Indonesia Struggles to Care For Mentally Ill

Jakarta Globe, Ahmad Pathoni, February 10, 2010

A patient named Totok at the Galuh foundation compound in East Bekasi, a home for underprivileged people with mental health disorders. (Reuters/Beawiharta)

Siti Maemunah says her son has been delusional for more than seven years, often talking to himself and sometimes becoming angry for no apparent reason.

But instead of taking him to a psychiatric hospital, she consulted a traditional healer, or dukun in Indonesian, who advised her that the 36-year-old Agus was a victim of black magic.

“I don’t know if people with illness like his can be cured. I just hope that he doesn’t attack people and destroy things,” she said.

Maemunah, 57, is not alone in her ignorance of mental health problems.

Belief in black magic is widespread in Indonesia, and people often take family members who are mentally ill to those who are believed to be able heal patients through magical powers, experts said.

In many cases mentally ill people are restrained for years in shackles, or stocks, in a practice known locally as pasung.

Basic mental health services are not available in many parts of the world’s fourth most populous nation, leaving many mentally ill people without access to treatment, experts and officials said.

“In a country of 230 million people, there are no more than 700 psychiatrists, half of them working on Java island, including about 200 in Jakarta,” said Prijanto Djatmiko, head of the Jakarta branch of the Indonesian Psychiatric Association.

According to a 2007 Health Ministry survey, 4.6 per cent of Indonesians suffered serious mental disorders, including schizophrenia.

The plight of mentally ill in Indonesia came into the spotlight in 2003 when the US news magazine Time published photographs showing patients in a mental institution being chained and held in terrible conditions.

A restructuring plan at the Health Ministry that may see the disbanding of a directorate in charge of mental health has sparked fears that mental health care is being further sidelined.

“If that happens, we expect cases of mental problems such as depression and suicide will increase because we don’t have a system to address these,” said Pandu Setiawan, chairman of the Mental Health Communication Network, a non-governmental organization.

Health Minister Endang Rahayu Sedyaningsih insisted that the ministry was not putting mental health care on the back burner.

“We are in the process of restructuring but we have not made a decision on what to do with the directorate,” she told parliament last month. “We are open to suggestions.”

She said there was a plan to set up a centre within the ministry to deal with mental health and substance abuse.

Sedyaningsih said community health clinics, known as puskesmas, and public hospitals were ill-equipped to handle patients with mental health problems.

“Very few puskesmas have psychologists or psychiatrists. Even in hospitals, psychiatrists only work in provincial capitals,” Sedyaningsih said.

She said a total of 48 psychiatric hospitals in a far-flung archipelago comprising 33 provinces was simply not enough. “In some communities, mentally ill people are confined and restrained,” she said.

According to the World Health Organisation’s Mental Health Atlas published in 2005, Indonesia’s ratio of psychiatric beds per 10,000 people was 0.4 while the number of psychiatrists per 100,000 people was 0.21.

A paper last year by the Advocacy and Human Rights Working Group of the National Taskforce for Mental Health System Development in Indonesia said hospitals and clinics did not prioritize mental health care, and the skills of clinicians were inadequate to detect illness and treat patients.

It also said the quality of mental health services in hospitals was generally poor and human rights protection for patients was weak.

“Custodial treatments dominate in psychiatric hospitals. Involuntary treatment is common, even though there is no legal basis for involuntary admission,” the paper said.

But at the state-run Soeharto Heerdjan psychiatric hospital in Jakarta, there are no such images.

Patients can be seen sitting in the hallway, chatting with each other; the wards are clean and the lawns well-manicured.

Muhammad Reza Syah, the hospital’s head of medical services, said the quality of health care had improved markedly over the past few years and patients were being treated humanely.

“This hospital used to be known as a place for crazy people. But there’s been a lot of progress in therapy techniques,” he said.

“With the shift in paradigm, we try to make sure patients don’t stay here too long. As a result, more people are served as outpatients,” he said.

Of the hospital’s 300 beds, only 200 were occupied, Reza Syah said.

But despite the needs, mental health programmes still do not receive the budgets they need. With only 1 per cent of the total health budget going to mental health, the sector is to receive about 22 million dollars this year.

Djatmiko of the Jakarta Psychiatric Association acknowledged that the government was not treating mental health as a priority.

“Research is scarce because of the lack of political will,” he said. “It’s partly because the government is preoccupied with other health issues such as malnutrition, TB, HIV/AIDS and other communicable diseases.”

DPA

Woman, 62, Arrested At Medan Airport For Allegedly Carrying Drugs in Her Handbag

Jakarta Globe, February 10, 2010

Customs officers at Polonia Airport in Medan, North Sumatra, arrested a 62-year-old woman on Tuesday night for allegedly carrying 400 grams of methamphetamines in small plastic bags wrapped in underwear and tissues in her handbag.

The woman, identified as Aceh resident Sapura Idris, was arrested at 10 p.m. after disembarking from a Sriwijaya Air flight from Penang, Malaysia, said the head of the airport’s customs office, Budi Santoso.

The woman caught officers’ attention because she looked nervous when exiting the international airport, he said. They approached her and when they checked her luggage, they allegedly found the drugs.

Sapura said the drugs belonged to another passenger on the plane who asked her to carry them in exchange for Rp 1.4 million ($150).

“It was given to me by a young man in his 30’s. He said somebody would meet me at the airport but I was arrested instead,” Sapura told TV One.

Polonia Customs Office have handed over the case to North Sumatra Police for further investigation.

Life sought for tourist killer

Ni Komang Erviani, The Jakarta Post, Denpasar | Wed, 02/10/2010 10:15 AM | Bali

Prosecutors are seeking a lifetime sentence for the sole defendant in the murder of Japanese tourist Rika Sano during a session at the Denpasar District Court on Monday.

The prosecutors demanded that the panel of judges hand down life imprisonment to David Goltar Wicaksono, 26, who allegedly murdered, raped and violently robbed the 33-year-old woman on Sept. 25, 2009.

“The defendant has intentionally murdered the victim and committed theft with violence and threats,” prosecutor Made Ayu Citra Maya Sari said before the judges.

The defendant was proven to have violated Criminal Code Article 339 on murder, Article 365 on violent theft and Article 285 on rape, the prosecutor said during the session presided over by judge Dewa Putu Wenten.

The prosecutors said David had also violated Article 289 of the Criminal Code for sexual harassing the victim’s friend, Mayumi Someya.

Pretending to be a police officer, the defendant approached Mayumi, who was riding on a motorcycle on Jl. Pantai Kuta with her boyfriend.

As Mayumi ignored him, David stalked her to Prani Hotel, where the woman was staying with Rika.

The bogus officer told Mayumi that he was investigating a drug trafficking case and asked her to go with him.

David then brought Mayumi to a bush around Jl. Dewi Sri in Kuta and sexually abused the victim, but she managed to escape.

The defendant later returned to the hotel to pick up Rika, once again pretending to be a police officer investigating a drug case.

He brought Rika around Kuta on his motorcycle and stopped at a vacant area near the Kampung Bali souvenir shop, where he raped and killed her.

Rika’s dead body was found there three days later.

After killing Rika, David returned to the hotel room and stole the victim’s cash and valuables, including ¥80,000, US$20 and Rp 200,000, a digital music player, a cellular phone and a suitcase.

The autopsy showed that the victim was hit by a blunt object that had broken her bones.

The victim sustained 30 wounds, including to her vital organs, and suffered from blood loss in her brain.

David was arrested by the police on Oct. 2, 2009, after escaping to his hometown Malang, East Java.

In response to the prosecution, David’s lawyer Nengah Jimat said his client would not file an objection.

The next session, to be held on Feb. 15, will hear witness testimonies.

Female drug users suffer double discrimination

The Jakarta Post, Inga Ting, Contributor, Jakarta, Wed, 02/10/2010 12:28 PM

Mum and daughter: Naomi and Esta stand in the street in South Jakarta, waiting for a bus to go home in Bekasi. JP/Moch. N. Kurniawan

Audio slide show: Former drug user Naomi

Naomi Esteria was 20 when she took her first hit of heroin. She is the first to admit that she spared no thought for her two-year-old daughter, Esta, or her one-year-old son, Bardonovo.

“I didn’t think about the consequences at all; I didn’t think there was any reason too,” she says. “I had no idea what heroin was or that it was addictive.”

Naomi, now 35, spent the next 12 years in the grip of an addiction that saw drug dealers share her bed more often than her two children. Even though she has been clean for two years now, she still doesn’t fully understand what motivated her behavior.

“It’s difficult to tell if you love the drugs or the person. Maybe both,” she says simply.

For the time being, Naomi’s goals are relatively simple. “I don’t know about my aspirations or hopes, but my greatest achievement is quitting drugs. It was the hardest thing I’ve ever had to do,” she says.

“It taught me that life goes on, even after addiction, and that I don’t need any idols or heroes. I am a strong woman.”

For women injecting drug users (IDUs), far more so than their male counterparts, the distinction between addiction, sex and survival are overlapping and imprecise.

“Sometimes you have to sell sex to get the drugs; sometimes you have to date the dealer,” says Sekar Wulan Sari, director of the Stigma Foundation, a community-based organization for drug users and former users. Wulan is herself a former heroin addict.

