In Indonesia, Palo has suffered a triple disaster, and the coronavirus is now looming on the horizon Indonesia News

The citizens of Palu, who are still tens of thousands in temporary shelters, began rebuilding their health facilities when the new coronavirus arrived.

Here and across Indonesia’s central Sulawesi province, the bloodiest earthquake struck in 2018, killing 4,845 people and destroying more than 100,000 homes. The earthquake, with a magnitude of 7.4, swallowed whole neighborhoods and caused a tsunami so quickly that geologists were surprised.

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When the earthquake struck, the main nursing and housing ward of Anutapura Hospital collapsed on its own with the loss of 250 hospital beds in a county with only 1,100 beds in all Class A and B hospitals and a population of over 2.6 million. The rebuilding was supposed to end next month.

But most feared by locals is what might happen if the virus enters shelters that are still home to tens of thousands of people across the city, despite 18 months of promises of rapid assistance.

“As soon as the government said that there were cases in Palu, I started to feel panic,” said Tarry Yaligama, a mother of three 32-year-old children who lives in temporary shelter. Ten families share the toilet they use. Her previous house still lay in a pile of rubble, pushing 150 meters down.

“But until someone is tested positively, everyone will go about their life normally. People think the heat will kill it,” she said.

The virus can spread between people without symptoms, and tests are difficult to perform.

Difficult to distance

“These shelters are far from adequate for physical extension procedures,” said David Pacaya, doctor and medical lecturer at Palo Tadulaco University. “Each family lives on an area of ​​less than 20 square meters [215 square feet] And without adequate ventilation. “

Some Palo survivors remain in tents more than 18 months after the triple disaster in September 2018; NGOs provide essential supplies this month [Supplied/Al Jazeera]

There are 699 government temporary shelters near 9,000 people. Twelve families share four bathrooms and one kitchen. In shelters built by private foundations, there are thousands more in small one-room huts with metal roofs and a shared bathroom by more people.

“We are facing a second crisis as we are still recovering from the last crisis,” said Dewi Rana, who leads a local women-focused non-governmental organization, Libo Birembuan.

NGOs continue to provide food assistance, 74 health facilities remain damaged at the beginning of the year, and damage to irrigation systems has left many livelihoods unsustainable and unreliable water sources.

“Some friends have just started recovering, but we are facing this virus,” Rana said.

Some are in tents

Just as health facilities have not yet been rebuilt, many residents are still living in emergency tents erected just after the September 2018 disaster.

Experts say such conditions could become fertile ground for the virus.

“If the SARS-CVV-2 virus infects a shelterer, it will spread easily,” said Bandu Ryono, a statistician and public health expert at the University of Indonesia.

In this September 2019 photo, a man hunts near a house destroyed by an earthquake, tsunami and liquefaction a year ago that destroyed Palu in central Sulawesi. Thousands still live in emergency shelters and tents [File: Ian Morse/Al Jazeera]

“It will be a catastrophe and the death toll will increase in conditions like these,” said Ryono.

Across Indonesia, experts predict the virus will spread much more and deeper than medical facilities can test it. According to a study by a team that includes Ryono at the University of Indonesia, hundreds of thousands will die without interference.

Central Sulawesi has detected twenty positive cases of the virus, but there are hundreds of other suspects and three deaths have already been recorded, including the country’s first public official – the head of the northern Morwali region, who has been confirmed by all of his team and family.

Officials told local media that shelters have become the focus of the government’s response to the epidemic. The Palo government attempted to interfere with the spraying of antiseptics in temporary shelters, despite evidence that they were insufficient and potentially harmful to human health.

Food and water are unreliable

On the other hand, it appears to have provided some reassurance to the community and calm the nerves.

“I’m afraid this will become another path that the virus can use,” said Rana, speaking on the poor health status of the population and weakened immune systems.

Malnutrition can also weaken the immune system, and inconsistent water supplies make it difficult to keep elbows and hands clean.

“There are health problems in the temporary shelters, including nutritional problems, psychological and social stress, degenerative diseases and other infectious diseases such as tuberculosis and dengue, all of which can reduce the body’s immune system,” said Pakaya.

The region continues to experience high rates of respiratory infections as a result of dust resulting from the rubble of damaged infrastructure and unsanitary living arrangements. Moreover, many residents find it difficult to purchase phone credit to access the Internet, which means that few of them have a great understanding of the disease.

“Insufficient access to correct information about the virus, ranging from its signs and symptoms and ways to prevent it, means that the population is not on the alert and cannot determine whether they themselves are infected with the virus,” said Pakaya.

Without help for home repairs, many are afraid of living inside cracked walls and ceilings that could collapse with another earthquake, which often happens. Dewey fears for the thousands who are still in these tents who live around the city and in the mountains.

Dewey Rana and members of her NGO delivered sugar this month to Palu families who are still living in temporary housing after more than 18 months of the disaster. It says access to food, water or medical care is limited [Supplied/Al Jazeera]

“You can’t get out of your house, so access to food is limited because there is no help now. Access to sanitation is limited and access to water is limited. You can also imagine that this might become more difficult for people who live in Rana,” she said.

Unfinished new homes

Rana and her organization distributed sugar to earthquake survivors living in tents near a neighborhood where the earth turned liquid and swallowed houses.

While others throughout Indonesia and the world are required to stay indoors as possible, many new homes built by private foundations, NGOs, and government get hotter during the day, increasing the risk of a serious heat stroke.

Last year, officials said the first homes would be finished by the end of 2019, but none had been completed. Thousands of people have yet to receive the three types of government-ordered aid they promised: two months of daily compensation, compensation for the death of family members, and money to rebuild homes.

Fathi Zubaidi, deputy director of Anutapura Hospital, the second largest hospital in Palu, says he is confident that the hospital now has adequate facilities, despite the stalled construction in the destroyed hospital building.

But access to health facilities remains limited, says Rana, whose non-governmental organization Libo Perembuan is recording spikes of gender-based violence in nearby temporary shelters. Narrow spaces and worsening crises for loss of livelihoods and unreliable food supplies have led to reports of domestic violence, child marriage and the invasion of privacy.

“We are building a database of all temporary shelters, so we know who is pregnant, when and how many children will be born, because access to hospitals or medical clinics is still limited,” said Rana.

Minnie Revay, a Palo resident, tried to test for coronavirus last month but was forced to jump across dozens of hoops as the fever worsened. In the end, she was struggling to breathe, and she said healthcare facilities were puzzled over what to do.

I finally got a test. Negative returned.

“The only way to take the test is to be stubborn,” said Revay.

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