Opinion 2 for Edition 36
DR. Dr. Sugiri Syarief, MPA: Family Planning as A Lifestyle
by: Riri Khariroh
- Dr. Sugiri Syarief, MPA was born in Pringsewu, 2 Agustus 1952. Since 2006, Sugiri serves as the Chairman of National Family Planning Coordination Board (Badan Koordinasi Keluarga Berencana Nasional (BKKBN)). He obtained Doctoral Degree in 1979 at Universitas Gajah Mada Yogyakarta. He also earned an MPA Degree (Master of Public Administration) in 1985 by Majoring in Population Policy from University of Southern California Los Angeles, United States. Another Doctoral Degree was obtained in 2009 from Universitas Pajajaran, Bandung.
The husband of Nuri Astralina Mardiani started his career as the Chairman of Public Health Center in Kurotidur Bengkulu during 1979-1981. Since then, his career accelerated. Not only in BKKBN, Sugiri has also chaired position as the Secretary General of Corruption Eradication Commission during 2004-2006. He participated in various national and international forums such as Harm Reduction Training in Sydney (1998), IUD Insertion Training in Beijing (1999), HRD Visiting Training in ICAC Hongkong (2006) and many more.
Visited by Riri Khariroh at his beautiful residence in Pondok Indah, the father of Befridesi Upastri (1982) and Elvena Prihastri (1983) explained the Family Planning program in the era of Reformation.
How has the concept of Family Planning been introduced so far in Indonesia?
The Family Planning in Indonesia is different from the concept already known internationally. The term Family Planning is indeed Keluarga Berencana in Indonesian language, but the implementation of family planning generally known is just to restrict the baby birth, or in another word, family planning means birth control. On the contrary, in Indonesia, Family Planning or Keluarga Berencana basically is to plot a family, that’s why we need to have a sufficient knowledge for this. Meanwhile, the contraception tools we know is not the same concept with KB, because the tools are not the essential thing. Contraception tools are just like a hoe, a knife; there is a big knife, a sharp knife and a blunt one. That is just a tool to support a good family planning.
Family planning begins when someone starts a family life. Therefore, we build a life preparation program for family since they start at the teen age, when they enter family life, they will already have a sufficient knowledge and a good plan. If someone wants to raise a good family and have children, a well-prepared planning must be made, not only it is based on an assumption that children are God’s business. Yes, it is true that God gives us children, but the important thing for us as a human being, is how to give birth and raise children so they can grow with a good quality both physically and mentally.
How does BKKBN socialize this Family Planning program?
BKKBN starts to educate about family life at very young age, which means we deliver this message to teenagers. We teach them how to prepare a family. If we want to build and raise a family, all supporting factors must be prepared, such as the financial condition of the father and the mother. How this necessity needs to be fulfilled. Another factor is protection, which is represented by the house or the family as a safe place for each family member, thus the children will not seek protection from someone else or any other means like drugs or committing a crime.
Being a parent is not only doing what a parent is supposed to do, but it is also to prepare how to start and build a family life. When someone wants to build a family and have children, he or she must have the thought of how many children will he/she have? Either one, two or up to God’s decision, because the fortune is in God’s hands, do we still have this thought in mind? If we want to have children, we must also be responsible with their needs. If we are capable of having 10 children, go ahead. If we can raise only 1 or 2 children, it’s not a problem. What matters is, we know exactly how to start and build a family life.
Speaking of which, BKKBN is also socializing contraception tools. If we want to have only one child, then explain how the tools work. If we want to have ten children, the contraception tools become useless. Contraception is a tool which always develops like technology. It is like communication tools we know, such as hand phone and else. But the contraception technology doesn’t develop rapidly like hand phone, because it requires a careful and long research.
What are strategies implemented by BKKBN in bringing up the concept of Family Planning since an early age?
We start to introduce the family life to teenagers. We ask them, what is a family? At level of Elementary School, we teach them about demography in a very simple way. For example, a family consists of a father, a mother and a child. When a child is born, he or she has rights that every parent must accomplish. This has to be taken into account that in a family, we are bond with rights and obligations. We must teach to them that a family will grow well if their life quality is also good enough. A character building must be built within. Family is the place where values are taught, like how to salute people, to give orders and ask for help politely. All these things must be taught by the family itself because children will internalize these values when they grow older and build a new family.
