Sunday, 23 September 2012

National Workshop on Health Care Needs of Older Persons




National Workshop on Health Care Needs of Older Persons
Organized by RI Ministry of Health in collaboration with Yayasan Emong Lansia,
 funded by UN ESCAP
Jakarta, 22 – 24 August 2005.


Background

The Madrid Plan of Action in 2002 called for “Attitudinal Change towards Older Persons and Development, however, every country in the world to a certain degree have to overcome difficulties in resources, knowledge, expertise and personnel related to supporting older persons both in the family as well as in the community.

In anticipation of the next high-level meeting on ageing to be held in Macao in 2006 and the global review on the implementation of ageing policy and programs to be held in New York in  2007, Indonesia funded by UN ESCAP will hold a national workshop on Health Care Needs for Older Persons that will focus on Individual, Family and Community Support of Older Persons in Indonesia: Past, Present and Future policy and programs of the older population in Indonesia.

The objectives of the workshop will be to deliberate on strategic issues related to policy and program of the older population in Indonesia and specifically emphasize on the updating of the 2003 Indonesia National Plan of Action with focus on health and long term care in line with the 2004 Government regulation No. 43 on older person protection, and 2004 Presidential decree No. 52 on the National Commission for Older Persons.

The strategic issues to be discussed in the national workshop are:

Ageing and Development: Implementation of the Healthy Paradigm towards Healthy Ageing
Speakers: UN ESCAP, National Commission, Health


Older Persons Empowerment, Needs and Enabling Environment
Speakers: Women Empowerment, Public Works, Social Affairs.
Moderator: IEN

The role of family and community in supporting an enabling environment for older persons
Speakers: Demography, NGOs of east Java, Jogjakarta and Jakarta
Moderator: BKKBN

Integration of Ageing issues into Policy
Speakers: UNESCAP
Moderator: InResAge Trisakti University
Methodology

A selected group of stakeholders representing government and social organization namely: peoples welfare, health, social affairs, women empowerment, BKKBN, national commission, manpower, public works, transportation, national education, internal affairs, religious affairs, as well as social organizations such as Pelita Usila, YEL, LLI, FKLU, Pergeri, DNIKS, Askes, University of Indonesia, Indonesia Epidemiology Network., will be invited as participants.

In the workshop participants will be trained by the UN ESCAP trainer on an Older Person methodology to assess the health care needs of older persons. The participants will be divided into 6 working groups consisting of stakeholders and facilitated by 6 facilitators of InResAge Jakarta Trisakti University member of Indonesia Epidemiology Network. After being trained on this methodology, the participants will apply this method in the evaluation of various inputs of the first plenary session in the workshop related to the issues addressed in the 2003 Indonesia National Plan of Action for Older Person Welfare. The participants will be divided into 3 working groups namely 1) older person empowerment, 2) health and social needs, and 3) enabling environment. This evaluation and recommendations will be further formulated in the final plenary through group presentations, and summarized by the steering committee in the executive summary.


The output of the national workshop on Health Care Needs for Older Persons will identify strategic issues to be addressed in the future amended Plan of Action for Older Person Welfare in Indonesia in the form of conclusions and recommendations, and these results will be conveyed as country report at the global review of implementation in Madrid 2007.

The national workshop will be a 3-day workshop held in Bidakara convention venue (Bumikarsa hotel), Jakarta, on August 22-24th , 2005.

Organization

Chair-person of the national workshop is Dr. Susilo Wibowo, specialist Cardiology, of Pergeri (Indonesia Gerontology Society)

Chair-person of the steering committee is Dr. Nugroho Abikusno, M.D., M.S., DrPH of InResAge Trisakti University, Jakarta member of IEN (Indonesia Epidemiology Network) with members Prof. Dr. Tri Budi Rahardjo (University of Indonesia/ IEN, Dr. Sonja Roesma, SKM (Former Director PT ASKES), Ir. Ngatiyo Ngayoko, MM (Assistant Deputy for Disabled and Older Persons, RI Coordinating Ministry for Peoples Welfare), Dr. Asviretty Nurgusany Yerly Asir, MPH (Assistant Deputy for Older Women and Disabled Women Protection, RI Ministry for Women Empowerment), Dr. Tony Setiabudhi (Pergeri) and steering committee members from National Commission, Health and BKKBN.

