RI’s response against Swine Flu, should the military be involved too?
Learning from the war against avian influenza, the SBY’s government has shown its responsiveness to the Swine Flu issue. Last Monday, an emergency meeting with various branch of the government was conducted. Ministers and officials coming to the meeting range from Health Ministry, Transportation Ministry, Interior Ministry, Culture & Tourism Ministry, Agriculture Ministry, Ministy of Finance, State Department to the Police Department. The quick, joined-up response shows the current government’s seriousness in dealing with the issue, although the Health Minister have said that the Swine Flu constitutes a lower danger to Indonesia than the Avian Influenza due to the Indonesia’s hot climate. Nevertheless, Indonesia has launched steps to stop the virus from coming by border control and screening at ports and airports, banning the import of pork and putting 38 billion rupiah of fund to combat the swine flu. The health department have also assigned more than 100 hospital all over Indonesia to handle any swine flu cases that may appear.
One thing we need to ask is whether the defence department c.q the military (TNI) should be involved in this Swine Flu response in this early stage?
The contra arguments is that that having the military involved now would be premature, as the situation is still very-very far from the emergency situation that calls for military intervention (e.g martial law), and could possibly trigger panic if falsely perceived by the public. Moreover, the task of keeping the internal security of the country is now legally belongs to the Police. However, there are some advantages that can be gained by involving the military involved in this swine flu response.
First, it will give the defence department and military (plus other parties that have been involved) early chance to harmonize their preparedness and contingency plan with other branch of government’s plan in an event of a deadly infection outbreak. In normal situation, the Health Department will be the spearhead that to carry out measures to combat a deadly infection outbreak. But if the situation escalates into emergency situation, such measures would likely need some force to put it into effect, such as forced evacuation, forced vaccination, area-wide cordon or forced quarantine of the infected population. The health establishment would need to work closely with the military and police. Such effort needs a close coordination and understanding of the role and nature of each parties involved, and early involvement would facilitate those essential needed ingredients. It will also provide time for the military to develop doctrine, make a contingency plan, conduct drill and exercises, develop capability and prepare for such MOOTW (military operation other than war) operations.
Second, the military can learn from the health department on dealing with such infection and apply the lessons to enhance its capability to defend against biological weapons. Years of chronic insufficient defence budget has made the TNI’s conventional forces capability deteriorated. When the budget is insufficient to develop or even just to maintain conventional capability, there is a big tendency to neglect the capability to deal with non-conventional threat, especially when such threat are deemed unlikely. On the other hand, constant battle with Avian influenza has made the Indonesian health department gained much knowledge and experience on this kind of biological threat. Clearly TNI, and the nation in general, can benefit from this.
Another point to be raised that it that helping the government in natural disaster relief is also a main task of TNI, as mandated by UU 34/2004 on TNI . While the term natural disaster is usually associated with physical harm brought by environment, such as earthquakes or landslides, an outbreak of deadly disease can also be categorized into such term.
Given the unpredictable behavior of influenza viruses, neither the timing nor the severity of the next pandemic can be predicted with any certainty. The influenza virus is constantly mutating, and new strains come up every several years with a global pandemic potential. So far, the human kind has been lucky. The H5N1 Avian Flu is highly lethal (with mortality rate up to 80%), but its spread is limited by bird-to-human transmission only. The H1N1 swine Flu is highly contagious, spreading to other continent within just 1 week through airborne infection, but so far the mortality rate is only about 6%. We have been lucky because the lethality has not met the ability to spread quickly in these viruses.
But someday, we might be running out of luck. In fact, we did run out of luck several times. Since 1900, three flu pandemics and several “pandemic threats” have occurred. The Spanish Flu pandemic in 1918-1919 infected 20-40 percent of world population that year and killed over 50 million people all over the world. The 1957’s Asian Flu caused 69,800 death in the US alone. Between 1968-1969 another pandemic, the Hong Kong Flu, caused 33,800 death (pandemicflu.gov).
With the massive deaths it can causes, plus the panic wave, a deadly infectious disease can to deteriorate security situation of a country, create nation-wide chaos, paralyzing a government and stopping the economy. In other words, it has a potential to escalate into a crisis and become a threat to our national security. When it happen -God forbid- the nation will need every asset she has to defend herself and her citizen. Whether the swine flu will escalate into such a threat or can be contained like the Avian Influenza virus is yet to be seen. Last week WHO already put the alert level into Phase 5, just below the global pandemic level of Phase 6. As history has taught us many times, being over-prepared is always better than under-prepared.