Thus, the strategy is implemented since teenage life. To those already have a family, we teach them how to maintain the family: how to raise our children to be a good person with a good quality. I try to make this family maintenance program as part of KB. For example, how to educate our children to become a smart person. Many people say being smart is naturally descended. But in fact, from medical point of view, a child’s intelligence can be prepared since his or her early age. A smart child has many brain cells, there is a process for this. The brain cells start to develop since the baby is still in womb until he or she reaches 7 years old of age. Afterwards, it stops. We call it the golden age. During this period, we must supply our children good nutrition in order to develop their brain cells so they can grow smart.
If we want to build this country and nation, to be prosperous and capable of competing with other countries, we must prepare and grow smart children. If their brain cells do not develop rapidly, we will be a nation lacking quality where people can only do unskilled works.
How has the implementation of KB programs been doing so far in reality? Do people still believe that having many children means having a lot of fortunes?
I think the concept having many children means having a lot of fortune is not too popular anymore, because living cost and the tuition fee is getting more expensive, and job opportunities become more competitive. The KB program educates our people to prepare a good quality family with skilled and smart children, so they can find jobs and have a prosperous life. If they don’t go to school, they will not earn a good living, but only become unskilled labors with low salary. People are now more realistic to decide how many children they would want to have, because life is getting harder. But, I think what we need to educate now is how to raise a good family and have children with a good personality and adequate skills. This is our main concern at BKKBN.
Most of KB acceptors are women, while quantity of men as KB acceptors are still very limited. How does BKKBN cope with this problem?
When we decide to raise a family and have two children, it means we must use contraception tools. There are modern and traditional tools, but if we want to plan it effectively, use the modern tools. Why? These tools are guaranteed, and research proven to work effectively. If you want to postpone your pregnancy, use contraception tool with high flexibility, like pills. When you stop your pills, you’ll get pregnant. If you want to postpone, distance between one pregnancy to another will match exactly as we want.
For example, you want to postpone pregnancy for 5 years, then use IUD, but if it is for 3 years, wear the implant so you will not forget since a lot of people disregard this, especially the syringe for injection (once in three months). If you forget to do the injection, the pregnancy will happen.
For deciding who should wear the contraception tool is agreed by both, the husband and the wife, not only one of them. This is to decide who will join KB program, is it the man or the woman. If it is the woman, use the right tool. Same thing applies for the man or the husband. If it is the husband who follows the program, use vasectomy or condom as an option. At the moment there are only two contraception tools for men. We always support the research to find another contraception tool. This takes time, also does the research.
BKKBN itself supports the KB program to be implemented by men, but most of Indonesian people culturally see this as women thing. We want to remind that KB is not only a woman thing, but it is for family, so the decision on pregnancy and having children shall be made together. Unfortunately, men are still dominant in Indonesia, women just accept the decision. If there is a discussion in the family about who will wear or use KB tools, the woman or the wife will answer usually, let me use it, not allowing the man to do so. There is a gender bias in our culture.
In our program, all the contraception tools are safe as long as we wear or use it correctly. The pills are 98% effective as long as we drink it every day. Periodic abstinence is also good as long as we are discipline and only do this during fertile period. An effective contraception tool is the one having no gradation, make a table planner to decide when you don’t want to get pregnant anymore. Whether it will be the man or the woman as an acceptor, it is up to them.
It is true sometimes we make mistakes, we promote vasectomy and condom as contraception tools for men less vigorously than those for women. Sometimes, the field officers rarely promote contraception tools for men, on the contrary they should explain all the existing contraception tools and give freedom to families to choose which one is good for them.
Many people are complaining about negative effects of contraception, in particular to their reproductive health, especially to women. What do you think?
It is true that all contraception tools cause negative effects and complication. But it is up to us on tackle this problem. The technology has helped us to reduce the negative effects. For example, KB pills created in 70s contained a mixed element of estrogen and progesterone, of which the estrogen can be harmful. But thanks to medical technology innovation, these negative effects can be reduced, resulted in KB pills without progesterone. Even though there is negative effect, the risk is very little. Now there are also KB pills which can make your body slim, because the estrogen elements have been lowered. There are KB pills which makes your skin looks smooth, KB pills which can cure your acne problem, and so on
Why do we have an impression this program is targeted to women only?
Yes, it is true. As I said earlier, we push men to participate more in KB program than women. We try to change the paradigm, for example if vasectomy could lower men’s sexual performance. Apparently, a lot of men testify they feel more passionate in having sexual intercourse after using that tool. I think, the negative effects are different depending on each KB acceptor. It is true every contraception tool has its negative effect because it is made by human, not God. We try our best it can be used safely and brings good results to the fullest.
In what ways does BKKBN promote KB program to religious groups?
