Paul Cleary in Canberra and Louise Williams in Jakarta – When Indonesia invaded East Timor 22 years ago, the population stood at 688,000 and was growing by 2 per cent a year. Today, instead of reaching a potential 1.1 million, the number of indigenous East Timorese is still roughly the same.
War and famine have been the accepted explanations for this, but a new study by an Australian academic, Ms Miranda Sissons, at Yale University has led to claims by East Timor activists that Indonesia's family planning program is part of the story, through covert sterilisation and compulsory injections of a controversial contraceptive, Depo-Provera.
But aid workers with experience in East Timor said that while stories about forced sterilisation were frequent, they had not come across any direct evidence.
The Indonesian Minister for Demography, Haryono Suyono, dismissed the findings.
"This is an ancient rumour and an undermining political hoax," Mr Suyono said. "Only 20 per cent of East Timorese adults use contraceptives. We never try to force any contraceptive use against their will."
Family planning was not used to prevent birth but to protect mothers by spacing births, he said.
Ms Sissons criticises the wide use of Depo-Provera, which she says is not recommended for use by adolescents and is likely to cause medical complications among a population where rates of malnutrition and anaemia are high. The method is used by 62 per cent of women using family planning in East Timor, twice the national rate.
Even if women were not being coerced to take contraceptives, "at a minimum we are looking at a worrying health situation", Ms Sissons says. "Maybe women are not being offered anything else."
The report cites a number of alleged instances in the 1970s and '80s in which schoolgirls were rounded up for "vaccinations", and suffered the after-effects of hormonal contraceptives. It says many women who gave birth with Caesarean section in government clinics, or those who had other operations, would later find themselves infertile, indicating covert sterilisation. In one instance of supposedly voluntary sterilisation, Ms Sissons quotes a foreign nurse who was in a hospital ward where 17 East Timorese women were awaiting sterilisation operations.
While she believed some of the women were happy to undergo the operation, she was distressed by the age and demeanour of others. "Many did not seem to know what was happening," the nurse said. She was also concerned by the lack of patient-doctor communication, as none of the patients spoke Bahasa Indonesian; nor did the doctors speak Tetum, the main local language of East Timor.
Ms Sissons herself says the family planning program could not have had a "major" impact on population growth, given that it covers only 20 per cent of the sexually active female population. But it was a major cause of stress to women, and consistently violated human rights, she said.
Mr James Dunn, a former Australian consul in Dili who is now a noted writer on East Timor, said that up to 200,000 deaths had been attributed to the 1975 Indonesian invasion.
He finds the estimate of a potential population loss of about 400,000 "quite appalling", and notes: "It is against Indonesia's interest for the East Timorese population to increase."
But Mr Dunn is "cautious" about claims of violations in the family planning program, having heard them "again and again over quite a long period of time", mainly from members of the Catholic Church.
He said that Indonesia might have simply applied its family planning program in a harsher way in East Timor.
"The Indonesian family planning program can be rough anyway," he said. "Add to that the constant pulling between the Timorese and the Indonesians, then you could see it being translated into a pretty heavy program from time to time."