More discussions needed for places of worship decree

Sunday, February 26, 2006
Hera Diani, The Jakarta Post, Jakarta

U2 frontman and Christian Bono once quipped that unlike millions of people out there, his least-favorite John Lennon's song was Imagine.

"At the root of it (the song) is some rigorous thinking about the way things could be, but people have stolen the idea and made it an anthem for wishful thinking. I'm against wishful thinking. I hate it," he told Time magazine when appointed as one of the publication's persons of the year 2005, along with Bill and Melinda Gates.

Amid the growing religious radicalism and conflict between religious groups in this country, his sentiment rings true. People in this multifaith society cannot just whisk away the problems between religious groups by singing "Imagine no religion."

And it remains to be seen whether the government's completion of the revised decree on places of worship will help things.

The joint ministerial decree, issued in 1969 by the home and religious affairs ministers, requires the consent of local administrations and residents to build houses of worship.

The revised version, already sent to President Susilo Bambang Yudhoyono, maintains the basic requirement of the original decree, but defines specific prerequisites.

It requires the establishment of the Communication Forum for Religious Harmony, consisting of representatives of all religious faiths, to review requests for permits to build places of worship and then provide recommendations to the local administration.

The decree also mandates the minimum number of congregation members for a proposed church, temple or mosque at 100. Any plan to build a place of worship must also be approved by at least 70 local residents of other faiths.

Religious minorities claim requirements in the existing decree have been used against them by hard-line Muslim groups.

Data shows that the past year, 23 churches -- other sources put the number as high as 35 -- have been shut down in the West Java capital of Bandung and neighboring areas by these groups.

The churches did not have permits as required in the joint decree, but had obtained operational licenses from the West Java Religious Affairs Office.

Data released by the Indonesian Committee on Religion and Peace (ICRP) showed that more than 1,000 churches nationwide have been destroyed or vandalized because they failed to meet the requirements of the decree.

ICRP secretary-general Theophilus Bela urged the government to revoke the joint decree.
"It is against the state ideology Pancasila and the Constitution as well as human rights. The government should protect people's rights to believe in a religion and perform acts of religious worship. The decree has the potential to tear apart religious harmony (here) and stop people from worshiping," he said.

Muslim scholar Azyumardi Azra, however, said without the decree there would be more disputes.

"Arrangements and regulations are necessary to maintain religious harmony. It's the social aspects that are being regulated, not the religious aspects," he said.

The decree was not about limiting people's right to worship but about keeping public order, he said.

"If in a neighborhood where the majority are Christians, suddenly this large mosque appears only for small number of people, I think the majority would be affected, if not angry. It works the other way as well."

Azyumardi said many countries imposed regulations on places of worship. Establishing them required the consent of municipalities and there were also zoning arrangements governing where religious facilities could be built.

However, despite the claims by Religious Affairs Minister M. Maftuh Basyuni, religious groups here say there has yet to be a across-the-board agreement on the revisions.

"We have yet to agree on the minimum requirements for congregation numbers and approvals. Details on legal protection, the composition of the religious forum and its responsibility, and other details have yet to be clearly specified," Indonesian Archbishops spokesman Benny Susetyo said.

The revision states that if the minimum congregation number is met and regional and government approval is obtained, then the government must provide facilities for congregations if locals in the area reject their plan to build places of worship.

"But this part of the bill is not well-known. And it's not in-sync with the other articles. Which articles will become policy has never been discussed," Benny said.

The most important thing for minority religions was legal certainty, he said.

"Everything has to be in line with the state ideology and Constitution. If local administrations refuse to give groups permits, then they have violated the Constitution."

Azyumardi urged the government to delay the implementation of the revision until it was acceptable to every party.

"While arrangements and regulations are needed, the detail of their content must be discussed thoroughly with representatives from all religious groups."

Labels: religion

Posted by hera at 8:43 PM | Permalinks | Comments

Kalla says 'efficient' democracy works best

Hera Diani, The Jakarta Post, Jakarta

There is much to enjoy from overseas trips, but Vice President Jusuf Kalla says the praise he hears heaped on Indonesia's democratic transition has begun to grate.

