BUILDING A PLANE WHILE FLYING IT PERJALANAN KOMNAS FBPI 2006-2010
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This book is not just pictures of the work done by a small but very dedicated group of people at Komnas FBPI, but it also reflects a journey of people in a nation, who are ‎​learning by experience how to handle one of the biggest health issues in the last 30 years. This book is dedicated to those who want to learn so they can make their own lives and those of others safer and healthier no matter what threat may lie ahead Dr. Bayu Krisnamurthi Chief Executive of Komnas FBPI/ Deputy to the Coordinating Minister for the Economy (2006-2010) Buku ini bukan sekedar kumpulan cerita perjuangan dan dedikasi para pejuang Komnas FBPI, namun juga sebuah refleksi perjalanan sebuah bangsa yang belajar dan bekerja pada saat bersamaan dalam menangani masalah kesehatan terbesar dalam tiga dekade terakhir. Buku ini dipersembahkan kepada mereka yang ingin belajar membuat hidup mereka dan orang sekitarnya lebih sehat dan lebih aman dalam menghadapi ancaman kesehatan apapun di masa depan. Dr. Bayu Krisnamurthi Ketua Pelaksana Harian Komnas FBPI/ Deputi Menteri Koordinator Bidang Perekonomian (2006-2010)
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CONTENTS DAFTAR ISI
Foreword.................................................... 9 Kata Pengantar
Storm Clouds ............................................. 11 Ancaman Baru
On the Ground ........................................... 17 Kompleksitas Permasalahan
Taking Off.................................................... 25 Lahirnya Komite Nasional
Turbulent. Times.......................................... 33 Kampanye Nasional
The Long Haul............................................ 57 Solusi Jangka Panjang
Flying into the Storm.................................. 67 Merespon Pandemi
Afterword................................................... 80 Akhir Kata
Komnas FBPI.............................................. 82 Di Balik Layar
Partners...................................................... 86 Mitra Kerja
Annexes...................................................... 88 Lampiran
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STORM CLOUDS ANCAMAN BARU
There are many different types of avian influenza, but H5N1 is highly virulent, and to date there is no cure. Virus avian influenza sangat banyak jenisnya, namun H5N1 dinyatakan sebagai yang terganas dan belum ditemukan obatnya.
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The Virus Emerges
Awal Mula
Avian influenza or bird flu was first detected in 1996. A single goose in Guangdong province, China died of a virus identified as H5N1. A year later the first documented human case was identified in Hong Kong. By the end of the outbreak, six of the 18 people infected died and every single chicken, duck and bird on the island had been culled.
Avian influenza atau flu burung pertama dideteksi di tahun 1996. Seekor angsa di Propinsi Guangdong, Cina , dinyatakan mati karena virus H5N1. Setahun kemudian, korban manusia bermunculan di Hong Kong. Sebelum akhirnya dapat dikendalikan, 6 dari 18 orang tertular meninggal dan semua ayam, bebek dan burung di kota pulau tersebut dimusnahkan.
Experts had hoped that the story would have ended there but the virus was detected again in December 2003, this time in South Korea. In the following months it was detected in other Asian countries, killing millions of birds. Vietnam and Thailand faced mounting human cases but nothing would compare to what was in store for Indonesia, the world’s fourth most populous nation.
Para ahli berharap penyakit baru dan mematikan itu tidak menyebar luas. Namun terlambat. Beberapa kasus di temukan lagi di bulan Desember 2003, kali ini di Korea Selatan. Kemudian beberapa negara Asia melaporkan kematian jutaan unggas. Vietnam dan Thailand mulai mencatat kasus flu burung pada manusia dan peningkatan pesat jumlah korban terjadi di negara terpadat keempat di dunia: Indonesia.
Indonesia often had to deal with diseases in poultry and other domesticated animals. The outbreaks were handled on a case-by-case basis, not even a blip on the nation’s radar screen. So when H5N1 emerged in Asia, there were a number of officials and animal health experts that actually played down the possibility that avian influenza had reached Indonesia’s shores, saying that the country did not import chickens from infected countries like Vietnam, South Korea or Thailand and the country, being an archipelago, was well protected.
Penanganan penyakit bersumber hewan sudah rutin bagi Indonesia. Namun belum pernah dalam sejarah, kasus zoonosis harus ditangani semasif, dan mendapatkan perhatian seluas ini. Saat virus H5N1 merebak di Asia, beberapa ahli kesehatan manusia dan hewan menganggap ancaman tersebut tidak akan sampai ke Indonesia karena negeri ini tidak mengimpor daging unggas dari negara-negara terinfeksi tersebut.
That same year thousands of chickens died in Bali, initially officials said it was Newcastle disease, a highly contagious avian disease that is, however, not harmful to people. They would soon be proven wrong.
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Tetapi kenyataan berbicara lain, ribuan ayam di Bali mati mendadak mati karena flu burung, wabah yang awalnya dikira tetelo (Newcastle Disease), penyakit unggas yang dianggap tidak berbahaya,
Health workers examine a patient suspected of carrying the H5N1 virus. Antivirals were the drug of choice but needed to be given within 48 hours. Petugas kesehatan memeriksa pasien terduga flu burung. Pemberian antiviral hanya akan efektif apabila diberikan dalam kurun waktu 48 jam.
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Countries affected by the H5N1 virus
Negara yang mencatat penularan H5N1
Countries with humans, poultry and wild birds killed by H5N1.
Negara dengan kasus flu burung pada manusia, unggas dan burung liar.
Countries with poultry or wild birds killed by H5N1.
Negara dengan kasus flu burung pada unggas dan burung liar.
The Virus Spreads
Penyebaran Virus
In early 2004, the government officially confirmed that cases of avian influenza has been detected. The infected poultry was identified in Pekalongan in the heart of Central Java. The Health Ministry designated hospitals in high risk areas to deal with any suspected human cases. It wasn’t long before suspected patients would fill isolation wards.
Di awal 2004, pemerintah resmi mengumumkan avian influenza telah ditemukan di Indonesia. Banyak unggas sakit ditemukan di Pekalongan, Jawa Tengah. Departemen Kesehatan menyiapkan rumah sakit rujukan di berbagai wilayah berkategori resiko tinggi. Dalam waktu singkat, pasien-pasien yang diduga terjangkit (suspek), mulai berdatangan ke dokter untuk memeriksakan diri. Sebagian terpaksa dirawat di ruang isolasi.
In July 2005, a 38-year-old father from a Jakarta suburb became the first laboratory confirmed case. His two daughters also died, but H5N1 could not be confirmed. An investigation could not determine where or how the victim contracted the virus. Cases quickly began to mount. Hundreds of thousands of poultry had died of the virus. Indonesia was fast becoming the center of the storm with only Vietnam having reported more human cases.
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Di bulan Juli 2005, seorang bapak berusia 38 tahun tercatat sebagai kasus positif pertama flu burung pada manusia. Kedua putrinya meninggal dunia sebelum sempat diteliti penyebab kematiannya. Sebuah penyelidikan epidemiologi dilakukan, namun asal-usul penularan masih belum dapat disimpulkan. Kasus mulai bertambah. Ratusan ribu unggas kembali mati karena flu burung. Indonesia dengan cepat mencatat banyak kasus baru, menyusul Vietnam yang saat itu memiliki lebih banyak korban.
Doctors examine a chest x-ray to determine if a bird flu patient is responding to treatment. Seorang dokter menganalisa hasil pemeriksaan sinar ultra violet seorang pasien flu burung.
A young girl is kept in an isolation ward at a hospital in Bandung, West Java. Seorang gadis kecil dirawat di ruang isolasi di sebuah rumah sakit di Bandung, Jawa Barat.
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ON THE GROUND KOMPLEKSITAS PERMASALAHAN
Indonesia Land Area =1.9 million square kilometers Human Population = more than 220 million Poultry Population = more than 1.3 billion Luas Kawasan =1,9 juta kilometer persegi Populasi Penduduk = lebih dari 220 juta orang Populasi Unggas = lebih dari 1,3 milyar ekor
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Indonesia’s Challenge
Tantangan di Depan Mata
Trying to stop the spread of avian influenza is vastly different from trying to control most other diseases where the focus is purely on human victims. Here poultry is at the root of the problem and Indonesia is home to millions of backyard farmers. In addition, many families are economically dependent on the commercial poultry industry which is valued in excess of US$ 6 billion a year; employs some 10 million people; and for many more domestic poultry owners, especially in rural areas, is a key source of food and income. Free range poultry are found not only in rural villages but also in cities and towns and the prized “ayam kampung”, the local free range chicken, is considered the tastiest of all.
Pengendalian flu burung tak dapat dibandingkan dengan penanganan penyakit menular lainnya, yang kebanyakan berfokus pada penanganan pasien. Indonesia punya jutaan peternak kecil, kelompok penting dalam perang melawan H5N1. Jutaan rumah tangga menggantungkan penghasilannya dari industri unggas yang ditaksir bernilai lebih sekitar Rp 60 triliun per tahun dan memekerjakan sekitar 10 juta orang. Peternakan “rumahan” tidak saja dipraktekkan di pedesaan, namun juga di kota-kota besar. Mereka memelihara ayam kampung, jenis ayam paling disukai konsumen, di halaman rumah mereka. Merebaknya peternakan rumahan diperkirakan terjadi di pertengahan dekade 1980an, saat pemerintah saat itu merasa bahwa tingkat konsumsi protein penduduk Indonesia masih rendah. Promosi pentingnya memelihara ternak dan juga menanam sayuran dilakukan sebagai solusi. Pada masa itu, ancaman kesehatan makanan tidak signifikan dan tidak ada yang menyangka bahwa virus H5N1 dapat menjadi seganas sekarang ini.
The boom in backyard farming began in the mid 1980’s. This was a time when most Indonesians consumed less protein than others in the region. The government began promoting the raising of poultry to help counteract the problem and provide fresh chicken and eggs for children and adults alike. There was little concern for food safety issues at this time and no-one could predict a virus as virulent as H5N1. But raising poultry is only a part of the problem. The powerful H5N1 virus can spread during transportation, while it’s being sold at the market or during the slaughtering and cooking process. Other related industries also pose the same threats. Feathers used for making shuttlecocks and the processing of chicken manure for fertilizers also exposed the virus to workers and there few controls over these informal industries.
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Pemeliharaan unggas rumahan bukan satu-satunya kendala dalam mengendalikan flu burung. Virus maut tersebut mudah menyebar lewat transportasi unggas, terutama saat pengiriman dari peternak ke pasar. Kemudian dapat menular saat menyembelih atau menyiapkan masakan. Industri berbasis produk unggas lainnya juga berpotensi menularkan virus. Misalnya, pembuatan kok bulu tangkis atau pembuatan pupuk dari kotoran unggas.
A typical backyard farmer. This man raises both ducks and chickens in an effort to augment his family’s income. Seorang peternak rumahan yang memelihara ayam dan bebek untuk menafkahi keluarganya.
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Minister Aburizal Bakrie and Health Minister Siti Fadillah Supari visit a suspected bird flu victim in Karo, North Sumatra. Menkokesra Aburizal Bakrie dan Menkes Siti Fadillah Supari mengunjungi pasien terduga flu burung di Karo, Sumatra Utara.
A man holds a prized rooster at a traditional market. At the start of the outbreak few understood the risks involved in handling poultry. Seorang pria memegang ayam jago aduannya di sebuah pasar tradisional. Pada awal mula flu burung, hanya sedikit orang yang mengerti cara menangani unggas dengan benar.
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Birds are popular pets in Indonesia and are sold in markets, malls and public streets. Burung adalah peliharaan populer di Indonesia dan dijual bebas di berbagai pasar, pusat perbelanjaan dan di kaki lima.
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A woman sells prize breeding roosters at a local market in Central Java Seorang ibu menjual ayam jago aduan di sebuah pasar di Jawa Tengah.
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“
Many Indonesians treat poultry as a pet and a rare breed is a prized possession.
Banyak orang Indonesia memperlakukan unggas sebagai hewan kesayangan.
The challenges also involved strengthening surveillance both in the human and animal world, restructuring the poultry trade which was deemed unhealthy, restructuring wet markets, regulating transportation and the biggest challenge of all, changing behavior. In addition, there were few animal experts to deal with the problem. Indonesia had only 1,500 trained veterinarians and most were based in large cities.
Tantangan mengendalikan flu burung harus memperhatikan penguatan pelacakan baik di kesehatan manusia maupun hewan. Program antiflu burung juga merestrukturisasi perdagangan unggas yang tidak sehat, menyempurnakan pasar unggas dan tradisional, meregulasi transportasi unggas dan yang paling menantang: mengubah perilaku. Tenaga kesehatan hewan yang tersedia juga sangat terbatas, hanya sekitar 1.500 dokter hewan yang bertugas di Indonesia.
