paradise: 12/13/10

Senin, 13 Desember 2010

Healthy Lifestyle

Promotion and Prevention of Communicable Diseases (PTM)

The National Policy PTM

The framework concept of prevention and control of non-communicable diseases is based on the basic framework of Blum, that health status is influenced by heredity, environment, behavior and health services. Prevention and control PTM policy is aimed at diseases that have the same risk factors are: heart disease, stroke, hypertension, diabetes mellitus, chronic airway obstruction.

Goal

Encourage community self-reliance in the prevention and control PTM to nmenurunkan incident non-communicable diseases (PTM) and improve quality of life for healthy people who are in all orders.

How do I?

By way of eliminating or reducing risk factors for PTM and consider other factors that may affect health. Department of Health, through the Center focuses on health promotion:

* Increase efforts to promotive and preventive health through both the Central and Provincial and District levels.

* Conduct an integrated intervention on the 3 main risk factors: smoking, physical activity and balanced diet.

* Perform network of prevention and control of PTM.

* Trying to prepare a national strategy and local management of diet, physical activity, and smoking.

* Develop Integrated Risk Behavior Surveillance System (SSPBT) PTM.

* Campaign PTM prevention and control of national and local level specific.

For future prevention efforts PTM will be very important because it is influenced by 3 main factors namely dokok, balanced diet and physical activity. Prevention of PTM should be supported by all parties, especially the decision makers of both national and local. Without it all would be in vain.

Target

* Determinants of policies both at central and regional (provincial and municipal).

* Determinants of policies in related sectors at both national and local (provincial and municipal).

* Professional organizations that exist.

* Non-Governmental Organization (NGO) Private sector and community.

Legal Foundation

Promotion and Prevention PTM of course referring to the existing legal basis nationally, namely:

* Act No. 23 of 1992 on health.

* Act No. 22 of 1999 on Regional Government.

* Act No. 25 of 1999 on Financial Balance between Central and Local Government.

* Government Regulation No. 25 of 2000 on Central and Local Government Authority.

* Health Ministerial Decree No. 1277/Menkes/SK/XI/2001 on Organizational Structure and the treatment of MOH.

* National Development Program (PROPENAS)

* National Health System.

* Health Ministers Decree of 1999 on Health Development Plan towards Healthy Indonesia 2010 Health Department in 1999.

* The Global Strategy for the Prevention and Control of Non communicable Diseasses (WHA 53-year-2000).

* Megacountry Health Promotion Network Initiatives (Geneva, December 2002).

Policy

Promotion and prevention PTM performed at all stages of life, through the empowerment of the various components of society such as professional organizations, NGOs, mass media, business / private sector.

PTM promotion and prevention efforts are focused on people who are still healthy (well being) and the community at risk (at risk) by not forgetting that the diseased society (deseased population) and people who suffer from disabilities and require rehabilitation (Rehabilitated population).

* Reduction PTM PTM prioritizing prevention onset major risk factor by increasing physical activity, balanced diet and not smoking.

* Promotion and prevention PTM also developed through the efforts that encourage / facilitate the issuance of public policies that support prevention and control in PTM.

* Promotion and Prevention PTM done through the development of partnerships between government, communities, community organizations, including professional organizations and private businesses.

* Promotion and prevention of PTM is an integral part of all medical services related to prevention PTM.

* Promotion and prevention of PTM should be supported by professionals through continuous improvement (capacity building).

* Promotion and prevention of PTM was developed by using appropriate technology based on the problem, the potential social and culture to improve the effectiveness of the interventions in the field of prevention PTM.

Strategy

Promotion and prevention targets operationally PTM done in some order (household, workplace, health centers, school sites, public places, etc.) The area of concern is the well-balanced diet, smoking, physical activity and other health support.

Promotion and prevention strategies in general PTM include Advocacy, Community Development and Empowerment of the community atmosphere. At the central level is mostly done in an atmosphere of advocacy and community development. While at the district / city with more emphasis on community empowerment? 3 (three) strategies for all the material is just different. Remember local autonomy, social culture, etc. specific local.

* Encourage and facilitate a sound public health policies that support prevention and control in PTM.

* Encourage and facilitate the functioning of inter-institutional cooperation network providers and promotional potential partners in efforts to prevent and control PTM.

* Increasing the active role of health promotion in the PTM control efforts in a comprehensive manner in their efforts to promotive, preventive, curative and rehabilitative in their respective healthcare institutions.

* Improve the professional capacity of the field of health promotion both at central and local levels, especially in the prevention and control of PTM.

* Improve the knowledge and ability independent health care community in prevention and control of PTM.

* Involving the community actively in the process of solving problems faced by PTM to increase the capacity of communities and the environment in the prevention and control of PTM.

* Develop a regional assessment of health promotion of appropriate technology in the response to PTM.

Indicator

To find out to what extent the successful implementation of prevention strategies PTM, there are few benchmarks that can be used for monitoring and evaluation through a system of recording and reporting activities of prevention and control of PTM.

Indicators of success of promotion and prevention strategies PTM, namely:

General Indicators

* The reduced mortality rate (mortality) of patients with major PTM.

* The reduced morbidity (morbidity) patients with primary PTM.

* The reduced rate of disability (disability), people with major PTM.

* The reduced number of risk factors with major PTM.

Special Indicators

* Decrease PTM three main risk factors (smoking, physical activity and low consumption of fiber).

* Decrease in the proportion of people who are obese, alcohol abuse and LBW.

* Improving cross-sector policies and regulations that support the prevention PTM.

* Increased community development partnerships in the atmosphere through the empowerment of community potential.

* Availability of models of effective interventions in promotion and prevention of PTM.

* Improved implementation of promotion and prevention in the healthcare institutions.

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COE Center for Health Promotion Following Jamb 100-3rd ASEAN Jamboree

Singapore Scout Association held a Jamb 100-3rd ASEAN Jamboree which was held on 4-9 December 2010 in Sarimbun Campsite, Singapore. The team from the Center for Health Promotion Ministry of Health to visitors at the event. The purpose of the visit was to determine the organization of international scouting activities. 3rd ASEAN Jamboree attended by nearly 1,000 Scouts in the recovery period from ASEAN countries and also beberapan other countries such as East Timor and Taiwan.
During the Jamboree held there are several activities, namely basic skills of Scouting (games, camping, adventure), outdoor activities (climbing wall, ropes, cycling and exploring the outdoors), sports (kayaking, archery, bowling, sports), arts and culture (traditional games, martial arts / yoga / wushu, liong, visits to tourist attractions), community development (environmental conservation, water turtles, volunteers and exhibitions), international nights and other activities.
The team from the Center for Health Promotion opportunity to observe the operation of the Jamboree, from the registration system, implementation of activities, camp participants, hygiene and sanitation systems, intake systems, kitchen and canteen, health teams, community development, and also Indonesia Day (Indonesia menampailakn distinctive art and culture Indonesia ranging from food, drink, clothes to dance and traditional songs. Centre for Health Promotion are also taking part in the exhibition which was followed by national scouts, especially about the media and health information and also Saka Bakti Husada.
The result of this visit will be useful to prepare the implementation of the National Encampment Saka Bakti Husada scheduled to be held in Gorontalo province in 2011. (Wln)

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The spirit of Partnership in World TB Day Commemoration

