The Body As Battleground in Indonesia
by Maggie Helwig

It has recently come to public attention that the Canadian government, via CIDA, is partially funding a coercive birth control program involving massive delivery of Norplant to women in Indonesia and its occupied territories.

The Indonesian Norplant program is administered by the Indonesian Department of Public Health, and funded by the Population Council and the United Nations Fund for Population Activities. CIDA provides core funding for the UNFPA, and has also provided funding to the

Population Council. The Population Council is an organization which develops and promotes birth control methods in developing countries, and whose board of directors includes McGeorge Bundy, and W. David Hopper, the vice president for South Asia of the World Bank.

It is questionable whether a high-tech contraceptive program like Norplant should be implemented at all, without the medical infrastructure to make it tolerably safe. And Indonesia is certainly lacking that infrastructure. Health care in Indonesia is poor even by the standards of the developing world, and both infant mortality rates (82 for 1,000 live births) and the rates of death in childbirth (4.5 for 1,000 live births; 11 for 1,000, for women 15 to 19) are very high. Of course, this is averaged out over the different regions. Mortality rates are lower in areas like Jakarta, but much higher in outlying areas, and highest of all in occupied East Timor; where, predictably, the health infrastructure is weakest. And where high-tech contraceptive programs are most eagerly pursued by Indonesian authorities.

Perhaps the most distressing thing about Norplant, though, is its potential for use in coercive birth control programs. More than any other method of birth control, it removes from a woman any possibility of choice -- once the implant is in, it is difficult to remove, and until it is removed she simply cannot decide to bear a child. Indeed, in a test case in Bangladesh in 1985, doctors refused to remove any Norplant implants, though some of the women were suffering severe side effects.

The involvement of the Population Council, with its World Bank links, is clear enough evidence of the sort of elite-based model of 'development' that is behind this, and other, birth control programs. Even in the United States, Norplant is already clearly being used in coercive ways; for instance, in the case of Darlene Johnson, who was convicted of child abuse and sentenced to Norplant. The Kansas state legislature is considering paying welfare mothers to get Norplant, and the medical director of Planned Parenthood of Sacramento Valley has said that "the best candidates are non-compliant patients" (i.e. women who want to bear children when their doctors don't want them to).

Norplant is as effective a method of forced birth control as sterilization, and much easier to carry out.

In Indonesia, there have long been accusations that the birth control program is coercive, that women are not given enough information about what is being done to them, that they are not offered options, that they may be threatened or bribed into compliance. It is important to note that Indonesian family planning authorities are trying to phase out methods, like the Pill and condoms, which are largely under the woman's control and depend on her co-operation. The family planning agency much prefers injections and implants. Indonesia is by far the world's largest user of Norplant -- fully two thirds of all implants produced are used by Indonesia. This is an all-too-familiar pattern, in which the excuse of 'population control' is used to deprive women of control over their own bodies and lives.

And, critics say, this is especially the case in East Timor.

The Depo-Provera program of 1987 strongly suggests that this is true. Depo, in fact, was and may still be the primary form of birth control in East Timor. Of the women using any form of contraception in East Timor in 1987, 60% were receiving Depo-Provera injections

(which are effective for about 90 days), compared to about 12% in most of the rest of Indonesia. Indonesian figures suggest that perhaps one in every 50 East Timorese women was receiving Depo injections regularly. Few women in East Timor used condoms or the Pill.

These figures alone would suggest a coercive birth control program, even without supporting testimony from East Timorese women that the visiting doctors and nurses came accompanied by soldiers, and that they were not allowed to refuse the Depo injections. Or, as in one instance documented by TAPOL, all of the girls and none of the boys at senior high schools in Dili, the capital of East Timor, were given allegedly anti-tetanus injections. When asked why only the girls received the injections, the Indonesian authorities were unable to answer.

The East Timorese are largely Catholic, and reject birth control on religious grounds; moreover, they know that the Indonesian government aims to replace them, the indigenous inhabitants of Timor, with transmigrants. They want to rebuild their devastated population, not to further reduce it, given that a third of the indigenous Timorese have died at the hands of Indonesia since 1975.

IHS Sterilizations

First Nations Cumulative Index