Changing the way people deal with poultry became a major issue. Many Indonesians consider poultry as their pets and a rare breed a prized possession and in some areas cockfighting was still a popular pastime.
Mengubah cara manusia berinteraksi dengan unggas bukan perkara mudah. Banyak penduduk Indonesia menganggap unggas adalah peliharaan berharga dan bahkan diperlakukan sebagai bibit unggul petarung, di komunitas-komunitas yang masih melanggengkan adu ayam.
It quickly became clear that AI was not only a health issue but involved working closely with the agriculture ministry’s as well as others such as transportation, trade and education. In the case of a pandemic every single ministry would need to be involved. Coordinating these ministries became a top priority.
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Jelas sudah bahwa flu burung bukan sekedar masalah kesehatan, harus ditangani secara terintegrasi antara Departemen Pertanian, Perhubungan, Perdagangan, dan Pendidikan. Bahkan dalam konteks pandemi influenza, semua kementerian harus terlibat. Mengkoordinasikan berbagai kementerian menjadi prioritas utama.
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TAKING OFF Lahirnya Komite Nasional
“Much of our time is actually spent ensuring that goverment officials understand the great danger of this disease,” said Bayu Krisnamurthi “Banyak waktu kami gunakan untuk meyakinkan sesama penyelenggara negara tentang bahaya flu burung,” ujar Bayu Krisnamurthi.
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The Birth of Komnas FBPI
Lahirnya Komnas FBPI
On March 13, 2006, President Susilo Bambang Yudhoyono issued a decree that formally launched Komnas FBPI, a ministerial-level committee, headed by the Coordinating Minister for People’s Welfare Aburizal Bakrie. The committee consists of 14 members, including all Ministers directly involved in combating the H5N1 virus, the Chief Commander of the Indonesian National Army, the Head of the Indonesian Police, and the Chairman of the Indonesian Red Cross. Bayu Krisnamurthi was to serve as Secretary and Chief Executive of Komnas FBPI and tasked to manage its day-to-day operations, while Dr. Emil Augustiono and Tri Satya Putri Naipopos, a senior veterinarian, would serve as deputies.
Tanggal 13 Maret 2006. Pada hari itu Presiden Susilo Bambang Yudhoyono menerbitkan sebuah peraturan presiden yang melahirkan Komnas FBPI, sebuah komite beranggotakan menteri dan diketuai Menteri Koordinator Bidang Kesejahteraan Rakyat (Menkokesra). Komnas FBPI beranggotakan 14 menteri ditambah dengan panglima Tentara Nasional Indonesia (TNI), kepala Kepolisian Republik Indonesia (Kapolri) dan ketua Palang Merah Indonesia (PMI). Dr. Bayu Krisnamurthi, deputi menteri koordinator bidang perekonomian, dipercaya sebagai sekretaris dan ketua pelaksana harian berikut Dr. Emil Agustiono dan Dr. Tri Satya Putri Naipospos sebagai deputinya. Sebuah panel ahli beranggotakan para ilmuwan dari berbagai kalangan dibentuk untuk memberikan masukan kepada Komnas FBPI. Asosiasi profesi dan industri juga disertakan dalam berbagai konsultasi.
Komnas FBPI was to be advised by a panel of experts and also consult with the key animal and human health professional associations in Indonesia. The committee’s day-to-day works would be undertaken by a secretariat established near the Coordinating Minister for People’s Welfare’s office. More than a dozen full time staff, including some senior retired officials who still maintain strong ties in their respective ministries, backed the secretariat. One of the main functions of the secretariat is to facilitate the flow of information between government agencies and to distribute the latest information and data to the public and news outlets through its media and information center.
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Kinerja Komnas FBPI dimotori sebuah sekretariat yang berlokasi strategis, dekat dengan Kantor Menkokesra dan Istana Negara. Didukung oleh lebih dari 15 staf, termasuk para pejabat tinggi yang sudah purnatugas. Salah satu nadi kerja sekretariat ialah pusat media dan informasi, memfasilitasi arus informasi antarlembaga pemerintah dan mendistribusikan data dan informasi terkini kepada publik dan media.
“
On March 13, 2006, President Susilo Bambang Yudhoyono issued a decree that formally launched Komnas FBPI.
Tanggal 13 Maret 2006, Presiden Susilo Bambang Yudhoyono menerbitkan sebuah peraturan presiden yang melahirkan Komnas FBPI”.
It soon became clear that one of Komnas’ major tasks was to make sure everyone was on the same page so that all ministries would have one vision and agree on how to tackle the problem from village level to the capital.
Komnas FBPI menghadapi tugas penting: meyakinkan semua orang dan kementerian yang terlibat memliki visi yang sama dan menyepakati langkah yang diperlukan untuk menangani flu burung, mulai dari tingkat desa sampai ibukota.
“Much of our time is actually spent ensuring that government officials understand the great danger of this disease,” said Bayu Krisnamurthi, who is also a seasoned economist, specializing in agronomics.
“Banyak waktu yang kami habiskan untuk meyakinkan semua aparat pemerintahan agar paham bahaya flu burung,” ujar Dr. Bayu Krisnamurthi, ekonom yang ahli dalam bidang pangan dan pertanian.
This was a huge challenge for the young institution. Agriculture and animal health officials debated on which measure to focus on: stamping out or vaccination? While medical experts were debating whether the virus had mutated and could now spread rapidly throughout the country.
Tantangan besar bagi organisasi baru tersebut. Debat ilmiah yang berkepanjangan senantiasa mewarnai perumusan kebijakan, seperti pada masalah pemusnahan masal atau vaksinasi unggas. Sementara di bidang kesehatan manusia, para ilmuwan beradu argumen tentang apakah virus sudah bermutasi atau belum.
Outbreak
Wabah Merebak
Even before the committee could formally open its doors, and with a skeleton staff, it was put to the test. A major avian influenza outbreak occurred that grabbed international headlines.
Ujian sudah datang dari hari-hari pertama Komnas FBPI lahir. Sebelum Komnas FBPI beroperasi penuh, sebuah kasus besar merebak, menjadi pusat perhatian media seluruh dunia. Pada akhir April 2006, di sebuah lokasi terpencil di Sumatra Utara, di Karo, delapan orang dinyatakan terinfeksi flu burung. Tujuh dari mereka meninggal dunia. Kasus ini kemudian dikenal sebagai kasus kluster flu burung terbesar di dunia. Salah persepsi memicu berbagai protes dari warga, termasuk di ibukota provinsi, Medan, dan banyak pejabat pemerintah daerah bingung.
At the end of April in Karo, a remote area of North Sumatra, eight members of one family fell ill; it is believed that seven died from bird flu. It became the largest human cluster of avian influenza in the world. A lack of information about this new disease, led to a demonstration in the provincial capital, Medan, and confusion among local officials.
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The media was also unsure of how to report this outbreak. Was this the start of a deadly pandemic or a local outbreak that could be easily contained? Even international experts could not predict the outcome. Komnas sent a technical team to the field and within days Deputy Chairman Bayu Krisnamurthi and Dr. Emil Augustiono, second in command, were on the ground coordinating with local and international officials. The issue was a sensitive one and the decisions made would have far reaching effects. In a closed-door meeting Komnas sat down with provincial leaders to discuss what steps needed to be taken to control the situation. Local officials feared more public unrest. Already in Karo residents were resisting scientific investigations by international experts. The poultry industry was also concerned about the long-term economic impact the outbreak would have. They too reached out to Komnas for advice. The government decided to set up a multi-sectoral command post. Led by Minister Bakrie’s adviser, Dr. Rizal Malarangeng, the post made sure that all the necessary steps were taken to respond to the outbreak.
Apakah ini yang pertanda awal pandemi influenza atau hanya kejadian lokal yang akan dengan mudah ditangani? Spekulasi pun berputar di kalangan ahli kesehatan internasional tentang skala Kasus Karo. Pemerintah Indonesia bergerak cepat. Dalam waktu singkat, Dr. Bayu Krisnamurthi dan Dr. Emil Agustiono sudah berada di lapangan, mengawasi ketat perkembangan dan mengkoordinir petugas lokal dan bantuan internasional. Kebijakan apapun yang diputuskan akan memiliki dampak luas. Dalam sebuah pertemuan, pejabat Komnas FBPI mendiskusikan dengan pejabat pemerintah daerah tentang langkahlangkah yang diambil. Para pejabat daerah mengkhawatirkan resistensi masyarakat apabila kebijakan tidak memihak rakyat. Di Karo, penduduk menolak tegas pemeriksaan yang dilakukan oleh para ahli internasional. Pelaku usaha juga khawatir. Mereka pun aktif berkonsultasi dengan Komnas FBPI.
By the end of the day, a town hall meeting was arranged to inform residents about the dangers of bird flu and to put a halt to the rumors that had been spreading. A seminar was also arranged for the media so they could help get the right information out to the public and a compensation scheme was launched to make sure farmers culled their infected poultry.
Pemerintah Indonesia kemudian memutuskan mendirikan pos komando multisektoral. Dipimpin oleh staf ahli Menkokesra, Dr. Rizal Malarangeng, posko ini memastikan bahwa semua kebijakan yang disepakati terlaksana di lapangan. Saat kekhawatiran mereda, sosialisasi digencarkan untuk memberikan informasi bahaya flu burung dan menghentikan isu-isu sumir dan meresahkan yang beredar. Sebuah seminar diselenggarakan untuk bekerjasama dengan media dalam menyebarkan informasi. Skema kompensasi bagi peternak yang unggasnya dimusnahkan pun diumumkan.
As for the poultry industry it was clear that longterm solutions needed to be put into place. There was no overnight solution to the decades-long practices of backyard poultry farming, transportation and market sales.
Kalangan pengusaha ternak kini paham bahwa kebijakan jangka panjang sangat diperlukan. Mereka mengerti bahwa keputusan sesaat, tak mungkin memecahkan dampak flu burung pada bidang peternakan, transportasi dan pemasaran unggas.
The dire predictions of Karo becoming the epicenter of a global pandemic did not materialize. But Karo served as a warning for Komnas that there was no time to just sit back and plan. This was a time to take action.
Prediksi banyak kalangan bahwa Karo dapat menjadi episenter pandemi influenza, tak terjadi. Namun Peristiwa Karo ialah peringatan bagi Komnas FBPI agar selalu proaktif dan agresif. Tiba saatnya Komnas FBPI beraksi.
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A woman protests culling activities in North Sumatra, not believing that poultry killed a family in the nearby village of Karo. Seorang wanita memprotes pemusnahan unggas massal di Sumatra Utara dan tidak percaya bahwa bahwa flu burung merenggut nyawa manusia di Karo.
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THE KARO OUTBREAK Kasus Karo
The outbreak started at a family barbeque when the Ginting family gathered to spend time together and enjoy an array of pork and chicken dishes. The 37-year-old mother had not been feeling well for a couple of days and had a bad cough. Five days later she was dead. She was buried before there was time to test for H5N1. The very next day another family member fell ill and others started to show symptoms. In less than a week, five more relatives would be dead including an 18-month old girl. The last victim died just over a week later. Only one person survived, a man who was treated quickly with Tamiflu. All had tested positive for the disease. There is still much speculation of how the virus spread.
Kasus Karo bermula dari sebuah acara jamuan makan yang digelar Keluarga Ginting, yang menghidangkan berbagai jamuan babi dan ayam. Ny. Ginting sudah merasa sakit dan menderita batuk parah saat jamuan dilakukan. Lima hari kemudian,nyawanya tak terselamatkan. Dia dimakamkan sebelum sempat diketahui penyebab kematiannya. Hari berikutnya, anggota keluarga lainnya sakit dan mulai menunjukkan gejala-gejala mirip influenza. Dalam waktu kurang dari satu minggu, lima orang meninggal dunia, termasuk seorang bayi berusia satu setengah tahun. Korban fatal terakhir meninggal seminggu kemudian. Hanya satu kasus positif yang terselamatkan, seorang pria yang dengan cepat diberikan tamiflu. Sampai saat ini, asal-muasal penyebaran virus masih diteliti.
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TURBULENT TIMES KAMPANYE NASIONAL
Take Action Against Bird Flu: Our Hands Prevent Bird Flu Tanggap Flu Burung: Tangan Kita Pencegah Flu Burung
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Battling the virus
Perang Melawan Virus
In August 2006 a second cluster was identified. This time in Garut, West Java, in the highly populated province of West Java. Nineteen people were confirmed to have contracted the H5N1 virus and 5 of them died. Komnas FBPI again sent a team into the district to help organize the response.
Agustus 2006. Kluster terbesar kasus flu burung pada manusia ditemukan. Kali ini di Garut, Jawa Barat. Sebanyak 19 orang positif terinfeksi virus H5N1. Lima diantaranya meninggal dunia. Komnas FBPI kembali mengirim tim untuk mengoordinasi respon terhadap kasus tersebut. Pascagarut, kasus manusia bertambah.
