The shape of the world a generation from now will be influenced far more by how we communicate the values of our society to others than by military or diplomatic superiority. William Fulbright, 1964

Sunday, March 24, 2013


Jesada Nittayajam
On the door of agronomist Jesada Nittayajam’s Malang office is a sign that reads: ‘Thank a farmer for your next meal.’
It’s there to remind his staff that the people who till the soil may have low status in Indonesia but they are the foundation of the country’s economy and without them the nation would topple.
“You can have plenty of money and a high position but without food you cannot survive,” he said.  “We need to respect the people who grow the produce we consume and not look down on them. 
“If you want to get to a farmer’s heart you must do, not talk. Listen to what they say, see what they do, learn from them.”
Not all countries put farmers at the bottom of the social order.  In Australasia they are generally well off and politically powerful, with major capital assets in land and machinery.
In Indonesia the men you see staggering through the paddy steering a primitive plough behind a straining buffalo under a cloudless sky are mainly landless peasants labouring for an absent landowner.
Sociologists claim that the reason many Indonesian women use skin whitening cream is not to mimic Westerners.  Traditional beliefs link pale skin to privilege and position. Only the lowly dark-skinned labor in the sun, so white is right.
Similar thinking has some men growing a long fingernail to show they don’t have to use their hands to make a living.
But such reasoning is lost on Jesada.  Despite holding three senior positions including production logistics manager for his company’s Asia Pacific region, and a master’s degree in business administration, he pulls on his gum boots and wades into the paddy to get dirt under his fingernails and talk to farmers about crop yields.
Which is extra difficult because he doesn’t speak Javanese and correctly reckons his Indonesian is “very poor”.
Jesada, 54, looks Indonesian (which causes communication difficulties when he’s alone in public), but he’s a Thai who has just completed a three-year stint in East Java before heading for Manila. (His successor is an Indonesian.)
It hasn’t been Jesada’s first posting to the Republic.  Early this century he spent two years working in North Sumatra.
So how does a manager without local language skills communicate?   One way is to employ Indonesians who speak English, a language he now knows, and use the staff to interpret his instructions
“Body language is also important,” he said. “I once calmed down a man with a knife who got agitated because of a misunderstanding, just through using smiles and gestures.
“Farmers in Indonesia are much like those in Thailand.  They know if you understand their job, appreciate what they’re doing and they see your intentions.  They may be poor but they are not stupid.  Many are more intelligent than me.  They just haven’t had the opportunities.”
Or luck.  In the early 1970s student Jesada demonstrated in the streets of Bangkok when Prime Minister Thanom Kittikachorn executed a coup against his own regime, scrapping parliamentary democracy.
“We thought we’d won so I went home,” he said. “But the situation reversed and the military opened fire.  If I’d stayed maybe I would have been killed.” 
About 75 demonstrators died in and around Thammasat University.  The protestors, who were seeking new elections, were labelled communists. Along with others Jesada was earmarked for surveillance by military intelligence.
“I wanted to help the poor and do something for my country,” he said. “My original plan was to be a dentist but I thought I could do more with farmers.  So I studied agronomy and after graduation worked for a Christian organization, though I’m not a Christian, for no pay, just for food, living with the people.
“But they spoke badly about the leaders behind their backs. I was told that was the way of the world, but I didn’t like it so left and worked on a pineapple plantation, then with cotton.”
Here he discovered the occupational perils. A backpack spray leaked and saturated his clothes and skin with insecticide.  He still suffers the impact and is allergic to synthetics and pineapples.
His parents worried about his job-hopping so he joined a bank lending money to farmers.  “My friends wanted to kill me because they thought I’d become a capitalist,” he said.
“I learned discipline and that you have to work with different people, even those you don’t like. I saw the other side of the economy. I quit over the bank’s policies. I would not allow them to cheat people.”
So did this behavior indicate an idealist?  “Somewhere between that and a pragmatist,” he replied. “I was too young and didn’t have the patience.  If I’d been a total idealist I would have gone to the jungle to keep fighting.”
Instead he was headhunted by a former professor to work for a US-based multinational developing hybrid seeds.
Still the rebel, Jesada offered to work unpaid for two weeks to see if he liked their policies.  “I did this because I didn’t want to take advantage of them,” he said.  “I thought they were good.” 
The feeling must have been reciprocated because the bosses overlooked his red-tinged past and sent him to the Philippines.  Here he found that English, a language he then didn’t understand, was the company’s communication tool.
This is the way things are run in the Malang office.  When his colleagues slip back into Indonesian or Javanese he reverts to speaking in Thai “so they know how I feel.”
“Indonesia has enormous agricultural potential and in some ways the farmers do a better job than in Thailand where yields are lower,” he said.
“The difference is that Thailand has a surplus and exports rice so they can concentrate on quality. Farms here will get bigger and more efficient. 
“With the right techniques, seed and training rice yields could triple. It will take time, but I’m optimistic.”

