.
"If there is a report, we are open to implementing health protocols. We are open to anyone and from anywhere, "he said.
One of the reports that Walhi is advocating collaboratively with other institutions is the revision of the Zoning Plan for Coastal Areas and Small Islands, the Omnibus Law, the case of the oil spill in Balikpapan Bay, and encouraging customary forests in Mahakam Hulu. In addition, the two activists who tested positive also had the status of legal counsel for Papuan students who were charged with treason against the state.
Striking from a series of cases carried out by Walhi and other activists in Samarinda, Deputy Chairperson of the Advocacy Division of the Indonesian Legal Aid Foundation (YLBHI), Era Purnama Sari, suspects that the Covid-19 examination is a new mode of silencing against human rights defenders (HAM). The presence of health workers without an assignment letter, according to him, is not in accordance with the Minister of Health's Regulation on Guidelines for the Prevention and Control of Covid-19. In Chapter III Epidemological Surveillance, contact tracing and monitoring are carried out by showing identity and assignment letter.
"Maybe there are other interests working outside the interests of preventing the spread of this epidemic," he said.
In order not to be suspected, Era advised the government to prepare a more detailed procedure for handling the corona outbreak. Inspections and restrictions on the movement of citizens should not be carried out arbitrarily.
"When the security guards did swab, procedures, who can be involved, what kind of monitoring, it must be explained. Today there is not a single law that regulates how restrictions are exercised. The Covid-19 guidelines also minimally discuss patient rights, "he added.
Meanwhile, the Head of the Disease Control and Eradication Division of the Samarinda City Health Service, Dr. Osa Rafshodia, stated that picking up residents exposed to corona was not solely based on health considerations. The government often uses social and economic factors for consideration in each region. Therefore, the pressure from residents in the Covid-19 inspection polemic at Walhi led the Health Office to take the initiative to provide a place of isolation for activists.
"They cannot be separated from one another," he said when contacted by Jaring.id on Thursday, August 6, 2020.
The presence of the Surveillance Team at the Walhi and Pokja 30 offices, according to him, was part of the active involvement of citizens in the response to Covid-19. This is in accordance with the Decree of the Minister of Health of the Republic of Indonesia Number Hk.01.07 / Menkes / 413/2020 concerning Guidelines for Prevention and Control. Coronavirus Disease 2019.
"Often many people gather without implementing health protocols," said Osa.
Osa denied that the examination of the three activists was carried out outside of health procedures. He claimed that the examination and pick-up of activists were in accordance with the revision of the five Minister of Health Decrees concerning Guidelines for the Prevention and Control of Covid-19. He confirmed that the three activists had been included in the report on the increase in positive cases in Samarinda City daily.
"Everything has been done," he said.
Even so, Spokesperson for the Task Force for the Acceleration of Handling Covid-19 in East Kalimantan Province, Andi Muhammad Ishak, admitted that he did not receive an official report regarding the examination of dozens of people at the Walhi office. However, he could understand what the Samarinda Health Office was doing.
According to him, the examination conducted by the Health Office can be carried out based on reports from the public. Meanwhile, physical evidence from laboratory examination results can be given later. What is important for the public to know quickly is the notification of the results of the Covid-19 examination, either directly or via telephone or electronic mail.
"To accelerate tracing we can be informed first, but after that the laboratory results will be given, "he said when contacted on Friday, August 6, 2020.
It's just that, after it was discovered that 3 positive people were found at the Walhi and Jatam offices, the officers no longer conducted searches (contact tracing) against people who come into contact with the patient. Neither Walhi Kaltim nor Pokja 30 were used as transmission clusters, even though there was one similar incident.
"After the results came out, the officer did not conduct a search to the family," said Rupang.
Based on the daily report of the Samarinda City Health Office, there are only 7 clusters of Covid-19 transmission. Among others, the Regional General Hospital (RSUD) Abdul Wahab Sjahranie, the Regional Representative Council (DPRD) of East Kalimantan, Jalan Hasan Basri Gg.2, KT2 (deputy governor of East Kalimantan), the Provincial Government of East Kalimantan and the Tanjung Aju cluster. The highest number, namely 55 cases detected came from outside the cluster (non-cluster).
Since the results of examining the activists' mucus samples came out on Thursday, July 30, 2020, there were 284 positive cases in Samarinda, or an increase of 11 people. After a day the number became 303 cases. Meanwhile, on Tuesday, August 11, the number of cases jumped to 402 positive cases.
University of Indonesia epidemiologist Pandu Riono warned local governments to carry out contact tracing of every confirmed positive case. This is important so that the chain of transmission can be controlled.
"Examination is done once enough to declare someone positive. Can be considered accurate. The fear is that false negatives are not positive, "said Pandu when contacted Wednesday, August 12, 2020.
If the search results show that many people are infected in one location such as an office, Pandu said that these locations can be made into one cluster. Even so, establishing a cluster is no more important than the process of finding people who have been exposed to the new corona virus.
“Not just testing but part of this covid surveillance is testing, trace and isolate, "he explained. (Deborah Blandina Sinambela)