“And sometimes, as a woman, you have to stand up for your man to get the drugs.”

When asked what that means, Wulan shrugs.

“When two people love each other but there are drugs involved, often we find it is the woman who is more willing to sacrifice everything.”

While it is clear that transforming the situation for women IDUs will require thorough social, economic and legal reform, Wulan believes the priority is providing an alternative ideology to the patriarchal culture of Indonesian society.

According to UNAIDS statistics, only 10 percent of the four million recorded IDUs across East and Southeast Asia are women. Researchers, however, voice serious doubts about the accuracy of such figures. Many believe that women make up around half the IDU population in Indonesia, even though only 10 percent of the IDUs accessing hospital and clean needle services are women.

As such, much of the discussion around helping women IDUs revolves around how to reach out to an invisible population forced into hiding by severe stigma and discrimination.

Sorrow view: Former drug user Naomi Esteria Tobing and her daughter Esta Melia Suniya Anthony in a public van in Jakarta. Female IDUs are discriminated against on several fronts. JP/Moch. N. Kurniawan

“The internalization of the shame forced onto them pushes women further underground and makes them even less likely to seek assistance… In the end, women and girls suffer worse consequences compared to their male counterparts because of their substance dependence,” according to Pascal Tanguay, an information officer at the Asian Harm Reduction Network (AHRN).

Research from the AHRN, UN AIDS and the Stigma Foundation has found that women IDUs suffer more not only because of the wider social disadvantages affecting women, but also because women are still expected to fulfill “traditional” roles that cannot accommodate the reality of poverty, substance abuse and disadvantage. Patriarchal culture, which is particularly dominant in Asia, underpins an almost hysterical intolerance of women’s drug use.

“Many families are so ashamed that they would rather keep the woman IDU at home, hidden from the public, than allow her to come to the hospital,” says Ratna Mardiati, a former director of the Drug Dependence Hospital (RSKO) in East Jakarta.

The subordinate position of women in the home also hampers women’s efforts to seek medical treatment for substance abuse.

“The women [at the Drug Dependence Hospital] always have a reason for being late or for not coming at all. Firstly, they have to finish their work in the home, doing things for their children and their husband,” Ratna says.

“Or, secondly, they have no money because the man or the husband has the power and gives them their money. Even when the woman is earning money, the money will be kept by the man. Most of the relationships we see are like that.

“This means that if the husband has not given them permission to seek help, then they cannot come to hospital.”

To make matters worse, the stigma is also common among doctors, many of whom shy away from offering assistance or services to women IDUs, according Ratna.

“I don’t know if it’s that they’re not familiar with drug abuse or that they avoid providing care for these people. Maybe they judge them,” she says.

The story is much the same in the legal profession, according to Ricky Gunawan, program director at the Jakarta Community Legal Aid Institute. “Among lawyers, there is an image of drug users as a demon, as evil, so many lawyers explicitly say they don’t want to advocate for drug users,” he says.

“And I’m not just talking about commercial lawyers. Very few lawyers working for legal aid provide services for drug users.”

The discrimination and abuse faced by women IDUs is perhaps at its ugliest in the deserted back alleys of Jakarta’s slums or behind the closed blinds of a dirty police station.

Fighting drugs: Naomi works at the Stigma Foundation office in Jakarta. JP/Moch. N. Kurniawan

“Through our work of the past one or two years, we’ve found so many cases of women IDUs who, when they were arrested or detained by police, were forced to have sexual intercourse in order to be released,” says Ricky.

Ricky and other experts believe the vast majority of women IDUs have some experience of sexual violence or abuse by police.

“When we conducted a visit to the women’s correctional facility in Tangerang, we found that all our respondents were forced to have sexual relations with police or to strip naked and stand in the street to have their bodies ‘searched’ by police.”

Police bribery, extortion and intimidation of IDUs are “standard practice”, according to lawyers and researchers. Torture of IDUs is also alarmingly commonplace, with women IDUs typically subjected to sexual torture, says Ricky.

Such was the case for Merry Christina, who in 2004 was caught injecting heroin with her boyfriend in South Jakarta. While her boyfriend was beaten and tortured in a separate room, Merry was blindfolded and gang-raped by police over five terrifying days. The pair was eventually released without charge.

Merry’s tale is not exceptional, says Ricky. He has also heard many tales of police failing to honor their side of the “deal”, even after the victim has acquiesced.

“Often the police say they’ll make the prosecution process quicker if you give them what they want…

You pay and you pay and you expect a lighter punishment, but in the end you find out it’s bulls**t. It’s all lies.”

“My goal is to increase awareness among women that they are not weak and do not need to be dominated by men,” she says.

The feminization of the HIV epidemic

The Jakarta Post, Feb, 10th 2010 12:42 PM

JP/Moch. N. Kurniawan

The overlap between injecting drug use and sex work is a driving force in the so-called “feminization” of Asia’s HIV/AIDS epidemic.

Between 70 and 80 percent of women injecting drug users (IDUs) are involved in some kind of sex work, according to Ratna Mardiati, a former director of the Drug Dependence Hospital (RSKO) in East Jakarta with 14 years’ experience dealing with injecting drug users.

“They are not formal sex workers but they sell their bodies when they need money,” she says.

Other sources of structural inequality, such as the gender wage gap — which sees Indonesian women earning on average 75 percent of what their male counterparts earn, according to the International Labor Organization — and health insurance policies that force women to depend on their husbands for medical cover, effectively trap women in unhappy or destructive relationships.

“That is why most [women IDUs] cannot bring themselves to make a choice,” Ratna says. “They are dependent on people — on partners, firstly, and then anyone who can give them money, shelter, and whatever else they need.”

Although there is a conspicuous lack of data due to gross under-reporting, it is widely believed that sexual and other forms of abuse are common in relationships that involve drug dependence in one or both partners. In many cases, such abuse involves the male IDU selling the woman’s body for drugs or money.

Economic disadvantage combined with the social stigma also means women IDUs tend to be dependent on their partners for drugs and needles.

“It’s not good for the woman to be seen buying drugs; it’s better that she stays at home,” says Sekar Wulan Sari, director of the Stigma Foundation, a community-based organization for drug users and former users.

“The exception is when finances are stretched or supply is low. Then the responsibility shifts to the woman, probably because she can get drugs more easily by selling sex.”

However, as Asmin Fransiska — a lecturer in law and human rights at Atma Jaya University and co-founder of the Indonesian Coalition for Drug Policy Reform — points out, the problems faced by women IDUs are inseparable from the wider issue of discrimination against women. It is extremely difficult, for example, to defend the sexual rights of women IDUs in a society that in many corners still denies the existence of marital rape, she says.

“There are laws against domestic violence but… if you are the wife and you say that you are being raped by the husband, society will think: ‘What? It’s your duty to serve your body to your husband.’

You cannot just say no. It’s taboo to say no to the husband,” Asmin says.

According to researchers and health workers, this makes women IDUs exponentially more vulnerable to infection by HIV and AIDS because they are far more likely to share both drugs and injecting equipment.

“Mostly, if the woman IDU has a partner who is also a drug user, she is treated as a second class person… Even when she is the one who gets the drugs, she will give the drugs to him and he will use first. This is partly why HIV rates among women are rising – because usually, if the male IDU partner has HIV, the woman will have it too,” Asmin says.

Furthermore, given the intersection between injecting drug use, sexual violence and sex work, women IDUs are not often in a position where they can negotiate for safer sex.

Finally, compounding the economic and social factors is women’s biological susceptibility to HIV infection. According to UNAIDS, women are almost twice as likely as men to acquire HIV from an infected partner during unprotected heterosexual intercourse.

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Endemic Leprosy in Subang

Tempo Interactive, Tuesday, 09 February, 2010 | 18:10 WIB

TEMPO Interactive, Subang: The Subang Health Office has announced that leprosy is now endemic in the area, with patients spread in all sub-districts. “The scale is one per 10.000,” Wawan Setiawan, Subang Health Office chief, told Tempo yesterday.

In Subang’s 35 sub-districts, most of the patients are found in Binong, Tambakdahan, Patokbeusi, Purwadadi, Compreng and Ciasem. Around 130 patients are suffering from the MB type of leprosy and 105 people are suffering from the PB type. “To anticipate more spreading, we have formed a “Leprosy Care” in all areas,” Wawan said.

NANANG SUTISNA

Proposal Would Strip Jakarta Smokers of Free Health Care

Jakarta Globe, Arientha Primanita, February 09, 2010

People on the city's free health plan should stop jeopardizing their health by smoking, city officials said. (EPA Photo/Jurnasyanto Sukarno)

Governor Fauzi Bowo on Tuesday announced a new proposal that would restrict the access of smokers to the city’s free health care program for low-income residents.

“How can they enjoy the free health care scheme when they know that smoking can cost them their health? That is just not fair,” he said.

Fauzi said deliberations were under way on a possible new city regulation that would alter the terms of the Gakin program, which provides free health care for less fortunate families across the capital.

He said the issuance of the SKTM, a letter normally issued by community leaders to confirm the low-income status of residents, could also be revised.

According to city records, more than 164,000 low-income households across Jakarta have a Gakin card, while an additional 50,000 households have SKTM letters.

