HOW THE DRUG WAR IS BEING LOST © Duncan Graham 2006
The Battle of the Banners is underway in Surabaya and many other cities.
They scream SAY NO TO DRUGS. They’re part of Indonesia’s war against narcotics – a conflict doomed to fail according to experts. Duncan Graham reports:
Dony Agustinus is truly junkie tired, as the addicts say. Though he’s only 25 he carries his lean body like a man who’s long passed 40 and seen too much, crippled with the cares of the world.
Yet he hasn’t had a hit for almost five years. Since 6 June 2001 to be exact – nine years after he started. The reason? “To be cool”.
Like most reformed addicts he knows the precise moment he made the decision to quit. He’d just been diagnosed as HIV positive, probably through sharing dirty needles.
“I didn’t know anything about the disease,” he said. “I thought I had only six months left and I didn’t want to die. So I stopped.”
He’s lived to turn his corroding negative experiences into positive action by starting a drug rehabilitation centre in the hill town of Trawas outside Surabaya.
Wahana Kinasih was funded by Dony’s mother, Margarethna Nanik Sunarni. She stayed the distance with her son through the soul-scarifying years searching for a cure in Indonesia and overseas.
Medication, counselling, shock therapy, religion, brutality – Dony’s had them all. He knows more about drug addiction and failed treatments than a hall full of experts who’ve never felt the soaring thrill of a hit and the wrenching agony of withdrawal.
But he has to sit politely in drug conferences and listen to doctors, government workers, police and others tell addicts to pray feverishly, drink coconut milk, see a paranormal – or just decline.
“The SAY NO TO DRUGS campaign isn’t working for the same reason it didn’t work in Australia 20 years ago,” said Joyce Djaelani Gordon.
“It’s pushed by people who have limited understanding of substance abuse, addiction, social marketing and behavior change.
“If they’d done solid research they’d know the message ‘say no’ is translated as ‘do’. Basic psychology shows most people want to try what they’re told not to do.”
Joyce is a psychologist and founder of the Yayasan Harapan Permata Hati Kita (YAKITA) addiction and treatment centre at Ciawi, Bogor in West Java.
She works with her husband David, also a psychologist and former user, helping addicts. Their strategy is based on a psychological spiritual approach and the 12 steps Narcotics Anonymous program.
This has been built from the internationally famous and proven Alcoholics Anonymous strategy. This provides an instant aftercare program through regular confidential group meetings where experiences are shared.
NA supporters believe addiction is a disease. Users have to take responsibility for their actions and recognise a power greater than themselves. Treatment has to involve the family – often the root of the problem. The spiritual principle is: ‘Trust God, love yourself and help one another.’
Indonesian statistics, as former President Megawati Sukarnoputri once observed, are not to be trusted. Officially the police say they handled almost 6,000 drug cases in Jakarta last year and made almost 8,000 arrests.
The Jakarta Narcotics Agency reckons there are up to 15,000 injecting drug users in the capital alone. NGOs talk about a pandemic and say maybe a quarter of a million people around the archipelago already have HIV – with the number growing daily.
One study involving the National Narcotics Agency and the University of Indonesia claimed Indonesians are spending more than Rp 12 trillion ((US $ 1 billion) on drugs.
Whatever the real numbers no one denies there’s a serious problem. The disputes come over ways to treat it.
At one extreme is the roughhouse heavy-penalty approach. As the junkies say – “if your only tool is a hammer, you see every problem as a nail.”
When politicians announce ‘crackdowns’ and ‘tough stances’ they know they’re on a vote-winner. Electorates everywhere find the issue dirty and too difficult to unscramble. Druggies are not nice people. There’s little sympathy - until a family member becomes a user.
Then the awful education begins.
“Recovery is a long process,” said David Gordon. “There can be four, five or more relapses before an addict gets clean. Parents get tired, disgusted and depressed. They lose faith in ‘cures’ and grow wary of treatments.”
In 2001 then President Megawati declared a ‘war’ against drug trafficking to much acclaim. But despite his past experiences and present front-line commitment Dony refuses to be conscripted. The bumper sticker on his little red car reads: DRUG ABUSE IS BAD; THE DRUG WAR IS WORSE.
The US has been running its drug war for years. Millions of dollars have been spent and nearly 500,000 are behind bars for drug crimes. Yet drugs get cheaper and more readily available.
The US-based Drug Policy Alliance advocates public health alternatives to the criminal justice approach; this means treatment instead of jail for users. The Alliance says the war on drugs has become a war against public health, constitutional rights and families who suffer dreadfully when a breadwinner is jailed.
The reasoning runs that a war has a clearly defined enemy, while the drug issue is too complex for them-and-us, good-and-bad solutions. But like all snappy slogans the appeal lies in the mind-numbing simplicity.
We get warm fuzzies by sponsoring a SAY NO banner, even when it hangs alongside a slick ad promoting cigarettes – which many say is the gateway drug to narcotics.