(First published in The Jakarta Post, Friday 22 March 2013)


Friday, March 08, 2013


Trade and treaty partners – or friends and neighbours?             

Student Zulino Rizky Hafiz is a bright lad hoping to become an engineer.  His parents in Surabaya are among the new Indonesian middle class, able to find $1300 to send their high school son to Perth’s Tranby College for a fortnight.

He’s been taking part in the Australian government and private BRIDGE programme linking schools on both sides of the Timor Sea.

“I appreciated the informality of teachers and students feeling free to ask for help, though I didn’t like the way teenage boys and girls get so close,” the 17-year old said on his return.

“I never knew we had a neighbour so different.”

Last October Prime Minister Julia Gillard announced Australia’s entry into the Asian Century.  Proposals included developing a new ‘Asia literate’ generation.

Her White Paper also sought the removal of ‘unnecessary regulatory impediments and disincentives to doing business in Australia and moving goods, services, people and capital across our borders.

Despite Keith De Lacy from the Australian Institute of Company Directors reportedly saying the policy was ’a bit patronising’, there was widespread applause – even from Canada. Toronto University’s Professor Irvin Studin called it a ‘strategy of vaulting ambition, with 25 national objectives ranging across social, economic and foreign policy.’

So far, so good.  However as others have written, Ms Gillard’s speech read well, but was more ritual delivery than new direction. Former PMs Paul Keating and Bob Hawke made similar statements about friendship and future.  These were warmly applauded and then quietly forgotten – and not just because the urgings weren’t married to cash.

The observations of young Muslim Zulino, offended by displays of teenage libido, were spot on.  The two countries need more than Canberra-imposed policy to span the gap, geographically close yet culturally distant, requiring huge prolonged efforts and political will to build even the foundations.

Look at the differences:

Australians are mainly big, white, brash, irreligious, pragmatic and well paid.  We live in a nation where powers are separated and the rule of law rules.

Indonesians are generally small, brown, restrained, religious, superstitious, exploited and poorly paid.  They live in a nascent democracy dominated by moneymen and the military. 

We’re eighth on Transparency International’s corruption perception index, with New Zealand number one.  A year ago Indonesia ranked 100.  Now it’s 118.

Our background is as recent transplants, Judaeo Christian, British democratic, colonial now multicultural. Our independence was granted amicably.

Indonesia’s history is ancient with Hindu and Buddhist traditions, feudal, patriarchal and colonised.  Liberal Islam dominates.  Independence was bravely won only after four years of brutal fighting.

The most significant political event in Australia is asylum seekers.  It hardly registers in Indonesia facing an election next year where the concern surrounds quality of candidates.

They tolerate government interference and celebrate community – we praise individualism and personal freedom. In Indonesia inter-faith unions are illegal, de-facto relationships rare. Citizens have to carry ID cards and follow an approved religion. We don’t, and won’t.

For every one of us there are eleven of them. Population growth rate of just one per cent - sounds manageable?  Another baby was born while you read this sentence.

Our friends speak English and live far away in Europe and the US, but we remain in the Anglosphere. Their friends are – well, we don’t really know, but fear they’re in the Middle East.

We speak the international language.  They use a language unrelated to any European tongue and unknown elsewhere

We eat foods based on wheat and milk, and drink alcohol.  Often to excess. Their diet is based on rice and water.