Quoting data collected by city officials, Fauzi said that almost a quarter of the average low-income worker’s income was spent on cigarettes.

“When Gakin cardholders smoke, 22 percent of their income goes up in smoke,” the governor said, adding that the number of women and young people taking up smoking was increasing annually across the capital.

Fauzi said he was determined to tackle this problem head on.

“I am not eliminating the Gakin scheme; I just do not want to give free health care to smokers,” he said.

Dien Emawati, who heads the Jakarta Health Agency, said on Tuesday that the city administration’s plan would stress that Gakin cardholders and residents with SKTM letters were not allowed to smoke.

That message, she said, would be formally publicized and strictly implemented across state hospitals, clinics, subdistricts and urban wards.

“We guarantee free health care for the poor, but they need to give up smoking and stop jeopardizing their health,” she said. “If there is even one person who smokes in a family, the entire household is affected.”

Dien said deliberations over a gubernatorial decree to restrict the Gakin card and SKTM letters to nonsmokers were already under way, with talk of “trained field officials” being tasked with checking the teeth and mouths of those claiming low-income status to determine whether or not they were smokers.

Dien said discussions would cover a number of issues, including whether medical services would be immediately stopped for active smokers suffering from lung-related illnesses.

A large number of low-income residents, she said, already suffer from lung diseases such as pneumonia and acute respiratory infections.

Husna Zahir, chairwoman of the Indonesian Consumers Foundation (YLKI), told the Jakarta Globe that her organization agreed in principle with the city administration’s proposal and would support its implementation if it were passed.

She said the strict measure could help increase awareness about the financial and health impacts of smoking.

“Many poor people still prioritize cigarettes over food,” Husna said. “Smoking is one bad thing that can be prevented and stopped.”

According to data collected by the University of Indonesia in 2008, some 35 percent of all Jakartans were active smokers.

The university’s research also found that a family of smokers would spend on average Rp 113,000 ($12) every month for cigarettes. That is slightly more than the Rp 100,000 direct cash assistance package (BLT) given to low-income residents by the government.

Indonesia's Low-Income Health Plan Needs Band-Aid: Lawmaker

Jakarta Globe, Nivell Rayda, February 09, 2010

Mothers and children taking worm pills distributed by a foundation focused on health for the poor in Ancol, Jakarta. (JG Photo/Safir Makki)

Strict implementation of the 2004 National Social Security System Law is needed to prevent millions of Indonesians from slipping through the cracks in the health insurance system, a lawmaker said on Thursday.

Indonesian Democratic Party of Struggle (PDI-P) legislator Rieke Diah Pitaloka said in a discussion hosted by Indonesia Corruption Watch that the House of Representatives health commission was pushing the government to implement the law. More and more low-income people are finding themselves inadequately covered or subject to inappropriate fees within the public health insurance system, commonly known as Jamkesmas.

“By implementing this law, there shall be no more discrimination against the poor because every citizen in the country would be protected,” Rieke said.

The law combines into a single entity existing state-run insurance schemes such as Asabri, the military insurance and pension fund; social security fund Jamsostek; and national health insurer Askes.

“Existing state-owned insurance firms are profit-oriented, with limited target members. The new system would ensure equality for all citizens, including the poor,” Rieke said.

Indonesia Corruption Watch researcher Ratna Kusumaningsih said the lack of transparency over claim procedures had led to widespread corruption within the system. The antigraft watchdog said that as much as 78.3 percent of the Jamkesmas members surveyed last year were still being charged by public and private hospitals, even though the program entitles them to free health care.

“Hospitals must be more transparent and accountable in treating their patients and complying with minimum service standards. The [Health Ministry] must immediately create a body to supervise and monitor the conduct of hospitals, as stipulated in the law,” Ratna said.

Aswanah, a 50-year-old mother of three, said at the ICW discussion that she still had to pay a portion of her medical bills despite being covered by Jamkesmas.

“I had an accident at work and injured my eyes. I was taken to a public hospital in Tangerang and the doctors told me that I needed surgery,” she said. “I was shocked when the hospital said that Jamkesmas only covered half of my Rp 20 million [$2,140] bill. When I got my Jamkesmas card, I was told that all my medical expenses would be covered by the government.”

But inappropriate fees are just part of the problem. Abdul Cholik Masulili, a Health Ministry expert, said low-income people often can’t join Jamkesmas . Meanwhile, those who shouldn’t qualify often do.

“There are poor patients who are not listed as eligible for Jamkesmas. In contrast, there are those who receive memberships but actually can afford their medical bills,” Masulili said.

The official said the ministry had estimated that only 70 percent of 71.8 million members of Jamkesmas can be considered as poor, while there are five million underprivileged people still not covered by the scheme.

“The problem is getting credible and up-to-date data,” he said.

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Jakarta's STIGMA Foundation Reaches Out to Drug Users

Jakarta Globe, February 09, 2010

Baby Virgarose Nurmaya, 29, started heroin at age 15. (Photo courtesy of STIGMA)

Baby Virgarose Nurmaya started using heroin in high school when she was just 15 years old. Now 29, her long black hair falls across her soft features as she quietly recalls the past. She is soft-spoken and smiles constantly, but the deep scars on her forearms remain, signs of her struggle with drugs.

A heroin addict for 10 years, Nurmaya has worked hard to turn her life around. She now works for the STIGMA Foundation, a nongovernmental organization that reaches out to drug users. Run out of a small house in South Jakarta, the group is funded by overseas agencies and the Australian government.

Nurmaya says she had no idea about the risks when she started using heroin.

“A girl I knew was taking heroin and I just wanted to try. I never had any education about it, I never knew I might get addicted or have withdrawal symptoms. There was no information back then. I didn’t know that it was possible to get HIV from sharing needles.”

Drug dealers rent out needles for as little as Rp 2,000 (21 cents) per use. Most drug users will rent needles and share them rather than buy their own. Nurmaya says the drug dealers have no time to sterilize the needles and HIV is easily spread this way.

Nurmaya says at the worst point of her 10-year addiction she was doing anything she could to pay for her drugs. “I was stealing, making my parents give me money, working odd jobs. I was still living at home so had no living costs, all my money went to my addiction. I would leave home and come back when my money ran out.

“A single dose of heroin cost me Rp 50,000 back then. A heavy user will need a heavier dosage. I was using five doses a day for a long time.”

Nurmaya speaks with an unhurried and gentle tone. She emphasizes that her parents were supportive of her during her addiction but they eventually reached their breaking point. “In 1999 they found out about my drug habit and tried to help me. But then they became tired. They lost everything and had invested so much. So in 2003, they just threw me out and said, ‘anything you want to do, do it, but don’t come back here.’ ”

“In 2005, I went back home and demanded money from my mother to pay for my drugs. She said no and I turned violent, smashing the glass out of the living room cabinet.”

Nurmaya says this incident made her finally want to give up her drug addiction. She felt she had lost control of herself.

“I fell to the ground with blood coming out of my arm. My mother just looked at me and didn’t help me. She said it would be better to lose me as a daughter then to have me like this. That was a really hard thing to hear and it made me decide to quit.

“I knew that if I didn’t stop then, I would never stop. When I saw my mother so sick of me I just thought, thank God I’m not dead and I have a chance to change things.”

Nurmaya went cold turkey in 2005, ridding her body in 10 days of the heroin that had taken over her life. She has now been clean for more than three years.

Her work with STIGMA involves research and development into harm reduction services, like providing clean needles and thorough information for intravenous drug users. Nurmaya says the NGO doesn’t try to rid people of their drug habit but to educate and inform them on the risks they are taking and the rights that they have.

“Even if you are doing drugs, if you want to use them safely so you don’t get HIV, that’s the first step. It doesn’t work if you tell a user to quit — they have to be aware of what they are doing and want to stop.

“STIGMA is constantly battling against cultural and religious beliefs; those with HIV are often seen as sinners or as abnormal. People from conservative backgrounds tend to see HIV as a moral problem and not a health problem.”

STIGMA has 22 staff, most of them former drug users. Nurmaya says this helps in reaching out to the community. “We know where the drug users hang out, we know what it is like to go through withdrawal and we can give that advice to people if they want it.”

Harm reduction services are already available in public health clinics, and STIGMA uses this as a forum to provide information to drug users through brochures and word of mouth.

STIGMA will publish a research paper in early March exploring ways female drug users can be provided with better access to harm-reduction services.

Many drug users are female, but because of domestic issues it is difficult for them to access services through NGOs and public health clinics. Up until now, there have been no specific methods for approaching women.

Stigma is working to formulate better ways to reach the female drug using community. One step they have taken is to use female outreach workers.

The new research focuses on why female injecting drug users are a hidden population that is so difficult to reach.

Recommendations of the research include:

• Improving gender sensitivity within the Harm Reduction programs
• Reducing discrimination against women based on marital status
• Creating policy to empower women in terms of their basic rights to health and protection
• More participation from the media to inform female intravenous drug users of their rights

STIGMA Foundation

Jl. H. Nawi I No 1 A, Gandaria Selatan
South Jakarta,
Tel. 021 765 1501

www.stigma-foundation.blogspot.com

Drug suspect to stand extradition trial

Desy Nurhayati and Ni Komang Erviani, The Jakarta Post, Denpasar | Mon, 02/08/2010 10:54 AM | Bali

Wrong kind of publicity: Drug smuggling and money laundering suspect Timothy Geoffrey Lee shields his face from reporters’ cameras after being questioned at the Bali Prosecutor’s Office in Denpasar, on Friday. He faces extradition to his native Australia, where he has warrants outstanding. JP/Stanny Angga

An Australian national suspected of committing drug trafficking and money laundering faces extradition at the Denpasar District Court this week.

