Military members alleged of occupying hospital in Paniai Regency – Patients leave hospital, all health services temporarily ceased

Intensified armed clashes between Indonesian security forces and members of the West Papua National Liberation Army (TPNPB) in the Paniai since early May 2024 reportedly resulted in the temporary closure of the only general hospital in the regency. The closure of health facilities in conflict areas due to the armed conflict has occurred in various regencies across West Papua, leaving the residents in these areas isolated from access to fundamental health services.

On 24 May 2024, all patients were reportedly asked to leave the Uwibutu General Hospital (RSUD Paniai) in the town of Madi, while military members were taking control of the third floor of the building to overlook the Madi area to approach TPNPB fighters. On 26 May all patients and health workers reportedly left the hospital. All medical services were temporarily ceased. Six intensive care patients had to be transferred to other general hospitals in the neighbouring regency Deiyai, and others to Nabire Regency.     

According to Dr Agus, Director of RSUD Paniai, the deployment of security forces was directly instructed by the Ministry of Health and coordinated with the Cenderawasi Military Command. He explained that the Paniai Hospital only followed instructions from Jakarta. Dr Kes denied that the patients were forced to leave, explaining that patients and health workers had voluntarily left the hospital afraid of being caught in the crossfire between the conflicting parties. XVII/Cenderawasih military command chief, Lieutenant-Colonel Candra Kurniawan, declared that the military members had been deployed to the hospital after receiving threats that the TPNPB had planned to burn the hospital to the ground.  

On 27 May 2024, health workers gathered in front of the RSUD Paniai to protest against the occupation of the public health facility, demanding the immediate withdrawal of all security force members from the third floor of the Hospital. They added that all hospital staff will return to duty from 28 May 2024.

Patients leaving the Uwibutu Hospital in Paniai on 26 May 2024

Health workers protesting in front of the Uwibutu Hospital in Paniai on 27 May 2024

Is West Papua facing a health crisis?

Indigenous Papuans face a stark healthcare disparity compared to the rest of Indonesia, especially Indigenous Papuans living in rural areas, where the availability and accessibility of medical facilities are severely limited. Remote regions often lack proper facilities, with outdated equipment and chronic medication shortages. Doctors are scarce, and concentrated in urban centres, leaving vast areas underserved. Some regions even lack hospitals, forcing residents to travel long distances for basic care.

The ongoing armed conflict further exacerbates the healthcare crisis. In the central highlands, poorly equipped hospitals may serve entire regions, while health centres are frequently abandoned or destroyed due to fighting.

Government efforts over the past years haven’t significantly improved access, especially in rural areas where most Papuans live. Though statistics show an increase in the number of hospitals, many regencies still lack basic facilities. As of 2021, 20 hospitals were available in the Papua Barat Province, and 52 hospitals were in the Papua Province. Six regencies in both provinces still do not have any public hospitals.

The low number of hospitals that only exist in urban settlements implies that West Papua’s healthcare system heavily relies on other medical institutions. The latest statistics available, dating 2021, indicate a negative trend in the availability of policlinics, maternity hospitals, health and subsidiary health centres. A particularly worrying trend is the decline in maternity hospitals, dropping from 12 in 2014 to only 2 in 2021. This has a direct impact on maternal and child health outcomes, as over 23% of women in West Papua give birth without medical support.^[1] Specific regencies report even more alarming figures, with over half of women lacking access to birthing assistance. These disparities contribute to higher mortality rates for mothers and newborns.

The government’s attempt to address the healthcare gap by deploying military personnel raises concerns.While they to certain expend support a constrained provision of medical services in both conflict and neighbouring non-conflict areas, their presence raises fear among Papuans due to past human rights violations and prevents them from accessing the limited services.

Beyond availability, the quality of care is another major concern. Statistics may show healthcare facilities exist, but they often lack essential resources. Most rural health centres lack medical specialists, forcing residents to travel long distances for even basic care. Government statistics on medical staff in health centres (Puskesmas) are contradictory. Papua province supposedly lacks specialists, while Papua Barat lacks general practitioners. These inconsistencies raise concerns about data accuracy.

Administrative negligence adds another layer of disruption to healthcare access. Delayed salary payments for health workers and medication shortages are frequent occurrences, leading to the closures of hospitals and health centres. Nduga hospital and Kenyam health centre closed due to unpaid staff. Poor management in Waghete Hospital led to medication shortages. Human rights defenders claim the shortage could have been avoided with better coordination. The General Hospital in Abepura, one of the largest public hospitals in Jayapura, temporarily ceased operations on 21 May 2024 due to the lack of medication and medical supplies.

Over 76,000 internally displaced Papuans face a health crisis. Displacement has been ongoing since the conflict in West Papua intensified in early 2019 and internally displaced persons (IDPs) since then have not had access to proper healthcare. Women and children are especially vulnerable. Long distances, transportation costs, and lack of legal documents create additional barriers to accessing medical treatment. Displaced children often show signs of malnutrition and respiratory issues, while pregnant women and the elderly face similar challenges. The lack of healthcare access contributes to a higher mortality rate among IDPs.