Family Planning Faces ProblemsFamily Planning Faces Problems
Despite government efforts that have met with world acclaim, teen pregnancy is increasing. INDONESIA: POPULATION GROWTH
HEAPED with laurels from around the world, Indonesia's family planning program is constantly cited as a central achievement of President Suharto's ``new order'' regime and a model for other teeming third-world nations. In accepting a June award from the United Nations Fund for Population Activities, Suharto outlined the program's major accomplishments over the last two decades: The birthrate dropped from 44 to 29 per 1,000, the growth rate declined to nearly 1.9 percent, and the number of couples using contraception jumped from ``around zero'' to 49 percent.
Two years ago the government embarked on family planning education for out-of-school youth, and both government and nongovernment sources say that it may only be a matter of five to 10 years before the subject is integrated into the required population education course - where grades four through 12 learn about the economic and environmental implications of population explosion.
Yet problems of teenage pregnancy and abortion persist behind this mask of international acclaim. While the Indonesian government has vigorously promoted contraceptive awareness among married couples, religious and cultural taboos still prevent such knowledge from trickling down to adolescents - defined as 12 to 24 years of age. This group constitutes at least a third of Indonesia's 178 million population, the fifth-largest population in the world.
``Teenagers usually have wrong information about sex and everything else,'' says Joyce Djaetani, a counselor staffing a new telephone hotline for youth in Jakarta. ``They are hesitant to talk to their parents or teachers.''
The government has held back from including sex education in the public school curriculum, fearful of provoking political instability by alienating Muslim religious leaders. Their hard-won support for the government's family planning program has been critical in a country where 90 percent of the population is Muslim.
Nevertheless, religious beliefs have failed to stem a rising tide of premarital sex. Urban migration, government-encouraged late marriage, and increased exposure to Western culture through mass media have all contributed to the trend, say Indonesian family planning experts. One recent study in Bali, for example, found that 27 percent of young adults surveyed had engaged in premarital intercourse. Seventy-two percent of youths surveyed in Jakarta knew a friend who experienced premarital pregnancy.
With abortion still illegal in Indonesia, national statistics on terminated or unmarried pregnancies have not been tabulated. But in Jakarta alone, more than 20 clinics perform first trimester suction abortion, known as ``menstrual regulation.'' MR is also available in East Java, Bali, and North Sulawesi, among other regions. Even a government-run hospital in Jakarta provides MR, ostensibly for teaching and research purposes. The hospital's adolescent fertility clinic, open three days a week, handles 10 clients daily. A third of pregnant young women opt for abortion.
Unmarried women in both rural and urban areas also resort to timeworn techniques thought to induce abortion, such as consuming unripe pineapple, chili, rice wine, special herbs, or submitting to a harsh massage administered by a dukun, a traditional midwife. Septic abortions increased between 1981 and 1986 in areas where MR was not available, another recent study concluded.
In addition, the Indonesian Planned Parenthood Association confirms reports that venereal disease among high school boys is on the rise. ``Young men ... have sexual intercourse with prostitutes or girlfriends without knowing the consequences,'' says Dr. Sarlito Sarwono, a Jakarta-based psychologist who studies adolescent sexuality.
Indonesian officials privately acknowledge that such problems exist. But for now, the administration has chosen to support the educational efforts of nongovernment organizations rather than rock the boat with curriculum changes.
``From the government point of view, we still consider that the time is not ripe to introduce it,'' says Sans Hutabarat, director of personnel training at the government's National Family Planning Coordinating Board. ``Before you implement a certain kind of curriculum, you have to get the green light from parliament. And according to members of parliament, it is not the right time yet to put it straightforward to youth.
``By using the (nongovernment organizations), on a very small scale, we condition the minds of the people that something can be done,'' he adds.
For example, the government allowed the Indonesian Planned Parenthood Association to organize seminars during vacations in selected public schools. Traveling teams of young counselors from a group called ``Friends of Youth'' have also been allowed to conduct discussions at junior and senior high schools in Java, Sumatra, and West Timor, in addition to answering mail and telephone queries.
And while private schools tend to be tightly regulated under Indonesia's highly centralized education system, many of them have provided ``family life education'' - the polite term used for sex education - since the 1970s, free from government censure. Surprisingly, Roman Catholic schools have been in the forefront.
The leading figure behind efforts to provide public school youth with family life education is 70-year-old Maftuchah Yusuf, formerly a member of parliament, vice-chairman of an influential Muslim women's group, and a professor at Jakarta's most prestigious teacher training institute.
Convinced of her cause and secure in her status, she has lobbied Ministry of Education and Culture officials, former colleagues in parliament, and revered Muslim leaders.
``Every time I talk about reproduction I cite the Koran first, so I am covered,'' says Mrs. Yusuf. ``The religious leaders say that sex education is Western, that (Westerners) want us to be promiscuous like they are. We don't want Muslim groups to think we are being influenced by the evil outside.''
She cites as an example, a local translation of a Swedish sex education book designed for children, which was banned by the government last March after religious and other community leaders condemned the book's graphic language and illustrations. ``This book was not in line with people's sense of ethics,'' explains Dr. Sarwono. ``Many expressions, many phrases were not nice.''
Sarwono and others committed to filling the information gap concur that any knowledge must be dispensed with a dollop of discouragement.
``The girls think they can win the attention and love of their boyfriend,'' says Jakarta counselor Djaetani. ``The boys still want the girl to be a virgin. If the girl does not live up to that, she may have problems later on.'' According to Nani Yamin, director of the Jakarta-based Institute for Consultation and Legal Aid for Women and Families, male resentment over wives' premarital activities has become a major factor in the high divorce rate on the densely populated island of Java.
``You have to start from the beginning,'' says Dr. F.A. Moeloek, a member of the obstetrics and gynecology department at the University of Indonesia school of medicine. ``If all these boys and girls know about family planning, it is very easy to continue when they are married.''