Timothy Geoffrey Lee, a fugitive of the Australian Federal Police (AFP) arrested by the Bali Police last month, will stand trial on Tuesday or Thursday in relation to his extradition, which has been requested by the Australian government to the Indonesian government.

Accompanied by his lawyer, Timothy on Friday underwent verification of the suspect’s dossier handed from the police to the District Prosecutors’ Office.

Head of execution and examination at the prosecutors’ office, Ida Bagus Made Argita Chandra, confirmed that the extradition would be ruled by the Denpasar District Court.

“The attorney general will then submit the court ruling to the President for approval. After the process is completed, the Indonesian government can extradite the suspect,” Chandra said.

Timothy’s lawyer Erwin Siregar said that his client would only be tried here concerning his extradition, while his alleged involvement in drug trafficking and money laundering would be taken to the Australian court. “We expect that the extradition may be completed by April, so that my client’s case can immediately continue with the legal process in his country,” Erwin said.

The lawyer said extradition usually takes between six months to a year, but he would continue to monitor the extradition to ensure it was completed earlier. He said he had also requested for voluntary deportation for his client since the process required simpler procedures than extradition, but voluntary deportation could only be carried out if the Australian Government had annulled the extradition request.

“We have asked the Australian government to withdraw the extradition request and we’re waiting for its reply.”

The Bali Police began searching for Timothy after receiving a Red Notice from the AFP on November last year and managed to arrest the 44-year-old fugitive on Jan. 9 in Kuta district. The AFP suspected Timothy for committing drug trafficking and dealing with proceeds of the crime. The AFP noted in its letter to the Bali Police that Lee left Melbourne for Bali around July 2006.

The federal police seized 1 kilogram of cocaine, 44 kilograms of MDMA tablets and powder, 45 liters of MDMA oil and equipment used for drug making.

Polish tourist found dead in Bali hotel room

The Jakarta Post, Jakarta | Tue, 02/09/2010 5:27 PM

Polish tourist Miroslaw Andrezj, 48, was found dead after allegedly drinking homemade distilled arak-type liquor in his hotel room in Badung, Bali, on Tuesday.

“South Kuta Police chief Adj. Comr. Nanang Prihasmoko said the victim’s death might have been caused by alcohol poisoning.

“The victim’s wife said that [Andreszj] drank the arak before lying on the bed. When she tried to wake him up, he was already dead,” Nanang said.

According to kompas.com news portal, the victim’s wife, Danuta Gromelska, 44, reported Andrezj’s death to officers of the hotel, where the pair were staying.

The victim was immediately taken to Sanglah General Hospital in Denpasar for a post-mortem examination. (nkn)

Mightier than the sword

The Jakarta Post, Antara | Tue, 02/09/2010 1:43 PM

Dozens of journalist from various media, who belong to the Medan Journalists Forum (FJM), lay down their press identity cards and cameras during a rally held in front of the North Sumatra gubernatorial office in Medan on Tuesday. Five journalists in Medan were reported to have been held captive following their allegations of medical malpractice. Antara/Irsan Mulyadi

Eight die after drinking spiked liquor in Yogyakarta

The Jakarta Post, Jakarta | Tue, 02/09/2010 4:34 PM

At least eight men have died after allegedly drinking adulterated alcohol in the past three days in Yogyakarta as police begin an investigation into the cases.

Yogyakarta Police chief of detectives Comr. Syaiful Anwar told Antara state news agency that a man from Karangkajen district died after being treated at the city hospital, while five others from Prawirodirjan district had died on Sunday and Monday.

Syaiful said the police had formed teams to investigate whether the deaths were related.

Another two men died at Muhammdiyah Islamic Hospital on Sunday and Monday, reportedly from severe intoxication.

Syaiful said it was possible that the later deaths were also connected.

The officer said that based on reports from the local residents, four of the victims from Prawirodirjan had been consuming liquor after a wedding party in the district on Friday night.

Facebookers, Others Give Rp 1b for Toddler’s Surgery

Jakarta Globe, Anita Rachman, February 09, 2010

Bilqis Anindya Passa in the arms of her mother Dewi Farida, watching coin contributions from the public being counted in Jakarta. (JG Photo/ Afriadi Hikmal)

After Facebook members and donors from the street raised more than the Rp 1 billion ($106,000) needed for a 17-month-old Indonesian girl’s liver transplant, the government has said it will pay for the procedure.

Bilqis Anindya Passa suffers from a rare condition known as biliary atresia, which is caused by a stumped bile duct. A liver transplant is the only way to treat the condition, but her parents couldn’t afford the surgery.

Her cause rallied Facebook users to join the Bilqis Love Coins group, dedicated to fund-raising via the collection of coins.

The group has so far accrued 98,000 members and raised Rp 1.5 billion for the toddler in the form of coins, cash donations and bank transfers, and at donation centers in Jakarta, Bogor, Bandung, Aceh, and Palu, Central Sulawesi.

“Indeed, the Facebook group made the greatest impact on this fund-raising effort,” said Citra, Bilqis’ aunt. “We have the money now. The decision of how and when [the surgery will take place] will be made on Tuesday [today].”

But on Monday, Usman Sumantri, the Health Ministry’s head of health insurance financing, told the Jakarta Globe that the ministry will pay for the entire operation, including the pre- and post-operative stages. “Yes, we will cover all the expenses,” he said in a telephone interview.

Citra said the Ministry of Health had once promised that the government would cover all the surgery, but “we don’t know yet whether they would really pay it. But the hospital has so far not charged us anything.”

Bilqis needs to be intensively treated for about three months following the surgery. “And she should take medicine for the rest of her life,” Citra said.

Citra said that if the ministry did pay all the expenses, the family would use the money to set up a foundation to help other children with similar conditions.

Accompanied by her parents and grandparents, Bilqis has been undergoing medical treatment at the state-run Kariadi Hospital in Semarang, Central Java, since Wednesday.

Last year a Facebook group collected hundreds of millions of rupiah — in the form of coins — to rescue Prita Mulyasari, a mother of two who had been ordered to pay Rp 204 million in damages to Omni International Hospital over a defamation lawsuit. Thousands of people collected more than Rp 650 million in coins, three times more than the ordered settlement.

IDs ‘should be enough to get health services’

The Jakarta Post, Jakarta | Tue, 02/09/2010 8:52 AM

Poor people should be able to immediately access health services by only showing their identity cards, once executing agencies are set up, activists say.

The government plans to set up the National Social Security Agency (BPJS) in line with the 2004 Social Security Law, and the Hospital Monitoring Agency (BPRS), based on the 2009 Hospital Law.

Usman Soemantri, the Health Ministry’s head of health security, said Monday that establishing the monitoring and executing agencies required extensive processes.

“First, you need regulations to establish a monitoring body, and once they are established, it does not guarantee that all the problems will be solved.”

Febri Hendri, Indonesia Corruption Watch (ICW)’s senior researcher, said the government should establish the agencies soon.

“The BPJS will hopefully ensure that people, especially the poor, will not have to be hassled with administrative procedures or be forced to borrow money for medical treatments,” he said Monday during a meeting with Health Ministry officials in South Jakarta.

The government is using the Jamkesmas health insurance scheme to provide health services for the poor. Those with Jamkesmas cards are exempted from any payments at state-owned hospitals and partnering private hospitals.

ICW’s Ratna Kusumaningsih said despite promises of wide access to health services there were still people who asked to pay for treatment even if they were using the Jamkesmas.

The meeting’s participants that day included two poor Tangerang residents, Aswanah and Amsiah, who claimed government hospitals had treatedly them unfairly.

Aswanah was charged Rp 10 million (US$1,000), half the full price, for an eye operation, despite having a Jamkesmas card.

Amsiah, who is suffering from an unidentified growth on her stomach, said although she did not have a Jamkesmas card, she tried to obtain documents to help ease the bills.

However, when asking for assistance from the local health agency, she was allegedly told she had to be hospitalized first before requesting a price cut, while she was afraid of being asked for payment in advance.

“The hospital said I should consult my family when I told them I didn’t have any money... I can’t work [with this disease].”

According to last year’s Citizen Report Card survey by ICW, there were 13 hospitals in Greater Jakarta that discriminate against patients who used health insurance systems or those that refused to allow patients to return home before paying their bills.

Another official, Chalik Masulili, said by 2012 patients should only have to show their single identity numbers to access health services.

But he said covering single identity numbers for all Indonesians took time, and the process might be finished by 2012. (dis)

Anti-drugs activist arrested in Medan over drug trafficking

The Jakarta Post, Jakarta | Mon, 02/08/2010 8:12 PM

North Sumatra Police arrest an anti-drug activist along with four other suspects for allegedly being involved in an international syndicate of drug trafficking.

