IT WAS just an ordinary vase of flowers. Seemingly innocent, it was located in the offices of the University of Indonesia’s Department of Community Medicine in Jakarta. Closer inspection by department head Firman Lubis, however, uncovered an uncomfortable truth.

“We were breeding Aedes aegypti mosquitoes. Dengue carriers!” he told The Straits Times last month. “I called in the cleaning lady and the department’s medical staff and showed them the larvae.”

Although the incident took place several years ago, he cites it as evidence of the fact that – even now – vigilance is often lax. And this is true even within organisations generally expected to be more aware of the problem.

Unlike in Singapore, there are few public service announcements on Indonesian radio or television warning citizens of the dangers of mosquito-borne diseases. Indeed, Jakartans have grown accustomed to regular dengue fever epidemics, with numbers spiking during the biannual transitions between rainy and dry seasons. Indeed, the problem remains more serious in Indonesia than in many neighbouring countries.

According to Mr Haryono, founder of the Pikoli Foundation, which focuses on eradicating dengue in Indonesia, there were 150,000 cases in 2010, with about 1,400 deaths. Compare this with Thailand, which had only 57,000 infections and 70 fatalities during the same period.

Malaria is yet another health risk, especially in rural areas. Last year, there were 256,500 cases of malaria in the country, up from 230,000 in 2010.

The Indonesia Malaria Care Foundation estimates that 107 million Indonesians live in malaria- endemic zones. The areas with the highest rates of infection are the largely underdeveloped provinces of East Nusa Tenggara, Maluku, North Maluku, Papua, West Papua and North Sumatra.

Malaria is spread by the Anopheles mosquito, which breeds in muddy water and feeds at night. More common in urban areas, dengue is the result of the activity of the Aedes aegypti mosquito, which prefers clear stagnant water and feeds during the day.

Sadly, the public in general remains largely apathetic. Mosquitoes, notes Dr Lubis, are more often popularly regarded as a nuisance than a danger to public health. Officials also fail to address the problem, focusing instead on technical aspects such as spraying suspected breeding areas or testing the blood of victims.

As a further example of the need for public education, Dr Lubis cites the case of Bangka Belitung, a two-island province north-east of South Sumatra. Tin mining by the local population has resulted in the islands being pockmarked with ponds ideal for mosquito breeding.

In an attempt to reduce the incidence of malaria, international donors have provided villagers with special nets, impregnated with insecticide, to help keep mosquitoes out when they sleep.

Visiting the islands last year, however, Dr Lubis found that the nets were rarely employed for their intended purpose. “Some used them as fishing nets instead,” he notes.

Fumigation using insecticides is often employed as a control technique, but Dr Lubis does not regard it as an ideal solution. “You are introducing chemicals into the environment whose long-term effects are not really known,” he says, citing the deleterious effect of the use of DDT in the 1950s and 1960s. Fumigation also kills the mosquitoes’ natural predators.

That said, there have been some imaginative solutions. During the colonial period, the Dutch introduced a small fish from South America to eat the mosquito larvae. Known locally as kepala timah or julung-julung, they can still be found in less polluted canals and ditches around Jakarta.

More recently, some Jakartans have been growing zodia in pots and placing them in their homes. The plant, a native of Papua, has small, flat, green yellowish leaves. The scent of its leaves and flowers is believed to disorient and repel mosquitoes.

But much more than this will be necessary if the government’s ambitious scheme to wipe out malaria on Java, Aceh and the Riau islands by 2015 is to be achieved.

Dr Lubis points to the need for stronger enforcement of municipal regulations “just like Singapore” regarding the elimination of mosquito breeding in homes.

Another idea promoted by non-government organisations is to get consumer goods companies to print preventive messages on their product packaging.

Meanwhile, the problem threatens to get worse.

“Drug resistance, financial constraints and inadequate public awareness threaten to reverse the gains achieved in malaria control in the past decade,” the World Health Organisation said in a statement marking World Malaria Day on April 25.

It really boils down to how seriously Indonesians view the problem. “People need to develop a hatred towards mosquitoes,” argues Dr Lubis.

Well said.

(C) Singapore Press Holdings Limited