Indonesians are on their own from cradle to grave.  No Centrelink. The welfare system is the family. Our education and health services are free. Theirs are not.

There are more Muslims in Indonesia than the Middle East – and more Christians in Indonesia than Australians in the world.

Democracy only returned in 1999 with minimal bloodshed. But the purge of the old guard was incomplete. Money politics is rampant, widespread and resistant to change.

We do all sports well on excellent facilities. They play soccer badly and practise in the street. So how can such two such radically different cultures intersect peacefully? 

Governments seem to think the way is through trade and aid.  So Australian taxpayers give around half a billion dollars a year to Indonesia. 

There’s no sign kampong folk know of this generosity, or if they did it would enhance their understanding of the people next door.

Despite the fact that the construction industry is rotten with kick-backs much of that money has gone on building 2,000 schools in remote areas in the belief that better educated kids, particularly girls, will benefit all.

It’s hard to argue – unless asking why the Indonesian government isn’t doing the job. 

Indonesia has budgeted US$8 billion on defence this year, including $1.5 million for new military hardware. The nation hasn’t revealed any external threat.  The armed forces are used to put down internal separatist movements, like those in West Papua.  More money goes to the military than any other government agency.

This year Indonesia is spending US$22 billion on subsidies, most of it on fuel, sucking up 20 per cent of the national budget.  Drivers enjoy the cheapest pump prices in Southeast Asia with a litre of standard petrol at 45 cents.

The refusal to scrap the handouts has been widely criticised by the World Bank and Indonesian economists.  They claim the money could be used to build the country’s crumbling infrastructure that’s crippling development.

According to the taxation directorate general, there are 60 million potential taxpayers - but only 20 million are listed and paying taxes. Just half a million businesses are registered out of an estimated 22 million. The government has long promised a massive shake up of the graft-ridden tax system but has yet to deliver.

The Jakarta-based think tank Perkumpulan Prakarsa (welfare initiatives for a better society) reckons the government may have lost half of its tax revenues (nearly USD 60 billion) through corruption and incompetence in tax collecting.

Education and development consultant Robert Cannon has aired some of these criticisms before, but there’s been little reaction.

How the Indonesian government gathers and spends its money is entirely its business. A nation that can’t even dig taxes out of the big miners and stuffs up its defence budget is in no position to point fingers.  But we can select our aid priorities.

Indonesia’s education system is in crisis.  As an Al Jazeera 101-East programme revealed this year, more than half the teachers are underqualified and many don’t always front for work.

The country is at the bottom of the Pearson Study of 40 nations’ schools.  Using aid money to bring top chalkies and administrators to Australia to learn how to teach, write syllabi and run schools would be far more beneficial than paying Indonesian contractors to plaster walls.

And why build schools when an estimated 150,000 classrooms are in urgent need of repair?

The BRIDGE project that helped open teenager Zulino’s eyes to Aussie culture is a splendid initiative that pre-dates Ms Gillard’s statement by four years.  So far it has attracted less than 100 school partnerships.  There are 9,500 schools in Australia.
We’ve been neighbors since Gondwanaland split. For much of that time we’ve viewed each other with suspicion laced with ignorance and travel warnings, inter-cut with moments of great generosity like our magnificent response to the Aceh tsunami and other natural disasters.

Suddenly we’ve heard that they’ve got money.  That means they must need foods and goods. It’s time to say hello, see what they want and how much they can pay.

Are these the foundations for a good and lasting relationship?

We want to join Asia but does Asia want us?  I haven’t heard anyone in Indonesia talking about the Australian Century.  Hillary Clinton launched the Pacific Century a year ahead of Ms Gillard’s statement.

The ideas in the 320-page White Paper are good.  They are also too few and too limited.  Maybe too late or poorly considered.  Like expanding a scheme to allow 1,000 young Indonesians to wander and work in Australia for a year. Previously the number was 100. In addition there are 500 scholarships for the talented and smart to study in Australia.

Generous? Do the maths: Indonesia has 240 million people. About 44 per cent are under 24.