In mid 2006, Indonesia recorded its 43rd human fatality, surpassing Vietnam. It was now the epicenter of bird flu infections with more human deaths than any other country in the world.
Dan di pertengahan tahun 2006, Indonesia mengumumkan kasus ke 43-nya, melewati jumlah total kasus Vietnam. Sejak itu, Indonesia menjadi negara dengan kasus dan kematian flu burung terbanyak di dunia.
This global threat meant that international agencies were fast becoming involved. Komnas FBPI worked with more than a dozen NGO’s, non governmental organizations and United Nations bodies, including FAO, the Food and Agriculture Organization, WHO the World Health Organization and UNICEF the UN Children’s Fund which supported communication activities. These agencies were then coordinated by UNSIC the UN System Influenza Coordinating Body under the leadership of Dr. David Nabarro.
Sejak flu burung dinyatakan ancaman global, lembaga bantuan dunia dan organisasi internasional turun tangan. Komnas FBPI menjalin kerja sama dengan berbagai lembaga swadaya masyarakat, badan-badan Perserikatan Bangsa-Bangsa seperti Organisasi Pangan Dunia (FAO), Organisasi Kesehatan Dunia (WHO) dan Badan PBB untuk Dana Kesejahteraan Anak (UNICEF). Pelbagai organisasi ini dikoordinir oleh UN System Influenza Coordinator yang dipimpin Dr. David Nabarro.
Gaining control over the fast moving virus required a multi-structured approach. This included restructuring the poultry industry, market and slaughtering practices. Strong veterinary services and the legal framework from national to district level were also key factors. But many of these solutions would take time to implement and required support from all sectors. To achieve these goals Komnas FBPI with support from UNICEF began developing a communication strategy. But the clock was ticking and there was little time to spare.
Pengendalian penyebaran virus flu burung perlu ber- bagai pendekatan, antara lain: merestukturisasi industri perunggasan. Penguatan sistem kesehatan hewan serta tersedianya peraturan dari mulai pusat sampai daerah sangat penting dilakukan. Kegiatankegiatan ini tak akan berarti apabila tidak di dukung oleh para pelaku yang terlibat. Komnas FBPI, bekerjasama dengan UNICEF, mengembangkan strategi komunikasi untuk meningkatkan kesadaran publik dan melancarkan advokasi ke berbagai institusi terkait.
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UNSIC Chief Dr. David Nabarro tours a bird flu referral hospital in Jakarta, accompanies by Dr Agung Sutiyoso and Bayu Krisnamurthi. Pejabat UNSIC Dr. David Nabarro meninjau kesiapan rumah sakit di Jakarta, didampingi oleh Bayu Krisnamurthi dan direktur Rumah Sakit Persahabatan Dr. Agung Sutiyoso.
Widespread outbreaks led to culling in many districts. Meluasnya wabah flu burung memaksa terjadinya pemusnahan unggas
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Representatives from the Japanese Embassy, KOMNAS FBPI and UNICEF kick off the campaign. Perwakilan Kedutaan Besar Jepang, Komnas FBPI dan UNICEF meluncurkan kampanye Tanggap Flu Burung.
Celebrity Mohammad Farhan tells a father and son not to touch sick or dead chickens. Humor was an effective tool in the first PSA’s. Artis Muhammad Farhan menganjurkan agar hindari menyentuh ayam sakit atau mati. Iklan layanan masyarakat yang lucu sangat efektif diterima masyarakat.
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“
“It was critical that the messages included the latest information about the virus.”
“Sangatlah penting pesan-pesan yang di-sampaikan berdasarkan temuan ilmiah terkini tentang virus.”
The Campaign
Kampanye Publik
The Chairman of Komnas, Aburizal Bakrie was to approve the communication strategy and a meeting was set up at the Coordinating Minister’s office. A detailed plan was presented. Ninety percent was approved but the minister wanted to make sure all lead ministries were on board. He gave the Komnas FBPI-UNICEF joint team 72 hours to gain approval not only from government ministries but also from UN agencies. This wasn’t an easy task. Usually it would take weeks, if not months, to get the thumbs up from all concerned. In addition, a key official was in Singapore attending an international bird flu meeting.
Ketua Komnas FBPI saat itu, Aburizal Bakrie mengevaluasi rencana kegiatan komunikasi tersebut sebelum menyetujuinya. Sebuah rapat diadakan di kantor Menkokesra. Presentasi rencana secara detil dilakukan. Menkokesra menyetujui 99 persen rencana kegiatan, namun ingin mendapatkan persetujuan departemen yang terkait dengan program antiflu burung, termasuk badan-badan PBB yang terlibat. Tim Komnas FBPI dan UNICEF harus mendapatkan persetujuan tersebut dalam waktu tiga hari. Waktu yang sangat sempit, mengingat umumnya, persetujuan bersama memerlukan waktu berbulan-bulan. Ditambah, beberapa pejabat kunci dari kementerian tersebut sedang bertugas di luar negeri.
Following a flurry of SMS text messages and phone calls. One by one senior officials from UN agencies were contacted and a meeting was set up to present the materials. It was critical that the messages provided the latest information about the virus and technical input was accurate. Next, the Health Ministry. By now there was less than 24 hours before the Ministers’ deadline. The Health officials met the team at a Jakarta hospital during a seminar. Finally with just hours to go before the meeting with the coordinating minister, the agriculture ministry officials arrived back in Jakarta and quickly reviewed the material. Now with everyone signed off it was back to Mr. Bakrie’s office. Following a close review, he approved all the materials and the team was set to spread key messages that could save lives.
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Berpuluh pesan singkat lewat telepon genggam disebarkan, termasuk mengubungi dan mendatangi langsung pejabat-pejabat yang berwenang. Masukan juga dihimpun karena sangat penting untuk memastikan pesan yang akan disampaikan ke publik adalah informasi ilmiah terkini. Dalam waktu kurang dari satu hari sebelum tenggat waktu, Departemen Kesehatan akhirnya memberikan dukungan. Begitu juga Departemen Pertanian, yang pejabatnya baru mendarat di Jakarta setelah pulang dinas luar negeri. Setelah mendapat persetujuan, proposal kembali dipresentasikan. Setelah kembali mengkaji isi usulanusulan yang disusun disetujui, dan mendorong pelaksanaan kegiatan tersebut agar didukung semua pihak.
The “hand” messages were adapted and spread to schools, health centers and public places nationwide. Pesan-pesan Tanggap Flu Burung disebarkan lewat poster dan stiker ke sekolah, puskesmas, dan tempat umum.
On September 1, 2006 the campaign was launched. The goal was two-fold. One, to raise awareness among the general public about this new issue and to show people how to reduce their risk of catching the virus and two, to motivate local authorities to be open to change centuries old poultry raising practices. Komnas FBPI then set up a communication working group. The aim was to coordinate all media relations and public awareness activities. The health and agriculture ministries had begun to disseminate some information and by this time, international funding began pouring into Indonesia both directly and through UN agencies, international partners and NGO’s. The USAID-funded Community Based Avian Influenza Control (CBAIC) and the United Nations’ FAO quickly became the lead agencies for the poultry- related information and UNICEF would support the government with the nationwide public awareness campaign.
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Pada tanggal 1 September 2006, kampanye nasional antiflu burung diluncurkan. Tujuannya: pertama, meningkatkan pemahaman publik dan menyebarluaskan pesan-pesan pencegahan, dan kedua, mendorong pemerintah daerah untuk turut mencari solusi terbaik dalam mengelola peternakan yang sehat dan aman. Komnas FBPI kemudian membentuk sebuah kelompok kerja komunikasi untuk mengoordinasikan seluruh kegiatan sosialisasi dan publikasi ke media. Masingmasing departemen, kesehatan dan pertanian terutama, sudah memulai kampanye mereka masingmasing dan pada saat yang bersamaan, bantuan internasional berdatangan ke Indonesia dan disalurkan melalui badan-badan PBB, mitra internasional , dan lembaga swadaya masyarakat. CBAIC, yang didanai oleh USAID, dan FAO menjadi lembaga komunikasi terdepan dengan target kelompok peternakan, sementara UNICEF mendukung kampanye nasional untuk masyarakat umum.
One of the key messages, washing hands before meals, went up from 37% to 68% among school children. Angka praktik mencuci tangan dengan sabun sebelum makan diantara siswa sekolah meningkat dari 37 persen ke 68 pesen.
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THE MESSAGES Pesan Penchegahan
The bird flu campaign dubbed “Tanggap Flu Burung: Tangan Kita Pencegah Flu Burung”, take action again bird flu, included the tagline “our hands prevent bird flu” and promoted four basic messages: 01. Do not touch sick or dying birds; if you do, immediately wash your hands and report to local authorities. 02. Wash your hands and utensils with soap and water before you eat or cook. Cook all poultry and eggs well. 03. Separate your birds and separate all new flocks for two weeks. 04. Go immediately to a health clinic if you have a fever with flu-like symptoms and have had contact with birds The initial campaign included TV and Radio PSA’s public service announcements, free public concerts, billboards, leaflets and posters.
Kampanye nasional diberi nama Tanggap Flu Burung: Tangan Kita Pencegah Flu Burung dan mempromosikan empat pesan dasar pencegahan flu burung: 01. Jangan sentuh unggas yang sakit atau mati, jika terlanjur cepat-cepat cuci tangan pakai sabun dan laporkan ke kepala desa. 02. Cuci pakai sabun tangan dan juga peralatan masak Anda sebelum makan atau memasak. Masak ayam dan telur sampai matang. 03. Pisahkan unggas dari manusia. Dan pisahkan unggas baru dari unggas lama selama dua minggu. 04. Periksakan diri ke puskesmas jika mengalami flu dan demam setelah berdekatan dengan unggas. Pesan-pesan ini disampaikan melalu berbagai media, seperti iklan layanan masyarakat, konser musik, papan reklame, selebaran dan poster.
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Spreading the Message
Menyebarluaskan Pesan
The program quickly led to a myriad of activities aimed at mobilizing communities in the bird flu battle. They included the PDSR program in which FAO, working with the Ministry of Agriculture and local Governments, established a village level Participatory Disease Surveillance and Response system. CBAIC, Community Based Avian Influenza Control, was in charge of the communication aspect of the program and worked with Komnas to ensure consistency in public messages.
Seluruh program komunikasi dilancarkan untuk mendukung kegiatan besar memobilisasi masyarakat memerangi flu burung. Salah satu contohnya ialah program PDSR (Participatory Disease Surveillance and Response) yang dilahirkan Departemen Pertanian, FAO, dan pemerintah daerah. CBAIC menopang sistem baru ini bersama Komnas FBPI dengan mengemas pesan-pesan yang sesuai dan konsisten untuk kelompok masyarakat peternak dan pedagang unggas.
CBAIC expanded community-level capacity in animal and human surveillance and response to more than 27,000 different villages across the western half of the country through a series of trainings that taught local volunteers and coordinators what to do in the event of an outbreak and how to protect their communities. This was accomplished through close collaboration with two local partners: Indonesian Red Cross and Muhammadiyah, whose existing community-based networks and resources facilitated training and dissemination of key messages to reduce the risk of AI transmission between animals and humans.
CBAIC meningkatkan kapasitas masyarakat dalam pengawasan dan respon terhadap kesehatan manusia dan hewan. Lebih dari 27.000 desa di bagian barat Indonesia telah memiliki relawan terlatih yang mumpuni dalam menyikapi penyakit dan melindungi warga dari ancaman penyakit tersebut. Program ini sukses terlaksana berkat dukungan Muhammadiyah dan PMI. Kedua lembaga ini memfasilitasi pelatihan penyebaran pesan pencegahan flu burung ke kelompok-kelompok yang masuk dalam jejaring mereka.
The PDSR program involved training officers to detect, report and respond to any bird flu outbreak. The program also involved working in communities to mobilize their resources to help prevent outbreaks in their villages.
Two PDSR officers use GPS technology during a surveillance exercise. The information is used to map AI control and response activities. Dua orang petugas PDSR menggunakan GPS dalam melakukan surveilans. Informasi lokasi yang dikumpulkan digunakan untuk memetakan pengendalian avian influenza.
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PDSR membantu mendeteksi, melaporkan dan merespon setiap wabah flu burung, termasuk menggalang kekuatan masyarakat untuk secara mandiri menangani kasus flu burung di wilayah mereka sendiri.
“Raising poultry is only a part of the problem. The powerful H5N1 virus can spread during transportation, while it’s being sold at the market or during the slaughtering and cooking process.” “Raising poultry is only a part of the problem. The powerful H5N1 virus can spread during transportation, while it’s being sold at the market or during the slaughtering and cooking process.”
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A man calls for help after finding a dead chicken. The PSA produced by CBAIC tackled the issue of proper disposal of dead birds. Seorang pria melaporkan ayam mati di lingkungannya, Iklan layanan masyarakat produksi CBAIC memfokuskan pesan “kubur” dan “bakar”.
