Life is Healthy

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

Audio slide show: Former drug user Naomi

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

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

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

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

For the time being, Naomi’s goals are relatively simple. “I don’t know about my aspirations or hopes, but my greatest achievement is quitting drugs. It was the hardest thing I’ve ever had to do,” she says.

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

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

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

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

When asked what that means, Wulan shrugs.

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

While it is clear that transforming the situation for women IDUs will require thorough social, economic and legal reform, Wulan believes the priority is providing an alternative ideology to the patriarchal culture of Indonesian society.

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

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

Sorrow view: Former drug user Naomi Esteria Tobing and her daughter Esta Melia Suniya Anthony in a public van in Jakarta. Female IDUs are discriminated against on several fronts. JP/Moch. N. Kurniawan

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

Research from the AHRN, UN AIDS and the Stigma Foundation has found that women IDUs suffer more not only because of the wider social disadvantages affecting women, but also because women are still expected to fulfill “traditional” roles that cannot accommodate the reality of poverty, substance abuse and disadvantage. Patriarchal culture, which is particularly dominant in Asia, underpins an almost hysterical intolerance of women’s drug use.

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

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

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

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

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

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

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

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

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

The discrimination and abuse faced by women IDUs is perhaps at its ugliest in the deserted back alleys of Jakarta’s slums or behind the closed blinds of a dirty police station.

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

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

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

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

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

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

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

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

“My goal is to increase awareness among women that they are not weak and do not need to be dominated by men,” she says.