Chair-person of organizing committee is Mrs. Eva. S. Sabdono, MBA of HelpAge Indonesia.

Tentative program schedule:

Day One:

9.00-10.15 AM

Opening Ceremony:
Welcome remarks by Mrs. Eva Sabdono (YEL/HelpAge Indonesia)
Report by Chair-person of Workshop (Dr. Soesilo Wibowo)
Speech by UN ESCAP
Speech by RI National Commission for Older Persons by Mrs.Inten Soeweno
Speech and Opening by HE Prof. Dr. Alwi Shihab, RI Coordinating Minister of Peoples Welfare
Keynote speech by the RI Minister of Health on Ageing and Development: The strategic role of older persons in Indonesia in the Global era

10.15-10.30 AM
Coffee break

10.30-12.00

Session One: Empowerment, Health, Social Needs and Enabling Environment.
Moderator: Prof. Tri Budi W. Rahardjo (UI/IEN)

Women Empowerment by HE Dr.Meutia Hatta
Public Works by HE Minister/ Secretary
Social Affairs by Dr. Pudji Hastuti (Director General)

12.00-13.30
Lunch

13.30-15.30
Session Two: Ageing & Development: Demography, Family and Community Support
Moderator: Dr. Ratnasari Azahari (BKKBN)

Demography of Older Persons in Indonesia by LD UI
Case studies:
Surabaya by Prof. Daldiri Mangundiwiryo (ABIYOSO/National Commission)
Jogjakarta by Mrs. Utaryo (DNIKS)
Jakarta by Mrs Eva Sabdono (YEL/HelpAge Indonesia)

15.30-16.00
Coffee Break

16.00-17.30

Session Three: Integration of Ageing issues into Policy
Moderator: Dr. Nugroho Abikusno (InResAge/ IEN)

Long Term Care in Indonesia by Dr. Sonja Roesma (Pelita Usila)
Guidelines of Shanghai implementation strategy by UN ESCAP
Use of ADL/ IADL by UN ESCAP
Media perspective of Ageing by UN ESCAP


Day Two:

Training sessions on UN ESCAP methodology

8.00-9.30
Session One: UN ESCAP method guidelines
Facilitator: UN ESCAP and InResAge/ IEN

9.30-10.00
Coffee Break

10.00-12.00
Session Two: Small group session

12.00-13.30
Lunch


13.30-17.00
Session Three: Small group session

Session Four: Small group session


19.30-21.30
Session Five: Small group session


Day Three:

8.00-12.00

Evaluation and Recommendation
Group Discussions on

I. Older Persons Empowerment

II. Health and Social Needs

III. Older Person Enabling Environment

12.00-13.30

Lunch


13.30-17.00

Plenary Session

Group presentations
Moderator: Dr. Nugroho Abikusno

I. Older Persons Empowerment

II. Health and Social Needs

III. Older Person Enabling Environment

Executive Summary and Recommendation of national workshop
Moderator: Dr. Soesilo Wibowo
Secretary: Dr. Nugroho Abikusno

Closing Ceremony

The Participants of workshop:
30 participants representing stakeholders in ageing affairs namely government, NGO, academia, older persons, business, and mass media, will be invited to participate in the national workshop.




INDONESIA’S COMPLIANCE





INDONESIA’S COMPLIANCE
with the Convention Against Torture and Other Cruel,
Inhuman and Degrading Treatment or Punishment

Issues for Discussion with
the Committee Against Torture

Submitted by
National Commission on Violence Against Women
(KOMNAS PEREMPUAN)
Jakarta, April 2008


Background

1.      This document is submitted to the Committee Against Torture (CAT) by Indonesia’s National Commission on Violence Against Women (hereafter, Komnas Perempuan), for the purpose of highlighting critical issues and challenges faced particularly by Indonesian women in fulfillment of their right to be free from torture and other cruel, inhuman and degrading treatment or punishment, as guaranteed by Indonesia’s Constitution and stipulated in the International Convention Against Torture and Other Cruel, Inhuman and Degrading Treatment or Punishment (hereafter, the Convention). This initiative is taken based on Komnas Perempuan’s mandate, as designated by Presidential Decree No. 65/2005, to create a conducive environment for the elimination of all forms of violence against women and the promotion of women’s human rights.