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MR. SUNAR’S STORY Kisah Pak Sunar
Mr. Sunar’s backyard poultry were wiped out by a silent killer. Alarmed, he reported the deaths to his neighborhood representative. They had learned that sudden death in poultry could signal an outbreak of deadly bird flu from a television announcement. From their sleepy neighborhood outside Medan in North Sumatra they could have felt panicked and alone. Instead, they stayed calm because the TV message had also taught them what to do: Report the suspected outbreak to local authorities. They reported the case to the authorities and intensive culling and disinfection in and around the outbreak area was carried out, followed by outreach to inform the community. The area was then checked again for cases of AI in the community. Fortunately, there were none.
Ayam peliharaan Pak Sunar mati mendadak secara misterius. Dia kemudian melaporkan kejadian tersebut ke ketua RT. Beberapa warga sudah paham bahwa kejadian tersebut pertanda adanya kasus flu burung di wilayah mereka. Mereka bisa saja panik, namun mereka memilih tetap tenang, karena semua iklan layanan masyarakat tentang flu burung mengajarkan mereka satu hal penting: Laporkan kematian unggas mendadak ke pemerintah setempat. Mereka melaporkan kejadian tersebut ke instansi terkait dan pemusnahan massal dibarengi penyemprotan disinfeksi dilakukan ditambah dengan sosialisasi ke masyarakat. Wilayah mereka kemudian didatangi petugas medis. Tidak ditemukan kasus flu burung pada manusia.
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The AI kit is launched in West Java. Some 100,000 kits would be used in villages across the country. Paket Pencegahan Flu Burung diluncurkan di Jawa Barat. Sebanyak 100 ribu paket disebarkan ke seluruh Indonesia.
A booklet with Islamic hygiene teachings is used by preachers to spread key messages. Buku panduan ajaran Islam tentang kebersihan diri digunakan oleh para ulama seluruh Indonesia.
Muhammadiyah volunteers help local communities to take action against bird flu. Para relawan Muhammadiyah membantu masyarakat merumuskan aksi-aksi tanggap flu burung.
Komnas also worked together with UNICEF to develop the Avian Influenza kit. Each AI kit included a mask, gloves, soap, educational materials and videos about bird flu prevention – plus a giant banner that each village can put up to remind people that keeping clean prevents bird flu. Some 100,000 kits were distributed to high risk areas in Java, Sumatra, Sulawesi and Bali. Another 80,000 were reproduced the following year. Some provinces and district administrations reproduced the kits with their own budgets. This program worked hand in hand with village level activities that helped get people involved in finding solutions to the problem. These ranged from communal chicken farming projects to local laws that banned free range poultry. Communities took charge of their own programs and developed songs and dances to spread the life saving messages to their neighbors. Komnas also supported communication activities not only among communities but also within religious groups. In 2007, the South Sulawesi chapter of the Ulema Council developed an AI booklet based on Islamic teachings to support the AI program. It includes age old advice on hygiene, separating poultry and washing hands. The booklet was used during Friday sermons and has been approved by the National Ulema Council and Ministry of Religious Affairs for nationwide distribution.
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Komnas FBPI bekerjasama dengan UNICEF kemudian meluncurkan ide untuk memproduksi Paket Tanggap Flu Burung (AI Kit). Setiap paket berisi masker, sarung tangan, sabun dan materi edukasi dan video pencegahan flu burung, plus sebuah spanduk untuk dipasang di setiap pemukiman warga yang sudah tanggap. Sebanyak 100 ribu paket disebarkan ke seluruh Jawa, Sumatra, Sulawesi dan Bali. Di tahun berikutnya, 80 ribu paket diproduksi kembali dan disebarkan ke desa-desa yang belum menerima. Beberapa propinsi dan kabupaten/kota menduplikasi paket tersebut dan mereproduksinya dengan inisiatif mereka sendiri. Program ini melengkapi berbagai program lainnya yang berbasis masyarakat desa dalam menangani masalah flu burung. Mulai dari inisiatif membuat kandang bersama sampai dengan mendorong lahirnya peraturan desa melarang ayam berkeliaran di lingkungan. Masyarakatlah yang mengawasi kegiatan mereka sendiri sambil menciptakan materi kreatif seperti lagu dan tarian yang berisi pesan-pesan pencegahan. Komnas FBPI juga menggandeng pemuka agama untuk mendukung kampanyenya. Di tahun 2007, Majelis Ulama Indonesia Sulawesi Selatan merumuskan sebuah buku saku Pencegahan Penyakit Flu Burung dalam Tinjauan Islam. Buku tersebut merangkum ayat Al Qur’an dan hadits nabi tentang pentingnya kebersihan diri dan penanganan unggas yang bersih dan sehat. Buku saku tersebut digunakan sebagai bahan khutbah jumat dan tarawih. MUI pusat dan Departemen Agama telah mendorong penggunaan dan penyebaran buku tersebut ke seluruh Indonesia.
A community show about bird flu includes a song about the importance of washing hands and keeping your chickens caged. Kesenian rakyat juga menyampaikan pesan-pesan pencegahan seperti mencuci tangan dan mengandangkan ayam peliharaan.
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A local leader tries out a public hand washing facility built by the community in West Java. Seorang tokoh masyarakat mencoba tempat pencucian tangan umum yang dibangun masyarakat di Jawa Barat.
Residents map out where poultry is kept in their village before relocating their chicken coops. Para warga memetakan penyebaran unggas di desa mereka sebelum membangun kandang ayam kolektif.
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Washing hands at school is reinforced in the community. Praktek cuci tangan di sekolah juga dibiasakan di lingkungan masyarakat.
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An elementary schoolboy in Papua gets the message when his teacher hands out AI stickers. The teachers guide explains how to present the AI school kit in the classroom. Seorang siswa di Papua belajar pesan tanggap flu burung dari stiker yang diberikan gurunya. Panduan untuk guru mengajar flu burung di kelas mereka.
School Kits
Siswa Tanggap Flu Burung
One of the most successful projects was the AI school campaign that was launched in Mojokerto, East Java in 2007. In the following months 70,000 kits were distributed. Each school received a variety of educational tools including a DVD, flip chart, stickers, a school banner and teacher’s guide that were specially developed using characters from a popular local TV series “Bajaj Bajuri”. A short cartoon and public service advertisements also aired on several stations. Teachers also developed curriculum, art projects and dramas and other activities to compliment the program.
Salah satu kisah sukses kegiatan kampanye Tanggap Flu Burung adalah yang menargetkan sekolah. Di Mojokerto pada tahun 2007, Paket Siswa Tanggap Flu Burung diluncurkan. Sebanyak 70 ribu paket disebarkan ke sekolah-sekolah seluruh Nusantara. Tiap sekolah menerima paket berisi materi komunikasi dan pengajaran flu burung. Semua materi menggunakan karakter pelaku sinetron “Bajaj Bajuri” yang dianimasikan. Iklan animasi itu ditayangkan di beragam stasiun televisi nasional. Kemudian para guru berkreasi dengan mengembangkan kurikulum pengajaran flu burung.
“Some 40 per cent of all victims are children. That’s why it is so important that they learn how to protect themselves,” said Komnas FBPI Chief Executive Bayu Krisnamurthi. “This bird flu virus will be with us for some time, so we must integrate life-saving bird flu information into schools to ensure that the next generation knows how to deal with this threat and future ones.”
“Sekitar 40 persen korban flu burung adalah anakanak...sangat penting bagi mereka untuk belajar melindungi diri mereka sendiri,” ujar Ketua Pelaksana Harian Komnas FBPI Bayu Krisnamurthi. “Virus flu burung mungkin masih akan bersama kita , maka dari itu generasi mendatang harus paham cara menangani ancaman ini dan ancaman lainnya di masa mendatang.”
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Some 40% of victims are schoolchildren. That’s why it is so important that they learn how to protect themselves.
Sekitar 40 persen korban flu burung adalah anak-anak usia sekolah. Oleh karena itu, sangat penting bagi mereka belajar cara melindungi diri mereka.
The result of the program was impressive . An independent survey found that hand washing among children rose from 37% to 68% and eating only well cooked chicken rose from 53% to 92%. The children also said they told there parents what to do to reduce their risk of catching the virus.
Sukses program sekolah sangat luar biasa. Sebuah survei menyatakan kesadaran cuci tangan di kalangan siswa sekolah dasar meningkat dari 37 persen ke 68 persen dan mengkonsumsi daging unggas matang meningkat dari 53 persen ke 92 persen. Para siswa juga memberitahu orang tua mereka cara mencegah flu burung.
The German International cooperation enterprise, GTZ , also worked concurrently with the National Education Ministry to develop curriculum that allowed students to learn avian influenza in their classrooms.
Di pihak lain, lembaga bantuan Jerman, GTZ, juga bekerjasama dengan Kementerian Pendidikan Nasional mengembangkan bahan ajar dan kurikulum untuk mengajarkan avian influenza di dalam kelas menggunakan mata pelajaran resmi. Keliru dalam berhubungan dengan media sama saja dengan menjadikan mereka lawan bagi program pemerintah. Khalayak umum mendapatkan informasi flu burung dari televisi, radio dan surat kabar. Namun informasi yang mereka sebarkan, pada beberapa kesempatan, sering keliru. Terutama, saat banyak kasus flu burung dilaporkan dan sedikit ahli yang dapat memberikan keterangan.
Print and broadcast media could become an enemy or an ally of the AI program. The general public got most of its information about AI from television, radio and newspapers. But the information could, at times, be misleading. This was particularly true in the early outbreaks when there were few experts to answer key questions. Even at the international level, experts often disagreed on how best to tackle the problem. Komnas set up a media center to help deal with the crisis. It quickly became the first stop for journalists needing to get the right information. At the height of the outbreak media conferences were held almost on a daily basis. The Komnas website was also launched and would receive up to 2 million hits per year both nationally and internationally.
Komnas lalu mendirikan sentra media untuk memecahkan masalah tersebut. Banyak jurnalis mengandalkan informasi terbaru dari unit ini. Jumpa pers rutin dilakukan saat kasus flu burung memuncak. Dan situs resmi Komnas dikunjungi sekitar 2 juta pemerhati flu burung dari seluruh dunia.
Journalists in the capital had more sources of information to draw upon than their colleagues in the provinces. Again working with UNICEF, Komnas supported a series of provincial level journalism workshops to help spread the word.
Para jurnalis di daerah tidak seberuntung mereka yang ada di ibukota dalam mengakses informasi terbaru. Bersama UNICEF, Komnas mengadakan lokakarya media di berbagai propinsi untuk menjembatani jurang tersebut.
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Bird are culled and burnt after a outbreak in Bali. Unggas sakit dimusnahkan dan dibakar setelah terjadi kasus flu burung di Bali.
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A medical worker prepares to examine an AI victim. Seorang petugas kesehatan bersiap memeriksa pasien flu burung.
No End in Sight
Perjuangan Panjang
Since the first human victims that emerged at the start of the decade, the virus had spread from Nigeria to Cambodia infecting adults and children from all walks of life. It seemed no one was immune from the threat. In 2007, more than 100 human cases had been confirmed in Indonesia. It was clear that the Komnas FBPI team could not slow down.
Sejak virus ini muncul diakhir dekade 90-an, dia telah berhasil menulari manusia di seluruh dunia, dari Nigeria sampai Kamboja, tanpa membeda-bedakan kelas dan ras. Terbukti bahwa tidak ada orang yang kebal terhadap penyakit ini. Akhir tahun 2007, sudah 100 kasus positif flu burung tercatat di Indonesia. Kerja Komnas FBPI tak akan menjadi semakin mudah.
Cases erupted throughout the country but it was a small outbreak in Bali that again would garner international attention.
Banyak kasus terjadi di pelbagai bagian negeri, namun yang sekali lagi menggemparkan dunia ialah kasus yang terjadi di Bali.
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OUTBREAK IN PARADISE Duka di Pulau Dewata
The village of Dangin Tukadaya in Western Bali is off the usual tourist track, a three-hour drive from resorts that host rock stars and world leaders. This small village is also where the deadly bird flu virus claimed the island’s first victim.
Agustus 2007. Desa Dangin Tukadaya adalah salah satu lokasi wisata pilihan turis, hanya beberapa jam dari resor-resor terkenal di Pulau Dewata. Desa kecil inilah tempat dimana virus H5N1 merenggut korban pertamanya di Bali.
The 29-year-old mother died just weeks after her daughter passed away. Now doctors suspect the five-year-old girl also may have died from bird flu too.
Seorang perempuan berusia 29 tahun meninggal setelah beberapa minggu sebelumnya putrinya meninggal. Namun kematian putrinya belum dapat dipastikan sebabnya.