Uncapped Working Holiday Visas have been available for years for other, mainly European nationals, keen to go Down Under.  What better way to learn of another culture by getting dirt under the fingernails, make friends alongside workmates, and build lasting contacts?

For Indonesians it’s the Work and Holiday Programme.  Note the syntax slip.  For this deal applicants have to pass an English test, be tertiary graduates and approved by their own government. 

The scheme is reciprocal but officials on both sides have nailed up the door. Australians are only allowed to teach English, work in hospitals and tourism.  There are reports of students giving up on the paperwork and going elsewhere.

Though jobs are not restricted in Australia, Immigration demands applicants have at least AUD $5,000.  Fees, insurance and air fares put visas even beyond the reach of the new Indonesian middle classes, defined as those who earn more than US $3,000 (29 million rupiah) a year.  Indonesians rightly claim this restricts opportunities to the rich.

The Opposition is proposing a ‘reverse Colombo Plan’ flooding Indonesia with Aussie undergraduates.  Professor David Hill who pioneered the Australian Consortium for In-Country Indonesian Studies forecast bureaucratic barriers.

He told The Australian: ‘Obtaining a temporary resident permit for study in Indonesia is something that individual students find very, very difficult’.

Australian leaders may be serious about an Asian Century where curious and open-minded youngsters can poke around their neighbor’s culture to erase prejudices.

But it’s clear they haven’t got the Indonesians on the same road, relying on change through symbiosis, not strategy.

 Ms Gillard described the policy as a ‘roadmap showing how Australia can be a winner in the Asian century.’ If so the track is tortuous and potholed, and the GPS is malfunctioning.

Discrimination, incompetence or both?  If implementation of such an easy policy can’t get into first gear, what hope for the rest?

Indonesia needs to stop being fearful of its neighbour.  We’re not all Kuta bar slobs determined to fracture the Unitary State and steal jobs off becak drivers.

Just as they’re not all fundamentalists bombing towards a Southern Hemisphere caliphate.

The Asia Century policy is a gentle shuffle forward and a welcome shift from the drivers of defence and security.  The hype makes it sound like a Southeast Asian version of the open border European Community that’s helped dissolve ancient hatreds and foster unity through people-to-people contacts. 

It’s not. It should be.

(First published in On Line Opinion, 7 March 2013)


Wednesday, March 06, 2013


‘To get our kids to understand each other’

Last year Australian Prime Minister Julia Gillard announced her Asian Century policy, which included the line: ’All schools will engage with at least one school in Asia to support the teaching of a priority Asian language.’
Fine ambition, tough assignment.  Duncan Graham reports on progress in Indonesia.

Despite her effervescence, teacher Vicki Richardson is surprisingly media shy.   “I’d never dream of approaching a journalist,” she said, “that’s just not me.”
Which is a pity because once cornered by The Jakarta Post in Surabaya the cultural coordinator for Perth’s Tranby College was delighted to tell a good news story about linking with the East Java capital’s  SMA Negeri 5 (State Senior High School 5).
The partnership started in 2009 when the two schools signed up to the Building Relationships through Intercultural Dialogue and Growing Engagement program, less clumsily known as BRIDGE.
The Indonesian section of the program, financed by the Australian government and the private Myer Foundation, has been the most successful with funding guaranteed till 2015.  However similar but more costly partnerships with China, South Korea and Thailand are reported to be floundering, with few contacts and the cash evaporating mid 2013. 
Started four years before Ms Gillard’s announcement the BRIDGE school partnerships ‘provide teachers and students with the opportunity to engage with peers in Asia’ through  face to face visits of teachers spending a week in an Australian school.