2.      Komnas Perempuan would like to extend its appreciation to the UN High Commission on Human Rights and CAT for recognizing the work of this national commission and for providing space for us to make a direct contribution to its functioning based on our national mandate. There are two international conventions mentioned as reference in the  Presidential Decree which established Komnas Perempuan: CEDAW and the Convention Against Torture. Both the UN Special Rapporteur on torture[1] as well as the UN Special Representative for the Secretary General on human rights defenders[2] gave special mention of our commission in their respective reports on Indonesia.

3.      Through this brief, Komnas Perempuan highlights eight critical issues which are key to Indonesian women’s human rights as they relate to CAT’s mandate and its communications to date with the Government of Indonesia. The eight critical issues are the following: (i) impunity on rape and sexual harassment; (ii) inadequate institutional framework for implementation of new legal breakthroughs; (iii) new forms of corporal punishment under decentralization; (iv) increasing risk towards regressive policies in the name of religion and morality; (v) lack of legal safeguards in social rehabilitation and migrant worker transit centers; (vi) inadequate reparation for victims of past violations; (vii) lack of a national  preventive mechanisms against torture; (viii) no effective protection mechanism for human rights defenders.

4.      Accompanying this brief is a report previously submitted by Komnas Perempuan to the UN Special Rapporteur on Torture during his official visit to Indonesia in 2007, which is also relevant to CAT and is submitted as an integral part of this brief.

Critical Issues

Impunity on gender-based forms of torture: rape and sexual harassment

5.      Indonesia’s Criminal Code applies a definition of rape which is outdated and does not meet current international standards on prosecution of rape cases. In it, rape is defined narrowly and exclusively in terms of forced penetration of the sexual organs. According to Indonesia’s Code of Criminal Procedure (KUHAP), the prosecution of rape requires evidence of semen through medical records (visum et repertum) and corroboration from two sources, including a witness. Such legal provisions make it practically impossible for women victims of rape and other forms of sexual violence to obtain justice through the courts. In effect, Indonesia does not have an effective legal framework which criminalizes this gender-specific form of torture.

6.      Indonesia’s Law No. 26/2000 on the Human Rights Court adopts the Rome Statute’s gender-sensitive definition of crimes against humanity which recognizes gender-based violence and sexual slavery. However, because Indonesia has not ratified and integrated the Rome Statutes in its entirety, including its procedures and rules of evidence, then women who have experienced sexual violence in the context of widespread or systematic attack on civilian populations still do not have access justice. At the moment, this Law on the Human Rights Court can only be applied using the existing Criminal Code and Code of Criminal Procedure which are not conducive to justice for women.

7.      Indonesia has no legal provision which criminalizes sexual harrassment.

8.      Severe limitations and silence in the legal provisions on rape and sexual harrassment within the Indonesian legal framework amount to impunity on major forms of torture which are gender based. (CAT list of issues no. 15, article 14)

Inadequate institutional framework for implemenation of new legal breakthroughs

9.      As part of Indonesia’s efforts for comprehensive reform, new laws have been enacted for the purpose of protecting human rights, including women’s human rights. Among others, in 2006, Law No. 13/2006 on Witness and Victim Protection was passed. The objective of this law is in accordance to Article 13 of the Convention, namely to provide a sense of security for witnesses and victims in providing information during a trial proceeding. It includes victims and witnesses in cases of gross violations of human rights.

10.  For enforcement of such protection, the Government is required to set up a Witness and Victim Protection Body one year after the law was passed. This body also determines compensation and restitution for victims. One year after the law was passed, in 2007, the President finally submitted candidates for membership in the body from which the Parliament has to make their final selection. To date, the Parliament has not convened a special session to finalize the members of the Witness and Victim Protection Body, consequently making the Law unimplementable almost two years after its was passed.