“It happened so fast, “ said I Nengah Budi Setiawan of his family’s illness. “My daughter had just started school and she came down with a fever. I took her to the local health clinic and they thought she had typhoid. Then a few days later she was in the hospital where she died. My wife fainted and then two weeks later I lost her too.”
“Semua terjadi begitu cepat,” cerita I Nengah Budi Setiawan, suami Sang Korban.“Putri saya baru saja berangkat sekolah kemudian langsung demam. Saya bawa ke puskesmas dan dinyatakan sakit tifus. Lalu beberapa hari kemudian, dia masuk rumah sakit dan kemudian meninggal dunia. Istri saya pingsan mendengar kabar itu, dan dua minggu kemudian, saya kehilangan dia juga.”
Within 24 hours Komnas FBPI was on the ground going door to door raising awareness, answering questions and alleviating fear in the village. “The plight of the Setiawan family has been seen across our great nation, people need to be cautious, but they don’t need to be afraid and that includes visitors to the island. They all need to know that authorities here are taking action”, said Chief Executive of the National Commission, Bayu Krisnamurthi.
Dalam kurun waktu 24 jam, tim Komnas FBPI sudah turun ke lapangan, berkampanye dari rumah ke rumah, menerangkan duduk permasalahan. “Duka Keluarga Setiawan juga terjadi di seluruh penjuru negeri. Masyarakat perlu tanggap, namun tak perlu panik, termasuk para turis. Yakinlah bahwa pemerintah sedang bekerja,” ujar Ketua Pelaksana Harian Komnas FBPI Bayu Krisnamurthi.
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THE LONG HAUL SOLUSI JANGKA PANJANG
AI presented a different scenario - one that required an integrated long-term strategy. Flu Burung adalah ancaman yang memerlukan solusi jangka panjang yang terpadu
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Restructuring and Long term Solutions
Restrukturisasi dan Solusi
Avian influenza is unlike other diseases that can be controlled in a relatively short time. Indonesia managed to successfully stamp out viral outbreaks such as small pox, polio, and other human diseases. However AI presents a different scenario - one that requires an integrated long-term strategy.
Penanganan Avian Influenza harus punya dampak jangka panjang, berbeda dengan penanganan penyakit menular lainnya. Indonesia telah berhasil memberantas cacar, polio dan banyak penyakit menular lainnya. Namun, masalah flu burung lebih kompleks dan butuh lebih banyak solusi jangka panjang.
To launch an efficient war against bird flu, Komnas FBPI focused on two important areas: market restructuring and wild bird monitoring.
Untuk memastikan program kerja Komnas FBPI berdampak jauh, lembaga ini mengangkat dua isu sentral yang dapat membuahkan hasil untuk dinikmati geerasi mendatang: Pembaruan Pasar dan Pengamatan Burung Liar.
Market Restructuring
Penataan Pasar Tradisional
Like many countries in Asia, traditional markets are the mainstay of the community. Women usually visit these “wet” markets to buy their daily produce, meat and poultry. Chickens and ducks are often transported live to these markets where they are slaughtered with little attention paid to hygiene or protection for market workers. In addition, consumers often opt to cull their chickens themselves in their own backyards, again without using proper precautions, which includes disposal of feathers and poultry by-products. This practice of buying live chickens is also, in part, due to consumer concerns that their poultry may not be fresh. Lack of proper refrigeration and labeling of poultry products contribute to this problem. Most consumers also want to make sure that their meat is halal, slaughtered according to Islamic law.
Pasar tradisional di Asia adalah pusat kegiatan masyarakat. Begitu juga di Indonesia. Kaum ibu adalah pelanggan setia pasar tradisional atau “pasar basah”, dalam memenuhi kebutuhan sehari-hari mereka. Ayam dan unggas dibawa dan disembelih di pasar-pasar, dimana para pedagang menggunakan perlindungan diri yang minim sekali. Beberapa konsumen bahkan lebih senang menyembelih sendiri unggas yang mereka beli dan kerap membuang bulu dan bagian yang tak digunakan ke sembarang tempat. Kecenderungan membeli ayam hidup juga di dorong ketakutan daging ayam yang tidak segar atau mati karena sakit. Tidak adanya sertifikasi dan alat pendingin menyebabkan masalah ini. Dengan menyembelih ayam sendiri, para pelanggan juga yakin bahwa ayam yang dikonsumsi adalah Halal.
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Poor transportation means the virus can spread from backyard farm to market. Transportasi unggas yang tidak sehat membantu penyebaran virus dari kandang ke pasar.
Slaughtering chickens in a Jakarta street puts everyone at risk. Menyembelih ayam sembarangan di rumah sangat beresiko tinggi.
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Disinfecting a bird market reduces the chance of viral transmission. Menyemprotkan disinfektan di pasar burung mengurangi resiko penyebaran virus.
A modern “wet� market a place where consumers and sellers can enjoy healthy poultry. Pasar tradisional modern menjadi tempat transkasi penjualan unggas sehat.
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To date there have been no reported cases of H5N1 in wild birds in Indonesia.
Sampai saat ini, belum ada burung liar yang terinfeksi H5N1 di Indonesia.
At the height of the outbreak in early 2007 more than a dozen human cases were reported most of them in the Jakarta area.
Pada saat kasus flu burung memuncak di awal tahun 2007, puluhan penduduk Jabodetabek dinyatakan positif terinfeksi hampir setiap minggu.
Komnas FBPI’s Chief Coordinating Minister for People’s Welfare Aburizal Bakrie summoned governors from the three neighboring provinces as well as mayors and district heads to a meeting at his office. The result was a bylaw on poultry slaughtering and transportation. The regulation requires all poultry collection yards and slaughterhouses to be moved to five areas on the edge of the city within three years. The bylaw also requires poultry traders to obtain animal health certificates whenever they transport their poultry and promotes the trade of safe and healthy poultry. Certificates are also required for birds raised as pets and anyone using them for scientific purposes.
Ketua Komnas FBPI, Menkokesra Aburizal Bakrie, mengundang gubernur Jakarta, Jawa Barat dan Banten bersama para walikota dan bupati mereka untuk menghadiri sebuah rapat darurat. Disepakati sebuah komitmen baru untuk meningkatkan perang terhadap flu burung. Kali ini lewat peraturan daerah (perda). Salah satu perda yang lahir akan merombak seluruh sistem perdagangan unggas di Jakarta. Pemerintah Propinsi Daerah Khusus Ibukota (DKI) Jakarta memutuskan memindahkan semua tempat pemotongan unggas dan lokasi peng-umpulan unggas hidup. Semua produk yang masuk akan berbentuk daging beku dan harus bersertifikat. Pemelihara burung dan peneliti pun harus memiliki sertifikat yang sama.
Several other provinces and districts are now studying the feasibility of implementing such a plan. Consumer studies on the initiative found that customers are willing to buy frozen meat in exchange for clean and healthy wet markets.
Pemerintah daerah lainnya sedang mengkaji kemungkinan mengikuti inisiatif pemerintah ibukota tersebut. Beberapa survei yang telah dilakukuan menunjukkan bahwa pelanggan rela membeli daging ayam beku demi terciptanya pasar tradisional yang sehat.
Komnas FBPI also held series of seminars and workshops in 2007 and 2008. Supported by various partners, including the United States Department of Agriculture (USDA) and Center for Indonesian Veterinary Analytical Studies (CIVAS) the meetings resulted in guidelines for poultry farming, collection yards, slaughtering houses, poultry transportation, a meat inspection system, consumer awareness and market reform.
Keseriusan Komnas FBPI mewujudkan pasar impian tersebut, diwujudkan dengan menggelar berbagai forum diskusi ilmiah yang didukung oleh USDA, CIVAS dan berbagai mitra lainnya, dalam merumuskan praktek yang sehat dan aman dalam beternak unggas, mengelola lokasi pengumpulan, tempat pemotongan, transportasi unggas, pemeriksaan kesehatan hewan, peningkatan pemahaman konsumen dan reformasi pasar tradisional.
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Wild Bird Monitoring
Pemantauan Burung Liar
At the start of the H5N1 outbreak there was global concern that migrating birds could spread the virus from country to country. Scientists in Asia, Africa and Europe detected the virus in a variety of species of wild birds. A number of outbreaks in domesticated poultry were blamed on these birds.
Pada awal penyebaran virus H5N1 ada kekhawatiran bahwa burung liar migran-lah penyebar virus maut tersebut ke seluruh dunia. Para ilmuwan di Asia, Afrika, dan Eropa menemukan jejak-jejak virus tersebut pada populasi burung liar. Beberapa kasus avian influenza pada unggas di beberapa negara dinyatakan terinfeksi oleh burung liar.
After a series of consultations, Komnas FBPI drafted a policy paper entitled A Strategy and National Action Plan to Control Avian Influenza in Migratory Birds. The document serves as a guideline for all parties involved in preventing the spread of avian influenza in the wild bird population. This included a plan for monitoring and surveillance. To date there have been no reported cases of H5N1 in wild birds in Indonesia. Most experts agree that the main cause of the spread of the virus in Southeast Asia is through poultry farming and trading and not through the migration of wild birds.
Komnas FBPI berinisiatif mencari solusi jangka panjang terhadap tantangan ini. Setelah berkonsultasi dengan berbagai mitra terkait, Komnas berhasil merumuskan Strategi dan Rencana Aksi Nasional Penanganan Flu Burung pada Burung Liar di Indonesia sebagai panduan bagi institusi-institusi yang memonitor kelangsungan populasi burung liar. Kabar baiknya, sampai dengan akhir tahun 2009, belum ditemukan burung liar positif H5N1 di Indonesia. Kesepakatan para ahli menyatakan bahwa penyebaran flu burung di Asia Tenggara lebih disebabkan oleh peternakan dan penyebaran unggas domestik.
However, monitoring and surveillance should be developed in the event of any changes to this or any new virus. To achieve this the government is currently identifying and mapping avian influenza surveillance activities in wild birds. At the implementation level, the Ministry of Forestry as the technical agency has formed a Task Force on Avian Influenza Control in Wild Birds.
Bagaimanapun, pengawasan burung liar tetap harus dikembangkan untuk mengantisipasi segala kemungkinan. Pemetaan kegiatan surveilans flu burung pada burung liar pun harus dilakukan. Kementerian Kehutanan bahkan telah membentuk sebuah Kelompok Kerja Pengendalian Flu Burung pada Burung Liar.
Although the risk of spreading the virus through wild birds is currently very low in Indonesia, other countries haven’t been so lucky. In China, the virus has killed thousands of wild geese and gulls at a nature reserve. It was the largest known outbreak in wild birds and a warning that in the future they might spread the disease far and wide.
Meski Indonesia tidak mengalami permasalahan besar dengan burung liar sebagai agen penyebar H5N1, namun lain halnya di beberapa negara lain. Di Cina, telah tercatat ribuan angsa dan burung camar mati tertular flu burung oleh burung migran. Kasus tersebut dianggap sebagai peringatan bahwa kemungkinan apapun dapat terjadi di masa mendatang.
The Komnas FBPI plan provides for the development and strengthening of an early warning system; research, development and coordination; epidemiological studies; data sharing, information system development and policy making procedures.
Rencana strategis yang disusun Komnas FBPI bertujuan mengembangkan sistem peringatan dini, memajukan penelitian tentang burung liar, pengembangan kapasitas dan koordinasi, mendukung studi epidemiologi, pembagian data, pengembangan sistem informasi dan perumusan kebijakan.
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Migratory birds are monitored to reduce the risk of transmitting the virus from island to island. Burung liar juga dimonitor untuk memperkecil kemungkinan penularan virus dari pulau ke pulau.
A ranger takes a closer look at wild birds in the Thousands Island chain. Seorang polisi hutan sedang mengamati burung liar di Kepulauan Seribu.
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ISLAND SANCTUARY Suaka Marga Satwa
A trip to Rambut Island shows the need for vigilance. Known as “Bird Heaven” it is part of the mini archipelago known as the Thousand Islands. It is where thousands of birds from more than 50 species gather, and the small island shows how vital it is that migratory and wild birds are monitored.
Pulau Rambut, yang menyandang gelar Surganya Burung Liar, menjadi salah satu lokasi penelitian Pengawasan Flu Burung pada Burung Liar. Satu dari begitu banyak pulau di Kepulauan Seribu, pulau ini menjadi tuan rumah dari lebih 50 spesies burung dan salah satu pusat aktivitas burung migran liar.
“They move a lot and it is difficult to check their health status. We need to remain vigilant to ensure these birds are not carrying diseases that could endanger domestic birds,” said Budi Kusuma Wardhana, a ranger who guards the conservation island.
“Sebuah tantangan untuk memeriksa kesehatan burung-burung disini. Namun, kami tetap harus memonitor dan tanggap kalau-kalau burung-burung disini dapat menulari unggas domestik,” terang Budi Kusuma Wardhana, polisi hutan yang bertugas di pulau tersebut.
