Role of leadership and local culture in COVID-19 control in Bali Province, Indonesia

Corresponding Author: Fatmah  Disaster Management Study Program, School of Environmental Science UI, DKI Jakarta; Tel. +628129998139 Email: ffatmah@yahoo.com Abstract. The increase in positive cases of COVID-19 in Indonesia since 2020 has led to various control measures, including prevention. One of them is through cultural approach and local wisdom that differs from one region to another, such as the one applied in Bali Province. The purpose of the study was to explore Bali’s experience in dealing with COVID-19 from the perspective of culture and local wisdom. A qualitative approach was used in this study using in-depth interviews with the Bali Provincial Disaster Control Office (Badan Penanggulangan Bencana Daerah, BPBD) and the Bali Provincial Health Office. Results of this study showed that the Bali Province has a strong religious approach, consisting of hupokara, which is the faith in the Creator as disaster is believed to be a tremendous force that has to be managed through a ceremony called niskala, which giving offerings to God for health and safety of the people of Bali Province. The Balinese believe that the COVID-19 virus can be controlled with rituals and offerings. The presence of Pecalang as a traditional security unit looked up to and obeyed by the Balinese people also supports the successful management of COVID-19. The unique approach of Bali Province that is based on the local wisdom through mobilizing Traditional Villages, promoting custom-based cooperation through the formation of a task force at the Traditional Village level, and with good leadership from the Governor of Bali has led to successful COVID-19 control in Bali Province. Bali has learned from the COVID-19 pandemic that togetherness and mutual cooperation among people are needed to prevent the spread of COVID-19 in the province.


INTRODUCTION
The WHO China Country Office reported pneumonia with no etiology in Wuhan City, Hubei Province, China, on December 31 st , 2019. On January 7 th , 2020, the case was reported as caused by a type of coronavirus  which the WHO then declared as a Public Health Emergency of International Concern (PHEIC) on January 30th, 2020 and as a global pandemic on March 11 th , 2020. Indonesia is also facing the problem of a high number of COVID-19 cases with a high mortality rate. The country reached the highest mortality rate of 9.11% on April 4 th , 2020, which was decreased slightly to 7.5% on May 4 th , 2020. Despite this decrease, the country's mortality rate is still higher than the global death rate of 5.7%. Currently, Indonesia is positioned as one of the three countries with the highest mortality rate from COVID-19 globally. The Government of Indonesia has declared the COVID-19 pandemic as a national disaster through the issuance of Presidential Decree Number 12 of 2020 on Declaration of a Non-Natural Disaster in the Form of Corona Virus Disease 2019 . In addition, the Indonesian COVID-19 Response Acceleration Task Force was established around that period that underpins the synergy between ministries/agencies and local governments. Regardless, the number of people infected with COVID-19 continues to grow. As of May 5 th , 2020, data showed 12 071 people positive for COVID-19, with 872 died. In terms of the geographical spread of the disease, all 34 provinces in Indonesia have reported COVID-19 cases in their area.
To support the acceleration of the COVID-19 response at the community level, Task Forces at the RW (community association)/RT (neighborhood)/village levels are established. The COVID-19 Village Task Force has the main task of preventing the spread of COVID-19 through applying physical and social distancing, educating people on clean and healthy lifestyle, and monitoring the mobility of people entering their area. The COVID-19 Village Task Force collaborates with the primary health care facilities (Pusat Kesehatan Masyarakat, Puskesmas) to prevent the transmission of COVID-19 among local people. Many villages have implemented measures to avoid COVID-19 transmission. For example, Pengauban Village in Garut District has provided handwashing facilities and soaps at several points and disinfectant spraying at several points. Other villages, RT, and RW also demonstrate good initiatives such as preparing people's houses, schools, village halls, and other places in the village/urban village as places for independent isolation of those contracted with this disease to prevent further spread. This reflects very good cooperation, which is one of the nature of the Indonesian people. The spirit of community-based cooperation, or gotong royong in Indonesian, may be used as the basis for actions at the grassroots to support the government in preventing transmission starting from the community at the village level. This unique positive is very beneficial for Indonesia in breaking the chain of transmission of COVID-19 and the medical treatment efforts (hospitalbased). Research is ongoing to study a native Indonesian herbal remedy known as 'empon-empon', which consists of turmeric, ginger, and lemongrass, which is believed to be able to prevent COVID-19. This proves that the Indonesian people have a positive belief that local potentials can be utilized to prevent COVID-19.