On the night of March 24, 1882, Robert Koch, a German scientist to present his findings in the form of mycobacterium tuberculosis, the bacterium that causes tuberculosis. Night at the later date designated as a day of Tuberculosis (TB) worldwide, Robert Koch reminds his listeners would be terrible threat from tuberculosis.
128 years later, TB remains a public health problem in many countries around the world. Indonesia itself ranked third after India and China from 22 countries in the world with the highest number of TB patients. The challenge of tuberculosis of the world increasingly severe with rising cases of HIV infection / AIDS and the emergence of MDR TB (Multi Drug Ressistance), which has undergone TB drug resistance.
In this year, with the global theme "On The Move Against Tuberculosis, Innovate to Accelerate Action" or in Indonesian "Boost Innovation, Speed of action against Tuberculosis" TB Day commemoration took the spirit of partnership in the fight against tuberculosis in Indonesia. A series of events within the framework of advocacy, communication and social mobilization have been prepared by the Ministry of Health following NGO partners, social organization, which has been incorporated in the TB Partners Forum as PP Aisiyah, PPTI (Association of Tuberculosis Association of Indonesia), KNCV, NU, and others.
Top event of the World TB Day March 24, 2010 was marked by a national seminar with the theme of seminar was opened by Menkokesra discusses among other groundbreaking efforts towards universal access to TB services, the services of the DOTS strategy (Directly Observed Treatment Shortcourse) on all levels of service quality, overcoming challenges TB in the future and the mobilization efforts of community participation in TB control. In the event that was also signed cooperation with PT. Social Security to include TB as a disease that will be covered under Social Security insurance scheme.
On the day before, March 23, 2010, will be the launch of MDR-TB services in Indonesia. Services for patients with MDR-TB has been started since August 2009 in two hospitals, namely Friendship Hospital, East Jakarta, and Dr. Soetomo, Surabaya. Service expansion is planned to be conducted this year to other areas.
In addition to seminars, a series of warning itself will be enlivened with Healthy Walking organized by the Executive Aisyiyah which will take place in the East Parking Senayan on March 28, 2010. Sub themes raised in these activities is "Save the Family of Tuberkulsosis". Planned activities will dihardiri by the Minister of Health, Affairs, State Minister and Chairman of BKKBN PP. In addition, a series of good media campaign using mass media and publications undertaken by Puskomlik, Promkes and KNCV also will accompany this year's TB Day commemoration. Number of active partners involved in TB Day commemoration, a reflection of the need for all elements of society work together to combat TB.

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DOTS in Hospital

In 1999, the Ministry of Health took the initiative to start cooperation with the Royal Netherlands TB Association (KNCV) to support the Hospital Association of Indonesia (PERSI) in an effort to expand DOTS in hospitals, which began with a pilot project in Yogyakarta.

Project work plan Hospital DOTS Linkage (HDL) have been prepared in cooperation KNCV, GTI (Gorgas Tuberculosis Initiative) University of Alabama, PERSI and NTP. PERSI, NGOs at the national level and Yogyakarta Province DOTS Committee to act as executor with technical support from KNCV. Funding obtained through sub-contracts between UAB and KNCV, and since 2003, training fully supported with funds from USAID (Tuberculosis Coalition for Technical Assistance / TBCTA). In general, HDL project goal is to create a model of partnership between public and private sectors to expand the DOTS strategy expansion at the hospital in Yogyakarta province.

HDL Project has contributed to the development of programs that connect the DOTS services from the public sector with private hospitals. To minimize the gap between sectors is carried out activities such as advocacy, training, networking and information systems together. HDL involve all sectors of the hospital in Yogyakarta and private practice physicians in the implementation of the program.

In its development, the project has gained some achievements HDL:

    *

      By doing various activities to improve quality and access to DOTS services, has been an increase in reporting of new cases by 30% (from 998 cases in 2003 to 1300 in 2004), with the highest increase in health center. The level of reporting of cases increased five-fold compared to the beginning of the program in 2000, to 40 cases per 100,000 population. Also an increase in treatment success compared to previous years. Identification of smear positive cases in all categories of health care providers at 80% and treatment success rate has reached the national target of 85%.

      Currently, 24 hospitals (out of 32) and 5 clinical lung (BP4) has been involved in the implementation of DOTS. To improve the performance of programs have been carried out intensive training, supervision and coordination meetings between health centers and hospitals.

      Has started a private practice physician involvement in the program that identified 390 suspects DOTS TB, including smear positive dengan106 (8% of the total reporting of smear positive cases during 2004).

      Strengthening laboratory networks and laboratory quality assurance system. Test cross sputum smear preparations have been made in 70% of diagnostic centers with an error rate of between 5% -10%

      Several initiatives have been undertaken to improve networking DOTS teams, create partnerships with community organizations, and collaboration with the academic sector.

â €?? Lesson Learntâ €? HDL obtained from the project become a valuable lesson for the National Tuberculosis Control Program at this time in the acceleration phase of DOTS. Yogyakarta DOTS team members regularly invited to as a resource for the implementation of the DOTS strategy in the hospital, and the DOTS teams from other provinces have made study visits to Yogyakarta to see how the implementation of the DOTS strategy in the government and private hospitals.

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Epidemiology of TB in Indonesia

TB prevalence surveys conducted in six provinces in 1983-1993 showed that the prevalence of tuberculosis in Indonesia, ranging between 0.2 â € "0.65%. Meanwhile, according to the Global Tuberculosis Control report issued by WHO in 2004, TB incidence rate in 2002 reached 555 000 cases (256 kasus/100.000 population), and 46% of them are thought to be new cases. Estimated prevalence, incidence and deaths from tuberculosis is based on the analysis of all available data, such as reporting of cases, the prevalence of infection and illness, illness duration, the proportion of smear positive cases, the number of patients who received treatment and who did not receive treatment, the prevalence and incidence of HIV , mortality and demography.
Currently TB Prevalence Survey was conducted GFATM funded by the National Institute for Health Research & Development (NIHRD) in cooperation with the National Tuberculosis Programme (NTP), and is in the process of completion. This survey collects data and sputum examination of 20,000 households in 30 provinces. This study will provide new data that can be used to update estimates of incidence and prevalence, in order to obtain a more accurate estimate of the tuberculosis problem.
From the data in 1997-2004 [Attachment: Table of Cases 1997-2004 Identification and Reporting Level 1995 â € "2000] saw an increase in reporting of cases since 1996. The most dramatic occurred in 2001, namely the level of reporting of TB cases increased from 43 to 81 per 100,000 population, and reporting of smear positive cases increased from 25 to 42 per 100,000 population. Meanwhile, based on age, TB incidence rates seen slowly moving toward older age groups (with a peak at 55-64 years), although this time the majority of cases still occur in the age group 15-64 years. [Attachment: Age Specific Rate Notification 2004]
Medication Immunity Dual (Multi Drug Resistance / MDR)Although current data on the drug immunity doubles / MDR in Indonesia is not yet available, but has prepared a survey to be conducted at the end of 2005. The data on this matter is considered important for several reasons:

      Indonesia is a high-burden countries, and are rapidly expanding the DOTS strategy, hence the baseline drug susceptibility data (DST) will be a monitoring tool and indicator of a very important program.

      Based on data from several areas, identification and treatment of TB through the Hospital reached 20-50% of smear positive cases, and so much more to the case of a negative smear. If it does not work with health centers, many patients are diagnosed by the hospital to have a high risk of treatment failure, and may cause immune drugs.

      Due to the absence of a national laboratory network with adequate standards and quality, generalization and quality of available data can not be determined.