The island, a one-and-a-half hour boat trip from North Jakarta, has been classified as a protected conservation site since 1999. It is known to be one of the hubs for migratory birds, mostly coming from Australia to breed. After a series of tests, experts confirm that the birds reside and travel to and from that island are H5N1-free.
Pulau Rambut telah ditetapkan sebagai wilayah konservasi cagar alam sejak tahun 1999. Pulau ini juga dikenal sebagai tempat singgah burung migran dari Benua Australia. Setelah berbagai kegiatan pemeriksaan, para ahli menyatakan bahwa populasi burung liar di pulau ini bebas dari avian influenza.
Komnas FBPI with the help of partners has published two manuals about this activity. The strategy and action plan and guidelines on wild bird and water fowl monitoring are now widely distributed among rangers, animal health experts, ornithologists, environmentalists and other concerned parties.
Namun pengamatan tetap dilanjutkan. Komnas FBPI telah menerbitkan dua panduan untuk penatalaksanaan kegiatan tersebut. Kedua panduan tersebut kini tersebar luas di tangan para polisi hutan, pakar kesehatan hewan, ahli burung, pencinta lingkungan dan mitra lainnya yang terlibat melindungi keberlangsungan burung migran liar.
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FLYING INTO THE STORM MERESPON PANDEMI
The world is now at the start of the 2009 influenza pandemic Dunia berada di ambang pandemi influenza 2009
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Preparing for a Pandemic
Bersiap Siaga
Komnas FBPI was also tasked with preparing the country for a possible pandemic. Experts had painted a grave scenario. The deadly H5N1 virus could mutate and pass easily from person to person.
Salah satu mandat Komnas FBPI ialah mempersiapkan Indonesia menghadapi pandemi. Para ahli telah memperkirakan skenario terburuk: virus H5N1 bermutasi dan kemudian menular antarorang.
No longer would poultry be the threat but mankind itself. Developing a vaccine to battle the new strain would take months and tens of millions of doses would be needed to protect the global community. Until that time, tens of millions would die.
Jika terjadi, ancaman bukan lagi terhadap unggas, tapi umat manusia. Vaksin tidak akan ada dalam waktu singkat dan miliaran dosis diperlukan untuk melindungi seluruh manusia. Bila ini terjadi, puluhan juta orang sudah meninggal dunia saat vaksin baru ditemukan.
Experts compared the threat to earlier pandemics. The worst recorded one being the 1918 Spanish Flu outbreak that killed between 20-40 million people.
Para ahli memprediksi kemungkinan-kemungkinan terburuk dengan membandingkan dengan pandemi sebelumnya. Pengalaman terburuk adalah Pandemi Flu Spanyol 1918 yang membunuh sekitar 20-40 juta orang.
Children take part in a pandemic school drill. Anak-anak ikut berpartisipasi di sebuah simulasi pandemi.
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“Warning Deadly Flu Outbreak” A poster informs residents about the simulation in Bali. “Awas, Penularan Flu Mematikan” tulis sebuah poster yang digunakan dalam simulasi Bali.
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Government officials review pandemic response activities during a simulation. Para aparat pemerintah sedang mengkaji kegiatan respon pandemi pada sebuah simulasi.
The Plan
Rancangan awal
In 2007, Komnas FBPI began developing a national pandemic plan, a living document which would set out in detail, actions to be taken by both the public and private sector in the event of a pandemic.
Di tahun 2007, Komnas FBPI memulai sebuah tugas besar merumuskan rencana kesiapsiagaan pandemi, sebuah dokumen kerja yang merinci tindakan respon pemerintah, publik, dan swasta apabila pandemi terjadi.
The National Pandemic Preparedness and Response Plan includes detailed protocols from ministries and government institutions that would be put into place in the event of an outbreak. The plan describes the ideal medical response and public health measures to be taken as well as business continuity planning, which encourages the private sector to be proactive in maintaining their services at the same time safeguarding their employees. It also regulates monitoring, surveillance and laboratory support.
Rencana Kesiapsiagaan dan Respon Menghadapi Pandemi Influenza merinci protokol berbagai kementerian dan lembaga lainnya yang harus dilakukan apabila pandemi terjadi. Protokol tersebut termasuk tindakan medis, kesehatan lingkungan, dan juga keberlanjutan dunia usaha, yang membantu dunia swasta bertindak proaktif untuk menyelamatkan bisnis dan menyelamatkan karyawan pada saat yang sama. Dokumen ini juga mengatur pengawasan dan pengamatan terhadap kasus serta dukungan laboratorium.
The plan includes a detailed risk communication strategy to raise awareness and to disseminate key health messages to the public. The last phase covers the post-pandemic period and how the nation can get back on its’ feet after the ordeal.
Strategi kegiatan nonmedis seperti komunikasi resiko untuk meningkatkan pemahaman dan strategi penyebaran pesan kesehatan juga telah dirumuskan. Dan yang juga penting: respon pascapandemi dan rehabilitasi untuk memulihkan kembali kondisi negara.
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The plan has since been disseminated throughout the country and tested through pandemic simulations. One of the largest simulations of its kind was held in Bali in April 2008. The Ministry of Health, as part of Komnas, led the field simulation. Funded by the Centers for Disease Control, CDC, with support from UN agencies, the simulation involved over 1,000 people over three days. They included, medical officers, police, security, humanitarian groups, airport officials, residents and “actors” who portrayed victims.
Rencana kesiapsiagaan dan respon ini kini sudah tersebar ke seluruh negeri dan telah disimulasikan. Salah satu simulasi lapangan terbesar di dunia bertempat di Bali pada April 2008. Simulasi yang melibatkan lebih dari 1.000 orang ini dipimpin oleh Kementerian Kesehatan, yang juga anggota Komnas FBPI. Dukungan datang dari CDC Amerika Serikat dan berbagai badan PBB. Simulasi ini melibatkan bukan saja ratusan pekerja medis, namun juga polisi, militer, relawan, petugas bandara, warga masyarakat, dan beberapa aktor yang berperan sebagai penderita.
The scenario focused on a small village, Dangin Tukadaya, where the H5N1 virus emerges and spreads rapidly from person to person. Health authorities quickly move to quarantine the village. In a real life situation such a quarantine would last for weeks. All food, water and supplies would have to be brought in. Armed security would guard the village no one in and no one out. The simulation also focused on Bali’s international airport where medical officers checked “passengers” to see if they have a fever and could eventually spread the virus to other countries. Those showing flu-like symptoms were immediately isolated.The simulation was hailed by the international community as a success.
Desa Dangin Tukadaya diskenariokan menjadi pusat wabah flu mematikan dan lokasi berbagai tindakan respon, termasuk karantina wilayah, dilancarkan. Warga desa tidak boleh meninggalkan desa dan semua kebutuhan hidup sehari-hari mereka dipenuhi oleh aparat berwenang. Di Bandara Internasional Ngurah Rai, aparat melakukan pemeriksaan kesehatan kepada penumpang datang dan pergi. Penumpang yang terdeteksi menunjukkan gejala mirip flu, diisolasi. Kalangan internasional mengakui sukses besar Indonesia dalam menguji rencana kesiapsiagaan dan responnya.
Another large scale drill was held in Makassar, South Sulawesi, the business hub of Eastern Indonesia. This time, the government officials were put to the test. “Simulations should be continuous because the threat is constantly evolving. That’s why, since 2007, we have held a series of targeted pandemic drills throughout the country”, said Dr. Emil Augustiono, Komnas FBPI Deputy, who is in charge of pandemic preparedness and response.
Simulasi berskala besar lainnya juga dilakukan di tahun 2008, di Makassar, Sulawesi Selatan.Kali ini, para para aparat pemerintah daerahlah yang diuji kesiapsiagaannya dalam merespon episenter yang berlokasi di tengah kota. “Simulasi harus berkelanjutan karena ancaman terus berubah. Itulah mengapa, sejak 2007, kami menyelenggarakan berbagai simulasi,” terang Emil Agustiono, koordinator bidang kesiapsiagaan dan respon pandemi influenza.
Those simulations included the country’s first ever village level drill in Banten province, the bird flu hot spot of Indonesia. The province recorded more human fatalities of bird flu than any other in the country. The simulation tested whether the national pandemic plan works on the ground, where the community themselves spearhead initial response activities. District officials were also involved, testing their response knowledge.
Komnas mengawali di Propinsi Banten yang mencatat kebih banyak kasus dan kematian flu burung lebih banyak dari propinsi lainnya. Simulasi perdana ini menguji apakah rencana kesiapsiagaan dan respon efektif dilakukan pada tingkat masyarakat dengan warga sebagai aktor utamanya. Pejabat propinsi dan kabupaten juga terlibat, menguji kemampuan mereka merespon pandemi pada skala terkecil.
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Indonesian Naval officers take part in a pandemic response exercise at Surabaya port. Tentara Angkatan Laut berlatih merespon pandemi di sebuah pelabuhan di Surabaya, Jawa timur.
Government workers prepare to hand out food and water to the quarantined village during a simulation. Pihak berwenang bersiap membagikan makanan dan minuman kepada masyarakat desa yang dikarantina pada sebuah simulasi.
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A “visitor� showing flu symptoms is stopped at the airport. In this scenario, he would be the first to die in the pandemic. Seorang turis dilarang masuk ke bandara. Dalam scenario pelatihan, dia adalah pasien pertama yang meninggal dunia.
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Experts predicted a pandemic would come in waves over several months.
Para ahli memperkirakan bahwa pandemi akan terjadi dalam beberapa gelombang dan berlangsung beberapa bulan.
Targeted drills for specific sectors were also carried out. Order and security were key sectors in order to minimize social unrest and the economic impact of a deadly flu outbreak. Komnas worked along with the army and the navy as well as the police to promote the country’s security forces’ capacity in coping with a future pandemic.
Keamanan dan ketertiban adalah kunci meminimalisasi dampak sosial dan ekonomi akibat pandemi. Komnas bersama Tentara Nasional Indonesia, terutama Angkatan Darat dan Angkatan Laut, serta Kepolisian Republik Indonesia telah beberapa kali melatih diri menghadapi pandemi.
Private industries, such as a major international steelworks, also tested their own business continuity plans showing the world how to protect employers and save business at the same time.
Pihak swasta, salah satunya industri pemrosesan baja di Batam, telah menguji rencana keberlangsungan usaha mereka dan mempertontonkan pada dunia cara melindungi pegawai dan bisnis mereka pada saat yang sama.
These large scale field simulations were not possible in all parts of the country. So Komnas FBPI together with provincial administrations and support from UNICEF developed a series of “tabletop” simulations that would test the capability of local government to respond to a pandemic in their regions. These tabletops proved to be a cost efficient method of raising awareness of the issue. Within three days some 50 officials from a variety of sectors from health and security to education and sanitation would learn the basics of pandemic response. Experts predicted a pandemic would comes in waves over several months. Questions for workshop participants included: How much food do we need to provide to families? Are there enough workers to keep water and gas supplies flowing? When do we close schools? What information do we need to give communities? The answers would, in the event of a severe pandemic, save thousands of lives. This method was then replicated by many provincial administrations in their regions.
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Simulasi lapangan baik skala kecil maupun besar tidak mungkin dilakukan di semua propinsi dan kabupaten. Maka dari itu, bekerja sama dengan UNICEF, Komnas FBPI mengusung seri kegiatan simulasi “table top”, sebuah simulasi rapat darurat. Dalam waktu tiga hari, puluhan pejabat pemerintah daerah terlibat dalam berbagai rapat genting merumuskan respon pandemi yang efektif dan sesuai wilayah mereka masing-masing. Para peserta lokakarya tersebut harus menjawab berbagai pertanyaan penting seperti: Berapa stok kebutuhan pangan untuk rumah tangga yang harus disiapkan? Apakah petugas air bersih dan bahan bakar dapat tetap bekerja? Apakah harus menutup sekolah? Dan pesan apa saja yang disebarkan ke masyarakat? Jawaban tepat terhadap pertanyaan-pertanyaan tersebut akan menyelamatkan banyak nyawa. Metode pelatihan seperti ini kemudian direplikasi oleh berbagai pemerintah kabupaten dan kota di berbagai propinsi.
Police quarantine a village. No-one in and no-one out. Polisi mengkarantina sebuah desa yang terinfeksi. Tidak ada yang boleh masuk dan keluar.
Participants in a table top simulation learn how to respond in a crisis. Para peserta simulasi rapat darurat belajar cara merespon situasi krisis.
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The H1N1 (swine flu) outbreak in Mexico put the world on notice. But the new pandemic was not what many experts had predicted. Pandemi flu A H1N1 (Flu Babi) di Meksiko mengejutkan dunia. Namun ternyata tidak seganas yang diperkirakan para ahli.