So far there have been 80 Indonesian engagements, though not all have survived, sometimes because the prime drivers, like Ms Richardson and her SMAN5 counterpart, Abdul Latif (left) retire or move on to other jobs. 
That seems to have been the case with Queensland’s Catholic Aquinas College that partnered with Islamic school Madrasah Aliyah Negeri 3 Malang in 2011. Teachers made visits but there have been no follow-up exchanges.
MAN3 has a new principal, Ahmad Hidayatullah.  “I’ve been occupied with other issues but the school still wants to be involved,” he said. “This is a high priority.”
Teacher Thohir Yoga, who has been to Australia, denied religious differences were the reason for the program stalling.  “We’re 200 per cent behind this and ready to go,” he said. “We have the money; we just haven’t had replies to our e-mails.”
They’re not the only ones.  An attempt to get Aquinas to comment for this story has also been unsuccessful.
There are more than 9,500 schools in Australia. The goal is for 512 teachers and 209 schools to be involved with the BRIDGE program by 2015. 
 “Little steps, little steps,” said Ms Richardson, a self-confessed ‘Indophile’ when questioned about the pace of progress during her tenth visit to Surabaya.  At the time she was on her annual leave.
 ‘It’s taken time for my school and colleagues to recognize the value of this program and the need to understand Indonesia. I deliberately wanted to be involved in Java, to extend knowledge beyond Bali, because Bali isn’t the whole country.
“All the Tranby and SMAN5 students have been involved with the exchanges for three years which is testimony to their ongoing friendships.  This is my personal aim, not sanitised visits and then forgotten.”

Last year Ms Richardson (right), who is fluent in Indonesian, was nominated for an Australian award recognizing her work in improving understanding between Muslims and non-Muslims. 

Hampering her mission to help lift Australians’ understanding of the people next door is the reality that most high school students stop studying languages  two years before graduating to concentrate on topics like maths and science.  Official figures show less than six per cent of year 12 students are tackling an Asian language, and even fewer are studying Asia in other subjects, like economics, history and politics.
SMAN 5 was founded in 1957 and has more than 900 students.  It has established links with schools in Singapore, the US and Germany. Tranby is a fee-paying 1000-student college run by the Uniting Church in a middle class suburb of the Western Australian capital.
Although two SMAN5 students pulled out when they learned Australians keep dogs as pets, Mr Latif hasn’t had problems getting parents to pay up to Rp 13 million (US$ 1,400) for air fares to send a child to Tranby for a fortnight.  They stay free with host families who’ve taken a course on cultural differences, including warnings not to serve their visitors bacon. 
“This is a rich school,” Mr Latif said, “just take a look at the students’ cars in the park outside. There’s a waiting list.”  He realized the advantages of exchange programs several years ago while waiting at an airport and seeing scores of Japanese students heading for the US. 
“Why not Indonesia?” he thought – and set about finding ways to make the idea work.  He also has an infectious enthusiasm for exchange programs that must help sway the sceptical and dismissive.
“I never knew we had a neighbor so different,” said Zulino Rizky Hafiz, 17, one of the few boys who’ve been to Tranby. Most exchange students are girls.
“I appreciated the informality of teachers and students feeling free to ask for help, but I didn’t like the way teenage boys and girls get so close.”
Fajar Sartika, 17, who plans to enter medical school, already speaks high level English. She also found the learning environment easier and subject choice more acceptable.  She doesn’t wear a headscarf but some of her classmates who did were jeered by boys at a seaside town, according to Ms Richardson.
“The Tranby girls robustly defended their visitors’ rights, responding that ‘there’s nothing wrong with Indonesians’,” she said. “Suddenly the reality of racism hit home.”
Australian families sitting down together for evening meals and discussing each other’s activities was also an unusual and pleasing experience; others found the absence of maids and having to share domestic duties a bit disturbing.
“Some teachers think that trying to develop exchange programmes is too difficult,” Ms Richardson said.  “But I’ve always thought this is the best way to get our kids to understand each other.”
21st century approaches
Lisa Hayman, senior projects manager at the University of Melbourne’s Asia Education Foundation said the BRIDGE project, which it’s helping develop, was “all about breaking down stereotypes and discovering our neighbors.”
The AEF ‘enables educators to develop Asia literate young Australians’ and provides teachers with resources to teach about Asia’. It’s been running for 20 years pushing mainly monolingual Australians to become ‘Asia literate’.
Ms Hayman’s colleague, former Indonesian language teacher Deryn Mansell, agreed that it was often just one person in a school who became the driving force in a BRIDGE project.  However support of principals and the whole school was important if a project was to survive.
Ms Hayman stressed that although student visits were ideal the cost put these beyond the reach of many.
“We’ve got to look more broadly than just physical exchanges,” she said.  “That’s a 20th century approach – we can’t keep flying around the world.
“It’s time to use 21st century information and communication technology, such as setting up Skype sessions between schools and students using Facebook and smartphones.
“This is already happening, including with some of the 2,000 schools built by Australian aid. Every partnership is different.”
Though not all contacts will be substantial or enduring, supporters say partnerships provide opportunities to learn about other cultures and lifestyles. 
The four-year AUD$4.2 million (Rp 42 billion) program is funded through a private/government partnership. There’s no contribution by the Indonesian government.

