Experts warn country faces rise in infectious disease even as it struggles to contain the coronavirus pandemic.
Medan, Indonesia – Viktorious Veni considers himself one of the lucky ones.
The high school music teacher, who lives in Kupang, the provincial capital of Indonesia’s remote East Nusa Tenggara Province, was able to get vaccinated against coronavirus in May but knows that many others have not been so fortunate.
“Every day there are developments and there are more and more patients being admitted to hospital here in Kupang,” he told Al Jazeera.
“The Delta variant has already entered East Nusa Tenggara, so every day the numbers rise, especially in places like Labuan Bajo and Maumere.”
Veni was able to get a vaccine as he is a teacher and considered a front-line worker in East Nusa Tenggara but the province, like the rest of Indonesia, has struggled with a sluggish vaccine rollout coupled with spiking numbers of new coronavirus case numbers.
To date, East Nusa Tenggara, with a population of 5.5 million, has reported more than 40,000 positive cases and more than 800 deaths. The province has 29 designated COVID-19 hospitals but 17 were full as of August 3, according to the Ministry of Health website.
“The hospitals are also already overloaded, so the governor of East Nusa Tenggara has asked for a special COVID-19 hospital to be built to handle some of the strain,” Marius Ardu Jelamu, the spokesman of the East Nusa Tenggara COVID-19 Task Force told Al Jazeera.
“We hope that this will promote confidence in the local population, as many people are stressed about the prospect of needing to be hospitalised in case there is not enough oxygen or beds available, so many make the decision to stay at home even if they feel sick.”
While Indonesia has managed to secure more than 173 million COVID-19 vaccines so far, only 46 million people have received a first dose and 19 million a second, according to figures from the Ministry of Health.
In East Nusa Tenggara, which is planning to vaccinate 3.8 million people, only 15 percent of the population had received a first jab, and just 7 percent the full two-dose regimen as of July 30.
East Nusa Tenggara is Indonesia’s southernmost province and is made up of more than 1,000 islands, including Sumba, Flores and western Timor where it shares a land border with East Timor or Timor-Leste. As a result of its geography and scattered population, vaccinating residents against COVID-19 presents a significant challenge to the health authorities.
The local government had originally hoped to achieve its ambitious vaccination target by the end of the year, with the rollout of the second phase of vaccines meant to begin in July.
Unfortunately, problems with supply meant they missed that goal.
“We are still trying to coordinate with the central government. The Ministry of Health has promised that it will distribute vaccines this year so that 70 percent of the population can be vaccinated and we can achieve herd immunity,” said Jelamu.
In order for vaccines to even reach East Nusa Tenggara, they must first be flown by air from either Jakarta or Surabaya in Java or Denpasar on the island of Bali.
According to Jelamu, the government’s decision to use commercial airlines rather than special charter flights to deliver supplies has created problems.
Local airlines often cancel flights to East Nusa Tenggara there are not enough passengers, which delays the delivery of vaccines. Passenger numbers have declined as the pandemic has made it difficult to travel and Jelamu said that flight schedules to East Nusa Tenggara have become increasingly erratic.
He added the central government should send the vaccines via Hercules military aircraft or by helicopter.
“This has been the standard procedure previously when we had medical emergencies and needed supplies, such as when East Nusa Tenggara was hit by Cyclone Seroja in April,” he said.
Even after stocks arrive in central Kupang, the vaccines still need to be moved to remote areas, often across difficult terrain or between islands by boat.
“We need to interact with the central government so that it can help us,” Jelamu continued. “This is also not just a problem for East Nusa Tenggara but for other remote areas such as Papua and Maluku as well. In other parts of the country like Java and Bali, they have had problems with rising cases. But they can use roads to distribute vaccines easily, whereas we can’t.”
The need to ration the vaccines due to limited supply has had a knock-on effect on residents of the province.
On July 14, a crowd gathered in the city of Kupang outside the polytechnic hoping to receive a vaccine. However, there were only 250 vaccines available and more than 500 people had been queueing since the early hours of the morning in the hope of securing their dose.
“The queue was so long and everyone was getting hungry and tired, so they broke down the front gate in frustration,” Veni, who had friends at the vaccine drive, told Al Jazeera.
When asked about the incident, Jelamu told Al Jazeera that demand for vaccines was high in East Nusa Tenggara, with many residents worried that they will not be able to travel easily between the various islands or by road if they are not vaccinated. Tensions are similarly high when vaccines are not available at all.
In more remote areas of East Nusa Tenggara, the situation is even more precarious.
In Sainoni Village about five hours’ drive from Kupang, 75-year-old Maria Eta says she is still waiting for a vaccine, despite being in the high-risk priority category due to her age.
“They have only vaccinated teachers here at the moment because there are not enough vaccines,” she told Al Jazeera.
Eta says that teachers across East Nusa Tenggara have been been given priority for vaccines over the elderly, as online teaching is difficult in areas like Sainoni Village where internet coverage is patchy and many students do not have access to smartphones. As a result, many students are still attending school in person and have to have face-to-face interactions with their teachers.
Eta hopes that she will be able to get a vaccine soon but is also worried about the logistics should one become available.
“The closest health clinic is a 45-minute walk away from my village and I’m old now, so hopefully I can find someone to take me on a motorbike,” she said.