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"ILL STATE saga Porodisa" IN poem

This time the beta want to humRaise issues that make dizzyIn the temple of the glorious and beautiful poemOld literature in a barely remembered
Let the master beta storyAbout the saga full of meaningPorodisa wild cry of the child domesticWho yearn healthy life as best I can
Tersebutlah story at one timeSeptember '97 period markerOn the island Miangas story beginsPregnant young women
Half of weeks ago alreadyYoung woman pushing upsetScreamed pain welled-disturbingThe baby never pour
The word midwife is a narrow pelvisIf so maternity complicationsCan not wait stintShould we seek hospital
Talks big and then liftedThe consensus so closely alliedTen September they agreedRound determination to depart
Haru blue host on the beach MiangasIsak relatives wept bitterly groveDeliver brother winced againSearch for survivors of the Rais

Diverting beta profiled hostGood lesson for many ladiesRisk pregnant quick search aidDo ladies out of embraces
In Dampulis no middle-aged ladiesWant to give birth to twoThe doctor said the baby is breech too bigIt must be to the city to reveal his
Adoptive friends agreeMade direct RujukanpunWhile still a strong womanJoin the pioneer vessel was to pass
Each port of the ship dockedLoad copra merchant dignifiedThe increasingly dying womanHe died in the port Tahuna
What word would dituturIf the rice has become porridgeHe witnesses black soil buriedLeave an increasingly blurred reflection
Malaria is also another story masterDiseases of the people who are still popularSince long decadesReemerging Deseases cool term
O lord beta not jokingA girl delirious feverHigh heat makes confusionAlleged act of Satan 'turvy'

Suspected disease because of the mindHow to mingle at issueThe story tilt-ulangkan agoThe farther from hope
Separated him from associationLocked up like prisonersA week-resistant pain detainedQuack medicine began to think about
Tersebutlah young handsome doctorIn Karatung he workedPresent as members of the familyPropose a simple drug
"Quinine" host name of the medicineDrugs taken a day threeAll who attended underestimatedLaugh as much as he can
The result is exceptional hostGetting people all awakeThe disease looks increasingly subsidedAt the weekend complete recovery
O noble lord arifForgive beta if excessiveMalaria often we forgetAlthough we often find
In the land of her dominant PorodisaOld men young women so laggananFrom Essang, Gemeh until DapalanMany residents of the lien
If allowed to continue hosting betaA touching storyThere was a virgin before fiancéeJoint and bone sickly
References multilevel he livedDoctor dressing changeBlood and marrow not forget testedDisease never proven diidap

Reportedly arrived at a timeWhen he was at workNo unexpected bleedingAccompany each when coughing
We finally met factsThe virgin suffered tuberculosisAfter the tired and desperateDoctor examined a variety of visual
To the doctor in the village of relatives pleadingAsks for help as best I canReturn to their city powerlessPlease try another drug
The virgin then taken to the clinicThere examined sputum ice ice peGiven anti-tuberculosis drugsSix-month recovery 'abis'.
O wise readerBeta is not making it upEngineered storyThis happened on the ground Porodisa
Maternal deaths in childbirthPeople living with a large spleenTB cases that are not foundWe must not ignore
There are noble generous donorsThe Global Fund to be namedAids, Malaria and Tuberculosis her opponentApril '07 was almost cut aid
At the center of the beta askMoney which will replaceWhat their master number,"Local Wisdom" to be done
Faithful old civil tersebutlahNan wise scholarIn Talaud he so nobleLead a charming country green

O wise grandparent guardianYou hang the country asa childBuild Talaudku being painSo the country "Blessing", distant glow
Grandmother of wise governanceLobbying central grandparent championAdu presentation grandparent jumawaGrandparents speak proper health issues
Ask grandparents observedIf necessary disiasati"Local Wisdom" proper understandableIn order for health programs are not dead
Go ahead grandparent while workingDo not run out in many talk laterGrandmother who is now a director of the civilFor people makmurkan northern tip
Create a master at home peopleArrange the lord strong budget positionBikinkan pro-people policyTo be wealthy and powerful people
Do not be someone super master merasalahInterests of the people and are pursuedComparative studies do not digeber-GeberTo fly-kloter pleats berkloter
Good lord always sprightlyAlso take a firm stanceHelping people who gasp for breathDo not tongue-tied and stutter host
Grandmother of executive officialsMr. legislative councilGood for synergistic and proactive SampeyanPupuskan "sick" the massive land
Make the people of the country PorodisaLet us togetherSame taste and equallyRealize "IRE" common commitment
Sansiote sampate-pateIrene su su wurru waiddeIapa aru 'u maru' Mire u iapa IRENa na poron nusane suaran buntuanne
Help grandparent guardian and master boardTo Success wheel constructionTo be better prepared to dress up PorodisaSo the girl's "Paradise" very beautiful nan
Beta Have master story hereAbout the sick child domestic sagaForgiven not contain beta sassyEven if allowed to beta please excuse me

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"ADVANCES MANY" POSYANDU OWNER!

If there is the question "Whose posyandu?" Surely will arise a lot of perceptions that it will invite the rhetoric or the polemic on the question of ownership neighborhood health center itself, because people will give their perception of different angles depending on the functions of each position.Qualitative research Purnawan Junadi, in 1998 in two different provinces, namely South Sulawesi province and East Java, which involve several components of the community with a different function positions, namely posyandu cadres, village officials / village, the PKK village / villages, health centers and related sectors , the BKKBN and the Village Administration Section at the district secretariat, concluded that the public perception of "who owns posyandu".According to the cadre posyandu, neighborhood health center is owned by the government. The reason is a neighborhood health center established by the government and the cadres of the position just as a maid. In addition, a whole series of activities posyandu just might be implemented by officers, ranging from weighing up to treatment. Cadres to carry out a child's weight, but in the event of weight loss, cadres can not explain the cause and the edges have to ask the officer. Kader also argued that if any officer posyandu road. When the officer did not come then the community does not come.Three-quarter money with a cadre of neighborhood health center, village heads and village leaders also stated that the neighborhood health center is owned by the government. The reason that the headman and village chiefs who founded the neighborhood health center and the basic stance is that orders from superiors so that the neighborhood health center owned by the government is a necessity. Also in its implementation, activities posyandu only have been possible if driven by health workers, because activity in the neighborhood health center is not a skilled cadre.Opposite perception is coming from the PKK cadres. According to the PKK cadres municipality / village neighborhood health center is owned by the community and to society in accordance with the decree along with three ministers. Although posyandu demanding role of health workers, but the role of communities and community organizations, especially the PKK is very big. This reasoning is based on the fact that almost all cadres posyandu PKK cadres. PKK have functional linkages with the activities of neighborhood health center because of the PKK was the one who more often to help the cost of implementing posyandu. Assistance provided by the municipality / village is because of the PKK programs that receive assistance from the government and channeled through the activities of neighborhood health center.Puskesmas.yang is the main actor in the implementation of neighborhood health center apparently synergize with PKK cadres in providing perception. For clinic posyandu it from, by and for the community. By him is society that is responsible for the survival of Posyandu. Officers assist health centers serve only neighborhood health center activity. Initiatives each month in the form of delivery schedule of activities is just a container posyandu of health centers to optimize the performance target programs such as Maternal and Child Health programs, immunization, provision of blood tablets and vitamin A or Supplementary Feeding. The dominance of the role of health center personnel in neighborhood health center is caused by the system of five tables at the neighborhood health center just might be better implemented by clinic personnel. On the other hand still have a cadre of its own weakness, that is not utilizing the skills acquired from training, such as neighborhood health center reporting system that still has not done routinely.For those of related sectors such as BKKBN and Section PMD in District Secretariat, neighborhood health center has two important framework. First is the integrated health model can be used as the real from the real public participation. Although in practice the visible domination role of health workers, but the role of society in this cadre is very prominent, began to announce the schedule of the clinic, preparing sites for neighborhood health center to mobilize young children, pregnant women and sick people. Second, the integrated health has its own power due to the contiguity of concrete interaction between the needs of society with its fulfillment is done by the officer, in an atmosphere that does not seem formal, which also is a place to carry out socialization pesen-important message from the government.Whatever the public perception of who the owner is not penjadi posyandu fundamental issues. What is important is the neighborhood health center should be maintained continuance, because with their work for more than 3 decades, since launched in 1986, has proved its worth as a container to optimize the participation of citizens to access health needs, easily accessible and cheap, as a model of interaction between citizens and government in a family atmosphere as well and as a vessel to optimize performance at the health center program.Health Department to probe claims that the integrated health is one form of Community based Health Effort (UKBM) are managed and held of, by, for and with society in the implementation of health development, in order to empower communities and provide convenience to the public in obtaining basic health services, primarily to accelerate reduction in maternal and infant mortality. So true posyandu is owned by the community.For that, the future should the community through neighborhood health center volunteers were given a larger proportion role by providing additional skills to the cadre of neighborhood health center such as how to use various forms of scales according to the availability of local facilities and knowledge about how and what steps are done when a decline in weight infants or a radical weight gain, so the role of health workers can be reduced and slowly but surely, people's perceptions about "who the owner of the neighborhood health center" is no longer obscure and ambiguous meaning, but will be replaced by a single perception that the neighborhood health center is owned by the community.Hopefully!