"I'm congratulated everywhere ... but I told them to cut the small talk. They don't care about democracy, they want stability. They congratulate us but then flood China for business investment instead of here. So (the demand for democracy) is a double standard," Kalla said Wednesday in a seminar for the launching of the book Understanding Indonesia.

Although he did not state that economic stability should be the priority to effect development, the businessman and chairman of the Golkar Party said democracy should promote economic stability through a constructive and efficient implementation.

"Our objective is to achieve (better) public welfare, with one of the elements being democracy. But it's not easy to achieve democracy with such low income," he said at the talk held by the Soegeng Sarjadi Syndicate, a research group which published the book.

Disputes marked democratic practices here, he added, with the attitude that the government could do no right and should face constant criticism.

"That's not democracy, that only causes political fatigue. Let's just make politics and democracy more efficient. Support what we agree upon, and give constructive criticism."

His comments were criticized by other speakers, who warned that they could be construed as support for those who claim the authoritarian Soeharto regime provided greater stability and security.

Political scientist J. Kristiadi warned the pursuit of stability should not be an excuse for the government to obstruct democracy.

"It's a complete misunderstanding that democracy should be efficient. Disputes and criticism are part of democracy ... What's worse is if people recommend the need for a strong state."

Economist Faisal Basri said the state needed to be more involved in regulating the market instead of leaving it to market forces.

"The state cannot wash its hands of electricity and leave it to the market because (state owned electricity company) PLN is a monopoly," he said, referring to the government's suggestion for businesses to negotiate on a one-on-one basis with PLN about a planned rate hike.

Faisal listed many of the problems stacked against the country's development.

"Tuberculosis, malaria and the maternal death rate in this country rank among the highest in Asia, causing us to lack competitiveness. Public spending is less than 1 percent ... Revenues in the regions are lower than when regional autonomy was imposed."

The country needed an economy providing autonomy for individuals and communities, Faisal said, although the government appeared reluctant to give up centralized control despite four years of regional autonomy.

"For instance, instead of having state-owned Pertamina monopolize the fuel distribution and production, why don't the regions produce their own alternative fuel so that their regions can be empowered?" he said of the oil company.

"That's the principle of market creation, where people have choices and at competitive prices."

State-owned companies monopolize the market but fail to meet public demand, he noted.

"PLN can only provide electricity for 53 percent of total demand, the state telecommunications firm (Telkom) can only install 4 percent of fixed lines across the country, while the regionally owned water firms (PDAM) can only provide tap water to 16 percent of the population."

Pending the implementation of a market system with adequate regulation, Faisal called for "a moratorium for liberalization, deregulation and privatization."

"There has to be mechanism to stabilize the price as well, and an economic system that meets the sense of justice and equity," he said.

Labels: Politics

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Overmedication of children does more harm than good

Tuesday, February 14, 2006
Hera Diani, The Jakarta Post, Jakarta

Whether it's a simple case of the sniffles or the worrying onset of
diarrhea, parents here are likely to trust a doctor and his prescription
pad to put their children right.

Yet it's children who stand to suffer the most as victims of the
chaotic drug situation in the country.

With doctors prescribing them medicines they do not need, and the
danger of significant side effects, the country's kids are considered
overmedicated.

In a society with a tradition of self-medication, a recent study showed
about 70 percent of parents gave their toddlers more than four kinds of
drugs at one time to treat their illnesses.

More than 35 percent of toddlers were taking from five to seven
different kinds of medicine, according to Foundation of Concerned Parents'
spokeswoman Purnamawati S. Pujiarto.

Moreover, 85 children in the study had taken antibiotics, on the advice
of doctors, for every malady they suffered.

"This phenomenon is dangerous. First, not all diseases can be treated
with medicines -- like influenza, for example. Second,
such an amount of consumed drugs could harm our children's
health, especially their livers," said the pulmonary specialist.

Pharmacologist and physician Iwan Darmansjah said there were few
clinical trials -- tests done on humans to determine the efficacy of a new
drug -- specifically for children.