The detectives detained anti-drug activist Raja Indra Jaya Pane along with Muhammad Rafi’i and Rosi in a hotel room on Jl. Sisingamangaraja in Medan, on last Saturday.

“Indra Jaya was about to sell 792 ecstasies to Rosi when arrested,” detective Adj. Sr. Comr. Andi Riyan told tempointeraktif.com on Monday.

Indra Jaya is known as a director of Tropikal Indonesia, a non-governmental organization that supports anti-drug campaign.

The two other suspects, identified only by their initial C and WS, were detained a day earlier on Jl. Asia in Medan, Andi added.

The police seized a total 824 ecstasies as evidence during the arrests. (nkn)

Indonesian hospitals lack concern for the poor

The Jakarta Post, Jakarta | Mon, 02/08/2010 4:31 PM | National

Indonesian hospitals in general do not support the poorer sectors of society, as people still have difficulties in accessing adequate health services even though they have cards classifying them to be from low-income families.

The finding was announced during a meeting between the Indonesian Corruption Watch (ICW) and the Health Ministry in Jakarta on Monday.

For this reason, the ICW urged the ministry to push for the deliberation of a bill on a national social security agency (BPJS) to implement a nationwide welfare system in line with the 2004 law on the national social security system (SJSN).

The ministry was urged to speed up the establishment of the Hospital Monitoring Agency to help improve hospital quality in providing health services and erase discrimination in their services to poorer patients.

"The establishment of the Hospital Monitoring Agency is needed to ensure patients' rights and hospitals' fulfillment of their obligations as well as to mediate and monitor hospitals' ethics," said Febri Hendri, an ICW senior researcher for public service monitoring, as quoted by kompas.com.

Teenage Girl Alleges Rape and Abuse in North Jakarta Orphanage

Jakarta Globe, February 08, 2010

A teenage girl living in an orphanage in North Jakarta has alleged that she was sexually abused by operator of the institution and beaten by his jealous wife.

The abuse allegedly began when the wife AS, 40, received an SMS message that was mistakenly sent by her husband, SU. The text message was intended for MP, 14, and read: “Where do you want me to pick you up, MP?” The wife concluded from the message that her husband was having an affair with MP and allegedly beat the girl up and cut off her hair.

The abuse allegedly took place in early January 2010. SU was the founder and owner of Yayasan Nurul Zahroh orphanage at Jalan Fort Timur, Koja, North Jakarta. MP’s father, Abdul Mukti, placed the girl in the orphanage after her mother passed away in 2008 because he could not take care of her by himself. However, he still financed her education.

After the beating, MP ran away from the orphanage and told her father about what had happened. He reported the alleged abuse to North Jakarta Police.

“She beat me up and cut my hair short,” MP told Poskota daily.

The girl also alleged that SU had forced her to have sex with him.

“It started in 2008, I was forced to have sex with him in his internet cafe and inside his car which was parked at a mall,” she said, adding that she was too afraid to refuse.

MP’s father, Abdul, hoped the police would investigate the case quickly.

“I’m disappointed because the police still haven’t started to investigate,” Abdul said.

Meanwhile, SU denied all accusations, including MP’s statement that he forced her to have sex.

“I could never do something like that, especially in places that she mentioned,” he said.

Police were not available for comment.

Criticism is Like Medicine, but an Overdose Can Make Us Sick: Yudhoyono

Jakarta Globe, Camelia Pasandaran, February 08, 2010

President Susilo Bambang Yudhoyono visiting the Marine Corps during an exercise on Sunday. (Antara Photo)

During a speech on Monday at the National Police Conference, President Susilo Bambang Yudhoyono likened criticism of the government to a powerful medicine, but said that an ‘overdose’ could have a negative effect.

“Criticism is like medicine. When the medicine is right for the disease and is given in the right dose, it will make us healthy,” Yudhoyono said in front of National Police officials in Jakarta.

“But if the medicine is given in the wrong dose, it will make us sick,” he said.

“Criticism, including insults, if it is in the right dosage and accompanied with the right solution, will bring goodness to everybody, including the government and the police.”

During his speech, Yudhoyono also recalled a question he was asked by a Police Academy graduate in Surabaya during the height of last year’s conflict between police and the nation’s Corruption Eradication Commission.

“Mr President, how should we behave when the spotlight, critics and accusations are focused on the police institution?,” Yudhoyono said, quoting the question.

“My answer was that the police must be clear-headed, rational and calm. Do not get emotional. Undertake evaluation and introspection, including on whether or not there are still weaknesses in carrying out your duties. If there are, then it has to be fixed,” the president said.

In his closing remarks, the president reminded police that they should always remember to be a role model for the public, despite the low level of respect shown to them at times.

“The service and dedication of the police are often forgotten by the people and they lack respect,” Yudhoyono said.

“During more than five years of leadership, the police have been working weeks and months to unravel the narcotics network, which has massive impact in protecting thousands and millions of people. They have also been (successful) in eradicating terrorism and preventing our nation from becoming an ‘ocean of violence.’”

“They have done more work than they should do.”

Chinese Medicine: Does a Pill a Day Keep Illness at Bay?

Jakarta Globe, Marcel Thee, February 07, 2010

Why do some people willingly risk their health and money on dubious Chinese-made pills and creams?

Yes! Exactly! You just need to work on your meal schedule and stick to it. Slowly but surely you’ll become thinner. But remember, it won’t happen instantly. You need to be patient and let the medicine work. Don’t worry, koko [Chinese for older brother] will guide you.”

Anton, a beady-eyed, smooth-tongued businessman, is talking rapidly into the telephone in the small ruko, or shop-house, where he and a friend teach Mandarin. He is busy doing what he seems to do best — hawking traditional Chinese medicines over the phone.

His inventory includes everything from appearance enhancers such as diet pills, weight-gain pills and breast enhancement creams — “You can have a body like Miyabi!” Anton proclaims — to pills for a host of illnesses like diabetes, asthma and tumors.

On Anton’s Web site, there are two photos of him in the section for diet pills: one of him overweight and another of him thinner. The strategic placement of the photos — chubby on the left and slim on the right — suggests that the chubby Anton is the “before” photo and the slim Anton the “after.” This is completely inaccurate, of course. Swap the photos around and one gets the real picture.

“It’s not lying” Anton says so passionately he’s almost hopping up and down. “It’s just people’s assumption [when they see the photos] that I was overweight but now I’m thin because of the diet pills. Really, I am much bigger now than when I was younger. I just put those photos there, but I didn’t write ‘before’ or ‘after’ below them.”

It isn’t clear why Anton feels the need to resort to such tricks, though. The number of repeat customers who call him day and night, as well as testimonials from buyers on his Internet forum thread praising his products, suggests that most of the pills and creams he sells seem to actually work.

Anton is just one of the many sellers of traditional Chinese medicine prowling the Internet for buyers. Previously, one had to travel to ethnic Chinese enclaves in Jakarta, such as Glodok or Kota, to buy these health items. As a matter of fact, this is where Internet merchants like Anton buy their medicines in bulk. But these areas are not easy to get to, and finding what your looking for in the crowded, narrow alleyways is always a challenge.

If one chooses to scour those maze-like passageways, however, there is a wealth of unlabeled jars filled with pills and creams that claim to be able to cure whatever ails you. Some of these even sport cheap-looking printed stickers.

As with other goods in Indonesia, Chinese medicines are often fake. The Web site okezone.com quoted Charles Saerang, chairman of the Jamu Producers Association, as saying that a loophole in the regulations passed by the Health Ministry’s Food and Drug Monitoring Agency (BPOM) allows makers of Chinese medicine to directly connect with health clinics around the country.

“The clinics themselves are legal, but the medicines themselves are questionable,” Charles says.

While their authenticity cannot be verified, most medicines sold at toko obat cina (Chinese medicine shops) on Jalan Pancoran in the Glodok area come with markings purportedly from the Food and Drug Monitoring Agency.

The bleach-haired Ling — who asked that her real name not be used — runs a Web site whose name she does not want mentioned, but should be the first thing that comes up if you type in the key words “selling Chinese medicine” in Bahasa Indonesia on Google.

She says that Chinese medicines do not have side effects because they are all herbal. “The way it works, the herbal medicines clear up the blood vessels first,” she says.

Ling explains that after the “detox” process comes the “balancing” process, where the body’s energy is balanced and normalized. After that, a “reactivation” of the body happens, before it undergoes “strengthening, where the “qi” (life energy) re-energizes the body’s immune system.

“You have to routinely take the medicines, though, to achieve real results,” Ling adds.

“Benny,” a merchant on Pancoran, says the side effects from the different pills include vomiting, diarrhea and stomach ulcer in some rare cases. But these occur very rarely, he says, and are usually very mild.

“Anita,” a 23-year-old bank employee who asked that her real name not be used, experienced some of these side effects. She says that she had to defecate four times or more each day for about a week after taking Anton’s diet pills.

“It wasn’t painful, but obviously, having to go to the bathroom so often is bothersome, especially when I was at work” she says.

She immediately called Anton, who helped put her mind at ease.

“He told me it was due to the detox process that the [diet] pills put you through,” Anita says. “So basically, it’s cleansing all the bad elements from your body.” “Detox” is one of the most frequent reasons that sellers give whenever customers complain about stomach-related problems.