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"REJECT CIRCUMCISION OF WOMEN", whole hit WALL TRADITION

"The midwife then inject drugs, surgical equipment before incised into the slit in the groin Sarah. Drugs were not working optimally. Sarah screamed and struggled. His mother tried to convince her stronger hold her thighs. Do not presume she fainted! But show must go on! Until finished. Later she found out. "Anunya" cut slightly. Circumcised!!, He said. (Tempo Interactive, Wednesday, October 11, 2006)
That piece of the portrait blurred bitter experience, repsentasi handful of women, who tested the pain when injured, to undergo "ceremonial" circumcision. Tragic indeed!. Pain can be prolonged until protracted. As already old once did. Even Fauziya Kasinga, 17 years old, a woman from Togo South Africa, fled from his country when he knew would be circumcision ala Pharaoh against him before the wedding. (Kompas Cyber Media, Thursday, March 4, 2004)
WHO's call it female circumcision or Female Genital Mutilation (FGM), which acts partially or completely cut from the outside of female sex organs, namely the labia majora, labia minora and clitoris, or other forms of injury, for cultural or other non-medical reasons. This action circumcision in Indonesia refers to the men, whose is known as circumcision or cutting around (circumference cut foreskin). This term is not suitable for female circumcision memggambarkan because female circumcision is not done cutting around. Transsexual surgery (sex change) is not included in this ceremonial. (Center for Data and Information PERSI, March 2007)
Definition of the term FGM is actually three-quarter money with the term circumcision infibulation or Pharaoh, a very significant damaging, namely the destruction of the female sex organs. (Kustiani and Rosi, 2006) Performed by excision of the vulva from the muscular wall of the pubis to the anus. After excision, the two sides of the labia majora sewn together, united by leaving a small hole in the vulva. Wound healing and scar formation will unify both the surface of the labia majora. Both legs of the woman tied up for about two weeks to speed up the healing process. All the action is performed without anesthesia (anti-pain). Unfortunately, infubilasi held in strict confidence and even with the consent of the husband or parents making it difficult to trace. (Marcoes, 2003)
UN estimation, about 28 million women of Nigeria, 24 million women of Egypt, 23 million women of Ethiopia, Sudan and 12 million women, with a very forced to have undergone this circumcision. (Kompas Cyber Media, March 4, 2004) mentioned that female circumcision carried out in 28 countries, mostly carried out in most African countries, some Middle Eastern countries, with smaller countries in Asia, the Pacific, Latin America, North America, and Europe. At least a hundred million women in the world has experienced these acts, which were in the approximately three million children aged under ten years of each year. (Data Persi, March 2007)
Publications for Population Research Centre, Gadjah Mada University on female circumcision practices in Madura and Yogyakarta proves, the practice of female circumcision performed Javanese family in both regions, regardless of religion and social levels. (Muhajir Darwin, from Marcoes 2003)). This study supports previous findings in West Java and Jakarta. (Anita Rahman, from Marcoes 2003). From historical studies, this practice is documented Feillard noted in the statement of the Government of the Netherlands East Indies, especially in Java, Sumatra, and Sulawesi (Feillard and Marcoes, Female Circumcision in Indonesia: To Islamize in Ceremony or secrecy, 1998: 337-365).
In Indonesia, female circumcision is minimized even though only a symbolic action, without cutting the genitals, but the principle "there must be blood", in Madura and "droplets" in Yogyakarta remains indicate that the mutilation is still being done. In general, in Java and Madura to cut the tip of the clitoris is the way most do, other than a symbolic way (Bacilica, 2003)). Population Council research in Indonesia said that the implementation of symbolic female circumcision without cutting / injury only 28% of cases of female circumcision and the remaining 72% which was performed incision and excision.
If analyzed with an ideological approach, no matter how symbolic execution of woman circumcision, the reasons behind the practice turned out exactly the same reason that genital cutting in Africa. More than just a process of initiation into manhood (Turner, from Marcoes 2003), or purification (Muhajir, from Marcoes 2003), female circumcision is done with the aim of controlling women's sexual libido.
Age implementation female circumcision varies, ranging from neonates, children aged 6-10 years, adolescent, to adult. In the United States and some other western countries, clitoridotomy or cutting the clitoris (the clitoris) is mostly done in adult women than in children. In some African countries where female circumcision infibulation type a lot done, these actions are taken at the age of two to six years. (Marcoes, 2003)
In Indonesia, female circumcision is generally done on the baby after birth. In Java and Madura, 70% female circumcision carried out at the age of less than one year and partially at the age of 7-9 years. In South Sulawesi, on average, performed at the age of 7-10 years, more synonymous with puberty ritual behind the women, and followed with a custom event. (Data Persi, March 2007)
A direct result of female circumcision are bleeding other than pain, shock, urine retention, and injury to surrounding tissue. Bleeding and infection can result in death. (Ardiyanto, 2004) Long-term impact is the emergence of cysts and abscesses, keloid and genital defects, pain during sexual intercourse, sexual dysfunction and difficulties in childbirth. In terms of psychology, circumcision can leave a lifetime impact. Women may experience depression, tension, and low self-esteem and not perfect. (Marcoes, 2003)
For some communities, female circumcision is a tradition that is often associated with religion. It is also still raises the pros and cons, because female circumcision is performed by many religions. Adherents of Islam, Christianity, Catholicism, animism, dynamism, one sect of Jews and even atheists, do it. The study ever conducted shows that the background is more dominant tradition, not a religious commandment. The practice of female circumcision is thought to have been started since the time of Pharaoh kings 4000 years ago, before there is a more organized religion. (Data Persi, March 2007)