Of the many provinces in Indonesia, Bali Province is considered to be the province that is most prepared to face the COVID-19 pandemic. This level of preparedness stems from Bali's experience in dealing with a series of natural and non-natural disasters in the past. This is also supported by good leadership from the Governor of Bali and the cohesiveness of all levels of government at the lower level. In addition, the local wisdom that is highly respected, maintained, and implemented by the Balinese has also strengthened their effort to prevent the transmission of COVID-19 (Lestari et al., 2020). The purpose of this study was to document the experience of the Bali Provincial Government in dealing with the COVID-19 outbreak from the perspective of leadership, socio-cultural aspect, and local wisdom aspect. The study results can be used as a reference for other provinces in Indonesia in dealing with COVID-19.

Location and Time
This study was conducted in Bali Province in March 2020. Bali Province was selected as the site of the study because this province is considered to be the province that is most prepared to deal with the COVID-19 pandemic. This preparedness stems from Bali's experience in dealing with previous natural and non-natural disasters.

Data Collection and Analysis Method
Since this study sought to observe the human elements to understand an event of the phenomenon more in-depth, the qualitative design was chosen (Creswell, 2007;Srivastava and Thomson, 2009). The primary data collection was carried out using in-depth interviews in March 2020 with two informants from Bali Provincial Disaster Control Board (Badan Penanggulangan Bencana Daerah, BPBD) and Bali Provincial Health Office. Transcripts of the interviews were then retrieved from the recording and analyzed using content analysis. Matrix was then developed, containing information on all components of the question. Secondary data on Bali Province were also collected to support the findings of the in-depth interview data.

COVID-19 Control
Bali Province has a total area of 5 780.06 km 2 with a population of 4 336 900 in 2019. In addition to the Bali Island, this province also includes smaller islands surrounding the Bali Island, i.e. Nusa Penida, Nusa Lembongan. Nusa Ceningan, Serangan, and Menjangan Islands. In addition to the tourism sector, the livelihood of the Balinese people also includes fisheries and agriculture. They use a globally known unique irrigation system referred to as Subak.
The adage "experience is the best teacher" is strongly believed by the Bali Provincial Government. Natural disasters that follow one after another on this island of Gods have made Balinese people resilient and always maintain optimism. Not surprisingly, at the beginning of the COVID-19 pandemic, the Bali Provincial Government received appreciation from the President of the Republic of Indonesia, Ir. Joko Widodo, and the Head of the Indonesian COVID-19 Response Acceleration Task Force, Lt. Gen. Doni Monardo, as the best province in COVID-19 control.
One example that reflects the preparedness of the Bali Provincial Government in dealing with COVID-19 is the formulation of the Operational Plan (OP) after they heard about the first positive case of COVID-19 in Depok City in early March 2020. A Focused Group Discussion (FGD) was conducted to prepare these operational plans for COVID-19 control long before the disease was spread in the province. Previously, the Bali Provincial BPBD has had experience formulating and implementing operational plans and contingency plans for all disaster events in Bali, such as earthquakes, volcanic eruptions, and SARS outbreaks.
Bali province has prepared for COVID-19 since January 2020, although no positive cases were identified yet. This was because they realized that the most significant number of foreign tourists in Bali came from China. The Bali Provincial Health Office coordinated with the Bali BPBD to develop scenarios on what steps must be taken if the COVID-19 disease entered Bali Province and determine which health facilities would be used as referral sites, etc.
Health protocol was implemented in each district/city under the supervision of the district/city Task Force. The screening was also performed to find new cases, followed by tracing a positive case. A high number of cases in a cluster were subjected to lockdown by the traditional village task force to break the transmission chains. The Traditional Village-based Task Force was established based on cooperation at the grassroots, and this task force is the spearhead of the control initiative at the village level. At that time, there was an appeal from the Governor of Bali to all regional regents in Bali Province to donate five cloth masks to all Balinese people through the Traditional Village. Since then, regulations have been issued for the mandatory use of masks based on the Tatwamasi philosophy. Tatwamasi means that "I am you, you are me". The meaning implied in using this philosophy to urge wearing mask was "that when you and I use masks, I protect you, and you protect me from exposure to COVID-19".
