Select Page

Medical Assistance – Tuberculosis in Indonesia

Obsolete treatments, the lack of an effective vaccine, and the lack of suitable diagnostic tools make it difficult to control the global TB epidemic

Incidence of tuberculosis in Indonesia

In Indonesia, there are roughly 500,000 new cases of TB annually and 175,000 attributable deaths. Tuberculosis is the second major killer of adults after cardiovascular disease and the deadliest pathogen out of all communicable diseases

Extract | Tuberculosis in Indonesia. The World Health Organization (WHO) has designated Indonesia a "high burden country" for tuberculosis. There are 22 high-burden countries worldwide, and together they account for about 80 per cent of the world’s tuberculosis infections. Expatriates or frequent travellers who spend a significant amount of time in a high-burden country may benefit from TB screening. Some countries may recommend that infants and children have a BCG vaccination. The annual risk of TB infection in Southeast Asia is 1-2.5%, representing an upward trend for the region. In Indonesia, there are roughly 500,000 new cases of TB annually and 175,000 attributable deaths.

Incidence of tuberculosis in Indonesia

The World Health Organization (WHO) has designated Indonesia a “high burden country” for tuberculosis.

There are 22 high-burden countries worldwide, and together they account for about 80 per cent of the world’s tuberculosis infections. Expatriates or frequent travellers who spend a significant amount of time in a high-burden country may benefit from TB screening. Some countries may recommend that infants and children have a BCG vaccination.

In Indonesia, there are roughly 500,000 new cases of TB annually and 175,000 attributable deaths. Tuberculosis is the second major killer of adults after cardiovascular disease and the deadliest pathogen out of all communicable diseases.

In global terms, there are one billion people infected with tuberculosis at any one time. Eight million new cases are reported annually with three million attributable deaths. However, despite these grim figures and without the influence of consistent treatment and immunization, its incidence is not as high as it was in the 20th century. The problem now is that with inadequate and inconsistent treatment regimes, a pool of persistent sputum-positive cases is being created.

Poverty facilitates the transmission of “Mycobacterium tuberculosis”. It is easier to catch TB if you live in poor, dirty, damp, dark or dusty conditions. Tuberculosis bacteria can live longer in damp, dusty rooms where there is no fresh air. Prolonged delay in diagnosis and increased vulnerability due to malnutrition and/or HIV infection. If it is dark, bacteria cannot be killed by sunlight. Poor living conditions and overcrowding increase the risk of tuberculosis.

Symptoms and Diagnosis of tuberculosis

Active TB causes a variety of symptoms that are sometimes vague, but often include cough, fever, night sweats, unintended weight loss, and lethargy. Latent (inactive) TB causes no symptoms. Most strains of TB can be treated with antibiotics. Up to four different types of antibiotics may be used together to treat a patient. If left untreated, active TB can be life-threatening.

At the local level, diagnosis is best achieved through microscopic detection of bacillus in a sputum smear. Culturing bacillus is expensive and impractical as it takes 6 weeks for results, and x-rays can be misleading. The most widely used test for diagnosing active TB in low- and middle-income countries rely on examining a patient’s phlegm under a microscope.

This method developed almost 140 years ago, detects less than half of all TB cases and largely fails to detect the disease in children and people co-infected with HIV – who usually cannot. produce the necessary sputum – and those that have drug resistance. forms of tuberculosis.

One diagnostic test, Xpert MTB/RIF*, cannot be used in many resource-poor settings, such as the rural areas where Fair Future is active.

It has been recognized that males in the 25 to 34-year-old age group are the most common transmitters of the TB bacillus. An infectious case will typically infect up to ten other people in a year. In case-finding, the general rule is that anyone who has had a cough for more than 3 weeks should have a sputum smear. Crowded dark places are ideal areas for the spread of TB, as direct sunlight will kill the bacillus in a few minutes but it can live in dark and dusty areas for up to 20 years.