Islam is a religion that maintain the integrity of human beings, both physically and spiritually. Cutting violate the integrity of this organ and degrading God's creation, which is considered perfect and do not need to be improved again. There is no command in the Qur'an or Hadith for clitoris cut or modified. It is God's creation and therefore should not be cut or reduced size and function. (Munir, 2006)
Conversely, on the other hand, the Indonesian Ulema Council chairman Amidhan, giving commentary that seemed memorable "double standards" against female circumcision. He reveals, in the Maliki and Hanbali schools, circumcision is considered as an act of the glory of it in moderation. While schools Syafii, which is generally referred to the people of Indonesia, requires female circumcision. "So long as not too much, because even the illicit and equal to castrate," he said. (Kustiani, 2006)
Nawal El-Saadawi, a feminist Muslim doctor from Egypt who became victims of infibulation, in his book The Hidden Face of Eve: Women in the Arab World, linking women's reasons for doing circumcision assuming the community about the importance of virginity and the hymen utuhnya before marriage, with sexual satisfaction husband or future husband. But with just circumcision decreased libido women so even disappear altogether. He compares with castration or female circumcision castration of the eunuch harem guards in most Middle Eastern countries, have a great body and sturdy body, but do not have any sex drive. (Data Persi, March 2007)
In fact, the "pleasure" is the right sex wife and husband. Verse 187 of surat Al-Baqarah states, "the wife and husband like clothes with each other, complement each other and complement each other." Also paragraph 21 of the Ar-Rum letter states that "God has made love and affection between them." And female circumcision violates human rights of women because deleting pleasure for women who are gifts of God. . (Munir, 2006)
Medicalization, which indicates that female circumcision for health reasons, even add a red thread kusutnya female circumcision. (Kompas, Wednesday, June 1, 2005) Although intended to reduce health risks, especially infections, which result in death, but if done by traditional birth attendants or craftsman circumcision. become very dangerous. The findings of the survey Population Council Foundation in collaboration with the Office of State Minister of Women revealed that the practice of female circumcision which uses various tools such as needles, knives, and scissors to make incisions by 22% and 72% excision. (Data Persi, March 2007) "If in the countryside who do shaman, then in urban areas generally midwives and also in the hospital," explained Dr. Meiwita Budiharsana, PhD, from the Ford Foundation Council.
Collective presumption that less fatsoen, if you do not want to say silly, that circumcision is performed to reduce or eliminate the sensitivity of the tissue in the genital area, especially the clitoris, in order to reduce the sex drive of women, so as not to spit napsunya and remain faithful in marriage, reap protests from feminists batty . For them this presumption is "defamation" against the rights and dignity of women. Until now there is no medical research that states that women who are not circumcised to be wanton, wild and hungry for sex. Even the baby girl was, since birth has been accused of sell sex, because female circumcision is done at birth. At this point actual feminists reject the practice of female circumcision and "because the country was obliged to consider re-ayemnya cool on the practice of female circumcision is". (Marcoes, 2003)
Whatever the reasons and background, female circumcision has become a controversial issue, both at the global, regional and national level. Controversy because sosiokultur authorities can not provide an explicit explanation of female circumcision which has been made since thousands of years ago and was adopted until now. Controversy because the religious interpretation of ambiguous, nebulous meaning as ambiguous, among which are allowed and what is not, which are mandatory and which are Sunnah. Controversy because "pleasure bring misery." Delicious for men, agony for women. Female circumcision controversy because it has dimedikalisasi without calculating who did it. Controversy because female circumcision as a reason that women without sexual lust circumcision will spit everywhere.
These controversies must be straightened. There should be a historical search to examine the justification sosiokultur tradition of female circumcision. There should be a fundamental review of the interpretation of ambiguous religious. There must be proof of what is true of women who were circumcised became super delicious for men and women who are not circumcised to be disgusting in matters of sex. There should be a correction to the medicalization of circumcision permpuan and the assumption that women are not circumcised indulgence in lust.
Thus, all components must contribute, sit together, make a fundamental assessment, formulate a policy breakthrough "best fit" with the cult sosiokultur, religion and medicine in this country, to solve all the controversy about female circumcision. If not, then the 'Reject Female circumcision "is only going to be like Dream Gone brimmed, tembangnya Anggun C Sasmi. Far from the truth!
Terbesit one hope. Minister of Women Empowerment Meutia Hatta Swasono, MOH urged to prohibit female circumcision medicalization. "We also sincerely hope that the Ministry of Health issued a prohibition for medical officers / paramedics, including government and private health facilities, not to medicalization of female circumcision." (Kompas, Tuesday, May 31, 2005)
Bak shoots beloved side dish arrived, tit for tat. Health Minister Siti Fadilah Supari in his written, in a workshop on Prevention and Combating Violence against Women associated with the practice of Female Circumcision, Wednesday, June 1, 2005, saying "female circumcision did not exist in the health service standards." Clop!. In terms of government policy has had a good will toward Reject Female circumcision. Just how the support of the scholars and authorities sosiokultur against government policy to produce a synergistic power. Reject female circumcision! And most important is to perform sero tolerance campaign, that female circumcision has no benefits of any such campaign organized by the UN began in early January 2003. (Kompas Cyber Media, Thursday, March 4, 2004)
When synchronization is realized synergistic power, the authors believe, thunder shouts from the feminist "Reject Female circumcision" will not hit the wall whole tradition and will continue to erode the practice of female circumcision formations in Indonesia, so that the bitter experience of Sarah and Fauziya Kasinga no longer occur .
Hopefully deh!. He ... he .. he!
Melong, Mid March 2010

