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Innovator For Public

Ashoka Fellowship – Innovator For Public, Health Category

There are 42 million abortion case per year in the world, 22 million or 52,4% among them are using the safe method according to WHO standard. But other 20 million or 48,6% are unsafe abortion, did by untrained person, unsafe method and equipment and unsterilized, not hygiene and without proper consultation to consider the physical and psychological impact. This unsafe abortion caused 70.000 maternal mortality and 5 million disability per year, according to WHO numbers.

In Indonesia, National Population, and Family Planning Board – BKKBN released that there are 2, 4 million abortions per year and 800 thousand among them by teenagers. BKKBN also mention that abortion rates tend to increase 15 percentage per year. While National Commission on Child Protection in 2008 said there is 2 million abortions, 62% by teenagers.

However, In Indonesia, the law forbids abortion. Indonesia Health Bill of 2009, article 75 states that abortion is illegal except to save the life of a woman, including cases when the pregnancy endangers the mother of the fetus, or when the pregnancy is the result of rape. Anyone who had an induced abortion for reason other than these will subject to a penalty: 10 years imprisonment or a fine of 1 billion IDR (105,374 USD)

Article 76 has an additional clause: abortions can be done before the 6th week of pregnancy: women seeking an abortion should go through the process of counseling: the procedure should be carried out by a medical practitioner, who is a certified and authorized. It is also stated that women need a permission of a parent or a spouse to get the abortion.

When restrictive laws block access to safe abortion, black markets exploit women in a time of need and desperation. Criminalization of abortion does not stop women from seeking safe abortion service. Unsafe abortion – using herbal, taking wrong medicine, roughly massage- close related to the high rate of maternal death in Indonesia, 228 per 100.000 (17%). Those who survive mostly have broken reproduction organs, long-term diseases, and psychological trauma.

Any woman can experience an unplanned pregnancy, even one who uses contraception and, therefore, the need for safe abortion services continues to exist. And the high rates of maternal death because of unsafe abortion and also rates of HIV/AIDS and STD’s in Indonesia is related to lack of access to information about reproductive health, sexuality, gender and women’s rights. This lack of information access about sexuality and reproduction health much more addressed to women in the rural area.

The solution is for the government to make abortion legal and make sexuality education and reproductive health services available for all women in Indonesia.

Samsara as a grassroots organization recognized the urgent need to inform women about these topics because many of them do not have sufficient knowledge about their own bodies, their sexuality, and their rights. What are needed are programs and strategies that can help women gain self-confidence and autonomy over their own bodies and minds so that they can be empowered to fight for their rights.

THE IDEA

To help women who have problems with her unplanned pregnancy and those who has post-abortion trauma, Inna Hudaya set up the hotline to provide counseling services. However, to prevent women especially young people to get unplanned pregnancy, education toward sexuality and reproduction health and right are the key.

Recently, the sex and reproduction health education can only touch the last term which is not enough according to the psychological and physical need of young people. Then Inna came with the module of sexuality and reproduction health and right education on Body Autonomy. Through the module, Inna emphasizes on the rights, autonomy and diversity of the bodies. This module not only contains subject on sexual and reproductive health but also includes life skills,  mental health, and personal development. This module not only to increase knowledge of young people but actually getting people to know and understand their bodies, includes the skills to understand how the body works, the biochemical behind the body, and to identify the problem within the body and give a basic treatment to it. Every woman needs the skill before she decided to see a doctor for medical treatment, which is expensive and lack medical access for those women who live in the rural area.

Inna established the school of sexuality and reproduction health and right – SRHR in Yogyakarta then spread the information toward Java Island to East Indonesia through SRHR Satellite. However, the information about SRHR, Safe Abortion, and Sexual Transmitted Diseases are freely accessible toward its website while the hotline and email respond daily.

STRATEGY

Started with her personal stories on the blog, Inna received lots of respond from women who has trauma physically and mentally from having an unplanned pregnancy and unsafe abortion. Others are women who still looking for information and solution for  their unplanned pregnancy and wanted to have an abortion, however, abortion is forbidden by law. Inna responded individually, until April 2008 when she met with two other girls and decided to have a supporting group of women with unplanned pregnancy, Samsara – Reborn.