First published in The Jakarta Post 6 March 2013


Monday, March 04, 2013


Not imprisoned by the past

Despite three and a half years as a teenage prisoner Theo Nijland still prefers his birthplace to his homeland.  On his 23rd trip to Indonesia the Dutchman told his story of survival to Duncan Graham in Malang.
“I was born in Batavia in 1928.  My father was a senior public servant from Holland.  My mother was born in Indonesia of German and Chinese ancestry.
 “After my father was posted to Padang, I went to a Catholic school.  We had a lovely house, a car and a good life.
“When the Japanese invaded Malaya we weren’t that worried.  We thought we couldn’t lose.  We were too strong, that they couldn’t get past Singapore.  We relied on the British – what can I say?
“The first Japanese soldiers I saw arrived while we were having breakfast. They ordered us out, or be killed. There was no time to flee. They took our watches and money. They were very small men with very long guns, longer than them.  It was 7 April 1942.  I will never forget.
“Because I was small I went into a prison camp with my mother, younger brother and sister.  She was seven. The camp had been a school.  About 3,000 lived there, 30 or 40 to a room.
“We didn’t know what had happened to my father. He was in the KNIL (Dutch army).  They tried to fight but the Japanese were like ants, everywhere, too strong.
“After six months the Japanese realised I was 14 and I was moved far inland to the same camp as my older brother. We lived mainly on tapioca.  There was no protein.  If anyone caught getting food from outside we were all lined up and hit on the head with rifles.  I learned to duck to reduce the blow.
“I was slapped a lot. Only a few guards had feelings. We slept on wooden beds we made ourselves.  The fleas were terrible.  I had a tooth pulled with a spoonful of salt as painkiller. My brother has his appendix removed without anaesthetic.
“We smoked anything, mainly dead leaves using pages from Bibles to make cigarettes. We boiled banana skins. They were tasteless but filling. We ate rats and sometimes snakes – not so fantastic.
 “The food was sent to Japan. I worked on a chicken farm. The Japanese were terrified of disease.  So we rammed bamboo splinters into the skin under the birds’ wings.  This made them collapse and the Japanese thought they were sick.  That was our revenge.
“About a third of the prisoners died. On one day I remember there were 11 bodies.
“I wanted school, but people would only teach for food. I used to think: ‘Is this real?’ I didn’t cry – everyone was in the same position. We got some outside news.  I never gave up hope it would end.
“After the atom bombs were dropped the guards opened the gates.  We didn’t leave.  We were afraid of the Indonesians.  But there was no trouble. They were less fanatical in Sumatra, maybe because women are bosses in Minangkabau culture.
“We had no clothes, just a strip of cloth folded between our thighs so we took Japanese uniforms. I weighed less than 40 kilos
“They transported us to Penang and I eventually found my family by asking around. It was very emotional. We had all survived though my mother had been sick.
“We were very lucky, sure, sure.  Why?  Don’t ask me, I don’t know. Maybe my karma.  Religious?  No.
“We were repatriated to Holland.  My father never spoke about his experiences.  He’d been forced to work on the Pakanbaru railway. He was so ashamed.  My mother told a little.  She had a gold watch from her grandfather that she kept hidden from the Japanese.  That was clever.
“We’d lost all our other possessions. We’ve sought compensation from the Japanese and Dutch.  Nothing.
“In Holland I was two centimeters too short for military service.  I became a marine engineer.  I married Mary Severens in 1953 and we had two sons.
“In 1979, after 34 years in Holland I came back to show my wife the prison in Penang. They let us in.  That was a big mistake. I was so stupid. After that I had nightmares that I was could never get out.
“In Holland I spent three years learning Indonesian and now we return every year, to Medan, Jakarta, Bogor, Bali and now Malang.  We try to spend two or three months here. 
“In Holland there’s no respect.  You get ignored in shops or told: ‘Hey, old man, what you want?’ They won’t even bring you coffee. It’s almost impossible to have a friendly conversation – here it’s every day.  My grandchildren don’t want to know my story. They say: ‘We’re living now, not in the past’.
“Here people are kind. They care and go out of their way to be helpful.  Indonesians don’t seem to bear any animosity to the Dutch. We enjoy the food and lifestyle.
“I hate the Japanese.  I try not to hire Japanese cars, but in Indonesia that’s difficult.  I was once approached by a Japanese on a beach outside Surabaya to chat but I told him to f**k off.  My wife says I shouldn’t hate but that’s my feeling.
“We seldom mix with the Dutch here.  Many are married to younger local women and my wife doesn’t like that.
“I tell Indonesians that I was born here and feel happier here than in Holland.  I say I have a stronger feeling for Indonesia than anywhere else.  Look, my skin is brown. But they say: ‘No, you are still Dutch.’
“Mary is my age, 85 this year. The only effect from my prison life is that I can’t drink milk. The nightmares have now gone.  I forget where I’ve put my watch or today’s appointments, but I remember the hunger. And the fleas.
“What did I learn from those experiences? That we must care for each other.”