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ISLANDS Nanusa in Kabupaten Talaud: "PHENOMENON AND outer islands REFERRING PATIENTS DILEMMA "

One afternoon in Lhok Seumawe, Nanggroe Aceh Darrussalam, the end of November 1997."Hello ...", phone ringing sound in the home office of Immigration head office of Class II Lhok Seumawe, Nanggroe Aceh Darrussalam. "Hallo ... This ...?", who answered Mrs. Urendeng-Banera, wife of the head office. "Mummy ..., this is of Micronesia, from Liti ...", replied the voice from beyond. "What ..., this is true Liti ...?", asked the lady. "Iyo mami, this is from Micronesia, the pa Liti ..." His accent is thick Manado in Miangas and color accent sounds typical, very familiar, make sure that the lady was really his son. The lady fainted. Haru happy mix. Later he knew that his son was still alive Urendeng Litisya midwife.Litisya Urendeng PTT is a midwife who was placed on the island Miangas, District Nanusa, who with his colleagues Albert Nusa Mantri and several others suffered ill-fated Miangas residents stranded on the island of Chuck, Republic of Micronesia, while referring to the mother gave birth to a health center of the island Miangas Karatung, the capital city Nanusa district.Starting from a mother who can not give birth because the pelvis is narrow, in early September 1997 and should be referenced. After the family agreed to be referred, they set off with wooden boats outboard motor and then lost in the Pacific Ocean, drifting amid fierce ocean waves for 72 days, before a Japanese ship to save them. In the event 10 people from 14 people who are in the boat were killed, including the infant.Footage of events over a re-recording phenomenon Nanusa islands as cluster outer islands in conjunction with the dilemma referred patients, which is repsentasi of many similar events and in the same matters as well. Referring patients!Imagine, just because business must compete refer patients to die berkubur lives even oceans. Do not know rimbanya. Strange indeed! While in some places to refer patients no longer a problem. Nanusa Mar in the islands, it is inversely proportional, occurs in the middle of the flow of information, communication and an increasingly sophisticated global transportation.Nanusa Islands is a cluster of islands in the area of governance Talaud Islands which are geographically located in the northernmost part of NKRI which directly borders with neighboring countries, the Philippines. Three of the five clusters in the outer islands of North Sulawesi province in this region, namely the island Miangas, Marampit and Kakorotan (Presidential Decree No.78/2005). Most of its population classified as "elite" (aka poor = difficult economic times), difficult to access due to various limitations and frequent disasters, especially lack of food (if you do not want to be regarded as famine) only because the weather is less friendly so that access to transportation to food distribution stalled.Now, a decade so passed, a rather long period of time to reform the slightest problem (or for?) Refer patients. Bijaklah we glanced backward at the position in 1997 Nanusa Islands in the affairs of referring patients, and compare it with current circumstances. To be honest, the island state of Nanusa now directly proportional to the situation a decade ago. Still the same! Just "nut in the split second"!Referring patients remains a serious problem, the root of the problem is multi-complex that need solving a complex multi as well. Nanusa Islands refer patients not just a health problem. Many facts are undeniable, proves this.Geographical circumstances Talaud Islands (CBS Talaud, 2005) which consists of the islands far-flung and hard to reach, especially Nanusa Islands, a factor which makes it difficult for patients to seek treatment or in effort to refer patients. Moreover, the distance with Mala Hospital in the capital of the district as a referral center is considered extremely remote.To refer patients Miangas island, a distance of 129 nautical miles from Melongguane, the district capital (CBS Talaud, 2005), Mala Hospital requires at least three days travel time by boat pioneer, having to drop anchor in every harbor pilot. Green, cited Sarmudianta, 2002, states that the distance and travel time is an enabling factor to hamper efforts to seek treatment (health seeking), adherence to treatment (compiliance) and referral (referral system). The accumulated distance and time will make the transportation costs would be higher.The absence of cost is a major problem families in an effort to refer patients. An empirical fact is that when the clinic made the decision to refer a patient, always collided with the problem of the cost of the family. Especially in a state of emergency patients must be referred at the time, then the "cost" for the family is like a time bomb ready to explode at the time.This can be understood considering the economic conditions mentioned above, make the family was not ready in terms of financial. Poor card that is expected to be the god of rescuers, unable to do much, because of poor cards are used to finance treatment and care, and not for transportation.Health financing in the budgets allocated pemkab Talaud Talaud 2006, 3.78% of the total 321 billion (Talaud Health Profiles, 2006), with funding per capita USD. 146 587 is already on target Millennium Development Goals, Rp. 120,000 per capita (MDGs, 2005), but can not be felt touching the public service to refer patients to a level as it is still more widely used to fix the health infrastructure, as a consequence of the new expansion area.The condition of absence cost a bit more severe when the time does not refer patients to coincide with the schedule so that the pilot boat Sea must use Pusling or motor boat population, because families have to be confronted with a larger jump in costs, the cost of fuel. Very high fuel prices severely limit the purchasing power of families, so that the fuel purchased is limited to "important to their destination" without any backup. A condition that is very risky!Tragically again, it is time to refer patients if fuel is not available in shops or at food stalls. Authors and other Karatung clinic staff with patient's family had the experience to push the cart from house to house residents, just to collect one or two bottles of kerosene for purposes of referring patients.Policies that prohibit passengers PT Pelni contain kerosene, especially gasoline, in the pioneer ships, adding more fuel access kusutnya red thread, because it almost made Nanusa Islands residents access to the fuel to be none at all, In this condition, look for fuel in the islands Nanusa is like "looking for a needle of a haystack." Even if there exorbitant price!The difficulty of transportation access to its own problems in terms of referring patients. In fact Nanusa transport access to the Islands are only accessible by sea which is served by vessels Pelni pioneer and a ship and takes place only once in 2 weeks (CBS Talaud, 2005).In the context of transportation access, refer patients from the island Miangas like "waiting for fate" of having to wait for the pioneer ship schedule with no other choice. Even more tragic if the ship could not be able to pioneer docked at the pier Miangas because of the unfriendly weather, then refer the patient as "pungguk miss the moon." Not at all! Far from the truth!Weather conditions more or less friendly. is a complication that almost no intervention because they have to deal with the forces of nature, is another obstacle in the effort to refer patients. A provincial official who visited the Islands Nanusa, whether true or not, once said that 10 months from 12 months a year, in the Islands Nanusa is tight season.Interestingly, in these circumstances, when referring patients is an absolute choice and must use a pusling sea, the decision to refer patients is highly dependent on the "engineer" who seemed to body and soul are united with the sea and weather. Although the patient was ready to be referred, if the engineer says "Torang Blum may brangkat now is the hour bagini this wind mo batiop kancang" then the health care workers and family do not helpless and instantly trust. A state that is less acceptable to common sense, but more truth than hurt.Inadequate health resources on the islands Nanusa, is a true priority in development efforts in the health sector in Talaud Islands, because in addition to quantity and quality is lacking, also because of the ease of intervention. Assuming that the health sector is the domain of regional autonomy (Law No.22, 1999), then the above problems can easily be intervention by the regional health department through a proposal to the local civil service agency.In terms of quantity, the ratio of health resources versus the total population (Minister of Health Decree No.1202, 2003), in the islands can be said Nanusa already adequate, especially the ratio of general practitioners and nurses. Nanusa Islands with a population of 4206 people (BPS Talaud, 2005) ideally 1-2 people served by general practitioners and 5 nurses, and is in conformity with the current state of the field. The ratio of midwives are ideally served by 4 people new midwife realized 2 people who all concentrated in the main clinic.But on the other hand, the geographical conditions of the islands, the ratio was felt still less and was not evenly spread, since most health resources are concentrated in health centers as the holders of the parent program. This situation is seen from the sub-health centers that have not been in occupied health resources. Even the Village Maternity Clinic Poly (Polindes) which should be occupied by a village midwife, everything is still empty. From the program side, the ratio of health resources are also still seem less, is proven by the clinic staff who still holds the dual program.Looking ahead, the state ratio of health resources will be even more stagnant because many health resources that do not want assigned to this area, because it considers this area as a place of exile and the only decent occupied by employees with problems, as punishment, so that the various kinds of ways trying to avoid the placement of tasks in this region (similar to Nusa Kambangan?).Lack of training on emergency management and how to maintain a patient's life (survival), making quality health resources on the islands still impressed Nanusa inadequate. When the constraints as mentioned above, offset by the ability of health resources, especially nurses and midwives, in the management of emergency and how to maintain a patient's life, then at least a referral of patients to be delayed until the ship arrived or awaiting readiness pioneer families of patients.Whatever the reasons and background, whether consciously or not, the empirical fact already happening. Referring patients from the islands Nanusa is like "eating the fruit simalakama". A real dilemma! Not referred, the patient died! Referred, families and health workers battered! For that we need a fundamental review, in order to obtain design policies that fit the typical of this region, so that the constraints in referring patients can be eliminated or at least reduced.Given the geography and natural conditions typical Nanusa areas that are less friendly, which can not intervene because they have to deal with the forces of nature, coupled with other constraints, hence improving the quality of health resources is the first choice. Training on the management of kegawat daruratan and how to maintain a patient's life is a "conditio sine quo none". A must!Cut the reference distance, is another alternative for accelerating patient referrals to the referral center. Distance of 129 nautical miles and takes about 3 days from the island of Mala Miangas to hospital, was too much for patient referrals. So Talaud district government plans to build a hospital in Gemeh (North Karakelang region), an alternative telling to cut the distance from the islands Nanusa reference.Another alternative is the provision of fuel depots in the islands Nanusa. It is not merely to refer patients needs, but also in touch with the needs of everyday life (daily living needs) such as the fuel needs for the fishermen and affairs in the kitchen cooking. With a fuel depot, then access to that barely any fuel can be overcome.Improving transportation access, is another choice that feels more difficult to be realized because not only involve Talaud district government, but that does not mean not at all. Experience that has ever existed a local shipping entrepreneur who open access cruises to the region Nanusa (KM Alkasa and KM Raflesia), can be considered Talaud district government to lobby other employers, open access cruises to the islands Nanusa, so that people have other alternatives besides pioneering vessel, including alternatives in referring patients.The authors very much hope, or at least suppose if there is improved quality of health resources, decrease the distance reference, the realization of fuel depots and the expansion of access to transport, hopefully to eliminate or at least reduce the constraints in the affairs of referring patients in this region, so that the future will no longer Litisya midwives and other Mantri Albert, who must compete in the wilderness of ocean life, simply to refer matters patient. And the most important thing is to refer patients from the islands Nanusa no longer an issue.Hopefully! He ... he ... he ...!