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The Pandemic
Pandemi H1N1
In March 2009 a new virus was detected in Mexico. In less than six weeks more than 850 cases of pneumonia were detected, by the end of April, 59 of the victims died. Schools and non-essential businesses were closed and many countries issued travel warnings to the stricken country. This outbreak would later be dubbed swine flu or H1N1. The outbreak sent shock waves through the medical community. Many experts had thought that the pandemic would emerge in Asia and that the H5N1 virus would be the one to spark it. This new virus quickly spread.
Di bulan Maret 2009, sebuah virus baru muncul di Mexico. Dalam kurun waktu sekitar satu bulan, ditemukan 850 kasus radang paru-paru. Di akhir bulan April, hampir 60 orang meninggal dunia. Sekolah dan banyak perusahaan ditutup dan larangan perjalanan dikenakan kepada negara-negara dengan banyak kasus. Wabah ini kemudian dikenal sebagai Wabah Flu Babi atau H1N1. Dunia dikagetkan dan dibuat sibuk oleh kemunculan penyakit baru ini. Sebelumnya para ahli berasumsi bahwa pandemi akan terjadi di Asia dan disebabkan mutasi virus H5N1. Virus baru ini kemudian menyebar ke seluruh dunia.
On June 11, 2009 the organization raised its alert level to 6 – the highest on the WHO scale and the Director General declared that “the world is now at the start of the 2009 influenza pandemic”. The announcement came as Komnas FBPI chief Bayu Krisnamurthi and vice chief executive Emil Augustiono were in Britain for an international pandemic conference. But even in the streets of a major city like London, which had already reported H1N1 cases, there was little evidence of a pandemic response. Business went on as usual and even a train strike couldn’t stop people form crowding buses and potentially spreading the virus. So the question was raised: what kind of response should there be? How far should governments go to protect people? What impact will these measures have on economies and on the daily lives of ordinary people? These issues were discussed and debated. In the early stages of the outbreak governments responded in varying degrees from virtually no response to quarantining visitors from infected countries. Indonesia had to decide what measures it would take. The Health Ministry was on the front line, announcing airport health checks and it alerted the country’s 100 referral hospitals. Komnas FBPI activated the National Pandemic Response Plan and set up a 24 hour hotline. Leaflets and posters were printed in a few days in an effort to curb public anxiety. PSA’s, a radio drama series and talk shows aired on TV and radio, while hygiene kits were handed out to families travelling after the fasting month: all to help raise awareness.
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Pada 11 Juni 2009, WHO mengumumkan pandemi tingkat enam--tingkat tertinggi kegawatdaruratan pandemi--dan Direktur Jenderalnya mendeklarasikan bahwa “dunia sudah berada di ambang pintu pandemi flu 2009.” Deklarasi tersebut terjadi saat Bayu Krisnamurthi dan wakilnya Emil Agustiono sedang berada di Inggris menghadiri sebuah konferensi tentang pandemi. Kota besar seperti London pun me-ngalami serangan H1N1, namun hampir tidak terlihat respon terhadap pandemi. Kegiatan seharihari tidak berubah, kerumunan orang di berbagai ruang publik seperti stasiun kereta api tetap ramai. Pertanyaan mulai menyeruak di benak pikiran banyak orang, seperti apakah respon yang tepat untuk pandemi ini? Seberapa jauh pemerintah harus bertindak? Apa dampaknya terhadap ekonomi masyarakat? Isu tersebut menjadi bahan debat dan diskusi yang panjang. Respon pemerintah di tiap negara beragam, dari mulai yang tidak acuh sampai ke mengarantina turis. Indonesia harus memutuskan tindakan-tindakan responnya sendiri. Departemen Kesehatan menjadi ujung tombak, mengumumkan pemeriksaan kesehatan bagi turis yang baru datang serta menyiapkan 100 rumah sakit rujukan. Komnas membuka saluran pengaduan 24 jam. Komunikasi resiko menjadi prioritas dengan menyebarluaskan selebaran dan poster untuk menenangkan reaksi publik. Iklan dan drama radio ditayangkan di berbagai radio dan televisi. Paket Kebersihan Diri dibagikan kepada para pemudik lebaran.
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LEARNING FROM THE PAST Belajar dari Sejarah
The infamous Spanish flu of 1918 spread around the world killing millions several times more than those killed during World War I. It was the deadliest natural disaster in human history.
Flu Spanyol 1918 membunuh jutaan orang di seluruh dunia pada saat yang sama Perang Dunia II berlangsungwabah termaut sepanjang sejarah sejarah manusia.
Indonesia was not immune from the pandemic. Research conducted by Australian historian Colin Brown and more recently by a team from the University of Indonesia has uncovered evidence of a country ravaged by the virus. The Dutch consulate in Singapore had seen cases in the region and warned Batavia about the possible arrival of people with flu. It advised Batavia to ban ships coming from influenza-affected areas. But the measures were not heeded and cases were soon detected in Sumatra and by 1919, the virus had spread to many parts of Java and Kalimantan and soon the Eastern islands would also be affected.
Indonesia, atau Hindia Belanda saat itu, tidak terlewatkan dari penyebaran pandemi flu tersebut. Sebuah penelitian oleh sejarawan Australia, dan kemudian oleh sejarawan Universitas Indonesia, telah mengungkap bukti-bukti pandemi di Nusantara. Pada awal merebaknya flu mematikan tersebut, konsul Belanda di Singapura telah memperingatkan administrator Batavia bahwa beberapa penumpang kapal terjangkit flu dan agar melarang mereka turun dari kapal tersebut. Namun peringatan tersebut diabaikan dan kasus flu mulai merebak di Sumatra. Pada awal 1919, seluruh negeri telah mencatat kasus flu mematikan.
“My mother would tell us the story of how many people in the village died one year when she was a child. They called the sickness “Raa’ba Biang” , or fallen trees, because people would die so quickly. Three of her close relatives were victims”, said Kun Masora, from the remote town of Tana Toraja in Eastern Indonesia.
“Ibu saya sering menceritakan kematian yang serempak di desa dalam setahun saat dia masih kecil dulu. Mereka menyebut kejadian tersebut “raa’ba biang”, atau seperti ilalang berjatuhan, begitu cepatnya orang meninggal. Tiga saudara perempuannya juga meninggal,” tutur Kun Masora, tetua adat Tana Toraja,. Sulawesi Selatan, mengisahkan pandemi 1918.
The Dutch administration also reported outbreaks of other infectious diseases. In 1918 almost 10,000 people died of cholera but this was nothing compared to the number who became victims of the deadly virus. Historians project that 1.5 million people died of Spanish Flu in the Dutch East Indies.
Pada saat yang bersamaan, Pemerintah Kolonial Hindia Belanda juga mencatat wabah penyakit menular lainnya. Pada tahun yang sama, hampir 10 ribu orang meninggal karena kolera, namun angka ini pun tetap tak sebanding dengan kematian akibat flu spanyol. Beberapa literatur sejarah memperkirakan, 1,5 juta orang di Hindia Belanda meninggal dunia karena pandemi flu 1918.
By early 1920, the Dutch Colonial government issued an “Influenza Ordinance” to ensure that response and mitigation measures were carried out promptly and correctly and a communication campaign was initiated.
Di awal tahun 1920, pemerintah kolonial mengesahkan Undang-undang Influenza (Influenza Ordinantie) yang meregulasi respon dan penanganan dampak pandemi. Sebuah kampanye publik tentang pencegahan flu juga dilakukan.
The measures put into place and even the key messages were very similar to what many experts would agree on nearly a century later
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Langkah-langkah dan pesan-pesan yang disampaikan hampir mirip dengan apa yang para ahli kesehatan serukan saat ini, saat pandemi 2009 terjadi.
Orphans from the 1918 pandemic in East Java Anak-anak kehilangan orang tua mereka saat pandemi flu 1918 menyerang Jawa Timur.
Flu victims are treated in a Javanese village in what was then the Dutch East Indies. Para penderita flu sedang diperiksa oleh dokter Jawa di sebuah desa pada masa pemerintahan kolonial.
AFTERWORD AKHIR KATA
Safe Landing?
Babak Berikutnya
Komnas FBPI may be closing its doors but the journey will continue. We have learned much over the past four years and these lessons will be put to good use as we move toward a healthier nation.
Mandat Komnas FBPI telah berakhir, namun perjuangan melawan flu burung tetap berlanjut. Kita telah belajar banyak selama empat tahun terakhir dan pengalaman tersebut akan berguna dalam membangun bangsa yang lebih sehat.
The AI experience has highlighted the need for closer links between the human and animal health world. Not only birds, but pigs, cattle, monkeys, rats and others, both domesticated and wild species, have been the source of new disease. In the past decade, some 75% of new diseases have come from animals or animal by-products. The findings make it clear that the health and animal sectors need to stay vigilant and more importantly work together. The AI experience may have helped us build that foundation for these networks and improve standards, but we must now expand this work. Doing so will not only benefit the health of our people but also the nutrition of our children and overall improved food security for the nation.
Pengalaman pengendalian flu burung telah menunjukkan adanya kebutuhan kerjasama yang lebih erat antara bidang kesehatan manusia dan kesehatan hewan. Bukan hanya burung, namun babi, sapi, monyet, tikus, dan semua jenis hewan peliharaan maupun liar berpotensi menjadi sumber penyakit. Dalam satu dekade terakhir, sekitar 75 persen penyakit baru berasal dari binatang, atau produk-produknya. Penemuan ini mempertegas pentingnya kerjasama erat antara kedua bidang kesehatan tersebut. Pengalaman flu burung akan membantu kita membangun landasan untuk mengembangkan jejaring yang sudah ada dan meningkatkan kualitas kerja, namun sekarang kita perlu perluas wilayah kerja kita.
How do we achieve this goal?
Apa yang perlu dilakukan?
Firstly, it requires all concerned to rethink the way health and animal issues are viewed and to “unlearn� old strategies.
Pertama-tama, dibutuhkan keterlibatan semua pihak untuk merumuskan kembali cara pandang dan merombak strategi usang dalam mengaitkan dunia kesehatan manusia dan hewan.
With this new frame of mind, we can then develop early detection and response systems. This will enable authorities to respond to initial outbreaks before they become a major threat.
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Dengan cara berpikir baru ini kita dapat mengembangkan sistem pelacakan dini dan respon kita. Jika hal ini terwujud, aparat pemerintah akan sangat terbantu.
We must also strengthen the multi-sectoral pandemic preparedness planning now and not wait for the next pandemic to arrive before taking action. There are many challenges that lay ahead. This includes the need to rethink the way funding for these activities are carried out. A restriction in this area can mean that response to health outbreaks are delayed or poorly dealt with. We also need to fill the gap of qualified health and animal workers, encouraging young people to pursue these careers and develop training facilities to meet that need. It is key that we develop strong communication both internally and externally to ensure that all of us are united under one vision. Then we can build the capacity of each province to handle these issues, including decentralizing authority and therefore the decision making process. We also need to build strong community involvement and this includes a strong volunteer system at local level to respond to health issues when they emerge. Each and every one of us can be a part of this important work to ensure the best possible future and a safe landing for Indonesia.
