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Jakarta Post

Female drug users suffer double discrimination

Mum and daughter: Naomi and Esta stand in the street in South Jakarta, waiting for a bus to go home in Bekasi

Inga Ting (The Jakarta Post)
Jakarta
Wed, February 10, 2010

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Female drug users suffer double discrimination

Mum and daughter: Naomi and Esta stand in the street in South Jakarta, waiting for a bus to go home in Bekasi. JP/Moch. N. Kurniawan

Naomi Esteria was 20 when she took her first hit of heroin. She readily admits she spared no thought for her two-year-old daughter, Esta, or her one-year-old son, Bardonovo.

“I didn’t think about the consequences at all; I didn’t think there was any reason too,” she says. “I had no idea what heroin was or that it was addictive.”

Naomi, now 35, spent the next 12 years in the grip of an addiction that saw drug dealers share her bed more often than her two children. Even though she has been clean for the past two years, she still doesn’t fully understand what motivated her behavior.

“It’s difficult to tell if you love the drugs or the person. Maybe both,” she says simply.

For women injecting drug users (IDUs), far more so than their male counterparts, the distinctions between addiction, sex and survival are blurred and imprecise.

“Sometimes you have to sell sex to get the drugs; sometimes you have to date the dealer,” says Sekar Wulan Sari, director of the Stigma Foundation, a community-based organization for drug users and former users. Wulan is herself a former heroin addict.

“And sometimes, as a woman, you have to stand up for your man to get the drugs.”

When asked what that means, Wulan shrugs.

“When two people love each other but there are drugs involved, often we find it is the woman who is more willing to sacrifice everything.”

According to UNAIDS statistics, only 10 percent of the four million recorded IDUs across East and Southeast Asia are women. Researchers, however, voice serious doubts about the accuracy of such figures. Many in Indonesia believe that women make up around half the country's IDU population, even though only 10 percent of the IDUs accessing hospital and clean needle services are women.

As such, much of the discussion around helping women IDUs revolves around how to reach out to an invisible population forced into hiding by severe stigma and discrimination.

Sorrow view: Former drug user Naomi Esteria Tobing and her daughter Esta Melia Suniya Anthony in a public van in Jakarta. Female IDUs are discriminated against on several fronts (photo above and bottom).  JP/Moch. N. Kurniawan
Former drug user Naomi Esteria Tobing and her daughter Esta Melia Suniya Anthony in a public van in Jakarta. Female IDUs suffer discrimination from police, doctors, lawyers and even their own families. JP/Moch. N. Kurniawan

“The internalization of the shame forced onto them pushes women further underground and makes them even less likely to seek assistance… In the end, women and girls suffer worse consequences compared to their male counterparts because of their substance dependence,” according to Pascal Tanguay, an information officer at the Asian Harm Reduction Network (AHRN).

Research from the AHRN, UN AIDS and the Stigma Foundation has found that women IDUs suffer more not only because of the wider social disadvantages affecting women, but also because women are still expected to fulfill “traditional” roles, which cannot accommodate the reality of poverty, substance abuse and disadvantage.

Patriarchal culture, which is particularly dominant in Asia, underpins an almost hysterical intolerance of women’s drug use.

“Many families are so ashamed that they would rather keep the woman IDU at home, hidden from the public, than allow her to come to the hospital,” says Ratna Mardiati, a former director of the Drug Dependence Hospital (RSKO) in East Jakarta.

The subordinate position of women in the home also hampers women’s efforts to seek medical treatment for substance abuse.

 “The women [at the Drug Dependence Hospital] always have a reason for being late or for not coming at all. Firstly, they have to finish their work in the home, doing things for their children and their husband,” Ratna says.

“Or, secondly, they have no money because the man or the husband has the power and gives them their money. Even when the woman is earning money, the money will be kept by the man. Most of the relationships we see are like that.

“This means that if the husband has not given them permission to seek help, then they cannot come to hospital.”

To make matters worse, the stigma is also common among doctors, many of whom shy away from offering assistance or services to women IDUs, according Ratna.

“I don’t know if it’s that they’re not familiar with drug abuse or that they avoid providing care for these people. Maybe they judge them,” she says.

