A scandal
over fake vaccines given to children prompted angry and confused parents to
physically attack a doctor in the Indonesian capital in a sign of deep-seated
problems in the country's health system.
Since
last month, vials marked as vaccines but filled with saline solution and
antibiotics have been discovered at 37 hospitals and clinics in nine cities,
according to the Food and Drug Agency. So far, 23 people have been arrested,
including three doctors. The number of affected children is still being
investigated but could be significant in a country of more than 250 million
people.
Indonesia
President Joko "Jokowi" Widodo this week visited a clinic where
nearly 170 children were to be revaccinated. He asked for patience while police
continue to investigate an "extraordinary crime" of bogus vaccines
allegedly going back as far as 2003.
"We
are in crisis right now," said Dr. Aman Bhakti Pulungan, head of
Indonesia's Pediatrician Association. "This is a medical emergency, and we
have to overcome this."
He said
he is not aware of any children dying as a result of not being protected
against diseases they were believed to have been vaccinated against, but added
it's possible some kids could have gotten sick without being detected. The fake
vaccines involved a number of shots routinely given to children, including for
measles, whooping cough, hepatitis and diphtheria.
The
counterfeits were falsely labeled as imported brands, Pulungan said. He
believes the number of children affected is likely small, given that only 1
percent of vaccines administered nationwide are imported. The government began
revaccinating children this week free of charge at affected hospitals and
clinics, including 14 in the capital Jakarta and its outskirts.
Local
television footage this week showed a mob of angry parents at Harapan Bunda
Hospital in eastern Jakarta arguing with a doctor and then punching him and
spitting on him before security officers broke up the brawl. Other parents took
their rage to the government, complaining to members of parliament and
demanding help.
Jane
Soepardi, the director of Surveillance, Health Quarantine and Epidemiology at
the Health Ministry said Friday the government estimates about 5,000 children
from 4.8 million targeted this year for immunization, have gotten fake
vaccines.
"Fake
vaccines arose because there was a scarcity of vaccine a few years ago that led
hospitals and clinics to look for imported vaccines," she said. "Also
because the middle class demanded imported vaccines rather than locally
made."
She said
the fakes did not contain harmful substances but it's possible the unsafe
process of producing them could cause infections in children they were
administered to.
Health
Minister Nila Moeloek has called for calm and warned parents not to panic, but
distrust of the health system runs deep in a country rife with corruption,
overcrowded hospitals and a lack of qualified doctors. For those who can afford
it, Singapore or Malaysia are often the first choice for treatment.
Danang
Susilo, the father of 14-month old Chelea, said he is worried about his
daughter's health even though doctors from Karya Medika Hospital at Bekasi on
the outskirts of Jakarta assured him the fake vaccine she received was
harmless.
"I
was shocked and very disappointed when the hospital management asked me, along
with about 300 other parents to bring our children for revaccination, because
the vaccine that is injected into our children turned out to be fake," he
said. "How could this happen?"
"We
need a medical check-up, not only an explanation," he said. "We need
concrete compensation."
In 2013,
the Food and Drug Agency received a report from British pharmaceutical company
GlaxoSmithKline about the circulation of counterfeit vaccines bearing its name.
The perpetrator was caught and fined less than $100. Additional problems were
discovered in 2014 and 2015. This year, PT Sanofi-Aventis Indonesia, a
subsidiary of French pharmaceutical company Sanofi, notified the National
Police about fake vaccines using its product labels, according to the agency.
Dr.
Kartono Mohammad, former head of the Indonesia Medical Association, said the
regulations are already in place to ensure that safe vaccines are administered,
but enforcement and monitoring are weak. He said that the vaccine scandal is a
symptom of a much larger problem, and that the country's entire health system
should be overhauled.
"The
attitude of the Indonesian people, especially the middle class, is that they
look at the building and the facility and they say: This is the best
hospital," he said. "But nobody knows if it really is a good hospital
or not because there is no quality control, no quality assurance done by the
government."
Niniek
Karmini and Margie Mason
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