Old wounds from past conflict fuel vaccine hesitancy in Aceh

Ben Husen, a journalist from Lhokseumawe in Indonesia’s ultraconservative Aceh Province, has a secret.

He has yet to be vaccinated against COVID-19.

“I tell people that I’ve already been vaccinated or I make up another reason why I can’t have it done, like an illness,” the 56-year-old told Al Jazeera. “I like to tell people I’ve been vaccinated so they feel comfortable with me.”

The real reason for his reluctance, however, is nothing to do with the kind of anti-vaccine propaganda that has found fertile ground in some other countries, or even a concern about taking a new medicine.

Instead, it has deep historical roots in the province which sits at the northwest tip of the island of Sumatra and follows Islamic law.

“The main reason is the conflict,” Husen admitted.

For decades, a bloody civil war raged in Aceh following the founding of the Free Aceh Movement (GAM) in the 1970s. GAM, made up of ethnic Acehnese separatists, wanted independence from the rest of Indonesia as a result of decades of cultural and religious tensions as well as disagreements over the use of Aceh’s natural resources. GAM felt the province’s oil and gas was being sold off to make a profit for the central administration while leaving the rest of the province in poverty.

In 1989, Aceh was officially declared “an area of special military operations” (DOM) with Indonesian troops stationed in the province to quell any unrest. The declaration led to frequent armed clashes with separatists until DOM ended in 1996.

Violence flared again in the late 1990s to early 2000s when Indonesian troops were once again brought in to root out “rebels” and clamp down on continued calls for independence.

“There are a number of factors why people don’t want to get vaccinated,” Husen said. “That includes religious beliefs as well as lack of education and lack of faith in medicine. But people are mainly scared of the COVID-19 vaccines because of a crisis of trust towards the authorities that stems from the days of DOM.”

‘Problem with trust’

Human rights abuses, such as forced disappearances, torture and rape, were common and carried out by GAM and members of the military during the conflict and at military checkpoints. Raids by the Indonesian army searching for separatists were also widespread.

Thousands of people, both civilians and soldiers, are thought to have died during the war, which only ended after the devastating tsunami of 2004 convinced both sides it was time for peace. After the Helsinki MOU was signed the following year, Aceh was granted semi-autonomous status in Indonesia.

Stories like Husen’s are something that Dr Ferry Dwi Kurniawan, a pulmonologist at Dr Zainoel Abidin Hospital in the provincial capital of Banda Aceh, has heard many times since the pandemic began.

“When I ask my patients why they don’t want to be vaccinated, many simply refuse without giving an explanation,” he told Al Jazeera, adding that sometimes patients will blame vaccine hesitancy on a prior condition like diabetes, despite him reassuring them that it is safe for them to be jabbed.

“Sometimes being a doctor is very challenging, giving education and advice,” he said. “And when their family members get sick and start to deteriorate, then they start to panic.”

According to Dr Iman Murahman, the head of the COVID-19 vaccination programme in Aceh, there is “a problem with trust in the authorities, not actually a problem with the vaccines” in the province.

“We need to restore trust in the government and extoll the positive effects of the vaccine. The problem is negative information that circulates on social media, which will always influence people more than anything the government says,” he added.

According to Dr Iman, 1.6 million people in the province have had their first dose of the vaccine and 900,000 have had a second dose, meaning that about 20 percent of the population of Aceh has been vaccinated, the second lowest in the country after Papua province. There has been an Indonesian military presence in Papua since the far eastern province was incorporated into the country following a controversial referendum organised by the United Nations in 1969.

Indonesia’s Ministry of Health says Aceh’s target is to vaccinate just over four million people out of a population of 5.3 million.

“I always point out that we have vaccinated over a million people and no one has had a fatal reaction to the vaccine but that people have died of COVID-19,” Dr Iman said.

‘Logic eaten away’

Since the start of the pandemic, Aceh has reported more than 38,000 cases of coronavirus and more than 2,000 people have died.

Al Jazeera spoke to residents not only in Lhokseumawe, but also in Banda Aceh, the provincial capital, and Langsa, on its eastern coast.

They said they were worried that the vaccines would perhaps kill them, but were afraid to say so publicly for fear of ridicule.

“We have had a tough time. Reason and logic have been eaten away by conspiracy theories,” Argamuda, the chief of police for West Aceh Regency told Al Jazeera.

“We need to reason with people but it is very tiring and adds to our workload. Acehnese people are difficult to convince because of the historical legacy of the conflict.”

To try and persuade the reluctant residents, Argamuda says he had to go village to village in person in the regency, bringing influential – and trusted – individuals such as village elders and religious leaders who have been vaccinated to give residents a pep talk and soothe their concerns.

In Argamuda’s regency – which has a population of about 200,000 – 30 percent of residents have had their first dose and 50 percent are fully vaccinated.

“We have to bring people they trust. They will only listen to them,” he said.

At the end of September this year, villagers in the neighbouring Southwest Aceh Regency went on a rampage and attacked a vaccine outpost, smashing 30 vials of the Sinovac vaccine and ripping up facemasks.

Syringes, blood pressure equipment and other medical supplies were also damaged at the facility, according to the authorities, leading to local leaders being drafted to “provide education on the importance of the vaccine”, said Police Grand Commissioner Winardy, head of public relations of the Aceh regional police.

Dr Iman said that positive messaging was crucial for Aceh’s vaccine drive, and that the media had not been helping the situation by focusing on negative coverage of the pandemic.

‘We need to tell people that getting vaccinated is really important and helpful. If people get vaccinated, they will get a vaccine certificate so they can travel around freely and go about their daily lives,” he said.

“If we explain, people will get vaccinated, but we are also competing with social media such as Facebook, TikTok and Instagram with all the negative commentary on there.”

Back in Lhokseumawe, Ben Husen says that the authorities have been trying to sweeten the vaccine message by giving away rice and other gifts to those who agree to get jabbed.

As a result of the charm offensive and continuing encouragement from the authorities, Husen has agreed to be vaccinated in the coming weeks, but says that he remains nervous at the prospect.

His mind always goes back to the armed conflict.

“I think about it a lot. What if they are going to try and kill us all again and take over our lands?” he said.

“If they want to kill us now, they don’t have to shoot us any more like they did during DOM. They can just vaccinate us instead.”