The new semester has begun amid a continuing controversy over reopening schools. While educators fret about the risks of a prolonged interruption of in-person studies, others worry about a worsening gap in access to education. Some teachers have been visiting students in their homes to assist those with limited access to the internet, but they are potentially exposing themselves and their students to COVID-19.
The pandemic has contributed to a rise in preventable diseases among infants because of a decline in immunization coverage. In the 1970s, mandatory vaccinations became routine at schools and health centers in the nation. Then, decentralization as a result of democratic reforms, a louder conservative movement and “anti-vaxers” were all blamed for lower coverage. Now, I worry about my grandkids’ exposure to vaccine-preventable diseases.
As World Health Organization director general Tedros Adhanom Ghebreyesus said, “The avoidable suffering and death caused by children missing out on routine immunizations could be far greater than COVID-19 itself.”
The long-term effects of measles, for instance, can include swelling of the brain, leading to convulsions and sometimes death. While the threshold of herd immunity for basic childhood vaccines is 95 percent coverage, the Health Ministry reported last year that 96 regencies and cities had coverage rates between 60 to 80 percent, and 40 others had coverage rates under 60 percent.
Health authorities have assured parents that vaccinating their children is safe, as protocols are in place to prevent the transmission of COVID-19. But as demonstrated by the family planning program, nationwide vaccination needs to be in sync with central and local bureaucracies, religious authorities and informal community organizations.
Nowadays even more intensive efforts are needed to stabilize disrupted vaccination programs as louder anti-vaccine groups raise dubious claims about harmful side-effects of vaccination and religious leaders seek to save the devout.
In 2018, Acehnese ulema council (MPU) officials requested that the measles and rubella (MR) vaccination program be delayed pending a fatwa from the Indonesian Ulema Council (MUI) to establish its halal status. Similar to the 2016 fatwa allowing vaccines with haram content in emergencies until a halal vaccine was discovered and made available, the MUI ruled that although the MR vaccine from India contained porcine enzyme, which is considered haram, it was permissible (mubah).
However, as in other quarters, such as in Riau province, parents and local Islamic leaders continued to resist the vaccination effort. Some were dragged into polarized camps ahead of the 2019 presidential election. Aceh’s overall basic childhood vaccination coverage in 2019 was 49 percent, and MPU support came only after reports that MR immunization coverage in the province was barely 7 percent.
This year, the MPU reasserted its support for vaccination programs, appealed for closer communication with the MUI and encouraged a more active role for Aceh’s health agency in spreading awareness about basic vaccinations. “We are ready to help,” said Faisal Ali, deputy head of the MPU.
Surveys have recorded similar declines in immunization coverage in other Muslim-majority countries, such as Afghanistan, Pakistan and Malaysia. However Indonesia, mindful of the potential for human rights violations, has not resorted to penalties for parents resisting vaccination as in Pakistan and Malaysia.
Therefore, major religious organizations and their leaders urgently need to remind parents to have infants vaccinated to avoid various diseases that could afflict them into adulthood. With their greater clout today, we have every right to demand that religious leaders show much more responsibility in saving lives.
Religious leaders should repeat their earlier role in Indonesia’s family planning program, when they endorsed initially controversial efforts to cut down family sizes and space out births. Though the globally lauded program of the authoritarian New Order was criticized by some for its intrusive, even intimidating nature, religious organizations should take the lead again to save millions of children.
Islamic leaders attempting to overcome resistance to vaccines have faced regional chapters of their organizations, as in Aceh and Riau, that hold greater sway with local populations than central boards. Blunders and a lack of speedy damage control have also added to confusion and distrust in national institutions such as the MUI and the Religious Affairs Ministry.
Another lurking danger is child marriage – which has reportedly increased since the arrival of the pandemic. One probable reason is parents marrying off girls to rich suitors – including revered elderly clerics – in a bid to ease worsening poverty. Despite the recently increased minimum legal marriage age of 19 for both men and women – which from 1974 to late last year was 16 for girls – parents can still file for “dispensation” from the courts to marry off minors in the case of an “emergency”, such as if the girl is pregnant.
Stands against child marriage have been made at the very top of religious organizations. A 2018 fiqih (Islamic legal ruling) on child protection by Muhammadiyah states that the ideal age of marriage is at least 21, to better ensure physical and mental maturity. Religious organizations must prioritize this kind of safeguarding of adherents, instead of attempting to justify the sexual exploitation of minors or instilling the fear of sin, especially during this health emergency.
To avoid the threat of infectious diseases and girls becoming mothers – on top of all the nation’s efforts to cope with COVID-19 – religious leaders can help make a social difference again. In family planning, they eventually turned around convictions that it was sinful to interfere with God’s command to procreate. As researcher Jeremy Shiffman notes, the focused approach of securing the support of faith leaders – involving advocates of family planning and the National Population and Family Planning Board (BKKBN) – accompanied by the persistent lobbying of then-president Soeharto was effective at securing family planning commitments. Intensive efforts started with the BKKBN’s first leader, a military doctor named Suwardjo Surjaningrat, and continued with his successor, a communications professor named Haryono Suyono. Field campaigns on birth control involving security personnel also helped in the efforts.
To save our demographic dividend and the coronavirus generation, the role of the military and police may be limited. Faith leaders, however, could be much more relevant in helping parents and community leaders protect children.
The writer is freelance journalist, formerly at The Jakarta Post.
Disclaimer: The opinions expressed in this article are those of the author and do not reflect the official stance of The Jakarta Post.