The popularity of Chinese medicines is on the rise, not only because of their increasing visibility on the Internet thanks to online sellers, Web forums and social networking sites, but also because of effective word of mouth.

Eve, a 27-year-old housewife, purchased a lotion designed to smoothen and whiten skin. She says that the product’s effect was immediate.

“All my friends saw how much my skin changed for the better, which all made them immediately want to buy the medicine,” she says.

The skin lotion is in tube form, with a sticker bearing the ironically Japanese-sounding name of Mashiroi.

Eve has a series of photos showing her skin’s transformation, which she claims occurred only after a month. With numerous friends asking her where to buy the medicine, Eve has now become a reseller of Mashiroi, peddling the lotion for almost double the original price of Rp 800,000 ($86).

The paunchy “A Hong,” a merchant in Pancoran who also asked that his real name not be used, says that skin lotions like Mashiroi work wonders by forcing the users’ skin to “die” and be replaced by “new, younger skin.”

But since one’s skin is often theoretically not “dead” yet, the lotion forces it to dry and peel prematurely. This results in an extremely visible skin peeling on the user.

“Susan” is another Mashiroi user. Like Eve, the 29-year-old mother of one has also kept a photo diary of her skin transformation, from a yellowish tone into a fairer complexion. But the whitening came at a price.

“The worst thing was the itching as my skin peeled. There was dead skin everywhere, on my face, which itself turned reddish,” she recalls. “But my mother and a lot of people I know prefer [these remedies], which makes me believe in them even more.”

Randy is a merchant in Pancoran whose store has been around since the 1930s. He says that the tradition of selling Chinese medicines in Indonesia goes back a long way.

“All the medicine that is sold here [in Pancoran] comes directly from China,” he explains. “You do have some other Chinese medicine stores in other areas in Jakarta, like in Kelapa Gading, but they are mostly labeled and licensed medicines and are not made and mixed in China.”

Randy adds that every good Chinese medicine store must carry three essential licensed brands: Pien Tze Huang, Angong Niuhuang Wan and Yunnan Baiyao.

While he claims that the skin, ulcer, hepatitis, heart, cholesterol and other medicines he has at his store “work, it is a case of compatibility. It may work for some patients but perhaps not for others.”

Anton says that the problem with selling medicines for other illnesses is that there are a significant number of fake medicines in the market that sellers claim as being made in China.

Seated in front of a closet filled with medicines such as cungkuo cegenduan (for hemorrhoids), pientan fuyenwan (for stroke victims) and anti cancerlin (for cancer), Anton says that Chinese medicines work, especially the herbal ones. However, he acknowledges that it is increasingly difficult to verify the authenticity of these medicines with suppliers.

“I try to mostly to stay away from that [selling health-related medicines] because the result of taking those fake meds could be life-threatening,” he says. “I don’t really want to sell ill people fake medicine, even if it is just by accident.”

Candidates sought for ASEAN child commission

The Jakarta Post, Sat, 02/06/2010 1:00 PM

JAKARTA: The government is looking for candidates to be selected as Indonesia's commissioners to the ASEAN Commission on the Promotion and Protection of the Rights of Women and Children.

"The 8th meeting of ASEAN's committee on women agreed that member countries must submit the names of their representatives by March 15 at the latest," Sri Danti Anwar, the head of the selection committee from the Women's Empowerment and Child Protection Ministry, was quoted as saying by Antara news agency.

Each country has to appoint two commissioners. Anwar said the selection process, which will also involve other ministries, including the Foreign Ministry, will be transparent. Candidates should have experience with issues facing women and children at the regional and international levels.

"They also should have moral integrity and wide networking," she said. The deadline for applications is Feb. 19. - JP

Race for food will get tougher, officials say

The Jakarta Post, Jakarta | Fri, 02/05/2010 10:24 AM

The country should get its act together and make several changes if it wants to keep feeding its people amid volatile commodity prices, climate change effects and an ever-increasing population, officials said Wednesday.

Deputy Agriculture Ministry Bayu Krisnamurthi said in a discussion about food security that Indonesia should make solid efforts in food provision matters to cope with current problems.

“We must be aware that food commodity prices are easily influenced by external influences, and this is not only concerning export-import matters, but a wider scope of international events,” he said.

Bayu added that commodity prices were vulnerable because people could easily shift their investment from one commodity to another.

Climate change has become another threat to the country’s agriculture, and thus, food supplies, he said.

“Right now, we are OK. But the situation will worsen if we encounter more droughts or floods,” Bayu said.

The need for resilience is urgent amid the growing population, he added.

“If the basic population growth is 1.3 percent a year, each year we have 3.5 million more mouths to feed,” Bayu said.

Using data from the Central Bureau of Statistics, the discussion heard that the current population, around 233 million, needed 32 million tons of rice, 18 million tons of corn, and three million tons of soy product.

In 2025, the population may balloon to more than 273 million people, who are predicted to need 38 million tons of rice, 32 million tons of corn and over 3.5 million tons of soy.

The country, on the other hand, is predicted to be capable of producing more than 39 million tons of rice, 19 million tons of corn and 1.3 million tons of soy.

However, despite the rice surplus, Indonesia depends on other countries to supply its soy.

In 2025, the ministry targets 55 million tons of rice, 53 million tons of corn and 4.3 million tons of soy production.

Bayu said that the term “food security” should also take into account the people’s nutritional needs, depicted as decent in statistics yet said to contain disparities.

“Our [average] carbohydrate intake is 48 percent higher than the recommended amount, and our protein intake is also higher than that recommended.

“However, we know that there are many people who suffer from hunger and malnutrition,” he said.

Sutarto Alimoeso, the president director of state-owned logistics company Bulog, said the country should pay more attention to food and agriculture.

He also called for food diversification, especially regarding staple foods such as rice. (dis)

Can the power of thought stop you ageing?

BBC News, by Abigail Williams

A cure to ageing is a holy grail of medicine

In 1979 psychologist Ellen Langer carried out an experiment to find if changing thought patterns could slow ageing. But the full story of the extraordinary experiment has been hidden until now.

How much control do you have over how you will age?

Many people would laugh at the idea that people could influence the state of their health in old age by positive thinking. A way of mitigating ageing is a holy grail for the pharmaceutical and cosmetics industry, but an experiment by Harvard psychologist Ellen Langer three decades ago could hold significant clues.

Prof Langer has spent her entire career investigating the power our mind has over our health. Conventional medicine is frequently accused of treating them as separate entities.

"Everybody knows in some way that our minds affect our physical being, but I don't think people are aware of just how profound the effect actually is," she says.

In 1979, Prof Langer conducted a ground-breaking experiment - the results of which are only now being fully revealed.

Prof Langer recruited a group of elderly men all in their late 70s or 80s for what she described as a "week of reminiscence". They were not told they were taking part in a study into ageing, an experiment that would transport them 20 years back in time.

The psychologist wanted to know if she could put the mind back 20 years would the body show any changes.

The men were split into two groups. They would both be spending a week at a retreat outside of Boston.

Ellen Langer in 1979 and today

But while the first group, the control, really would be reminiscing about life in the 50s, the other half would be in a timewarp. Surrounded by props from the 50s the experimental group would be asked to act as if it was actually 1959.

They watched films, listened to music from the time and had discussions about Castro marching on Havana and the latest Nasa satellite launch - all in the present tense.

Dr Langer believed she could reconnect their minds with their younger and more vigorous selves by placing them in an environment connected with their own past lives.

And she was determined to remove any prompt for them to behave as anything but healthy individuals. The retreat was not equipped with rails or any gadgets that would help older people. Right from the off she was determined to ensure they looked after themselves.

When they got off the bus at the retreat, Prof Langer did not help the men carry their suitcases in. "I told them they could move them an inch at a time, they could unpack them right at the bus and take up a shirt at a time."

The men were entirely immersed in an era when they were 20 years younger.

Understandably, Prof Langer herself had doubts. "You have to understand, when these people came to see if they could be in the study and they were walking down the hall to get to my office, they looked like they were on their last legs, so much so that I said to my students 'why are we doing this? It's too risky'."

But soon the men were making their own meals. They were making their own choices. They weren't being treated as incompetent or sick.

Pretty soon she could see a difference. Over the days, Prof Langer began to notice that they were walking faster and their confidence had improved. By the final morning one man had even decided he could do without his walking stick.

As they waited for the bus to return them to Boston, Prof Langer asked one of the men if he would like to play a game of catch, within a few minutes it had turned into an impromptu game of "touch" American football.

Obviously this kind of anecdotal evidence does not count for much in a study.

But Prof Langer took physiological measurements both before and after the week and found the men improved across the board. Their gait, dexterity, arthritis, speed of movement, cognitive abilities and their memory was all measurably improved.

Their blood pressure dropped and, even more surprisingly, their eyesight and hearing got better. Both groups showed improvements, but the experimental group improved the most.

Prof Langer believes that by encouraging the men's minds to think younger their bodies followed and actually became "younger".

She first published the scientific data in 1981 but she left out many of the more colourful stories. As a young academic, she feared this might taint the experiment and affect the acceptance of the results.