Tests showing the different reactions of the drugs in adults and
children, whose smaller body mass would affect how they were absorbed, are
also extremely rare.

"It was only in 1998 and 1999 that the FDA required pharmaceutical
companies to do the study on all medicines for children," the professor
emeritus at the University of Indonesia said, referring to the U.S. food
and drug regulating body.

"Before then, the data was always based on adults. It's not like a
child is a small adult that you can just halve the adult dosage the
dosage."

There have been a few studies since, he said, but none conducted in
developing countries.

"That's why children in Jakarta go to the same doctor every
two weeks, with the same disease, to receive the same, wrong
medication which reduces their immunity," he said.

"Ninety-five percent of the children are suffering from cough,
fever and cold, which should've been treated with a symptomatic
drug instead of stuffing them with antibiotics."

Executive director of the International Pharmaceutical
Manufacturers Group Parulian Simanjuntak said that clinical
trials of children were difficult to conduct due to ethical
concerns.

"A trial must be carried out voluntarily, where a person knows
what s/he is doing, the risks and so on. It is still being
debated whether children can give informed consent, as an adult
could, or whether parents can decide for the children. That's why
studies on children are not as wide as adults," Parulian said.

"And it's why pharmaceutical industries estimate the dosage
for children based on the dosage for adults."

Parulian said developed countries have discussed "assent
consent", where children can say yes or no about participating in
trials.

"But so far, it's still only under discussion."

Labels: drugs, health

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Embattled BPOM chief says agency doing its job to monitor drugs

Tuesday, February 14, 2006

Although known for his Javanese politeness and fine manners, Food and Drug Monitoring Agency (BPOM) chief Sampurno was clearly irritated when asked about criticism his organization has failed to properly monitor and regulate the pharmaceutical industry.
"It's all talk with no proof," he said.

After the flak BPOM received last month, when carcinogenic formaldehyde was found being used to preserve tofu and other food, his sensitivity is understandable.
Many also fault the agency for the haphazard drug situation in the country, which is not limited to high pricing and overdosage.

Prof. Iwan Darmansjah of the University of Indonesia's medical school said the local market was awash with useless drugs which drained the funds of unwitting consumers.
"False drug claims and wrong doses are blatantly condoned and fill the pages of the formal drug information (guide) called MIMS Indonesia," said the pharmacologist and doctor.

For those who like to self medicate, cheap drugs are readily available on the black market, such as Pasar Pramuka in East Jakarta and Pasar Senen in Central Jakarta. There are dozens of drug stores, selling products of questionable quality, safety and efficacy over the counter.

Cases of fake drugs are rampant, as well as substandard drugs, which contain less active compounds than defined on their labeling.

"In Indonesia, governance of drugs has never been well organized. The BPOM never had the manpower and the organization to protect the public from the presence of bad drugs on the market. The BPOM has been closer to and more protective of the industry than the public," Iwan said.

Marius Widjajarta of the Indonesian Health Consumer Empowerment Foundation said the situation worsened after the BPOM was removed from the auspices of the Health Ministry in 2001.

The agency was separated to become a stronger, independent body (the only other country to do this is China) after butting heads with the ministry on authority.

"The agency liked to usurp the ministry's authority, from drug registration to
issuing permits to build pharmaceutical factories. From 2002 through 2004, the agency approved 240 import licenses, which they had no right to do. Monitoring drugs is already a gargantuan task, so why trespass on other's authority?" he said, adding the agency should be moved back to the health ministry.

Sampurno defended his ministry against all the allegations, saying the BPOM did its job. He noted it was selected the fourth best agency in the world according to the 2005 audit of WHO.

He denied drugs were too pricey here, saying there was a wide selection of products available with a varied price range but of similar quality.

"When it comes to generic drugs, it's very competitive. The key is to exercise patients' rights, so they don't just bow to doctors' prescription prices," Sampurno said.

Effectiveness of drugs, he added, was a subjective matter.
He also termed "an emotional recommendation" the calls to return the BPOM to the Health Ministry.

