Indonesia’s Covid-19 crisis: China to the rescue?

The rapid spread of Covid-19 throughout Indonesia is a serious challenge that could have strategic implications for Australia. But, unlike in previous disasters, there’s little Australia can do to assist Indonesia in the short term. Instead, it will be China that comes to Indonesia’s rescue.

After weeks of denying that it had any Covid-19 cases and claiming that adequate screening measures were in place, Indonesia now faces a health disaster. Although the first infections were reported only a month ago, current numbers indicate that more people in Indonesia are now dying from the virus than have recovered, giving it the highest death rate in Southeast Asia. It’s also ranked among the lowest countries in the world in terms of its testing rate, which suggests that numbers could be worse than reported.

The virus has already been detected in 29 of the country’s 34 provinces, and the densely populated areas of Jakarta, Banten, West Java, Central Java and East Java have over 80% of the more than 1,000 confirmed cases. Videos posted on social media showing Indonesians collapsing of respiratory failure on the streets of Jakarta have sent most of the middle class into self-isolation, forced some ethnic Chinese to seek refuge in Singapore, and driven the elite inside the walls of military compounds and gated communities to wait out the crisis.

The central government has tried to follow other countries by implementing work-from-home and social-distancing measures, but they’re proving difficult to enforce. Millions of Indonesians depend on the income from the informal sector built around the movement of people for their day-to-day living.

Ironically, the closure of offices, markets and factories across Java is increasing the risk of local transmission. Many Indonesians can’t work from home and the decline in economic incentives has forced thousands to return early to their villages ahead of the post-Ramadan Idul Fitri holiday period, likely spreading the virus further. It will be some time before Indonesia and its people understand the true extent of the crisis they face.

The government is now considering a local travel ban to prevent millions from returning to their villages, but it may be too late. Local transmission outside the capital has already occurred, and the safest place for many may now be their villages. Leaving the city could give the urban poor a better chance of isolating for an extended period. The Indonesian military is already building makeshift regional hospitals and commandeering non-vital government property in preparation for what will likely be thousands of patients in the coming weeks.

Indonesia’s health system is struggling to cope with the few cases that it has detected. The country has one of the worst deficits in hospital beds per capita in the region, with about 310,000 for its 260 million population, which roughly equates to 1.2 beds per 1,000 people. The ratio is even worse for intensive care beds, at about 2 beds per 100,000 people. Many of Indonesia’s hospitals also lack stored oxygen, ventilators and other equipment that can save patients with severe infections.

Even if Indonesia can increase its number of beds and acquire enough medical equipment to keep up with demand, it still lacks skilled respiratory and intensive care practitioners. This makes healthcare workers the key to the government’s response and is why the government needs to prioritise the supply of personal protective equipment to frontline workers. At least seven doctors have already died from Covid-19 infections and hospitals have resorted to stop-gap solutions such as plastic raincoats in a last-ditch effort to protect staff.

If the infection rate among frontline healthcare workers continues to rise, the government will face a serious morale problem that could exacerbate the crisis. The government is putting healthcare workers into hotels, ostensibly to keep them closer to hospitals, which will make them easier to monitor. The downside of that move is that it increases the risk of an outbreak among health workers.

Providing medical aid to Indonesia is something Australia would normally do, but it has its own shortages to contend with right now. Instead, Indonesia has been forced to accept offers from China and even to use its own military to pick up medical equipment. That’s a sign that Indonesia is already desperate for medical equipment, and suggests that the success of its response could depend on how much assistance it gets from China.

Indonesia’s options for averting crisis are limited. If lockdowns are implemented to reduce local transmission, enforcing them would be more than a question of manpower. The central government would be responsible for providing food to millions of Indonesians unable to provide for themselves. Food shortages could easily result in a breakdown of law and order and the scale would likely overwhelm security forces and weaken the government’s hold on power.

Like most countries, Indonesia’s priority has been to avert another economic crisis. The government has already injected around US$18 billion of liquidity into financial markets. Indonesia’s economy is consumer-driven, which has helped it weather previous financial crises. But a prolonged Covid-19 crisis will require substantial government spending and policy responses that bring the domestic economy to a standstill. Indonesia will need financial assistance and there will be few options apart from China.

Socioeconomic instability in Indonesia in the past has often been followed by political instability and change. Australia must therefore watch critical indicators closely—some of which Indonesia has already met—and provide medical aid and expertise as soon as possible before Indonesia becomes completely dependent on China to avert this crisis. Australia will have a limited capacity to provide the financial aid that Indonesia might require. But it can offset Indonesia’s dependence on poor-quality equipment from China, which has occurred in countries such as Spain and may actually prolong the crisis.

As soon as Australia has a handle on its own Covid-19 situation, it should start planning to assist Indonesia with expertise in workplace health and safety, diagnosis and treatment, all of which can be done at a distance. Otherwise, China will have a monopoly on influence and potentially take strategic advantage of Indonesia’s dire circumstances—an outcome that would have an adverse impact on Australia’s interests in the region.