Bali province also has restricted activities long before the implementation of the large-scale social restriction (known as PSBB in Indonesia) was implemented by other provinces in Indonesia through Community Activity Restriction activities such as postponing social religious activities, public transportation, Work from Home (WFH), 'learning from home' and closing tourism access. Bali does not use the term adaptation to new habits (new normal).
Bali does not implement PSBB because Bali still needs to collaborate with other provinces and they feel that the situation in the community is currently under control. However, Bali has actually implemented PSBB without actually calls it PSBB long before the PSBB is implemented in Indonesia. The Balinese people also used a spiritual approach to deal with COVID-19 by holding a joint prayer activity on July 9 th , 2020.
July 5 th , 2020 is the holy day of the full moon, where Hindus in Bali will pray at temples, and Balinese from other religions pray in their respective places of worship. Bali will begin to open up in several sectors other than tourism and education, starting with the issuance of protocols in the field of public transportation for both transportation users and transportation service providers, as well as protocols for modern shops and traditional markets for users and service providers. The education sector and tourism sector are still closed to avoid the high risk of COVID-19 transmission.

Leadership in Crisis
Bali Province has advantages compared to other provinces in terms of controlling COVID-19 spread. As previously mentioned, the Bali Provincial Task Force started activities earlier than the National Task Force because the Bali BPBD had started activities at their post on March 10 th , 2020. The establishment of the Bali Task Force is based on the Governor's Decree Number: 236/03-B/HK2020 chaired by the Secretary of the Bali Province. Since March 29 th , 2020, an affirmation has been received from the National Task Force through a Minister of Home Affairs Decree for the uniform nomenclature of the term task force throughout Indonesia, down to the grassroots level, with the words "Task Force". Heads of sub-national governments, such as governors, regents, and mayors, become the chair of the task force, assisted by deputy chairmen, including the executive chairman. The Bali Provincial COVID-19 Response Acceleration Task Force plays three roles: command, coordinating, and executor.
Bali Province BPBD has the function of embracing, accommodating, and synergizing all components in the region to accelerate the response to COVID-19. There are 5 (five) main elements in the Bali Provincial COVID-19 Response Acceleration Task Force: the Indonesian Armed Force (TNI), BPBD, Health Officer, and Communications and Information Office. The synergy between the TNI, Indonesian National Police, and Civil Police (Satpol PP) is established to strengthen the law enforcement sector. The Bali Provincial Health Office is in charge of the public health sector of the COVID-19 control, and Bali Provincial Communications and Information Office controls the data, information center, and general communications. Meanwhile, Bali Provincial Transportation Office regulates the entry and exit of air and sea transportations. It is obvious that these efforts are inseparable from the support of other elements, such as the community, private sector, universities, and the media, as depicted in a well-known concept of the Penta helix.
Leadership in dealing with a crisis or disaster is referred to as crisis leadership, defined as a form of leadership character that is effectively applied in an emergency or disaster situation (Utomo and Margaretha, 2020). In Bali, all activities during crises are under the command of the Governor of Bali. The government of Bali Province has issued 54 policy products until this article was written. These include Governor and Provincial Secretary Circulars, Decision of the Governor, Governor Appeal, Joint Decrees, Governor Instructions, Notices from Governors, Joint Appeals, Health Protocol documents, and the Minutes of Meeting. Also related to the National Task Force Circular No. 7 of 2020 on travel restrictions for domestic travel of people with negative COVID-19 rapid test results, Bali has slightly different requirements in terms of travel. These policies continue to grow and change from time to time.
The success of Bali marks the Bali Provincial Government's preparedness as the only province among 34 provinces in the country that owns and has set a special day for commemorating disaster alertness or disaster alert day. The 26 th of each month is assigned as the Local Preparedness Day. The purpose of establishing the National Preparedness Day is to train and invite all components, all stakeholders in Bali, especially the people and residents of Bali, to be prepared in facing disasters. The most obvious implementation is a simulation event that is carried out periodically that simulates things to do in a natural disaster. They routinely do the simulation every month. This activity also involved the pedanda, which is the name for a highly respected Hindu priest, and under the supervision of the pecalang, the traditional Balinese police figure who is tasked with maintaining order and security.