Drugs have founded a major legal industry in Indonesia. The police, lawyers, jailors (50 per cent of prisoners have been sentenced for drug crimes), bureaucrats, doctors, clinics, journalists, ad agents and many other professionals are making money. They do so by catching, prosecuting, defending, denouncing and treating users. There’s no shortage of work.
Attitudes alter when the kids of the powerful fall victim. When former Australian Prime Minister Bob Hawke revealed his daughter Roslyn was a user the image of the druggie as a down-and-out lout who deserved no pity took a battering.
The PM’s admission encouraged others to be frank, showing that drug abuse has no class, education, social or religious barriers. Public discussion opened the issue and the old taboos collapsed. A new campaign began.
President Susilo Bambang Yudhoyono has said Indonesia is committed to fighting AIDS, but there is no nationally agreed strategy on prevention and intervention.
“Countries which have adopted harm-reduction programs (like needle exchanges, factual information and easy access to condoms) have brought HIV / AIDS under control,” said Joyce.
“However Indonesia and the US where they’ve focussed on eliminating illicit drug use have seen the diseases spread rapidly.” Commented her husband David: “Indonesia has plans for action, but no action. Few have any idea what to do.”
WHY DO PEOPLE USE DRUGS?
Family breakdown, peer pressure, spiritual crises, avoiding reality, sexual hang-ups and trying to handle the hormonal turbulence of puberty are all factors that turn some people to mood-altering substances.
But not all. Supporters of the disease model of addiction say people with this affliction are like diabetics; they have a genetic code (a yet undiscovered X-factor) not of their making and which can never be cured.
Just as diabetics have to avoid sugar to survive, so junkies must stay clear of narcotics to live. However others without this code can use drugs without becoming dependant – just as not all whisky drinkers become alcoholics.
This is a fact the scare-tacticians won’t admit – but most users know. Drug use doesn’t necessarily lead to a ghastly death and interment in an unconsecrated phantom-filled pit – so shock-horror programs don’t work.
The other fact not recognised in the current campaign is that drugs are fun. They give pleasure, and who doesn’t seek that? That’s why millions use the legal drug nicotine.
Not all psychologists accept the disease model. Others say addiction is learned behavior and can be unlearned. Many of us can become addicts, though not necessarily to drugs. Working, gambling, shopping and eating to excess are all forms of addiction.
HARM REDUCTION OR DRUG PROMOTION?
The idea of responsible drug use by people who know the facts and use clean needles and condoms collides with the current laws and community values.
Harm reduction, as advocated by people like Joyce Djaelani Gordon and other professionals, is interpreted by religious moralists as an encouragement to sin.
Conservatives argue ignorance is bliss because the more people know the more they’re likely to try. Look at the logic: Abstainers never get HIV. Sadly that’s not true, as many monogamous lovers of promiscuous partners have discovered.
Appalling health problems that can impact on the whole community are already here and expanding. In one study of injecting drug users who used prostitutes, the percentage of men who had unprotected sex was far higher in Surabaya than any other Asian city surveyed – including Bangkok and Hanoi.
These same men go from brothel to marriage bed, passing on HIV to their innocent wives – and their future children. Meanwhile their infected sex worker partner continues serving scores of clients.
Experts working in HIV /AIDS programs have calculated that every day another 100 people are infected across the archipelago, and the rate is accelerating.
Nepal, India, Bangladesh and Vietnam have already started harm reduction programs, though these are reportedly being outpaced by disease.
Harm reduction boosters claim it’s impossible to stop people using drugs and having sex. Their opponents say they’re being weak and defeatist – and that people must rise above their basic instincts – as all religions advocate.
SO WHAT CAMPAIGNS WORK?
Human psychology is complex. The government health warnings on cigarette adverts and packages are explicit: You could get cancer, have a heart attack, become impotent … but sales continue to rise.
That’s because every smoker can point to a nicotine addict who’s still alive – and assumes the deaths of others were from natural causes.
Few light a smoke or take a hit and drop dead. The time between cause and effect can be years, so really effective campaigns focus on the immediate result.
Comics produced by Streetwize Communications are in basic language and show situations that kids on the margin can understand. Like users being unable to play sport, getting kicked out of the band and losing mates. The comics are tested for effectiveness with the kids – not the bureaucrats.
Celebrity endorsements help. When pop idol Kylie Minogue got cancer last year thousands of young women who had long ignored medicos urging mammograms suddenly got their breasts checked.
A successful Australian campaign to persuade people to exercise was called Life. Be In It. It didn’t talk about heart attacks and other negatives but concentrated on the fun in playing sport.
Psychologists know that people change their behavior when they realise their lives are unhappy. There are many ways of getting to that point, and most take time.
AT THE FOOTHILLS OF THE MOUNTAIN
Tri Anggun Prihanti and her colleague Diah Laksmi Gumilang assembled their bravest faces and fronted 250 teenagers in a crowded Muhammadiyah junior high school library.
The noise was like Mount Bromo erupting and the sweat enough to start a landslip, but the teachers pushed on with astonishing vigour.