In the national scope, we have been doing activities related to KB program supported by religious leaders. In 2008 we initiated a roundtable discussion with several religious leaders, not only from Islam but also other religions. In 2009 they initiated to organize a discussion forum for all religions entitled the Interreligious Discussion Forum on Family Caring and Demography. This discussion was carried out six times, even the Minister of Religious Affairs had also participated in one of the sessions. There was also participation from other leaders, from NU, KH. Hasyim Muzadi, from Muhammadiyah, Syafi’i Maarif in 2007.
They also help us in drafting guidelines, sermon materials and references on how to implement KB program not only to Muslim. I have also spoken out about this program in front of High Councils of Indonesian Bishops. At that moment, they didn’t agree with me, then I replied, how could you oppose KB program with a good purpose to prosper every family, while each religion teaches us to do so? They said several contraception tools were forbidden to use because it is against the religion. I answered, we can use other contraception tools which are more suitable to us and not forbidden by religion. The most important thing is, let’s plan a better family with prosperous life.
Since the implementation of this socialization, a young generation network actively involved in interreligious forums is born to support KB program. They have organized several activities altogether with BKKBN. Last year we organized an event in Kuningan to teach the young generation to comprehend this more, by introducing the family life preparation program, providing them knowledge on reproductive health and demography.
What are the obstacles you encounter in promoting KB program?
I think the obstacles from religious people are very little. We must be quite rationalist that KB program we carry out is different from other existing programs, we want a program which will prosper every family.
Instead, the obstacle we encounter is the target we have made cannot be achieved because of decentralization process, which makes us difficult to communicate. A long ago, it was easy to give an order to someone to do something, because the communication channel is good. But now the problem is, when we ask someone to go to a certain district, there is no budget. That makes us difficult to implement the successful program. Even at the headquarter, the budget is very limited. When a field officer from a remote region comes to us and asks for a budget, our own budget is very limited, the program cannot be carried out, only a very little part.
What are the innovations have been made regarding KB program compared to previous era?
I became the chairman of BKKBN when the KB program was nearly collapsed. We had only 700 billion left, but in fact we needed 4 trillion! How we could run the program with such minimum budget? I tried hard to ask for an additional budget, let alone innovation. But thanks God now it has been raised three times, let’s say 2,4 trillion in 2006. But that wasn’t enough, I was thinking how to make a breakthrough by achieving target with limited budget. So I changed strategies by inviting several institutions to become partners, starting from professional organizations such as IDI, IBI, or mass organizations like Muslimat NU, Fatayat NU, Aisyiah, even governmental institutions. We also invited police corps and the national army to reestablish the program. It has shown several improvements.
What I have been doing since last 5 years is revitalizing the program, which has been accomplished partially, still we need to run other strategies. For villages, there is already decentralization program, means these villages can choose nearest district or regency. If we intervene too much, they will protest. This is the obstacle, so we will infiltrate market segments which haven’t implemented KB program thoroughly, such as the less-fortunate families and young generation. We will educate them by campaigning KB program as a new lifestyle.
What do you mean of KB as a lifestyle?
That is just the package because we understand KB program will succeed if it becomes a new lifestyle. As an example, the new lifestyle of Indonesian people today is wearing hijab, so the campaign is designed to support a lot of people to wear hijab. So does the KB program, we design a campaign that “modern people should follow KB, otherwise you’re not cool enough”, that is what we mean about lifestyle. So people will say, “You’re so old fashioned not to be in KB program”. It is like, you’re not modern enough if you don’t eat pizza. Thus, people are triggered to do so. The campaign of KB as lifestyle must be supported by a lot of parties, especially by our public figures. To make it as a new lifestyle, how a modern family should look like? This is what we want to do, this can succeed if we do this continuously. Like drinking extra joss, that’s also a lifestyle; or another popular advertising which says smart people drink tolak angin. That is how the campaign will look like.
The last question, recently there have been some news saying an agreement made by BKKBN and the Ministry of National Education will add new education materials about demography and reproductive health in schools. Could you explain it a little bit more?
Yes, it is true we add topics about demography and reproductive health for school subjects starting from elementary school to university level. Of course with different content according to their ages. For example, for students of elementary school, we introduce family institution, the role of father, mother, and so on. We also emphasize on character building and children’s character. For students of junior high school, we introduce the demography topics, and students of high school, we let them know about reproductive health. For students of university level, the topics on demography and reproductive health are more scientifically detailed. The Minister of National Education has agreed with us on this, he considers the topics on demography and reproductive health are very important to be socialized to our children since their early age.
We make a small team who will talk about the materials and arrange the modules. I presume 1,5 years is enough to prepare and finish all the modules. We are preparing the contents. Insha Allah next year we will add in the school subjects. I hope so. Riri Khariroh