Religious Ceremonies and Local Wisdom
Bali Province has a unique special/specific approach in preventing the spread of the COVID-19 pandemic. This approach is based on a fairly strong religious approach. Starting from the field of hupokara that emphasizes the relationship with the Creator because one of the strengths or basic beliefs of Hinduism is that disasters are extraordinary powers. The many temples in Bali are used for doing religious rituals. Usually, in religious activities, the Governor of Bali personally goes to the rituals accompanied by the Head of Bali Provincial Health Office and the Head of Bali BPBD. Figure 1 Niskala is also performed by doing sacred rituals (kabar bisnis, 2020) There is also niskala ceremony (Figure 1), which is praying by giving offerings for the safety and health of the people of Bali Province. The religious, spiritual approach that is also performed to deal with COVID-19 is Trihita Karana, to create a harmonious relationship between the three forces: the Creator, humans/living beings in the universe, and the world surrounding humans. The concept of Trihita Karana is harmony. According to Hindu community, the COVID-19 virus is an invisible figure, but it is believed that by giving upakara, or offerings, called Caru, the COVID-19 virus will be harmoniously returned to their respective functions, namely the good and the bad side, the positive and negative side.
In 9 directions of the compass at the temple, religious ceremonies are carried out together through offerings, traditions, and offerings by bringing in pedanda (religious leaders). Religious ritual ceremonies are carried out at the top of Mount Agung while carrying holy water for the rituals with prayer readings and upakara. Then, the holy water is brought back to Denpasar to be distributed to all patients treated at the Referral Hospital, migrant workers/ship crews undergoing integrated quarantine in the district/city, and all people who have just returned from overseas trips.
In addition, there are traditional villages which are customary law governed units at the lowest level. At this moment, there are 1 493 traditional villages and 746 service villages. The traditional village-based task force is formed down to the neighborhood/banjar level. Each traditional village consists of 3 until 6 neighborhoods/Banjar. Before the COVID-19 case was identified in Bali, the Bali Provincial Government has performed early anticipation through the rapid test on 4 800 ship crews and migrant workers, assisted by the Traditional Village Task Force. Even though the results were all negative, these crews and workers still had to self-isolate themselves in their respective homes under close supervision of pecalang or the traditional village security officers. Pecalang's task is to coordinate people on a regional basis, including collecting data on travel history and reporting people with a history of traveling abroad and outside the Bali area who experience complaints or clinical symptoms of COVID-19. Each Traditional Village has one unit ambulance that will take people with COVID-19 complaints or other disease symptoms to the referral hospital. The synergy between the Lurah (official head of village) and the Bendesa (the term for the traditional village leader) is evidenced by the division of tasks complementary between the two at the community level. The Lurah takes care of government administration, while the Bendesa takes care of customs, traditions, and religious affairs. The very interesting thing is that they can co-exist in society.
The Bali Provincial Government plans to distribute a village fund budget (ADD) or BKK/Special Financial Aid of 350 million per traditional village. In the traditional village, there are essential figures such as community leaders and religious leaders from all religious groups who join the religious harmony forums, starting from the provincial level down to the village level meant that the provincial level is down to the lower level. In Bali, there are 26 associations for people coming from other areas, such as Flobamora for people from East Nusatenggara, associations for Maluku, Minang, and Sunda ethnics, and 10 IKAT (Toraja Family Association).
Bali has a diverse population which is multiethnics, multireligious, and multicultural. However, they have one thing in common, which is they all live in Bali. With their efforts to empower local wisdom-based communities as mentioned above, it is sensible that the Province of Bali receives appreciation from the President of the Republic of Indonesia for their efforts in controlling COVID-19 as well as the appreciation from the Head of the Indonesian COVID-19 Response Acceleration Task Force, as already mentioned at the beginning of this article. However, until now, the crisis continues as the number of COVID-19 cases in Bali continues to increase.