"Come on, compare the performance of the agency (now) to when it was still part of the ministry. You can see that we perform better as an independent body." -- JP/Hera Diani

Labels: drugs, health

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Pill-popping public 'victims of unregulated market'

Tuesday, February 14, 2006
Hera Diani, The Jakarta Post, Jakarta

If you are a health consumer in Indonesia some of these situations may be familiar to you.

-- You go to a doctor instead of self-medicating for your cold and fever and end up with three different types of medicines, plus vitamins, which cost you a cool Rp 400,000 (US$43.50).

-- You are stuck in an emergency room of a hospital with a bad case of food poisoning, when you get another reason to vomit -- the price of your bill for the medicines is Rp 700,000. Then the doctor gives you a shot and you feel fine, but annoyed.

-- You take your toddlers to the pediatrician almost every month, forking out good money for many packets of medicines to treat the same reoccurring cold and flu symptoms. Your pocket hurts and you worry about the effect the many pills are having on your children's development.

-- Unable to afford your medical bills, you pay half -- and get only half -- of the prescribed drugs. Or you risk all and go to the Pramuka black market in East Jakarta for cheaper medicine.

Health is wealth, as the saying goes, which in this country could translate to mean "getting sick can rob you blind".

Experts say doctors here often overprescribe drugs to unwary patients, who are also paying too much for medicines -- a situation they say is caused by a lack of regulations and monitoring.

University of Indonesia medical school professor and pharmacologist Dr. Iwan Darmansjah said an absence of regulations governing the retail prices of prescription drugs here had caused some doctors and companies to inflate prices to ridiculous, rip-off levels.

"The amoxycillin antibiotic, which in other countries only costs between Rp 400 and Rp 500 (about 4 U.S. cents) a tablet, is being sold here by several companies for as much as Rp 2,800 a pill. That's deceiving, unfair business," Iwan said.

Health Ministry rational drug use department director Husniah Rubiana Th-Akib said manufacturers were also taking advantage of the erroneous public perception that generic drugs were less effective than their patented counterparts.

Husniah said all drugs were categorized as either generic or patented. Patented drugs were generally the latest generation of a drug, and were usually more expensive. But generic drugs -- often made specifically for low-income consumers -- should be no less effective and prices should be considerably cheaper in most cases, she said.

Patented drugs have only a 2 to 3 percent market share but make up 15 percent of national drug revenue.

"What manufacturers do, however, is take a generic drug, make it more appealing with packaging and everything, and then slap a 'brand' and a high price on it. We can call this type of drug a 'branded' generic drug," Husniah said.

"For amoxycillin, for example, there are over 100 brands on the market, with (wildly) fluctuating prices, while the content (in the tablets) is the same."
Often cheaper generic drugs are sold at the same price as patented drugs -- or worse, were packaged as such, she said.

Marius Widjajarta of the Indonesian Health Consumer Empowerment Foundation said drug prices should not fluctuate much.

"(Prices) tend to decline because newer, more sophisticated drugs enter the market."
However, international Pharmaceutical Manufacturers Group director Parulian Simanjuntak said drug prices here were based on the simple market mechanisms of supply and demand.

Because health insurance is not common in Indonesia, about 80 percent of drugs are being bought by individuals or companies, Parulian said.

Large insurers, as big buyers of drugs, could help set market limits on prices, he said.

With a total market value of about $2 billion a year, many companies here are involved in drug manufacturing -- 34 multinational companies and another 170 local ones, according to data from the group.

In such a competitive market, companies often pay doctors commissions to prescribe drugs, meaning patients often get medicines they do not need.

Indonesian Doctors Association chairman Farid Anfasa Moeloek said the government should subsidize drugs for low-income groups, who were supposed to get free medical treatment.

Farid said the unregulated system, not doctors, was to blame for the high prices.
Husniah, meanwhile, said the Health Ministry planned to regulate the packaging of drugs to ensure consumers could easily tell the difference between generic and patented medicines.

Branding on generic packaging would be 20 percent smaller and retail prices and ingredients would also be listed, she said.