11.  In 2004, Indonesia passed Law No. 23/2004 on the Elimination of Domestic Violence (CAT list of issues no. 18, article 14). Since the law was passed, reporting on domestic violence has increased significantly, reaching more than 20,000 in 2007 alone. Through its annual report on violence against women, Komnas Perempuan shows that women’s organizations, special units within the Indonesian police force which deal with women and children victims of violence, and local courts have been the most active in using this new law. In 2007, the Indonesian National Police came out with a policy to nationalize its special units for women and children (CAT list of issues no. 23, article 10). However, a significant proportion (30-40%) of domestic violence cases are addressed by the religious courts, through divorce cases within Muslim families, while these religious courts are in fact the least knowledgeable of this law.[3]

12.  Obstacles to effective enforcement of the Law on Elimination of Domestic Violence originates from limited regulations and protocols for implementation, low levels of understanding of law enforcement agents on this new law, insufficient allocation of Government funds to provide the necesarry support system and capacity building requirements.

New forms of corporal punishment under decentralization

13.  As part of the peace agreement in Aceh, Law No. 11/2006 on Aceh Governance stipulates that the Sharia Law is enforced in this province as recognition of its special autonomy status within the Indonesian Unitary state system. Local regulations produced in Aceh have their own Arabic term, qanun (cannon). Through the qanun, Muslim dress is obligatory for Muslim women and close proximity between an unmarried woman and a man who is not her guardian (khalwat) is a violation punishable by public flogging. This  form of punishment has never existed within the Indonesian legal system and undermines the provisions of Law No. 23/2004 on Local Government which stipulates that law, religion and security as sectors which remain under the authority of the national government and are not decentralized to local governments.

14.  The procedures of implemenation violates basic legal guarantees, including the principle of presumption of innocence. The prosecution process developed in enforcing Sharia Law provides no protection to the rights of those accused of its violation. The accused are provided with no opportunity to defend themselves, have no right to legal counsel, and, therefore, increases the risk of punishing innocent women. The provincial government in Aceh has established a new body to enforce the Sharia Law, the wilayatul hisbah, another unprecedented body within the Indonesian system of governance.

15.  Punished women face persistent stigmatization by the community. Komnas Perempuan has found that this form of punishment, which is carried out in public view (including children), results in a persistent stigmatization of those accused of violating the Sharia Law. The generated social sanctioning lasts far beyond the execution of flogging. For women, the impact of the punishment is worse than for men. Women sentenced with public flogging are labeled as immoral by their community, families and husbands.

16.  As part of their newly-gained autonomy, under Indonesia’s decentralization scheme, other parts of Indonesia has started introducing public flogging as a form of punishment, such as Bulukumba District (South Sulawesi), although it has not been implemented.

17.  In his report on Indonesia (A/HRC/7/3/Add.7, point no. 17), the UN Special Rapportuer on torture expressed his concern about this form of punishment, based on the principle that corporal punishment constitutes degrading and inhuman treatment in violation of article 7 ICCPR and article 16 CAT and should therefore be abolished. The Special Rapporteur recommends that the Government should ensure that corporal punishment, independently of the physical suffering it causes, is explicitly criminalized in all parts of the country.

Increasing risk towards regressive policies in the name of religion and morality

18.  Komnas Perempuan is alarmed at the preparations being made by the Attorney General, Minister of Religion and Minister of Internal Affairs to come out with a Joint Decree which would criminalize the religious activities of Ahmadiyah, a small Muslim minority group. The Ahmadiyah community has been targets of violent attacks in the past few years (CAT list of issues no. 38, article 16), which is part of a larger trend of rising militancy among Islamists in Indonesia. These attacks have been legitimized by the proponents as implementing a fatwa of the Indonesian Council of Ulama (MUI). If the Joint Decree against Ahmadiyah is passed, it will create a new precedent where the Indonesian Government is effectively outlawing a religious group, in violation of Indonesia’s own Constitution which guarantees freedom of religion.  