On June 12 th , 2020, there were 33 additional cases, which is the highest number of new cases found in one day since the emergence of the first positive case. Compared to other provinces that have hundreds of new topics in one day, the increase in the number of cases in Bali Province is relatively tiny. However, efforts are still being made to prevent further increases in positive cases. One of them is by commemorating the Day of Preparedness, as stated earlier, related to disasters that often occur. On June 12 th , 2020, there were 33 additional cases, which is the highest case since the emergence of the first positive case. Compared to other provinces, which already number in the hundreds, Bali Province is relatively small because the number is still in the tens. But, they still performed preparedness efforts to prevent enhancing the positive cases. One of them is by setting a Preparedness Day for frequent disasters. As mentioned earlier, Bali Province has benefitted from the use of local wisdom, mobilization of traditional villages, and custom-based cooperation in the form of a task force at the traditional village level for controlling the spread of COVID-19.
Local wisdom and local culture can be used to establish efforts to prevent and overcome COVID-19 (Nugraha, 2020). Local wisdom is a part of the community's culture passed down from generation to generation through word of mouth. The noble values contained in local wisdom apply in people's lives. The goal is to protect and manage the environment sustainably for people's lives to be well maintained. Local wisdom is very important because it has the principle of togetherness to run the wheels of life in society in a good manner. The application of local wisdom can train people to recognize and respect the environment (Supriyatno, 2020;Yasa, 2019).
Diseases are often caused by human culture (way of life), or at least disease can easily create an epidemic because certain cultures in the society facilitate it. Diseases have a tremendous impact on aspects of human culture so that disease control must be performed using socio-cultural approaches. Socio-cultural aspects play an important role in establishing strategies to prevent the COVID-19 pandemic from the perspective of the community, such as in the application of social and physical distancing, Large-Scale Social Restriction (PSBB), local quarantine, and other various aspects related to the socio-culture. Culture contains noble values and beliefs that guide the behavior and become the basis for solving problems between generations. These values confirm cultural alignments with environmental sustainability and also with sustainable development. The concept of Tri Hita Karana is taught in Balinese culture, emphasizing the existence of three harmonious relationships that will create human happiness. The three relationships are Palemahan, Parahyangan, and Pawongan. The holy temple (Pura) that represent God is a Parahyangan. The unit in the traditional community as the elements of human relationships with each other represents Pawongan. Palemahan is in the form of a certain unit or area as an embodiment of the elements of the universe or the environment. Basically, humans have 4 environmental, cultural attitudes: maintaining, repairing, destroying, and ignoring. Traditional culture includes the culture of improving the environment and maintaining it. The human cultural model will affect the behavioral responses to the environment (Lupiyanto, 2020). The character of the Balinese, who usually lives in mutual cooperation, always lives together in the community, and always obeys the pecalang as the traditional security unit and also the traditional village leaders is the key in dealing with the COVID-19 pandemic (Azzani et al., 2020).
Furthermore, the leadership of the Governor of Bali Province in COVID-19 pandemic control also determines its success. The aspects of leadership that combine initiatives and collaborations have become the dominant pattern of the Governor's leadership. The initiatives mean looking for new ways and breakthroughs to deal with the problem. The collaboration includes efforts to look for resources that can fill in the gap in the limited resources from the national government. The role of traditional villages in Bali Province is also quite effective in implementing social restriction policies in the community (Permana, 2020). Various breakthroughs made by the Governor of Bali Province include establishing the Gotong Royong Task Force at the traditional village level, issuing 54 policies, et cetera. The policy is a product of leadership that can be seen from the measurable results (Bali Post, 2020). Strategic leadership owned by the Governor of Bali is applied through multiple policies, including establishing Bali Provincial COVID-19 Response Acceleration Task Force, domestic travel restrictions, etc (Wibowo and Maria, 2021).

CONCLUSION
In principle, it appears that the leadership strategy as well as the local wisdom are the important keys in Bali Province in dealing with the COVID-19 pandemic. The Bali Provincial Government continues to seek innovative and progressive strategies. Until now, the provincial government still refers to the three indicators of the success in handling COVID-19. First, suppress the increase in the number of positive cases. Second, increasing the number of patients who recover from the disease reduces the mortality rate.
The leadership character presented by the Governor and Deputy Governor of Bali in dealing with the crisis can become an example. It shows the ability to understand developing issues and quick response to the ongoing situation. Another characteristic of leadership demonstrated in Bali Province when dealing with crises is making the right decisions in difficult and stressful situations and trying to find solutions. From this COVID-19 pandemic, Bali learns that togetherness and cooperation among the Balinese people are important to overcome the spread of the COVID-19 disease.