The story is much the same in the legal profession, according to Ricky Gunawan, program director at the Jakarta Community Legal Aid Institute. “Among lawyers, there is an image of drug users as a demon, as evil, so many lawyers explicitly say they don’t want to advocate for drug users,” he says.

“And I’m not just talking about commercial lawyers. Very few lawyers working for legal aid provide services for drug users.”

Fighting drugs: Naomi works at the Stigma Foundation office in Jakarta.
Fighting drugs: Naomi works at the Stigma Foundation office in Jakarta. JP/Moch. N. Kurniawan

While the abuse and discrimination faced by women IDUs permeates virtually every layer of society, it is at its ugliest in the deserted back alleys of Jakarta’s slums or behind the closed doors of the city's many police stations.

“Through our work of the past one or two years, we’ve found so many cases of women IDUs who, when they were arrested or detained by police, were forced to have sexual intercourse in order to be released,” says Ricky.

Ricky and other experts believe the vast majority of women IDUs have some experience of sexual violence or abuse by police.

“When we conducted a visit to the women’s correctional facility in Tangerang, we found that all our respondents were forced to have sexual relations with police or to strip naked and stand in the street to have their bodies ‘searched’ by police.”

Police bribery, extortion and intimidation of IDUs are “standard practice”, according to lawyers and researchers. Torture of IDUs is also alarmingly commonplace, with women IDUs typically subjected to sexual torture, says Ricky.

Such was the case for Merry Christina, who in 2004 was caught injecting heroin with her boyfriend in South Jakarta. While her boyfriend was beaten and tortured in a separate room, Merry was blindfolded and gang-raped by police over a period of five days. The pair was eventually released without charge.

Merry’s tale is not exceptional, says Ricky. He has also heard many tales of police failing to honor their side of the “deal”, even after the victim has acquiesced.

“Often the police say they’ll make the prosecution process quicker if you give them what they want…

You pay and you pay and you expect a lighter punishment, but in the end you find out it’s bulls**t. It’s all lies.”

While it is clear that transforming the situation for women IDUs will require deep and far-reaching social, economic and legal reform, raising public awareness about drugs and the impacts of substance abuse is an important first step.

The story of how most women become entangled in substance abuse betrays a frightening naivety about the impacts and consequences of drug taking among Indonesian adults.

Wulan says she first tried heroin at the suggestion of her two brothers, whom she watched fight a horrific battle with heroin addiction.

“They told me I wouldn’t be able to understand until I’d had it myself. So I did,” Wulan says.

For Naomi, an unhappy marriage coupled with simple curiosity led to her 12-year addiction. “I had a lot of male friends, which is where I got the idea,” she says.

“The first time I tried it I wanted to vomit. People talk about feeling like they’re flying or floating; I didn’t have anything like that. But the boys told me I should try it again; I just wanted to join the fun.”

It was the mid-1990s, a time when most Indonesians still knew almost nothing about drugs. It would be another five years at least before drug education was incorporated into school curriculums and before the public would begin to learn about a terrifying disease called HIV.

There is a desperate need, says Asmin, to eliminate the social stigma associated with injecting drug use, especially among women. “The first step is to recognize that women IDUs should not be hidden. They are not something to be ashamed of because in reality there are hundreds and thousands of them.

“We also need to adopt a gendered perspective that takes into account the particular needs of women IDUs,” she adds.

For Wulan, who has run a women-focused program through the Stigma Foundation called Femme, the priority is providing an alternative ideology to the patriarchal culture of Indonesian society. “My goal is to increase awareness among women that they are not weak and they do not need to be dominated by men,” she says.

For the time being, Naomi’s goals are relatively simple. Having recently begun working for the Stigma Foundation, she is keen to share her experiences and give strength to users and ex-users seeking to change their lives.

“I don’t know about my aspirations or hopes, but my greatest achievement is quitting drugs. It was the hardest thing I’ve ever had to do,” she says.

“It taught me that life goes on, even after addiction, and that I don’t need any idols or heroes. I am a strong woman.

Audio slide show: Former drug user Naomi

Related story: The feminization of the HIV epidemic

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