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SEXUAL AND REPRODUCTIVE RIGHTS OF WOMEN: "HEAVEN IS MISSING AN"

SEXUAL AND REPRODUCTIVE RIGHTS OF WOMEN:"HEAVEN IS MISSING AN"

This gloomy twilight at Karatung, Talaud Islands! At that time, May 2005.That afternoon, a convoy of pedestrians entering the garden center, after a weary oar rowing across the sea from the island Kakorotan. Delivering patient! A pregnant teenage girl lying on a cot old bamboo carried four middle-aged man drenched in sweat. Bleeding from the womb to abort! It is said that pregnant before marriage!. "Accidents association of young people", whispered one of his entourage who delivers. The teenager was forced to have abortions at the instigation of her parents to cover the disgrace of the family.Elsewhere!A mother lying astride on the "bed gynecology" in the practice of obstetrics and gynecology physician. With the help of midwife assistants, the doctor gives the cue to bear the pain to the mother, putting the "cocor duck" into the mother's intimate hole. "Hold again bu", the doctor said, turning the screw "dilators" cocor duck for the mother's intimate canal widened and loose for easy inspection. The mother screamed. Sick indeed! But the show must go on! Until the investigation is complete!.
Outside, her husband sat on a bench waiting mengelonjor long as he repeatedly smoke Gudang Garam Surya that he bought at the stall next to the clinic doctor. Do not know what he is feeling his wife at the doctor's room. The mother was forced to try out the pain when cocor duck and the hands of "big" the doctor went into the burrow intimate. Her husband told sex organs and its contents examined after six years of marriage do not get the "baby".That bitter experience blurred portrait of two women who try out the pain, even facing death because of powerlessness, due to sexual and reproductive rights are not protected. To be honest, the above events, is repsentasi of a large number of women who experience the same thing, although not in the same condition. Once again because of "sexual and reproductive rights are not protected"! Tragic indeed! Therefore, it is worth all the women in Indonesia, North Sulawesi, especially women, understand and comprehend, or at least are aware of the sexual rights and reproductive attached to him.Starting from the basic human rights possessed by all people, regardless of gender, skin color, age, sexual orientation, religion, political views, and so forth in order so that everyone can understand her self-esteem, self respect and develop his potential maximum . This then triggers the feminists to fight for women's sexual and reproductive rights. the fact that when women's reproductive rights are ignored, can adversely affect physical, mental and social development in women and can end in death.Reproductive rights and sexual rights of women is part of human rights. The goal is that every woman can enjoy risk-free sexual life (sexual life free from risk). The state should ensure that every woman is able to determine how many children who want to have, determine the distance born children, regulate sexual behavior in accordance with the wishes and feelings without any fear or shame, free from pain and disability that might interfere with the function sexual and reproductive.Here are 12 sexual rights and reproductive female, which has been identified, such as those downloaded in the "Sexual and Reproductive Rights" Within Everyone  s Search, http://www.ippf.org/Home.aspx, with little additional literacy from various sources, namely:1. Right To Life.This applies equal rights for men and women, but when we talk about reproductive and sexual rights, the rights are aimed primarily at women, who have the right to not be dead by the causes that can be avoided or prevented, which is associated with reproductive process. That is, a woman has the right to not make his life at risk to die from events promiscuity, pregnancy, and parturition.When will a woman become her life at risk because of the reproductive process? When the more permissive sexual relationships due to the lack fatsoen collective orientation, which considers sexual relations as a "recreation" or when there is sexual coercion against a woman or also when a woman does not want to get pregnant but not using contraception (unmet needs), which resulted in pregnancy not desirable, then at that time the woman will tend to make decisions or recommended, either by their families or their sexual partners, to have an abortion. When abortions are not performed by qualified personnel or equipment is not adequate, then that's when women at risk for death. In Indonesia death of women due to pregnancy, and parturition to reach 373 deaths in 100 thousand live births and estimated that there are at least 20 thousand women die each year from complications of pregnancy. Among the complications of pregnancy is 45% is because of bleeding due to unsafe abortion.When women become pregnant at a younger age than 16 years old or older than 35 years, when the pregnancy is too much (more than 5 times or 3 times a Caesarean section) or too often (1 time a year), is also a precondition that can lead to death for a woman.In these conditions a woman has the right to prevent pregnancy if it is endangering his soul.2. Right to Independence and Security.Women as well as men have the right to choose whether he wants it or not, to build relationships, including sexual relations and to exercise control over their reproductive lives. And the choice was taken freely.That is, no one can force others (including the legitimate spouse) to have sex and not a perempuanpun who could be forced to become pregnant or have an abortion by anyone.All surgery-related sexual and reproductive health, including abortion, should be done by an authorized person and have the competence to perform those actions. According to WHO, unsafe abortions are performed on an unwanted pregnancy is carried out by untrained personnel, or do not follow the medical procedures or both. Of the 46 million abortions per year, 20 million made by insecure, of which 800 women died from complications of unsafe abortion, and at least 13 percent contribute to the Global Maternal Mortality Rate (AGI, 1998).Estimates of national states that every year there is 2 million cases of abortion in Indonesia. This means there are 43 cases of abortions per 100 live births pe rtahun in 1000 women aged 15-49 years (Utomo, 2001).
3. Right to Equality and Freedom from Discrimination.All men and women are born free and have dignity and equal rights. No special task "for men" or specifically "for women". All job duties within or outside the house must be done together between men and women equally and equitably.Boys and girls have equal opportunity to obtain education and employment.Lack of girls in gaining access to formal education, describes the helplessness of women in determining the way of life. Sometimes a woman forced to marry at the age of school for various reasons that could have been prevented or avoided. While young age at marriage of women is positively correlated to the high risk of maternal mortality. BPS 2003 report states that the median age of first marriage Indonesian women 19.2 years. Women 18.3 years in rural, urban 20.3 years.As a result of the difficulty women have access to education for women in Indonesia resulted in over 10 years do not attend school for 11.56% of the total population, 12.28% female illiteracy,In the context of equality seyogianyan affairs of a female contraceptive method does not require a husband's consent or permission, to choose or change the method of contraception and contraceptive method when the method is not suited to the conditions of his body.4. Getting Privacy Rights.Every person, male or female has the right to keep secret the doctors or other medical staff, including secret about things related to sexual and reproductive lives. This means that any information given to the physician or other medical staff associated with sexual life or the life of one's reproduction is part of the patient's personal life, and therefore also a good physician or other medical staff have an obligation to not talk to anyone except the patient own. Report YLKI (period 1998-2004) there were about 306 complaints of breach of contract and as much as 2 cases resolved dijalur court.Teenagers, as well as adults, have the right to privacy should be respected as well.5. The Right to Freedom of Opinion.With reference to sexual and reproductive life, everyone has the right to freedom of thinking and acting in harmony to maintain family relationships (read: sex), especially in maintaining, caring for and treating intimate organ.Religious or cultural or political party actually does not restrict one's way of thinking or expression in relation to sexual and reproductive life. Freedom of speech to sexual and reproductive health should not be limited based on the interpretation of religion, philosophy or culture. Certain actions related to the reproductive organs such as abortion, cesarean section or female circumcision, it should not be done on an interpretation, let alone command, religion or philosophy or a particular culture, but solely because of medical indications.UN estimation, about 28 million women of Nigeria, 24 million women of Egypt, 23 million women of Ethiopia, Sudan and 12 million women, with a very forced to have undergone female circumcision pharaoh model, which is more often called infubilasi or FGM (Female Genital Mutilation) is done because cultural reasons and the ambiguity of interpretation of the Sunnah. (Kompas Cyber Media, March 4, 2004)