The questions were hardly challenging and included: “What’s a man’s reproductive organ called? Ovary, womb, testicles or vagina?”
Predictably some boys sniggered, but the girls (in a separate group) paid attention. The two young women working for the Empowered Youth Program handled the class well, conscious the school day was ending and extra-curriculum classes are seldom popular.
“Most know about sex but not safe sex,” said the program’s field coordinator Jusuf Agung.
“We’re trying to get information into the schools but not all want us. Some impose restrictions. Often the word ‘condom’ is banned which makes the lesson ineffective. Ideally the topic should be in the curriculum.”
Since the program started late last year more than 10,000 high school students in East Java have been given some information about safe sex and addiction.
Funded by the United Nations Children’s Fund and Yayasan Kita the program has 57 workers around the province wrestling the bureaucracy, school timetables and inadequate funds to inform kids about their bodies.
“I hope that when these kids become parents they’ll be able to communicate with their children about sex,” said Tri. “The present generation finds it so difficult.”
THE BUSINESS OF COUNSELLING
Opening rehabilitation centres has become a racket according to Dony, whose claims are backed by other drug workers. “Some unscrupulous doctors have opened clinics, charged huge fees up front and prescribed expensive medication,” he said.
“When the treatment fails they close up shop. Other religious-based treatments think addiction is a moral flaw caused by a failure to follow ancient teachings. Some are brutal and believe bashing or sexually abusing inmates helps a cure.
“I’ve experienced these ‘treatments’. I’m a Catholic, not an agnostic. Most users are religious.”
In Indonesia there are no controls on who can open a rehabilitation centre or call themselves counsellors. Elsewhere such centres are monitored by the government or professional body, and a ‘counsellor’ must have qualifications from an approved educator.
It’s a very tough job that requires extraordinary skills. By their own admission junkies are very difficult to work with – and experts at manipulating. As the survivors say, it takes “hard wisdom.”
At last count there were around 80 rehab centres, most in Jakarta. But they open and close like curtains and there’s no user guide to the quality or success rate.
Fees charged vary from nothing to hundreds of millions of rupiah. (Dony’s Wahana Kinasih charges Rp 3 million a month for full board and treatment, but waves this when clients are proven poor.)
There are no court diversion programs in Indonesia where addicts are given the choice of rehabilitation instead of incarceration. In any case, said Dony cynically, most would prefer prison knowing that drugs would still be available inside jail and cheaper than on the streets.
Many rehab centres don’t have aftercare or re-entry units. The result is that apparently clean clients go from several months’ treatment straight back into the environment which first caused them to become users.
POLICE HELP – OR HELP, POLICE!
Free rehabilitation centres and de-tox treatments for the poor in East Java aren’t necessary because users come from rich families, according to Police Commander Sarwono.
The province has three hospital-based de-tox units and six rehab centres registered with the police, though many others operate without telling the authorities.
“Users fear that if they go to a rehab centre they’ll be arrested,” he said. “That’s not so – they’re victims. We’re looking for the suppliers, the Mr Bigs. It’s better to prevent than repress.
“The poor can’t afford to use drugs. (Former users say a hit of heroin costs about Rp 100,000 – US$ 11). Sellers target the rich kids.”
Sarwono, who heads the 85-strong drug unit in the East Java Police said last year more than 2,000 suspects were arrested. More than 60 per cent were later convicted of trafficking. Most drugs were found to have come from Thailand and Aceh.
“I’m optimistic about the future,” he said. “The problem is getting bigger but we are also achieving more arrests and finding more drugs and drug factories.
“But to catch the suppliers we must have the support of the community and people who will inform us of drug sales. They should not be frightened to do that. We’ll protect them from any retribution.”
Drugs have produced a blight of bureaucracies and acronyms to bamboozle the newcomer.
Former president Megawati gave the task of coordinating the anti-drug campaign to the spooks - the National Intelligence Agency (BIN), maintaining the law-and-order approach. Previously the job had been done by the National Narcotics Coordinating Agency (BKKN).
This became the National Narcotics Agency (BNN) with responsibility for implementing programs rather than helping funding agencies and NGOs work together. Critics say this has created a mess of competing and overlapping programs.
The ideal system according to Joyce would have agencies assigned specific tasks and research by one authority so there’s no duplication.
Then there’s GRANAT - the National Anti-Narcotics Movement. This organisation believes about four million Indonesians use drugs – and most are poor. Many use drugs to escape the ugly reality of their almost hopeless position.
Overseas money is widely used to fund agencies running programs to combat HIV / Aids because the disease is considered a global problem. UNICEF, the Ford Foundation, AusAID and many others have all been involved.
WHERE TO GET HELP
Unfortunately there’s no 24 / 7 national hot line for parents seeking help.
For agencies associated with Yayasan Kita call: East Java (031) 503 9228; West Java (0251) 243 077; Bali (0361) 465 203; Makassar (0411) 873 658 or e-mail email@example.com
(First published in The Jakarta Post 8 March 06)