"It's important for consumers to know what is in the tablets they buy," she said. If they had a choice between three chemically identical drugs, they could then choose the cheapest one, she said.

Manufacturers are opposed to the new labeling rules, which they say are against trade laws and will only increase their costs.

Parulian said international manufacturers already labeled their drugs clearly and included tablet ingredients.

"The plan would change the layout of the whole packaging. Besides, (the idea) goes against the regulation for Trade-Related Intellectual Property Rights on brands."
"We need brands, we invest in them. By including a drug's generic name, it will weaken our brands. We are going to protest this plan," Parulian said.

The industry has yet to make up its mind on price labeling, but Parulian believes it would be difficult to impose.

"Price labeling already exists on the primary packaging that (doctors' buy and) consumers do not see. If there was a change in prices, it would be impossible for manufacturers to relabel the old stock."

Labels: drugs, health

Posted by hera at 8:47 PM | Permalinks | Comments

Reality hits screen with R&R dream

Sunday, February 05, 2006
Hera Diani, The Jakarta Post, Jakarta

When was the last time you watched an Indonesian film and still talked about it for hours, or even days afterwards -- and not because the lame dialog, dim-witted storyline and absurd plot (paging Sembilan Naga and Garasi) left you so traumatized that you wished you could reclaim those two hours and had never watched the film in question.

No -- but because the film is so real, so honest, so true to itself, so high-spirited and so hilarious at the same time.

Enter Realita, Cinta dan Rock 'n Roll (Reality, love and rock 'n' roll).
The title may sound dead pretentious. The premise also invites eye rolling and head scratching: Two angst-ridden boys, rebels at school and at home, bump into harsh reality as one turns out to be adopted while the other turns out to have a transsexual father -- all while caught in a love triangle.

Judging from the disasters produced in the screenwriting department from which too many local movies have suffered, it has seemed that there is no way that a local filmmaker could make a good film out of such material.

Director Upi's past productions also seemed to indicate this. She wrote and directed 30 Hari Mencari Cinta (30 days seeking love) and wrote Lovely Luna, which were among the endless list of crappy teen flicks that have inundated movie theaters in recent years.

But boy, I've never been so happy for being proven wrong and for prejudging something.

A few directors have made an attempt to make a coming-of-age film but failed miserably, portraying teenagers as either too dumb to live or too wise and mushy to be real.

Only Realita has come up with a true-to-life depiction of teen boys, complete with their angst, stupidity, anxiety and silliness -- perhaps amazingly, as the writer/director does not have any testosterone to be able to understand a boy's world, never mind speaking their lingo.

Upi has managed to come up with a great script that succeeds in turning the cringe-inducing premise into a believable and enjoyable story.

The characters are well developed, and theatrical characters -- like a transsexual father and a New Age-obsessed mother with her hippie boyfriend -- enriched the film instead of impairing it.

The dialog is natural and funny, although there are moments when it slips into a soap opera cliche, along with some scenes. The story also drags a little in the middle, but the script is solid overall.

Occasionally, the small budget also lets Upi down, particularly in terms of poor sound quality and blurry camerawork. Seems like the production budget to make this movie came from the wrong hands.

But as a whole, the film is a delight to watch. Its flaws are also compensated by the two young and barely experienced actors, Herjunot and Vino. They really shine in their roles as two silly boys who actually have good hearts.

Meanwhile, their aspiring to become rock stars but not really having the skill will just crack you up. The chemistry and friendship between the laed actors are strong and touching without being sentimental.

Newcomer Nadine Chandrawinata, also Miss Indonesia 2005, is not disappointing either as a troubled teenage girl. And after his good comeback in 2005's Janji Joni (Joni's promise) as a chatty taxi driver, former action star Barry Prima again delivers an excellent performance as the transsexual father.

Realita really compensates for the recent poor fare -- some of which were from celebrated filmmakers.

Thanks to Upi, we can regain our hope in the local film industry -- let's just hope Upi does not get into the hype. *** (out of ***)

Labels: Film, review

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