Huge numbers of young people have an unplanned pregnancy and committed to unsafe abortion as Inna own experience when she had an abortion in her young age. Therefore, Samsara put youth as their main beneficiaries of the venture.

Samsara started by providing reproduction health and safe abortion information on the website. It promotes and support the access to education and information on SRHR – Sexual and Reproductive Health and Rights and to promote “Body Autonomy.” Started by emails, she expands her works by set-up hotline services in 2008. Samsara Hotline provides pre and post-abortion counseling to help women understand their situation and exercise their rights. Thru the counseling process, women will learn about their own body, learn about intrapersonal skills – able to identify their problem, be the decision-making –  The counseling is also about made woman able to tell the difference between safe and unsafe abortion.

In 2010, Samsara realized counseling and education through the website are not enough. With the support from HIVOS-Netherland fund, Samsara established Sexuality and Reproductive Health School (SRHS) in Yogyakarta. Small groups of 15 people, young male and female from the various background but interested to learn about sexuality and reproduction health. This school designed to give knowledge and skill in these two main subjects of sexuality and reproduction health with the goal that everyone should have control and autonomy of their body and have the basic skill of method to treat themselves. SSKR consist of 16 sessions, twice a week on Saturday and Sunday in two months intensive. It is free, but those, who skip one maximum three sessions, will be considered quit and has to pay fine. But until the end of the school, none of the participants left the session. This is proof that teenagers are very interested in learning about sexuality and reproductive health.

Samsara created the module that consists with materials. They are (1) Basic concept of Sexuality and Reproductive Health, includes gender identities, sexual diversity, sexual and reproductive rights, (2) Anatomy and physiology of reproductive organs includes menstruation, breast health, contraception, pregnancy, birth, and breastfeeding, (3) Abortion, includes women and abortion, abortion in Indonesia and abortion counselling, (4) Sexually Transmitted Infections, (5) Safe sex & Sexual pleasure, includes taboo and myths (6) Emotions & Relationships includes stress management, healthy relationship and violence and (7) Body Autonomy, includes the body image, myth of beauty, media, religion and culture and (8) Physical exam includes Bimanual exams, breast self-exams, vaginal and cervical exams.

Along the way of the workshop, somehow Inna still found it hard to explain theoretically and the best way to learn is through the five senses. She came out with the idea of Body Model; with other 4 volunteers, she got naked in front of the class to show them that every human body is different. Most of the young people lived in their fantasy and surrounded by the myth of which is normal and abnormal. The goal is, by seeing those models with the different type of body, the participant will learn to accept their uniqueness of their body.

Other development of its program, Inna brought Vaginal and Cervical Exam module. It is to enhance the intrapersonal skill to identify the problem and basic knowledge to treat the problem. For example, vagina produces liquid, but how and when can we say that the liquid or flour album be considered danger or not. With her medical background, Inna transfers her knowledge and skill to these women to identify and do a treatment before decided to go to the doctor.

Since 2011, Inna brought this module wider and reached to more women in the rural area in East Indonesia. The program name Sexuality and Reproduction Health and Right – Satelite Workshop (SRHR-SW), a six-week educational and advocacy program. In addition to the educational objective, the program also conducted to mapping the abortion issue and the availability of Misoprostol in Eastern Indonesia. Samsara will travel and visiting communities, local NGO, school and universities to conduct the workshop.

Samsara is actively involved in regional and international networks engaged in health issues, especially safe abortion. Including the Women on Waves (Netherlands), Asia Safe Abortion Partnership (ASAP), the Women’s Global Network for Reproductive Rights (WGNRR) and the International Consortium for Medical Abortion (ICMA). Currently, Women’s Network and communities in Yogyakarta are engaged on the workshop series. Although Inna personally doubts her unique technique of Body Model and Vagina and Cervical Exam could replicate without controversy, but she believe, it will happen gradually

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