*The Xpert MTB/RIF is a cartridge-based nucleic acid amplification test (NAAT) for simultaneous rapid tuberculosis diagnosis and rapid antibiotic sensitivity test. It is an automated diagnostic test that can identify Mycobacterium tuberculosis (MTB) DNA and resistance to Rifampicin© (RIF). It was co-developed by the laboratory of Professor David Alland at the University of Medicine and Dentistry of New Jersey (UMDNJ)

Treatment of tuberculosis

No matter the treatment regime used, the following basic rules must be observed:

  • Any drug intake must be supervised.
  • Drug intake must continue until otherwise directed, which may be many months.
  • There needs to be an uninterrupted drug supply to prevent emergent drug resistance.

When patients are resistant to the two most potent first-line antibiotics (rifampicin and isoniazid), they are considered to have multidrug-resistant tuberculosis (MDR-TB*). Treatment is long and arduous, with the drugs having many potential side effects, including psychosis and deafness. People can take up to 20 pills a day for two years – only to have a cure rate of just under half. Extensively drug-resistant tuberculosis (XDR-TB) occurs when a patient is resistant to second-line drugs. Only a third of people with XDR-TB are cured.

It is essential that a patient completes all of their treatment, even when they begin to feel better. incomplete treatment can lead to the development of drug resistance. Decentralizing treatment by having people care at home can help them adhere to treatment and overcome barriers they may face.

Most drugs to treat tuberculosis are old and toxic. But over the past decade, Bedaquiline©*, Delamanid© and Pretomanid©, three new tuberculosis drugs – the first in half a century – have been developed, giving patients hope and options for treatment providers.

But making these drugs available to patients who desperately need them has been painfully slow.

To date, one in eight people with drug-resistant tuberculosis who could have benefited from the new life-saving drugs Bedaquiline© and Delamanid© have been treated with them.

Prevention of tuberculosis

Travellers and expatriates may be able to reduce their chance of contracting TB by limiting the amount of time they spend in crowded places. Avoiding people who are coughing also minimizes risk. If you live in an area with higher rates of TB infection, consider screening local staff who live with you – especially if you have young children in your household.

The BCG vaccine has been used for many years and is usually given to infants in the first month of life. Studies have shown conflicting results, ranging from limited usefulness to 14 years of protection. However, it only provides protection against serious diseases.

Countries such as Canada and the USA have preferred to concentrate their preventative efforts by monitoring the spread of the disease and treating those who test positive, rather than immunizing the whole population. They feel that a positive test fails to differentiate those who have been immunized from those who actually have the disease and that the vaccine is ineffective and complicates diagnosis which takes many weeks to begin with.

European authorities believe that even the partial protection provided by the BCG vaccine is worth the increased diagnosis difficulty, and they also believe that repeated Tine testing will cause a false-positive reaction after a number of tests. This is caused by a response to the inoculation with reactive parts of the organism in the previous tests.

MDR-TB: The bacteria that cause tuberculosis (TB) can develop resistance to the antimicrobial drugs used to cure the disease. Multidrug-resistant TB (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs;
Bedaquiline: Sold under the brand name Sirturo, is a medication used to treat active tuberculosis. Specifically, it is used to treat multi-drug-resistant tuberculosis (MDR-TB) along with other medications for tuberculosis. It is used by mouth;
Delamanid: Sold under the brand name Deltyba©, is a medication used to treat tuberculosis. Specifically, it is used, along with other antituberculosis medications, for active multidrug-resistant tuberculosis. It is taken by mouth;
Pretomanid: This is an antibiotic medication used for the treatment of multi-drug-resistant tuberculosis affecting the lungs. It is generally used together with Bedaquiline© and Linezolid©. It is taken by mouth

Prevention of the spread of infections from a single source

In order to limit the spread of infection in confined spaces and crowded areas such as offices, institutions, and schools, Fair Future observes and recommends that the following minimum precautions should be observed in addition to the medical and possibly radiological screening of the staff :

  • Sanitary and washing facilities in accommodation should be clean and cabins should be available for individual ablutions and sleeping;
  • There should be a generous supply of clean towels. Soap and warm or hot water should be provided in all sanitary facilities, especially near kitchens and toilets;
  • Mess rooms with facilities for covering food and washing hands should be available;
  • Paper napkins are preferable to cloth napkins;
  • Living and sleeping areas should be constantly inspected for health issues;

Especially in air-conditioned, humid, and confined environments, people with respiratory infections should not go to work when sick without consulting a doctor. Such environments are ideal for the spread of tuberculosis via aerosol droplet transmission;

A system should be in place to report symptoms of throat and chest infections and provide medical supervision of site personnel.

Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic

The COVID-19 pandemic has reversed years of global progress made in the fight against tuberculosis and, for the first time in more than a decade, deaths from tuberculosis (TB) have increased in 2021.

Indeed there are far fewer people diagnosed, treated, or receiving preventive treatment against the disease compared to 2019, and overall spending on essential TB services decreased.

Disruptions in access to TB services and reduced resources. In many countries, human, financial, and other resources have been reallocated from TB to COVID-19 response, limiting the availability of essential services.

Mycobacterium tuberculosis (M. tb)?

This is a species of pathogenic bacteria in the family Mycobacteriaceae and the causative agent of tuberculosis. First discovered in 1882 by Robert Koch, M. tuberculosis has an unusual, waxy coating on its cell surface primarily due to the presence of mycolic acid. This coating makes the cells impervious to Gram staining, and as a result, M. tuberculosis can appear weakly Gram-positive.

Give for Fair Future programs

Donate to programs initiated by Fair Future and Kawan Baik Indonesia, and be on the ground with us. We are committed to ensuring that as many people as possible have access to a better and healthier life. We are focusing on creating solutions for sanitation and access to drinking water and clean water, sanitationaccess to energy sources, access to school and knowledge, access to medical care (basic and emergency care), especially for children, healthy food, women's rights, and minorities living in rural and ultra peripheral areas.

**Click here to make a donation

Give for Water Connections Program

Fair Future works every day to improve the living conditions of rural communities in eastern Indonesia.

One of the Foundation's tasks is to ensure equitable access to water in quantity and quality, in order to prevent diseases such as cholera, diarrhea, dysentery, hepatitis A, typhoid, and poliomyelitis. With, for children and vulnerable people, a high mortality rate., and maintain lives and livelihoods. This is to reduce environmental risks to health, by managing sanitation safely and with dignity. Still, the foundation seeks to involve women and men in the management of water resources, in sanitation by the implementation of safe hygiene practices in order to maximize the benefits for their communities.

**Click here to make a donation

Give for Basic medical care

Whether it is to fight against famine, diseases linked to the lack of clean water, the lack of sanitation system, the fight against the Covid-19 pandemic, respiratory diseases linked to air pollution, tuberculosis, or any other form of recurrent illness, Fair Future does what it can to best help populations in need.

Help us to provide us with medicines, medical equipment, logistics, my indispensable faith also to get us where no one ever goes. Help us to heal, to give a better life, to help us to save lives!

**Click here to make a donation

Give for 1st emergency relief

Fair Future teams intervene to provide care, including in situations of social and natural disasters, how and why we adapt our activities to each. We have developed emergency actions that have been implemented in the fields of health, access to drinking water, food, and medical care, and have coordinated a multitude of actions since their different medico-social Base Camps. Our teams of professionals fight every day against epidemics and serious illnesses, due to lack of water, food, hygiene, and care for children or pregnant women and vulnerable people.

**Click here to make a donation

Give for Rumah Kambera

Fair Future and Kawan Baik Indonesia Foundation incorporate in all its choices and decisions taken in the context of its actions and field programs, the notions of risks for communities, what is good or bad for them, for people, children, and villages. And for years, we have for mission to develop, support, and create humanitarian programs and actions linked to education, training, and medical care. This is why Fair Future and Kawan Baik Indonesia have created Rumah Kambera, our Base Camp in the Eastern part of Indonesia.

**Click here to make a donation

Give for Rebuild MbinuDita program

After building a new school, bigger, stronger, with materials resistant to storms, bad weather, earthquakes, Fair Future and Kawan Baik, as part of the program, we named “Rebuild MbinuDita “, continue to provide basic things for the lives of thousands of people there.