19.  On April 2006, the Supreme Court rejected a request by civil society organizations for a judicial review of Tangerang’s discriminatory local regulation prohibiting prostitution which, in effect, criminalizes all women who ‘creates the impression of being a prostitute’. The Supreme Court’s rejection of this review was made on basis of a procedural consideration, namely that the formulators had made sufficient public consultations when preparing the draft, and therefore no review of the substantive content of the this local regulation – whose objective is to uphold public morality –  was considered necessary. Until now, the Supreme Court has not released its documents on this particular decision, despite their legal responsibility to do so and in spite of constant requests from rights organizations, including Komnas Perempuan.

20.  As Party to the Convention, the Indonesian Government should take all measures necessary to prevent and address cruel, inhuman and degrading treatment, particularly in light of current trends which target minority groups and women.

Lack of legal safeguards for social rehabilitation and migrant worker transit centers

21.  Through his report on Indonesia, the UN Special Rapporteur on Torture expressed concern over social rehabilitation centers which are held outside the criminal legal framework, resulting in a lack of legal safeguards applied with regard to these institutions. He also notes that there is no independent assessment of who should be detained and no right to habeas corpus for the detainees.[4] Many of those who inhabit these social rehabilitation centers are women and children, making them particularly vulnerable to abuse.

22.  Komnas Perempuan notes a paralel concern with regard to transit centers for Indonesian migrant workers – the majority of whom are women –  who are on their way out of the country as well as those who are on their way back to their hometowns (CAT list of issues no. 36, article 16). In 1999, Government of Indonesia opened Terminal 3 at the Soekarno Hatta International Airport as a special place of migrant workers who just returned from their workplace abroad. Terminal 3 is intended as a protection effort for migrant workers, but in practice, it is a place of deception, exploitation, robbery, and other forms of abuse against Indonesian migrant workers. On average, the number of migrant workers going through this terminal is more than 300,000 persons per annum. Migrant worker transit centers is a critical issue of concern at a large scale, as approximately half a million Indonesians leave the country for work every year.

Inadequate rehabilitation and reparations for victims of past violations

23.  In post-conflict Aceh, a mechanism to provide compensation of the victims of the armed conflict has been established as part of the Helsinki-based peace agreement. Komnas Perempuan’s Special Rapporteur on Aceh[5] has reported cases in which women victims of sexual torture during the armed conflict period have been denied access to the post-conflict rehabilitation program set up by the Government. The type of torture recognized is limited to physical torture, and excludes other forms of torture,  especially its sexualized forms. As a result, many women victims of torture cannot benefit from this Government and internationally-supported rehabilitation program.

24.  Overall, Aceh’s rehabilitation program is focused mainly on physical rehabilitation or monetary compensation and is disconnected from any process of truth-seeking and accountability. Particularly for women victims of sexual violence who are subject to community tendencies of blaming the victim, they require a process of collective recognition that they are victims of systematic violence rather than individual actors of immoral conduct.

25.  Women victims of other past human rights violations beyond Aceh, such as victims of massive arbitrary arrests and sexual violence in 1965 and victims of sexual violence in the mass riots of May 1998, have no access to any reparation or rehabilitation scheme at all.

26.  Law No. 26/2000 on Human Rights Court, which is focused on crimes against humanity and genocide, has an implementing government regulation (PP No. 3/2002) on compensation, restitution and rehabilitation. This regulation has been unimplementable as it is narrowly linked to Law No. 26/2000 and because there has been no convictions on crimes against humanity to date in Indonesia.

27.  Indonesia’s post-authoritarian transition to democracy requires putting focus on the victims of past human rights violations. Not all victims take their cases to court, and even when they do, the unfinished process of legal reform means that justice for the victims is still far away from realization. A comprehensive and gender-sensitive rehabilitation and reparations scheme (CAT list of issues no. 32, article 14) has become an urgency especially since many of these victims are elderly by now.