(First published in The Jakarta Post 4 March 2013)

Sunday, March 03, 2013



Indonesia isn’t safe for pregnant women. In 2010 almost 10,000 Indonesians lost their lives giving birth. The ratio is at least 228 deaths per 100,000 live births.  It used to be much worse – 20 years earlier the figure was three times higher. What chance has the nation of reaching its much publicised Millennium Development Goal of 102 by 2015?  Duncan Graham reports:

Blond Noelle is the ideal pregnant patient.  She lies naked and unembarrassed with her mouth open and legs apart while two nervous gloved and gowned teenagers tend to her intimate needs. 
Monitors check her blood pressure and the foetal heart beat.  Colored lines snake across screens. A technician fine-tunes the equipment.  Beep, beep, beep – every ear is tuned to a shift in tone or pace.
Slowly the baby appears followed by the placenta.  It’s a girl! No, there’s too much confusion, a boy, little Hal.  Yet no signs of joy from the mother who continues to stare at the ceiling. Nor does she get distressed when her newborn turns blue and needs resuscitation.  Goodness, she didn’t even scream.
Nor will she, for Noelle S575 is a Rp 450 million (US$45,000) computer-controlled birth simulator, the first brought to Indonesia from the US and used in Malang’s largest midwife college, the Akademi Kebidanan Wiro Husada Nusantara.
Inside her plastic womb is a hydraulic pump that pushes baby through the birth canal. The system is so sophisticated that lecturers using WiFi can manipulate the procedure from a distance.  They can create a breech birth, prolong delivery and add other complications, including haemorrhaging, one of the main reasons many women perish during delivery.
The college’s 1,200 student midwives (no men are accepted) only use Noelle when they’re less clumsy in the second year of their three year diploma course that includes attending at least 50 live births. Four year degree programs are also offered.
After a six month internship and getting national certification they head home, usually to villages in Nusa Tenggara, Kalimantan, Papua and other distant areas where professional colleagues and other medical support can often be far away. 
Families spent around Rp 35 million (US$3,500) in course fees and living costs to get their daughters this far, but with more than 3.5 million babies born in Indonesia every year they’ll seldom be idle.
“One of our graduates is getting Rp 7 million (US$700) a month in a hospital (most get about a third of that salary), but others rely on the government’s Jampersal birth insurance program so mothers don’t pay,” said college director Donny Yunamawan.
“Midwives are supposed to get Rp 540,000 (US$54) for a delivery and some pre and post natal care.
“I hear that payments are often late and the sum can decrease as it passes through other hands.  There’s a rumor that the figure will rise to Rp 700,000 (US$70) next year.”
Sunarsih Yudawati, 56, head of Ikatan Bidan Indonesia (IBI - Indonesian Midwives’ Union) in the Malang region and mother of two doctors, reckoned her members would be content with the higher sum paid in full. 
She’s delivered about ten babies a month for the past 30 years.  She said she’d never lost a mother and only two babies, one stillborn.
“There are about 200,000 midwives in Indonesia,” she said.  “The need is for higher quality education at university level and higher payments. The other issue is educating families to accept professional support. This is best done through word of mouth.”
Registered midwives are not the only ones bringing the next generation into the world. A survey of Malang’s midwives by IBI found they were outnumbered by dukun, traditional birth attendants, untrained, uncertified but often the first to offer help in the villages.
