Even with smile on his face and the agility of an eleven year old, Syahrul can never be too tired or symptoms of malaria can recur. Syahrul’s father, Alim, said that his son has malaria relapsed for seven times if he got too tired.
Ekuatorial, Ternate – Although Alim said that his house was clean enough and regularly change the water, it did not stop the disease infecting his son. On the contrary, malaria has been a common disease in Ternate, which is known also as malaria epidemic area, for more than a decade.
The city’s geographical location which comprises of lots puddles allows malaria infected mosquitoes to breed. There are at least eleven breeding points of malaria infected mosquitoes. The highest case in the city was 17,625 cases back in 2003. It had reduced to 2,000 cases in 2012.
However, most of people in Ternate, including Alim, responded casually to the fact that his neighborhood has been the breeding ground for infected Anopheles sp mosquitoes.
“Malaria is [considered] as ancestor’s legacy by these people. So, they just act normally [towards the disease],” said Tati Sumiati, head of Public Health faculty of University Muhammadiyah, North Maluku, to Ekuatorial. Furthermore, Sumiati said that people’s perception that malaria was a common disease and not dangerous has also contributed to increasing malaria cases in the city.
In the latest development, malaria occurring in Ternate might be triggered by climate change. Mohamad Riva, head of Data and Information at the Ternate Meteorological Climatology and Geophysics (BMKG), said that records have shown that temperature in the city was 22 to 29.6 degrees Celsius, ten years ago. But, it has increased to 23-33 degrees Celsius in 2012.
“[Even] with 23 degrees Celsius, [malaria cases] have been occurring, but, now [the temperature] is rising,” said Riva adding that rainfalls have also shifted from its normal cycle making it difficult to predict the pattern.
From last year data, he said rainfalls intensity and volume, has been showing changes from normal patterns.
In addition, land use changes especially for housing have been contributing to the city’s malaria epidemic. Sumiati said that dead or dry rivers were breeding ground for those mosquitoes.
Malaria spread high areas in Indonesia
Malaria cases have also spread to much higher location, such as Papua and Papua New Guinea, which normally have cool temperature. However, forest conversions to timber and plantation industries have forced these mosquitoes to migrate to other places. To survive, malaria infected mosquitoes are adapting to live in areas with 16 degrees Celsius and 3,600 meters above sea level.
In 2010, Papua Biomedical Research and Development Center, in Intan Jaya district, reported that malaria had reached to their place leading to 40 people from four villages died. The district was located in 1,900 meters above sea level with average temperature 19-25 degrees Celsius, a condition which was regarded as impossible for mosquitoes to breed.
Malaria cases were also found in Cimahi, West Java, located 1,075 meters above sea level with average temperature 18 – 22 degrees Celsius.
Rina Kuswidiati, head of Disease Control, Cimahi Health Agency, said that malaria case in Cimahi was categorized as ‘imported case’. “Lots of soldiers were stationed in eastern part of Indonesia living in this city. When they got back, it is possible they have already been infected [with malaria] and spread the city,” said Kuswidiati.
Though malaria case happens every year in Cimahi, she said that there was nothing to worry about. “There are not much breeding place for malaria [infected] mosquitoes in Cimahi. We don’t have swamps or beaches. Cimahi is not suitable for Anopheles [mosquitoes],” she said.
Climate Change Impacts
Supratman Sukowati, scientist from the Research and Development Center, Ministry of Health, said that extreme and high rainfalls as one of the impacts of climate change can cause diseases such as malaria and dengue fever, diarrhea, cholera, filariasis, leptospirosis, influenza, and shortness of breath.
Based on World Health Organization report in 2012, global warming will increase two to three degrees Celsius temperature which will lead three to five percent of world’s population potentially infected with malaria.
In other words, 210 – 350 million out of seven billion people on earth will be potentially infected with malaria. Most of the cases are predicted coming from tropical countries in Asia and Indonesia is listed as one of the nation with high malaria deaths.
Iswahyudi, manager at the Malaria Center of North Maluku, said that climate change has triggered malaria cases in Ternate. “The [malaria] peak usually happened twice in October and April or during rainy season. That was before 2008,” he said. “But, it had increased to four times every year since 2009. We have lots of rains meanwhile we were supposed to enter dry season.”
The weather changes had also caused floods on the coastal areas, especially near mangrove forests, which are ideal breeding place for mosquitoes. IGG Maha Adi (Jakarta), Januar Hakam (Cimahi, Ternate)