The program “Rebuild MbinuDita” is to give access to clean water to all the inhabitants of the community, but also to medical care, to healthy food through the creation of organic gardens. These activities have no other objectives than to increase the quality of their life, to provide better health to people (especially children, vulnerable people, pregnant women), access to health and medical care, and for people to be able to increase their income.

**Click here to make a donation

Give for The Truck of Life Program

In the most inaccessible territories, live thousands of people who do not have access to the most basic needs in order to ensure them a healthier life, or basic medical care, access to drinking water so as not to be ill, or a source of light for reading or studying for children.

The Truck of Life program allows us to provide medical care and take children or even a doctor or dentist to the nearest town. Truck Of Life allows us to bring equipment, food, and drinking water to wherever no one goes while ensuring the safety of our volunteers and specialized collaborators.

**Click here to make a donation

You don't have access to e-banking?

Sometimes, it is not possible to make a donation via modern solutions, by what is called "e-banking".

From then on, you can participate in one of our projects or programs by making a bank transfer, via one of our two bank accounts in Switzerland.

**Click here to make a donation

Antimicrobial resistances. What happens when drugs stop working?

Bacteria, viruses, parasites, and other microbes are constantly changing to ensure their survival, we have seen this with variants of influenza, COVID-10, etc. Some have adapted so well to medical treatment that the drugs commonly used for preventing or killing them are no longer effective. These microbes cause drug-resistant infections. Their ability to survive the drugs used against them is called antimicrobial resistance (AMR). In the case of bacterial pathogens, for which antibiotics are the most common and important drugs available for treatment, this is called antibiotic resistance (ABR). We mustn’t wait until it’s too late to tackle this major health challenge.

Massive pest attacks that destroy all crops and starve the people

In East Sumba, for several days now, grasshoppers have been destroying all crops, vegetable gardens, soybeans, and corn. For three years, it has come back regularly. During high population years, they feed and severely damage almost all crops, trees, shrubs, and vegetable gardens. We are in contact with the most affected populations who tell us how the fruit of their work, their fields But also their garden, are totally destroyed in a few minutes. The impact is enormous for these poor families since their income is not enough to buy food. Rice in particular is expensive, therefore corn harvests are very important and vital for families. A new trade is in the process of being born: The sale of grasshoppers by the kilo; this is in order to eat and be nourished. The price is IDR. 5,000,000.- per kilo, i.e. less than 50 cents.

Fair Future and Kawan Baik change the nature of water

Clean water is life, health, food, leisure, energy… Water covers more than 70% of the Earth’s surface. It is in water that life on Earth began, so it is not surprising that all living things on our blue planet need water. Water is indeed many things: it is a vital need, a home, a local and global resource, a transport corridor, a climate regulator. And, over the past two centuries, it has become the end of the journey for many pollutants released into nature and a newly discovered mine rich in minerals to exploit. To continue enjoying the benefits of clean water and healthy oceans and rivers, we must fundamentally change the way we use and treat water.

There will always be people who live too far away, we are here to help them!

There are no toilets here, everyone practices open defecation. Furthermore, no one has direct access to water of any kind, and no access to a source of clean, drinkable water. Fair Future and Kawan Baik Foundations are changing that with the #waterconnections program, but there will always be people who live even further than far. We meet those people, all those families that we don’t forget. Thanks to all of you and our teams who are there, on the ground at the time of writing this line, they will also have access to one of our solutions, a borehole, a reservoir connected to the network…

Water is when we don’t have it that we realise how important it is!

Water we do not realize how important it is when we have access to it like that, by opening a simple tap and sometimes forgetting to close it. Water is when we don’t have it that we realize how important it is, how vital it is for our everyday life. So for a moment, let’s try to imagine what our life could be like without water. And if we have access to it, that this water is not consumable! This is what the families experience here, the children of all these villages in which Fair Future works almost 24 hours a day. The health of people, the prevention of diseases, the reduction of infant mortality, offering a better quality of life, food every day, a shower every day and for everyone are just a few aspects that oblige us to work and develop. innovative and sustainable solutions, relating to access to water in quantity and quality for families in the poorest and rural regions.

Magic works, construction continues, people are happy, there is water!