Brawijaya mathematics department Professor Waego Hadi Nugroho, who started the midwifery college in 2007, said the dukun were a fact of Indonesian life that couldn’t be legislated away.
“Scholarships are sometimes given to help dukun become professional midwives,” he said.  “I can’t deny they have a role so we teach our students how to collaborate.
“We also don’t have enough puskesmas (community health clinics).  The government’s goal is two midwives for every village.  That’s fine, but the policies don’t match.
“In an ideal situation midwives should develop a relationship with women when they get married. Good nutrition is important. So is family planning. Many girls give birth too young.
“Midwives need to be active and ensure early prenatal care. But even in Malang (East Java’s second biggest city) there are still pregnant women who hide from midwives.”
On the plus side Indonesia has yet to experience the litigation wave that’s swamped countries like the US and Australia with patients suing doctors and hospitals when things go wrong.
The result is that medical insurance premiums have risen steeply and some doctors have given up obstetrics for fear of litigation.
The Indonesian government’s previous policy was to train high school girls for a year and then send them into the regions.  The maternal death rate fell, but not sufficiently.  The data is confusing and elastic, but the World Health Organisation has boiled down its figures to produce a chilling ‘lifetime risk of maternal death’ category.
In Indonesia one in every 210 women of child bearing age faces a premature, awful and largely avoidable death. In Malaysia it’s one in 1300 and China one in 1700. By far the safest place to be a woman is Singapore where the ratio is one for every 25,300.
WHO groups Indonesia as one of the nations ‘making progress’.   Clearly there’s some way to go.
Delivered into poverty

Less than ten kilometers separate Malang city hall from the village of Buring where new Mom Kurniawati, 17,( right)  lives the stark reality of Indonesian life, worlds apart from the offices of government workers shaping health policy.
She has never been to school and only speaks Madurese.  Her baby Sekar Arum was born last month on a crude bed built of scrap timber.  The new Indonesian’s first breath was polluted, her first view of her motherland a patched one-room lattice-wall shack.  
Kurniawati lives together with her casual laborer husband Misle, whose age she doesn’t know, two elderly childless ‘aunts’ who adopted her and are often sick, and a sister.
Aunt Toen earns about Rp 15,000 (US$1.50) a day hawking bananas in the rich suburbs, well below the official poverty line. That’s the family’s income along with Misle’s earnings.  The people are cheerful, the kids are wrapped in love, but the environment is vile.
Outside are two large piles of smoldering timber in a charcoal maker’s yard.  The stench of toxic tars from burning garbage is inescapable.  Inside the kitchen roof leaks through the plastic sheets used covering cracked tiles.
Kurniawati never attended the local puskesmas during her pregnancy even though consultations are free because her husband said ‘no’.  She didn’t know why.
Instead the couple paid a local bidan (midwife) Rp 15,000 for a pre-birth check and Rp 200,000 (US$20) to attend the delivery.  It’s unclear whether the woman was registered.
Commented Sunarsih Yudawati:   “This situation is not unusual.  The puskesmas staff need to get out and find the pregnant women, not wait for them to come.”
 Sekar Arum’s birth only took an hour. There were no complications and the breast-fed baby girl looks fine, confirming village wisdom that fussy professionals aren’t needed in a natural process -  making reform that much harder.

(First published in The Sunday Post, 3 March 2013)