Now after over 30 years of research into the connection between the mind and the body and with the confidence and conviction of a Harvard professor, she feels she has a fuller story to tell.

"My own view of ageing is that one can, not the rare person but the average person, live a very full life, without infirmity, without loss of memory that is debilitating, without many of the things we fear."

Richard Wiseman, professor of public understanding of psychology at the University of Hertfordshire, thinks the results of Prof Langer's experiments are fascinating but the big question is what's causing them. "I think there could be multiple things going on here and the question is which explanations really hold water.

"Part of it could be self perception, for example if you get people to smile they feel happier. The same could be going on here, by getting people to act younger they feel younger."

Prof Weisman believes another factor could be motivational, the men are simply trying harder by the end of the week, or it could be similar to hypnotism, where people do better on memory tests because they are told they have a better memory.

Whatever the cause he believes there is a place for the type of positive thinking shown in the study.

"If you take something like heart disease positive thinking can have a role, because while it won't heal your heart on its own, positive thinking will feed into positive actions like healthy eating or exercise which will help."

In any event there is likely to be more interest in the 1979 experiment. The retelling of the study has been snapped up by Jennifer Aniston's new production company, with Aniston tipped to play Prof Langer.

Related Article:

Horizon: Don't Grow Old is available via iPlayer and will be repeated at 0250GMT on BBC One on Tuesday 9 February

You really can be bored to death, scientists discover

Are humans really beings of light?

My talking walls are creating my reality?

Miraculous Messages From Water

Female genital mutilation causes aggression

Radio Netherlands Worldwide, 6 February 2010 - 11:04am

Many women who have undergone female genital mutilation suffer psychiatric problems.

This is the finding of a study by Pharos, which gathers information on refugees and health. In the study 66 Dutch African women, who had been subjected to the practice, were questioned. They were found to be stressed, anxious and aggressive. The study also found that this group of women were more likely to have rows with their partners or in some cases would not dare enter a relationship.

On the positive side, women were more likely to say no to the practice if they knew it was banned in the country where they live.

An estimated 50 women or girls are believed to be circumcised every year in the Netherlands. Critics of the practice say it is mutilation of the female genitals.

This is the first time that a study has been carried out into the psychiatric and social complaints associated with female circumcision.

The report has been published to mark the international day against female genital mutilation today.

Related Article:

Female genital mutilation (WHO)

News focus: promoting healthy life by donating blood

Antara News, Fardah, Saturday, February 6, 2010 17:54 WIB

Jakarta (ANTARA News) - New chairman of the Indonesian Red Cross (PMI) Jusuf Kalla has urged the public to make donating blood part of their life style and something to be proud of.

Kalla`s appeal is not an exaggeration as according to the World Health Organization (WHO), blood transfusion saves life and improves health.

"Donating blood should become part of people`s life style and an act one can be proud of. People should feel awkward or unhappy if they have not donated blood," Kalla, a former vice president, said in Surabaya last Friday (Feb. 5), when visiting the Surabaya Blood Donation Center run by Surabaya`s PMI office.

Donating blood was healthy and should be promoted among all layers of society, including university students, businessmen and professionals, he said.

He suggested that blood donation units be opened in public areas such as shopping

centers to facilitate people who wished to donate blood.

"We (PMI) must approach the public," he said.

On his visit in Surabaya, Kalla was accompanied by representatives of the International Federation of Red Cross (IFRC) Bob McKerow, and Syver Hvammen of the Norwegian Red Cross.

Surabaya`s PMI office supplies around 400-500 pouches of blood daily to 33 hospitals and community health posts in the country`s second biggest city.

In a dialog with Jusuf Kalla, Herry Hadiwasito, a blood donor, hoped that the PMI could support blood donors by asking government hospitals to give discounts to them.

"We hope that blood donors can get discounts when they are treated at government hospitals," he said.

Kalla responded that donating blood was basically a voluntary act but he promised to discuss what could be done to reward blood donors.

On a separate occasion, Kalla said that although donating blood was voluntary PMI personnel must carry out their tasks professionally and be always ready for action to help people in emergency situations.

"Disasters are unpredictable. Therefore, PMI personnel must always be ready," he said.

"The foundation of PMI is humanitarian but it must be managed professionally, not socially. So, PMI is like the cooperative movement, from the people and for the people," he said.

He also hoped that PMI could improve its performance and facilities in order to encourage the public to donate. PMI tasks basically consists of two, blood transfusion and disaster emergency handling.

However, he asked PMI personnel to also help the communities face any emergency situations. For instance in case of dengue fever outbreaks, PMI personnel should not only supply blood for dengue fever patients, but also inform the public how to avoid dengue fever infection, he said.

Although Indonesia has a population of around 230 million, the PMI had so far only managed to collect 1.7 million pouches of blood annually, while demand nation-wide is around four million pouches, or around 2 percent of the total population as stipulated by WHO.

Therefore, PMI had set itself the target of collecting three million pouches of donated blood in 2010 to meet increased public demand for the vital body fluid.

"Last year, we only obtained 1.7 million pouches but this year our target is three million, and in 2011, four million," PMI Chairman Jusuf Kalla said in Yogyakarta on Saturday (Feb. 6).

Consequently, he said, PMI would launch public campaigns in public areas such as shopping centers, bus terminals, railway stations, and places of worship, as well as in companies and mass organizations, Kalla said at a meeting with personnel of Yogyakarta`s PMI. Blood donation units would also be set up at universities, he said.

The public campaigns, bearing the theme "Donating Blood is Healthy," would be carried out in conjunction with the setting up of permanent blood donation units at strategic locations.

"So, we will collect blood donations not just occasionally, like monthly or ceremonially. We will make donating blood part of people`s life style," he said.

Kalla also has an ambition that PMI would also set up a blood pouch-making plant to end its dependence on imported pouches, he said.

PMI gets around 80% of its blood stock from voluntary, unpaid donors, while the remaining 20% is collected from family replacement donations (where a member of the patient`s family is obligated to replace the units of blood given to the patient).

According to the WHO, the basis for an adequate supply of safe blood is a pool of healthy, regular, voluntary donors who give blood without financial or other reward.

Research has shown that donors who give blood of their own free will without the expectation of payment are the `safest` donors.

WHO said on its official website that since World Blood Donor Day was celebrated for the first time in 2004, 111 countries reported an increase of the number of voluntary donations; 32 of these 111 have more than doubled the number of voluntary donations as compared to 2004 figures; All these 32 countries are developing or transitional countries.

Eleven countries (Bosnia and Herzegovina, Burkina Faso, Cook Islands, Cape Verde, Kuwait, Guinea Bissau, Mauritania, Myanmar, Niue, Vanuatu and Vietnam) report more than a 10% increase in voluntary unpaid donations in 2007, as compared to 2006 figures, WHO data showed.

Meanwhile, Dr. Yuyun Soedarmono, Director of the Blood Transfusion Unit of the Indonesian Red Cross (PMI) told ANTARA few years ago that "In Jakarta every day we receive more than 10 requests for our mobile units to go to certain offices that organize blood donation events. However, since our staff members and mobile facilities are limited, sometimes we have to turn down several requests."

Another obstacle is the expiration date on the blood stock, which can be stored for no longer than three weeks.

"If we collect too much blood in a certain period, it will be wasted because we can not keep it for more than three weeks in our storage," she explained.

"We screen 100% of donated blood for four diseases, namely syphilis, hepatitis B, hepatitis C and HIV," Dr. Yuyun said.

Basically, it is `in the blood` of many Indonesians to routinely donate blood, as many organizations, state-owned and private companies often organize blood donation activity when celebrating their anniversaries.

Donations top Rp 1b for Bilqis

Suherdjoko, The Jakarta Post, Semarang | Fri, 02/05/2010 9:43 AM

A suitable liver transplant donor has not been found for Bilqis Anandya Pasha, the baby suffering from a rare liver condition, after her parents were found on Thursday to have different blood types.

Bilqis’ blood type was AB, while her mother, Dewi Farida, was A and her father, Ardianta Pasha, B.

“It would be risky if the graft for the transplant is taken from his parents,” Dr. Hirlan, one of the 41-member medical team from Semarang’s Dr. Kariadi Hospital, said Thursday.

He added the greatest risk would be tissue rejection, saying that if the procedure were performed, it would be pointless. “That’s why we will conduct the second phase of testing to verify the blood types,” he said.

Financing for the operation does not seem to be an obstacle as public donations, in the form of the “Coins for Bilqis” drive launched in December 2009, reached Rp 1.108 billion (US$115,000) as of Wednesday.

The team of doctors will consult with family members to find another donor. The child, who arrived in Semarang on Wednesday, is currently being monitored.

Hopes to find a suitable type of blood from relatives are also slim with no member reported to have AB blood.

Ardianta said, “We have not thought of finding a donor [outside the family]. Our hopes rest with the medical team. “For us, this is a test from God, and we hope for a miracle.”

Bilqis, born on Aug. 20, 2008, is suffering from biliary atresia, a condition in which the bile duct between the liver and the small intestine is blocked or absent.

Medical team leader Dr. Soemantri said Bilqis underwent a series of medical tests when she arrived at the hospital. “We are waiting for the test results to determine the right treatment,” he said.

To save her life, Bilqis underwent surgery to attach a liver to the intestines when she was six weeks old.