Having clean water close to home is a real challenge that Fair Future and Kawan Baik have taken on, so that the more than 2,200 villagers of Mbinudita can have clean water in their homes for the first time in their lives. This is so that everyone’s life is healthier, happier on all fronts, clearly more harmonious. Even if it is very hard physically, sometimes morally because we are isolated from everything and everyone, there is not a day during which we are not happy to be able to work within the framework of this immense project, one of the largest ever conducted by the Swiss foundation and its Indonesian twin sister, Kawan Baik Indonesia foundation.

Without or with very little water and food, it is very difficult to go to school!

Go to school, learn, concentrate, walk… All this with little water and food! This is the challenge faced by thousands of kids, their teachers and families. Not having enough water when you are a child, sometimes having to walk several kilometres to get to school. Not having enough to eat, not being able to wash. The difficulties of the teachers, their testimonies are revealing of the food, economic and access to water crisis which the children and their families have to face every day of their lives. Fair Future and Kawan Baik try to respond in the best possible way to these vital problems. Avoid malnutrition, improve health, provide access to a source of clean water so that children can go to school and learn in the best possible conditions.

Lifestyle habits: “-Because we’ve been doing it for a long time”

Pollution of streams and natural springs and everywhere. It is rare to find still pure sources whose water is not dangerous for health. Fair Future, within the framework of its prevention programs and access to better health, meets people from the most rural and poor regions of this immense country, offers affordable, simple and understandable solutions for all. At the same time, we are building clean water networks, we are drilling deep wells to provide access to quality water, in quantity, to families, children and vulnerable people.

The Water Crisis in Indonesia – Focus in Napu, Wunga, Sumba Timur

Drinking contaminated water can lead to serious health problems. Cholera, diarrhoea, dysentery, hepatitis A, typhoid, scabies, onchocerciasis, schistosomiasis, trachoma, typhoid and paratyphoid fevers, hepatitis, malnutrition and poliomyelitis, significant metabolic fatigue causing disorders of all vital systems, to death.
In the long term, consumption of water loaded with heavy metals, pesticides, nitrates and other chemical components such as arsenic are likely to cause serious congenital malformations in newborns: Limb deformation, hydro-encephalitis and other physical or mental disabilities.

Water Connections, the ongoing project on the MbinuDita Site

Where are we with MbinuDita’s Water Connections project? What are the funds that we have already collected, those that we have already invested in this vital project like never before for more than 2000 people without access to clean water? We present to you via a small infographic what we have already done, what remains to be done and the schedule for the next steps.

Common diseases we work on

Tuberculosis in Indonesia: A social disease affects the poorest communities, those living in difficult conditions. There are hundreds of thousands of new cases in Indonesia, such as HIV, which is not often mentioned here!

Dengue virus infection: DENV is a real major cause of acute febrile illness here. In the most affected regions, mortality is very high & affects the most vulnerable. Especially for those who do not have access to medical care.

Malaria and the vulnerable: Every year, malaria kills thousands of people in Indonesia, in all regions, even the richest. 70% of all deaths are children under five, and affect people and families who cannot access medical care.

Antimicrobial resistances. In here, this is a real health emergency, almost all drugs are available over the counter! This scourge turns simple wounds and easily treatable diseases into causes of death.

Air pollution and health: Plastic that burns, everywhere! Air pollution is responsible for almost 50% of mortality here. Dioxins, furans, mercury, and polychlorinated biphenyls are highly toxic!

Malnutrition and famine: Malnutrition causes serious illnesses where we are! The phenomenon, creating a vicious cycle of starvation & disease. This is a major problem in which we deal with!

Medical care for children: Far too many children still die from easily preventable problems, especially in their first few days/weeks of life, as well as from diarrhea and pneumonia. Access to clean water and good sanitation solutions is one of the future goals to help them get better.

And about the Dengue fever?

Quick facts about Tuberculosis

Click to open it

FFF Base Camp NTT, East Sumba

Your feedback is valuable to us & our work

Thanks for your feedback, we will always get back to you!

Notify of
Inline Feedbacks
View all comments

How your donations are used?

Your donations pay for tons of food, medical treatments, solutions to have a better and healthier life!


Socio-Medical Mission




Management & General Admin