COVID stalks Indonesian villagers who fled Semeru’s burning ash

Surabaya, Indonesia – Dugijan, a farmer from Curuk Kobokan village at the base of Indonesia’s Mount Semeru volcano, was asleep in his home when he was woken by the sound of a deafening explosion.

Stumbling out the front door, he saw his friends and neighbours running to safety as the mountain began to erupt, spewing ash and volcanic debris 4km (2.5 miles) into the glowering sky.

“The road was dark and covered in mud and ash. People were running and screaming. It was raining and lightning was crackling around the mountain. It looked like the Day of Judgement,” the 60-year-old told Al Jazeera.

“I thought I wouldn’t make it. It was raining rocks and I wasn’t strong enough to run anymore. So I just started to walk slowly and I left it all up to God.”

As he painstakingly made his way to a nearby mosque, where he sheltered for three hours before help arrived, Dugijan saw that some of the people running next to him were covered in burns and blisters from the heat of the thick ash cloud that was bearing down on the villagers.

“I still can’t believe what happened. I can’t go back, I’m too afraid. I’m old and I’m waiting for my time, but don’t let it be because of a disaster like this,” he said.

The eruption, which took place on Saturday afternoon, killed at least 34 people, with dozens still missing.

According to Indonesian authorities, more than 3,000 residents have been displaced as ash and mud continue to blanket villages, making rescue difficult and raising questions among experts about the potential effect on the COVID-19 pandemic.

Dr Irandi Putra Pratomo, the chief medical officer of the COVID-19 Task Force and the Pulmonology Medical Unit at Universitas Indonesia Hospital in Depok, near the capital Jakarta, said doctors are still discussing whether the eruptions could cause a rise in COVID-19 cases, or exacerbate COVID-19 symptoms in patients.

“We aren’t sure yet whether the COVID-19 virus and volcanic ash will interact with each other,” he told Al Jazeera.

“But we already know that volcanic eruptions can cause acute inhalation injuries to the lungs.”

Health complications

Irandi said the study on the effect of volcanic ash on the lungs is relatively advanced in Indonesia, as the country is located on the Pacific Ring of Fire and sees frequent seismic activities, including volcanic eruptions, which means that ashfall is something that many residents across the archipelago might experience.

Volcanic ash is made up of gas and small particles which can include rocks, crystals and glass, and can have a dangerous effect on the respiratory system if inhaled.

In a situation where a volcano has erupted and patients have been exposed to ash, Irandi said that emergency cases may require advanced support for breathing, including bronchoscopy, a medical procedure inserting a thin tube in the nose or mouth to observe and locally treat airway injuries.

For non-emergency cases, patients are usually treated as if they have a lung infection using traditional pulmonary treatments such as antibiotics and anti-inflammatories.

The COVID-19 virus is also known for being a respiratory disease that causes inflammation and injury in the lungs known as Acute Respiratory Distress Syndrome (ARDS).

As a result, people who have suffered lung damage and scarring after contracting COVID-19 or who are still in the recovery phase of the virus may have an increased risk of having worse symptoms due to volcanic eruption debris, the doctor said.

Indonesia has reported more than 4.2 million coronavirus cases since the start of the pandemic and more than 140,000 deaths. More than 100 million people are fully vaccinated out of a population of more than 260 million, according to data from the Ministry of Health.

Displacement of residents

There may also be other reasons why the Mount Semeru eruption could exacerbate the COVID-19 pandemic in Indonesia: the displacement of large swathes of the local population.

One such displaced resident, 30-year-old Siyamti Anggraeni, lived at the foot of Mount Semeru in the village of Curah Kobokan.

She had seen the mountain erupt three times before, but told Al Jazeera that she had never witnessed anything as terrifying as the events of Saturday afternoon.

“The roof of my house was pummelled by pebbles. I don’t know how many kilometres I ran with the other people in my village. We could hardly see anything because the ash cloud was so thick,” she told Al Jazeera.

“The air felt scorching hot. Many of my neighbours are still missing. The ash and mud is as high as a house in some places. We can’t even search for anything because the mud is still hot.”

Siyamti and her family are now sheltering in a communal hall in Penanggal village in East Java along with about 30 other people.

Dr Irandi worries the proximity into which the evacuees have been forced to stay could put them at risk of contracting COVID-19 from other evacuees.

In October 2021, a study by the Institute of Applied Sciences in Rwanda and the Jomo Kenyatta University of Agriculture and Technology found that after Nyiragongo erupted in the Democratic Republic of the Congo in May, there was a rise in COVID-19 cases in neighbouring Rwanda. Some 8,000 Congolese crossed the border to escape the volcano, exacerbating the spread of the virus, the researchers said.

Despite the preliminary study and doctors’ knowledge of the risks of ash inhalation following a volcanic eruption, it will be some time before they know the true effect of the Mount Semeru eruption in the midst of the COVID-19 pandemic.

“We haven’t got any clear evidence about all the risks,” Irandi said.