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By UNICEF Australia
19 October 2020

The COVID-19 pandemic has wreaked havoc on health systems worldwide.

With over 35 million men, women and children infected across the globe, hospitals and health centres have been overwhelmed by critically ill patients suffering from COVID-19 and hundreds of thousands of doctors, nurses and other health professionals have found themselves amongst the sick.

In Indonesia, one of the worst hit countries in Asia, physical distancing measures led to the temporary closures and suspension of services in health centres, known as ‘puskesmas’ and village health posts, known as ‘posyandu’, the backbone of routine maternal, newborn and child services across much of the country. This left millions of children at risk of missing out on life-saving care including vaccines and other health interventions, both critical and routine.  

In fact, data from a rapid assessment jointly conducted by the Ministry of Health and UNICEF shows that between March and May 2020, the coverage rates of life-saving vaccines decreased by more than 35 per cent, compared to last year during the same period in 2019, and that more than 84 per cent of the reporting health facilities had seen their immunisation services “significantly disrupted”. 

In Yogyakarta however the Tegalrejo puskesmas were able to reopen their doors to the community. How was this possible? 

A midwife cleaning her face shield
A midwife cleans her face shield at a health centre in Yogyakarta, Indonesia.
© UNICEF/UNI350147/Ijazah

1. Strict PPE Protocols for Staff 

At the beginning of the pandemic in March, many staff members at the health centre were afraid of becoming infected, which reduced their ability to deliver services. In response, the Government of Indonesia, with support from UNICEF and other partners, has provided guidelines and supplies for health workers to carry out their jobs safely and effectively during the pandemic. To reduce the risk of transmission, the centre mandated that all staff wear personal protective equipment (PPE) including masks, gowns and gloves. This helped keep both health workers and their patients safe from COVID-19.

Health workers vaccinate a child
Health workers vaccinate a child wearing masks to protect themselves and patients from COVID-19
© UNICEF/UNI350142/Ijazah

2. Masks Made Mandatory

It was made mandatory for adults visiting the centre to wear masks for the duration of their visit. Whilst it’s not safe for babies to wear face masks, the use of cloth face masks heavily reduces the risk of a respiratory virus like COVID-19 being passed on. 

Mother and daughter washing hands
A mother washes her hands before entering a health centre in Yogyakarta, Indonesia.
© UNICEF/UNI350077/Ijazah

3. Soap For All! 

It may sound simple but soap is an incredible weapon in the fight against COVID-19. The virus can survive for hours (or maybe even days) outside the body and whilst disinfectants, alcohol gels and sanitisers can help stem the spread, none of them are quite as effective as humble soap. Why? Well it is all quite complicated science, but essentially the virus includes a fatty layer which is destroyed by a good wash with soap.

Whilst disinfectants, alcohol gels and hand sanitisers work in the same way, soap is better because you only need a very small amount when combined with water to cover the whole surface of the hand and help stop the spread! Soap was provided in the clinics for staff and for patients who must wash their hands before entering the clinics. 

Doctor checking patients temperature and blood pressure
A doctor checks the temperature and blood pressure of a pregnant mother.
© UNICEF/UNI350161/Ijazah

4. Temperature Checks At The Door 

All staff and patients must have their temperature checked before starting work or attending their appointment. This helps to ensure that anyone with a fever is quickly isolated and treated in safe conditions. 

A mother waits for her child to be vaccinated
A mother waits for her child to be vaccinated whilst maintaining physical distancing.
© UNICEF/UNI350106/Ijazah

5. Physical Distancing Inside 

In order to ensure that patients did not come into close contact with each other, or with staff without proper PPE, waiting times at the clinics were shortened and visitors were asked to wait in the hallway before being called in one at a time for their vaccinations or other health procedures.  Moreover, air circulation inside the facility was improved. To enforce physical distancing requirements, chairs inside the centre were taped off to prevent people from sitting too close to each other.  

Doctor inputting data in to computer
Reana, a nutritionist, inputs toddlers' weight and height data collected online from health workers who received the data from mothers.
© UNICEF/UNI350144/Ijazah

6. Mobile Phones For Medics 

With many in the community still afraid of contracting the virus, the number of patients coming to the centre decreased significantly. Since the new health measures were put in place, however, staff report that more families are slowly starting to come back.  Mobile phones have been  a critical tool in enabling staff to provide health services during the pandemic. They allow them not only to have regular contact with patients for appointments and initial consultations but to do it while physical distancing.  

UNICEF Australia wishes to express its sincere gratitude to key donors, including the Australian Government for their assistance in supporting care for Indonesian mothers and children during COVID-19.