Lack of a national preventive mechanism against torture

28.  Comments from CAT as well as the report on Indonesia from the UN Special Rapporteur on torture both highlight the lack of a national preventive mechanism on torture in Indonesia (CAT list of issues no. 16, article 4). This is a serious vacuum.

29.  Komnas Perempuan has a complaints handling mechanism for violations of women’s human rights but the current system is not accessible by women in detention. Komnas Perempuan conducts monitoring of detention centers only on an ad hoc basis and, at its current state, does not have the means nor capacity to carry out a comprehensive monitoring system for detention centers for women.

No effective protection mechanism for human rights defenders

30.  The Indonesian Constitution recognizes the right of its citizens to collectively defend their rights. There is no policy framework to operationalize effective protection for human rights defenders (CAT list of issues no. 37, article 16), however.

31.  In the meantime, human rights defenders continue to work under intimidative situations Komnas Perempuan has documented that Indonesian women human rights defenders experience particularly gender-based forms of attacks and intimidations, including being accused of being bad mothers, sexual harassment and rape.

32.  The UN Special Representative for the Secretary General on human rights defenders gave special notice to the activities and safety of women human rights defenders which have been adversely affected by laws, policies and a social environment that place restraints on their fundamental freedoms. For instance, Ms. Ellen from Bhinneka Tunggal Ika Group received death threats and was publicly discredited in the media (‘dirty woman’) after demonstrating in Jakarta against the Anti-Pornography Law which is said to have a negative gender impact. Similarly, Ms. Ismawati Gunawan from the Coalition of Indonesian Women was insulted and assaulted during a demonstration in Tanggerang against a local regulation on “immoral” acts also believed to have a negative gender impact, by supporters of the regulation and in front of police officers present at the rally. The Special Representative was disturbed by the case of Ms. Wa Ode Habibah, KPI Muna, Sulawesi Tenggara who was advocating for the right of women to be free from domestic violence and whose house in Muna was burnt down because of her activities. A complaint was reportedly filed with the police, but the investigation did not lead to any arrest; instead, the defender was accused by the police of having burnt down her own house.

Recommendations

33.  To ensure that Indonesian women live free from torture and other cruel, inhuman and degrading treatment or punishment, it is imperative that the Indonesian Government take immediate action to:

a.       revise the legal definition of rape and its rules of evidence within Indonesia’s Criminal Code and Code of Criminal Procedures

b.      criminalize sexual harrassment

c.       establish the Witness and Victim Protection Body with a gender-balanced selection of its Members

d.      abolish public flogging in Aceh, on the grounds that law is not decentralized, and further eliminate all other forms of corporal punishment (such as the death penalty) throughout Indonesia

e.       establish effective legal safeguards in social rehabilitation centers and migrant worker transit centers, including in Terminal 3 of the Soekarno-Hatta International Airport in Jakarta, as well as their transparant and accountable management

f.        formulate a gender-sensitive and accessible reparation scheme for victims of past violations

g.       ratify the Optional Protocol for the Convention Against Torture and develop an effective national preventive mechanism for torture and other cruel, inhuman and degrading treatment or punishment which is responsive to the gender-based vulnerabilities of women

h.      open dialogue with Indonesia’s human rights defenders, men and women, on how to establish an effective nationwide protection system.

Komnas Perempuan continues to initiate and participate in constructive dialogues with the relevant State agencies on these matters.


[1] Report of the Special Rapporteur on Torture, Mission to Indonesia, March 2008. A/HRC/7/3/Add.7
[2] Report of the Special Representative to the Secretary General on human rights defenders, Mission to Indonesia, January 2008. A/HRC/7/28/Add.2
[3] Komnas Perempuan, Ten Years of Reform: Progress and Setbacks in Combatting Gender-based Violence and Discrimination (in Indonesian), March 2008.
[4] Report of the Special Rapporteur on Torture, Mission to Indonesia, March 2008, point 47. A/HRC/7/3/Add.7

[5] See Komnas Perempuan Special Rapporteur on Aceh, Aceh Women’s Experience: Seeking and Accessing Justice from one Era to the Next, 2007, page 25.