Bayu Krisnamurthi Chief Executive KOMNAS FBPI Vice Minister of Agriculture
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Mereka dapat merespon kasus-kasus awal sebelum menjadi sebuah wabah mengkhawatirkan. Kita juga harus memperkuat perencanaan kesiapsiagaan pandemi sekarang juga, jangan menunggu pandemi berikutnya tiba. Tantangan ke depan masih banyak. Termasuk mencari cara terbaik mendanai kegiatan-kegiatan tersebut diatas. Mekanisme yang kaku di bidang pendanaan, dapat menghambat respon atau bahkan memperburuk situasi. Kita juga perlu meningkatkan kualitas petugas medis dan kesehatan hewan kita, mempromosikan profesi ini di kalangan generasi muda, dan mengembangkan sarana pelatihan untuk memenuhi kebutuhan tersebut. Membangun komunikasi yang kuat baik internal di kalangan penyelenggara negara dan eksternal dengan masyarakat luas penting untuk memastikan kita semua bekerja dengan visi yang sama. Kemudian kita bangun kapasitas tiap provinsi, satu per satu, dalam menghadapi tantangan baru ini, termasuk mendelegasikan kewenangan dan proses pengambilan kebijakan. Pengalaman Komnas FBPI menunjukkan bahwa dengan kerja bersama, semua orang dapat memainkan peran dalam agenda penting memastikan masa depan yang terbaik dan mengantarkan Indonesia menggapai cita-cita gemilangnya . Bayu Krisnamurthi Ketua Pelaksana Harian Komnas FBPI Wakil Menteri Pertanian
KOMNAS FBPI DI BALIK LAYAR
Committee Membership Keanggotaan Komnas FBPI Ketua/ Chair: • Menteri Koordinator Kesejahteraan Rakyat/ Coordinating Minister for People’s Welfare Wakil Ketua I/ First Vice Chair: • Menteri Koordinator Perekonomian/ Coordinating Minister for Economic Affairs Wakil Ketua II/ Second Vice Chair: • Menteri Pertanian/ Minister of Agriculture Wakil Ketua III/ Third Vice Chair: • Menteri Kesehatan/ Minister of Health Anggota/ Members: • Menteri Dalam Negeri/ Minister of Home Affairs • Menteri Luar Negeri/ Minister of Foreign Affairs • Menteri Keuangan/ Minister of Finance • Menteri Kehutanan/ Minister of Forestry • Menteri Perindustrian/ Minister of Industry • Menteri Perdagangan/ Minister of Trade • Menteri Perhubungan/ Minister of Transportation • Menteri Pendidikan Nasional/ Minister of National Education • Menteri Kebudayaan dan Pariwisata/ Minister of Culture and Tourism • Menteri Komunikasi dan Informatika/ Minister of Communication and Information Technology
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• Menteri Negara Riset dan Teknologi/ State Minister of Research and Technology • Menteri Negara Lingkungan Hidup/ State Minister of Environment • Menteri Negara Perencanaan Pembangunan Nasional (Kepala Bappenas)/ State Minister of National Development Planning (Head of the National Development Planning Agency) • Panglima Tentara Nasional Indonesia/ Commander of the Indonesian National Armed Forces • Kepala Kepolisian Republik Indonesia/ Chief of the Indonesian National Police • Ketua Palang Merah Indonesia/ Chairman of the Indonesian Red Cross Secretary/ Sekretaris: • Deputi Menko Perekonomian Bidang Pertanian dan Kelautan/ Deputy to the Coordinating Minister for Economic Affairs for Agriculture and Marine Resources
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KOMNAS FBPI DI BALIK LAYAR
Komnas FBPI Executive Tim Pelaksana Harian
The Secretariat Sekretariat • Dr. Bayu Krisnamurthi • dr. Emil Agustiono, MPH • Drh. Memed Zoelkarnain Hasan • Dr. Drh. Heru Setijanto • Drh. Bachtiar Moerad • Drs. Soetijono, M,Si • Yoga Satria, SKM • M. Iqbalur Ramadan, SKM • Ika Wahyuningsari, SKM • Nurul Fajriyah, SKM • Drh. Farida Camallia Zenal • Drh. Andhi Trapsilo
• Drh. Dedeh Yulianti Rahayu • Widya Anjung Pertiwi, SP • Andika Aji Pambudi, SE • Habibie Yukezain, SSn • Nurmeidian Argarini, SKM • Agustina Kurniasih, SKM • Drh. Novita Tricahyani • Drh. Mira Fatmawati • Drh. Rian Arisandy • Galih Putri, SKM • Sarino Trimansyah, SKM • Drs. Taufik Kusumo, MM
• Drg. Naalih Kelsum • Hendriyanto, SE • Novi Rochmawati, SE • Evita Handayani Sri Hapsari, SE • Santono Sihotang • Tifa Laily Savitri, S.Pt • Rini Lenggogeni, SS • Dewi Anggraeni, Amd. • Sukri, SE • Sutrisno • Saniman
• Prof. Dr. Muladno • Prof. Dr. Widi Adnyana Morati • Drh. Tri Satya Putri Naipospos, M.Phil, Ph.D • Ir. Naily Chilmijati, M.Si • Dr. Ir. Delima Hasri Azahari, MS • Dr. Drh. Sjamsul Bahri, MS
• Drs. H. Krisna Tirtawidjaja, Apt • Ir. Mathur Riady, MA • Dr. Lily Sriwahyuni, MM • dr. Lula Kamal • Dr. Benyamin Lakitan, M.Sc • Dr. Ir. Dedi M. Masykur Riadi • Parluhutan Hutahean, MA
• Dr. Ir. Endah Murniningtyas, M.Sc • Ignatia Maria Honggowati, M.Sc • Syulpajli Andri, SH. MM • Dra. Indah Suwarni , M.Si • Drs. Marsudi Harto
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Komnas FBPI Panel of Experts Susunan Panel Ahli • Prof. Dr. Amin Soebandrio, MD, Ph.D, SpMK • Drh. Tri Satya Putri Naipospos, M.Phil, Ph.D • Prof. Dr. Drh. I Gusti Ngurah Kade Mahardika • Prof. Drh. Charles Rangga Tabbu, M.Sc, Ph.D • Prof. Dr. Hadiarto Mangunnegoro, Sp.P • Prof. Dr. Agus Sjahrurrachman, MD, Ph.D • Prof. dr. Tjandra Yoga Aditama, Sp.P(K), MARS, DTM&H, DTCE • Prof. Drh. Widya Asmara, MS., Ph.D • Prof. Dr. Ir. Dwisuryo Indroyono Soesilo, M.Sc • Prof. dr. Faisal Yunus, Ph.D, Sp.P(K) • Prof. Dr. Nuning M.K., MPH, DRPH • Prof. Yanto Lunardi Iskandar, MD., Ph.D • Drh. Kamaluddin Zarkasie, Ph.D • dr. Widjaja Lukito, Ph.D • Drh. Wiku B.B. Adisasmito, M.Sc, PhD • Dr. Roy G. A. Massie, MPH, Ph.D • Dra. Ani Margawati, M.Kes, Ph.D • dr. Herawati Sudoyo, Ph.D • dr. Endang R. Sedyaningsih, MPH, DrPH • dr. Agus Suwandono, M.PH • dr. I Nyoman Kandun, MPH • Dr. Drh. I Wayan Teguh Wibawan, M.S • Dr. Drh. C. A. Nidom M.Sc • Dr. Drh. Agus Wijono • Dr. Drh. Martin Malole • dr. Drh. Mangku Sitepoe • dr. Priyanti Zuswayudha, Sp.P • Dr. dr. Ratna Djuwita, MPH • dr. Santoso Soeroso, Sp.A., MARS • Dr. Drh. Widiyanto Dwi Surya, M.Sc • Laksamana TNI (Purn) dr. Harijanto Mahdi, Sp.THT, Sp.KL • Brigjen TNI (Purn) dr. Adib Abdullah Yahya, MARS • dr. Sardikin Giriputro, Sp.P, MARS • Drh. Wiwiek Bagja • Dr. Drh. Denny Widaya Lukman, MS • dr. Maramis Ahmad Hisham, MPH, MBA • Dr. Hari Santoso KOMNAS FBPI 85 / Building a Plane While Flying It / KOMNAS FBPI 2005 - 2010
PARTNERS MITRA KERJA
International Partners Mitra Internasional 1. AusAID
12. UNOCHA
(The United Nations Organization for
2. USAID
Coordination of Humanitarian Assistance)
(United States Agency for International
13. UNRC
Development
(The Australian Government’s Aid Programmee)
(United Nations Residence Coordinator)
3. European Commission
14. ASEAN
4. JICA
15. World Bank
(Japan International Cooperation Agency)
(The Association of South East Asian Nations)
5. UNICEF
16. ILO
(United Nations Children Fund)
(International Labor Organization)
6. FAO
17. UNSIC
(Food and Agriculture Organization)
7. WHO
(World Health Organization)
8. GTZ
(United Nations System for Influenza Coordination)
18. ICITAP (Department of Justice United States of America)
(Deutsche Gesselshaft fur
19. JSI Deliver-USAID (John Snow Incorporated)
Technische Zusammenarbeit)
20. CIDA
9. USDA
(United States Department of Agriculture)
10. CBAIC
(Community Based Avian Influenza Control)
11. IOM
(International Organization on Migration)
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(Canadian International Development Agency) 21. ARC (American Red Cross) 22. CARE Indonesia
National Partners Mitra Nasional 1. CIVAS
10. PMI
(Center for Indonesian Veterinary Analytical
Studies)
11. BSMI
(Palang Merah Indonesia)
2. PB-IDI
12. PP-Muhammadiyah
(Ikatan Dokter Indonesia)
(Bulan Sabit Merah Indonesia)
3. PB-PDHI
13. WI-IP
(Perhimpunan Dokter Hewan Indonesia)
(Wetland International Indonesia Programme)
4. IAKMI
14. IdOU
(Ikatan Ahli Kesehatan Masyarakat Indonesia)
(Perhimpunan Ornitolog Indonesia)
5. AIPI
15. (YKI)
(Akademi Ilmu Pengetahuan Indonesia)
Yayasan Kutilang Indonesia
6. IHVCB-UI
16. WCS-IP
(Institute of Human Virology and Cancer
(World Conservation Society
Biologyof The University of Indonesia)
Indonesian Programmee)
7. ISPI
17. Kepraks/Himpuli
18. Danamon Peduli Foundation
(Ikatan Sarjana Petenakan Indonesia)
8. GAPPI
19. FMITFB
(Forum Mahasiswa Indonesia
9. GOPAN
Tanggap Flu Burung)
20. Pramuka
(Gabungan Pengusaha Perunggasan Indonesia)
(Gabungan Organisasi Peternak Ayam Nasional)
21. Octopus Batam-Indonesia
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ANNEX LAMPIRAN
Presidential Regulation (2006) on the establishment of the National Committee on Avian Influenza Control and Pandemic Preparedness
Peraturan Presiden Nomor 7 tahun 2006 tentang Komite Nasional
The regulation created a legal framework for a government body to coordinate avian influenza control and pandemic preparedness programs. The regulation states that Komnas FBPI answers directly to the president and is led by the coordinating minister for people’s welfare and includes members from 17 ministries, the military, police and the Indonesian Red Cross.
Pengendalian Flu Burung (Avian Influenza) dan Kesiapsiagaan Menghadapi Pandemi Influenza Peraturan presiden ini menjadi dasar hukum pembentukan sebuah lembaga untuk mengkoordinasi kegiatan pengendalian flu burung dan kesiapsiagaan menghadapi pandemi. Berdasarkan PP ini, Komnas FBPI berada langsung dibawah presiden dan diketuai oleh Menteri Koordinator Bidang Kesejahteraan Rakyat dan beranggotakan 17 menteri, TNI, Polri dan Palang Merah Indonesia.
It specifies that Komnas FBPI will be responsible for coordinating these ministries and become the center for data information gathering. Daily operations will be run by a secretariat that is led by the deputy to the coordinating minister for the economy. The Presidential Instruction on Intensifying Avian Influenza Control (2007) The instruction directs seven key ministers, governors, mayors and district heads to step up efforts to curb the spread of bird flu and intensify public communication. It also urges closer involvement of the military and the Indonesian Red Cross as well as improving the funding mechanism in order to speed up activities and provide compensation to farmers. The president also called on all government institutions involved be publicly accountable for their programs.
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PP juga berfungsi sebagai pusat data dan informasi. Kegiatan sehari-hari akan dilaksanakan oleh sebuah sekretariat yang dipimpin oleh deputi menteri koordinator bidang perekonomian. Instruksi Presiden Republik Indonesia Nomor 1 tahun 2007 tentang Penangangan dan Pengendalian Virus Flu Burung (Avian Influenza) Inpres ini memerintahkan tujuh kementerian kunci, gubernur dan walikota/bupati untuk meningkatkan program pengendalian flu burung dan mengintensifkan komunikasi publik. Inpres juga memerintahkan pelibatan Tentara Nasional Indonesia dan Palang Merah Indonesia sekaligus memperbaiki mekanisme anggaran untuk mempercepat implementasi program dan kompensasi kepada peternak. Presiden memerintahkan transparansi informasi kepada publik tentang kegiatan-kegiatan mereka.
The Indonesian National Pandemic Preparedness and Response Plan
Rencana Nasional Kesiapsiagaan dan Respon Dalam Menghadapi Pandemi Influenza
The National Pandemic Preparedness and Response Plan lays down detailed protocols from ministries and government institutions that would be put into place in the event of a serious pandemic.
Rencana Kesiapsiagaan dan Respon Menghadapi Pandemi Influenza merinci protokol berbagai kementerian dan lembaga lainnya yang harus dilakukan apabila pandemi terjadi.
The Jakarta by law on the Raising and Movement of Poultry (2007)
Peraturan Daerah Provinsi Daerah Khusus Ibukota Jakarta Nomor 4 tahun 2007 tentang Pengendalian Pemeliharaan dan Peredaran Unggas
The bylaw regulates the distribution, transportation, collection and marketing of poultry. It obliges owners of poultry collection yards and slaughterhouses to move out of the city center to specific locations that are regulated by the Jakarta government. The bylaw also stipulates that the transportation of poultry be regulated and provided the legal framework for poultry markets restructuring.
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Perda ini mengatur masalah penyaluran, pengangkutan, pengumpulan dan penjualan unggas. Perda mewajibkan pengepul dan pemilik tempat pemotongan ayam
ANNEX LAMPIRAN
Presidential Regulation 7 2006 Perpres No. 7 2006
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Presidential Instruction 7 2006 Instruksi_Presiden no 1 2007
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