By Miranda Sissons, International Relations Program, Yale University. Summary of a forthcoming publication of the East Timor Human Rights Centre

This report examines human rights abuses perpetrated against women in East Timor in the implementation of the Indonesian national family planning program, Keluarga Berencana Nasional (KB). It investigates long-standing allegations that the Indonesian government has used both the KB program and the government health system to covertly sterilize East Timorese women. It also examines reports of coercive recruitment practices and the covert use of injectable hormonal contraceptives. In addition to its main focus, the report also examines other kinds of violations of women's sexual and reproductive rights in East Timor. The report is based upon evidence gathered from on-site fact-finding in East Timor, as well as research and interviews conducted in Indonesia, Australia, and the US

Findings

Set in a context of widescale repression and fear, the KB program in East Timor consistently violates internationally-recognized standards of family planning and reproductive health care as set out in Chapter 7 of the Report of the International Conference on Population and Development (ICPD). The design and implementation of the KB program in East Timor have caused serious violations of women's human rights under both international and Indonesian domestic law.

Although complaints of human rights violations have been made against the KB program in other parts of Indonesia, those in East Timor differ in both nature and effect. These include breaches of such fundamental human rights as the right of security of person; the right to freedom from torture and cruel, inhuman and degrading treatment; the right to marry and found a family; and the right to life.

The coercion and violence associated with the KB program constitutes physical and psychological violence against women. Because these abuses are suffered exclusively by women, the actions of the Indonesian government also violate the fundamental right to freedom from discrimination enshrined in the International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Social and Economic Rights (ICESCR) and the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW).

Specific violations include:

• strong evidence of the covert, forcible injection of young women with hormonal contraceptives during 1987-1989. Such actions violate the fundamental rights to bodily integrity, security of person, and freedom from cruel, inhuman and degrading treatment contained in Articles 7 and 9 of the ICCPR and Article 19 of the Convention on the Rights of the Child;
• denial of treatment in life-threatening circumstances. This is a breach of the right to life enshrined in Article 6 of the ICCPR, and of Articles 6 and 24 of the Convention on the Rights of the Child. It is also a breach of Article 12 of CEDAW, which explicitly obliges states to provide women with appropriate services in connection with pregnancy;
• ongoing breaches of the principle of informed user consent in KB recruitment and service practices, a breach of Articles 14 and 16 of CEDAW, as well as the right to marry and found a family contained in Article 23 of the ICCPR ;

  - failure to provide KB users with basic follow-up care, violating international family planning standards set out in Chapter 7 of the Report of the International Conference on Population and Development and contained in Indonesian domestic law 10/1992;

• continuing military involvement in both recruitment and service provision, contributing a strong element of structural coercion to the KB program and violating norms on user consent enshrined in CEDAW and Chapter 7 of the ICPD; and
• a disturbingly high reliance on injectable contraceptives, which at 62% of all continuing family planning users is double that of the next nearest province, Irian Jaya. This pattern suggests that KB users in East Timor have highly restricted choice of contraceptive methods. It also raises larger questions regarding the likelihood of covert contraceptive usage, as well as the effects of such injectable hormonal contraceptives on women's health in East Timor.

Effects

These and other abuses have contributed to a strong belief on behalf of the local population that the KB program is used by the Indonesian government as a politically-motivated instrument to deliberately undermine the survival of the East Timorese as a national group, an activity expressly forbidden by Article II (d) of the Genocide Convention. Although there is insufficient evidence to judge that the KB program has been used with such intentions, widespread abuse of women's reproductive rights, poor communication, and insensitive administration – set against a background of intense political oppression – have undoubtedly contributed to this perception. The scale and severity of women's health problems in East Timor also indicate that the current prevalence of injectable contraceptives has strongly negative health consequences for users. Fear of the KB program has severely undermined the efficacy of the government health system in East Timor. According to statistics in the U.N. World Population Report (1996), the death rate in East Timor is double that in Indonesia and the worst in Southeast Asia. Infant mortality in East Timor outstrips even that of Rwanda and Iraq. Yet women are unwilling to turn to the government health system for fear of covert injection or sterilization, nor do they trust public health initiatives that rely on injections and tablets. These fears are compounded by linguistic difficulties and the attitudes of health care providers. High levels of distrust have created a situation in which the practical efficacy of a large part of the health system is open to doubt. Government indifference to this situation gives rise to serious questions regarding its commitment to fulfilling even the minimum content of the right to health in East Timor, a right enshrined in Article 12 of the International Convenant on Economic and Social Rights. Fear of covert injections through the medium of school vaccination programs has also had a negative impact upon women's access to schooling.

Recommendations

• The report concludes with a number of recommendations to improve the condition of women's human rights in East Timor. These include:
• conformity with international and national human rights obligations under CEDAW and domestic laws 7/1984 and 10/1992;
• abolition of military participation in health care provision and family planning recruitment;
• government action to ensure that coercive practices such as 'safaris', target-setting, and military recruitment of contraceptive acceptors have ceased, and that the covert administration of contraceptives is unambiguously prohibited; and
• a substantive review of health delivery services in East Timor. This process should prioritize improvements in the communication skills and attitudes of providers, and include a thorough re-assessment of the efficacy of the primary care system.

Conclusion

Human rights abuses in the KB program have affected a wide range of women's human rights in East Timor, including the right to security of person, the right to health, to education, and freedom from cruel, inhuman and degrading treatment. Other violations of women's human rights in East Timor include rape, forced marriage, and and sexual servitude. Given that these violations and their repercussions are suffered almost exclusively by women, this report concludes that they constitute discrimination against women as defined by Article 1 of CEDAW. Indonesia is a party to CEDAW and has also signed the Convention on the Rights of the Child. It has also signed the Declaration on the Elimination of All Forms of Violence Against Women and has incorporated international standards on reproductive issues and women's rights into domestic laws 7/1984 and 10/1992. These gestures towards international legitimacy will remain meaningless until the Indonesian government ceases to tolerate the widespread violations of women's human rights in East Timor.