6. Right To Information and Education.Every person, male or female productive, have the right to obtain equal access to the latest information about sexually transmitted diseases, family planning services and methods, and all things related to sexual and reproductive lives. Teenagers have a right to obtain information and programs on adolescent reproductive health, wrong treatment, violence, and all things related to sexual activity, in accordance with their age. Education affects a person's perception of the acceptance of new ideas.Research Sri Ratna Dewi Omarsari and Juwita (2005) in Sumedang District showed that low-educated female teens a chance to become pregnant before marriage by 1.43 times than women with high education. Higher education to widen the range of age between childhood and adulthood. In the Special Region of Yogyakarta women aged 14-24 years who experienced premarital pregnancy secondary education 9.1%, 54.6% high school and college Tinggi36, 3%. (Pratiwi, 2004) means that the ratio of premarital pregnancy over 3 to 1 among female adolescents and young adult women.The boy should be educated and prepared to take responsibility for the consequences of sexual behavior and reproduction.Adolescent women who become pregnant have a right to receive specific support from family, society and state, so he got the information for how to support themselves and their babies.Family plays an important role in the process of education and provide equal opportunities for boys and daughter in getting information on sexual health and reproductive health. Parenting parents play a significant role here. There is a correlation between the pattern of parenting and adolescent premarital pregnancy. Adolescent women who have permissive and authoritarian parenting (not good), potentially having premarital pregnancy by 3.23 times compared to adolescent girls who have a democratic parenting (good). (Ratna Juwita, 2008).7. Right to Choose or Not To Marry, Shaping and Family Planning.Every person, male or female, has the right to vote or not, when and with whom to marry. That is, no one, for any reason, forcing others to marry him. No one can be forced to stay married or stay with someone he was not happy with him.The decision to marry or live together should be taken without pressure, with full responsibility and is done by people who are already adults.8. Right Want To Deciding Whether or When to Have Children.Every person, male or female, has the right to gain the broadest access to family planning methods are safe and effective. That is, every person has the right to freely determine the number of children who want to possess, and how to manage his birth. Permission of sexual partners is not always necessary when a person chooses or wants to use any contraceptives.The decision to determine the number of children should be free from pressure and carried out with full responsibility, it means a chance to think about them (his children) to get the best welfare.At issue is when infertile couples are encouraged to check repruduksinya organs. When the husband tends to encourage (or ordered?) Wife to consult in advance, whereas gynecological examination of women are very complicated and painful. In terms of medical infertility factor 40 percent of husbands, wives factor of 45 percent. In terms of cost, initial examination of the husband is much simpler and cheaper than the examination of the wife. (Center for Data and Information PERSI, March 2007)9. Right To Obtain Service and Health Protection.Each person has the right to enjoy life, risk-free sexual life, and have human relations with the conditions he wanted. That is, each person has the right to receive the highest quality health care for sexual and reproductive health.Sometimes the wife has to contracting sexually transmitted diseases or HIV / AIDS, resulting in infertility, miscarriage, and even extra-uterine pregnancy and pelvic inflammation, not a result of his actions, but due to husband's sexual behavior that are not controlled (like unsafe sex outside).In Indonesia there are 1577 cases of HIV and 578 AIDS cases, 21% of women, (PERSI Data, October 2001)A user of sexual health services and reproductive health have the right to ensure that he gets quality service.10. Right To Obtain Benefits Of Advancement of Science.Each person has the right to benefits of science and technology, current reproductive health. That is, each person should have access to modern family planning methods, safe and acceptable, and complete information to these family planning methods. Collective presumption that less fatsoen that the affairs of pregnancy and childbirth are women's affairs so that family planning is the business of women's affairs and also a more dominant character's husband in the family planning decisions and choosing a method of contraception without considering whether it is suitable or not for women, is an empirical reality which advocates against women, which can not be denied.On the other hand availability of reproductive health care programs appears to be merely directed to women. In fact at the health center program is available only Mother and Child Health (MCH). Also accessibility to public services male contraception is still low, because the contraceptive method is still more geared to women. This was shown in which the male contraceptive methods is still limited condom and vasectomy.11. Right to Freedom of Assembly and Participate In PoliticsEach person has the right to gather with others and ask and to voice the rights to sexual and reproductive health. That is, each person has the right to assemble in a group to participate in developing and respect the rights of reproductive health and sexual health. And this is guaranteed by the state constitution. (45 Constitution Article 28)Organization of a group who have similar interests (women's organizations, youth, reproductive health observer, etc.) is important to provide information and support matters relating to the rights of sexual and reproductive health.12. Right To Freedom From Torture and The Treatment.Each person has the right to be free from all forms of violence. That is, each person has the right to not get the violence (physical or verbal) by their sexual partners, or from someone else. Each person has the right not to be forced in sexual intercourse.In daily household husband forced wife often asked to provide "bed service", although at that time the wife not being wanted. If the wife refuses, then the husband will be upset. This condition is vulnerable to the occurrence of domestic violence. Data Stop Crisis Centre (PKT) RSCM, 2003, there were 655 cases of violence against women, 50 percent are sexual assault, which occurred on 47% of women under 18 years old, who perpendidikan elementary to high school (74%). If violence is done in the household, this is very ironic, because precisely the violence done by people they love.
Guarantee the fulfillment of the current situation regarding the rights of sexual and reproductive rights of women, shows that the recognition and fulfillment of sexual and reproductive rights of women are still far from expectations. Here and there there are still many violations of women's sexual and reproductive rights such as trafficking of women, sexual exploitation of girls, sexual coercion, sexual harassment, either sexual behavior, kekerasam in the household until the imposition of an abortion.Thus it is necessary to understanding, understanding and shared commitment between women and their sexual partners (read: wife and husband) on equality in the fulfillment of sexual and reproductive rights. Strict regulation and tough sanctions and voicing advocacy defense of sexual rights and reproductive women also needed in the fulfillment of sexual and reproductive rights. The fact so far, domestic violence, is regarded as the domain of household, marital domain, which is closed and may not be accessible to others, especially when used as a criminal case.In relationship between pairs of equality, freedom and mutual respect between the pair must exist. Only by giving respect and need respect the sexual rights and reproduction, the reproductive health and good sexual health will be achieved by everyone, so do not need no women forced to have abortions are not safe and tested the pain because dicecar cocor duck.

Melonguane, December 2010.

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