She was found to suffer from biliary atresia at the age of two weeks when her skin turned yellow and black. Her abdomen was distended and she broke out in rashes.

Soemantri said the team would examine Bilqis’ medical record before performing the transplant.

In the past, the hospital has performed a liver transplant on a child, the organ being donated by a family member and not a volunteer, he said, adding that an organ from the patient’s family was more suitable and minimized the chance of rejection.

Red Cross volunteers to undergo military training

The Jakarta Post, Jakarta | Sat, 02/06/2010 6:11 PM

The Indonesian Red Cross (PMI) will select 60 volunteers for a rigorous training under tutelage of the Special Force instructors.

PMI chief Jusuf Kalla said the special training would help prepare the volunteers for humanitarian missions in difficult terrains.

“We have received offers from the Mobile Brigade, the Special Force and the Marine Corps,” Kalla told Antara on his way to Yogyakarta on Saturday.

The special physical training will be given to PMI volunteers who live in Surabaya and Jakarta. “It’s only a small team, not all the volunteers will undergo the training,” Kalla said.

The volunteers, he added, would focus on disaster mitigation works that require high-level skills. Kalla said the volunteers would be armed with the best equipment.

“We are still negotiating the cooperation offer, its technicalities and the place for the training,” said Kalla.

Police Shoot Five Burglary Suspects Trying to Flee Bali

Jakarta Globe, Made Arya Kencana, February 05, 2010

Police in Bali have deliberately shot and wounded five men they said formed a criminal gang that specialized in burglarizing houses occupied by foreigners on the island, a Denpasar police official admitted Friday.

“They were attempting to escape and we decided to shoot them. Their main targets are foreign tourists,” said Police Chief Sr. Comr. Gede Alit Widana.

He said that the men were shot in the leg as they tried to escape.

The gang members all came from Palembang in South Sumatra, Alit said, identifying them as Andi Irawan, Zulkarnaen, Rusli, Arbain and Fikri Anang.

Widana said four of the suspects were arrested as they were about to board a Batavia Air flight at Ngurah Rai Airport on Wednesday. The other one was arrested in Kuta earlier.

Police started hunting for the men by tracking their car’s license plate after they had robbed a house at the Graha Pesona housing complex in Denpasar. A witness had noted the number.

“From the first suspect we arrested, we obtained information about the other four, who were staying at a hotel. But when we arrived at the hotel, they had already checked out. Finally, they were arrested at the airport,” Widana said.

The suspects told police investigators that they had been in Bali for just three days but had managed to rob seven houses, mostly belonging to foreigners.

Police confiscated evidence worth around Rp 1 billion ($107,000), including gold jewelry, watches, United States dollars and Chinese yuan, as well as electronic gadgets.

Police also confiscated a car and three motorbikes the suspects had allegedly used in their operation.

The group reportedly conducted their acts during daylight, coming by car and breaking in only after ascertaining that the houses were empty.

“We are still investigating the case so there is the possibility that the number of victims could increase,” Widana said.

In the latest crimes to befall foreigners in Bali, an Australian national identified as Simon Klen, lost two video cameras after two men on a motorcycle broke into his parked car in Sawangan, Nusa Dua.

At the end of January, two foreign tourists also became victims of similar crimes. Andrea Martinello, an Italian citizen, lost Rp 13 million worth of valuables after her car window was smashed. Jablons Kihans Joachimhorstenil, a German citizen, lost his laptop which had been in his parked car. His car’s window were also smashed in the break-in.

City braces for dengue fever

Indah Setiawati, The Jakarta Post, Jakarta | Fri, 02/05/2010 9:27 PM

The city health agency is gearing up to face a spike in dengue fever attacks as 914 cases have been recorded in two months.

Agency head Dien Emawati said on Friday her agency would provide 20 beds and medical staff in five community health centers, including in Ciracas in East Jakarta, Cempaka Putih in Central Jakarta and Cilincing in North Jakarta.

“We will give priority to health centers that are far from hospitals. The patients won’t need to go to the hospital so we can reduce the burden on hospitals,” she said.

Dien added that doctors and nurses who would be assigned to the health centers would be selected from 313 new medical workers who were recruited last year.

The agency reported that the number of dengue fever cases reached 914 as of Feb. 3 this year, a 25 percent decline from the same period last year.

The first two months of 2009 saw 1,202 cases, with total incidents reaching 18,000.

Police Arrest Man For Publishing Girlfriend's Nude Picture On Facebook

Jakarta Globe, February 05, 2010

Police in Mataram, West Nusa Tenggara have arrested a man named they identified as Toto for posting a nude photo of his girlfriend on Facebook.

“The man was arrested after intensive interrogation on Thursday night,” Mataram Police chief detective Andi Dady Nurcahyo told Metro TV on Friday.

He said Toto, a non-permanent staff member with the West Nusa Tenggara Office of General Works, had confessed to putting the photo on the popular social networking site.

“The suspect admitted what he did and erased the nude picture,” said Andi.

Police said Toto would be charged with Chapter 282 of the Electronic Information and Transaction Law (ITE) for spreading pornography, which carries maximum punishment of six years in prison.

The girlfriend confirmed it was her picture even though it did not show her head. Police said they had also confiscated a pair of underwear that was lying on the floor in the photo.

The woman told police Toto posted the photo after she tried to break up with him.

JG

Algae Extract Fights Dengue: Study

Jakarta Globe, Dessy Sagita, February 04, 2010

Patients suffering from dengue fever at Pasar Rebo Hospital in Jakarta. (Pembaruan/Jurnasyanto Sukarno)

Dengue fever sufferers may have a new option in the treatment of the often fatal disease as Indonesian doctors have found that a chlorella extract, a genus of single-celled green algae, accelerates the recovery process and increases the chances of surviving the disease.

“Our latest study found that giving a chlorella extract to dengue fever patients increases the blood platelets and improves the hemoglobin, allowing patients to recuperate faster,” Dr. Adi Teruna Effendi, an internist who headed the research team, told a news conference on Thursday.

The study ran from April to October 2009, involving 84 serious dengue fever patients at the Karya Bhakti Hospital in Bogor under the supervision of researchers from the Indonesian Internists Association and the Faculty of Human Ecology at the Bogor Agriculture Institute.

Adi said the team divided the patients into two groups; the first getting the chlorella extract as a supporting supplement during treatment while the others received standard treatment as advised by the World Health Organization.

“Those who were given the chlorella extract stayed in hospital only 2.76 days on average, while those who didn’t stayed 4.4 days,” he said.

Adi said the quick recovery was the result of the chlorella boosting the body’s immunity system because of its high concentration of amino acid and a range of vitamins.

He said that chlorella worked as an inhibitor that prevented the dengue virus from replicating and decreased the chance of patients suffering from high fever.

“The supplement could shorten the patients stay in the hospital,” the doctor said.

During the study, Adi said, the team monitored the patients’ platelet and hemoglobin level everyday and those who were given chlorella extract showed impressive progress.

Adi said the findings had been reported to the Ministry of Health and received a positive response. “The ministry has asked us to research chlorella further to develop more possibilities,” he said, adding that scientists in Japan were also interested and wanted to collaborate on the study.

Unfortunately, he said, Indonesia was not yet able to produce the extract locally and had to import it from Japan.

“We already know how to grow green algae but we don’t have the technology to extract its certain substances yet,” he said.

Adi said chlorella could be consumed as a preventative medicinal supplement.

“The chlorella extract is quite expensive but people can take raw chlorella or the tablet to boost their immune system,” he said.

World Cancer Day

The Jakarta Post | Thu, 02/04/2010 3:18 PM | Jakarta

Cancer is preventable: Commemorating World Cancer Day, held every year on Feb. 4, demonstrators distribute flowers at the Hotel Indonesia traffic circle in Central Jakarta on Thursday. The rally held to draw attention to the harmful effects of smoking on human health, and to promote the message that “Cancer Can Be Prevented”. JP/Nurhayati.

Police detain 4 key suspects in ATM scams

The Jakarta Post, Jakarta | Wed, 02/03/2010 8:20 PM

Police detain 4 key suspects in ATM scamsThe National Police have detained four key players in the Automatic Teller Machine (ATM) scams, bringing the total number of suspects arrested to 37.“Last night we managed to arrest [suspected] big players who have roles as middlepersons and collectors of the stolen money,” National Police spokesman Insp. Gen. Edward Aritonang said Wednesday as quoted by kompas.com.Edward further said seven of the suspects allegedly conducted their crimes in Bali.The scams have incurred more than Rp 6 billion (US$650,000) in losses to big banks, mostly in Jakarta, Bali, Kalimantan and Sumatra. (nkn)

The National Police have detained four key players in the Automatic Teller Machine (ATM) scams, bringing the total number of suspects arrested to 37.

“Last night we managed to arrest [suspected] big players who have roles as middlepersons and collectors of the stolen money,” National Police spokesman Insp. Gen. Edward Aritonang said Wednesday as quoted by kompas.com.

Edward further said seven of the suspects allegedly conducted their crimes in Bali.

The scams have incurred more than Rp 6 billion (US$650,000) in losses to big banks, mostly in Jakarta, Bali, Kalimantan and Sumatra. (nkn)