JAKARTA (JP): Unwanted pregnancies frequently lead to abortions in Indonesia, despite the controversy over the legal and moral implications.
To have an abortion in a slum area by an old dukun (traditional midwife), or in a modern gynecological clinic or hospital outfitted with sophisticated medical instruments, is now merely a matter of choice and only depends on one's financial situation.
Jakarta has the largest number of clinics and hospitals that cater to those who want to have an abortion. The fees range from tens of thousands to millions of rupiah. Since abortions are illegal here, none of the clinics, hospitals or doctors who perform abortions want to admit they do it.
The Raden Saleh clinic, named after the street it is located on in Central Jakarta, tops the list of well known clinics offering the service.
"There are around 10 requests a day, but we may only accept one or two. Most who come here ask for other services related to contraceptives and pregnancy," a doctor at the clinic, who asked to remain anonymous, indicated.
He stressed that the clinic's stipulations are very tight. A woman must have the consent of her husband, who must also accompany her.
"We might take in unwed women, but they must be accompanied by their parents or an older member of the family. Boyfriends do not qualify," said the doctor.
He admitted that the clinic is still the primary place that other doctors, who refuse or cannot give such a service, refer their patients.
"But that simply means they ask the patients to consult with us. Just like the other patients, she will be counseled by a psychiatrist and then by us before a decision is made," he explained.
"For example, we suggest that the parents rent a house in Puncak and hire a private tutor to enable the girl to continue studying when the baby is born. Or, a relative could adopt the child," he pointed out.
If a woman has trouble meeting all these requirements, there are plenty of calo (middlemen) operating for other clinics and gynecologists in the clinic's parking lot.
A survey carried out by Andreas Boy, a graduate of the School of Social and Political Studies at the University of Indonesia, reveals that many other clinics in Jakarta and also some gynecologists station their calo in front of the Raden Saleh clinic. The middlemen lure "victims of love", who wish to get rid of their "love marks", into their services. Boy conducted the survey for his graduation thesis in 1993.
"The calo's easy prey are usually girls who enter the Raden Saleh's compound looking reluctant and timid," Boy told The Jakarta Post.
A quick observation however shows that the target has now been extended to almost every woman who goes to the clinic or passes by.
"They warn the victims that if they want to have an abortion at the Raden Saleh clinic they must submit a marriage certificate or a letter of consent from their parents, husbands or wali (guardians). The calo also advertise other clinics' more competitive prices," explained Boy. To complete his thesis he went under cover and worked as a middleman for a clinic in the Tanah Tinggi area with other calo for almost a year.
A doctor at the Raden Saleh clinic said that the management has reported the middlemen because patients feel uneasy. "But we cannot do anything else, we're not the police and they are basically outside our fence," he commented.
Investigation
The Post reporters investigating the activities in the Raden Saleh clinic's parking lot were "assisted" by a tall and young calo. He immediately welcomed us with his questions and offer.
"Are you going for a medical consultation?" he asked.
We tried to look as hopeless as possible as we replied yes. He said the clinic had closed at 11 a.m. It was around midday. We sighed our disappointment.
"But you can go directly to Doctor Inge's (not real name) private practice room in Central Jakarta. It is not far from here, you can take a bajaj, it costs only Rp 1,000 (45.87 US cents) to go there," he said. He then quickly added that the gynecologist also practices at the Raden Saleh clinic and the state-owned Cipto Mangunkusumo General Hospital.
So far, we had not yet told him our objective, but we asked him the price. His answer clearly indicated that he was speaking about an abortion.
"It depends on the age of the pregnancy. A two-month-old pregnancy costs around Rp 300,000 ($137)," he affirmed with an obvious knowledge of the price if not the technical terms.
"Is it safe?" we asked.
"Sure, the doctor practices at this clinic (Raden Saleh). And it won't take long. Only two hours for the anesthetization and the tindakan," he assured. Tindakan (action), refers to the abortion. The same term, we found out later, was also used by the nurse who greeted us and answered our questions at Dr. Inge's practice room.
"Is there any cheaper service?"
"Sure, there is another clinic in Central Jakarta. They have two doctors (he mentioned two names) from the army. They charge around Rp 250,000."
"It is better to go to Doctor Inge,mbak (polite Javanese word for young women). It is not far from here, the doctor is a woman and the price is competitive enough. If you want I can ask a bajaj to take you there," he said.
We pretended to discuss the matter. The calo gave us the doctor's name card, with the calo's code name written on it also, after we agreed to go.
"That is how they operate. Everyone has a code name on the name card. If a woman has an abortion, the doctor from the clinic will ask for the name card. It is used to tally how much they have to pay the middleman," Boy explained.
A calo can earn between 10 to 15 percent of the abortion fee. The earlier the stage of pregnancy, the higher is his commission. This is due to the level of complexity of an abortion. An abortion at an early stage takes less medicines and less time.
Boy said the Central Jakarta clinic received at least 12 persons per day during the period between January and June 1992.
Finally, we were at Dr. Inge's house. There was no other patients waiting in the hot afternoon. We entered, reluctantly, through an overgrown yard where a rujak (fruit salad) vendor's cart was parked and into the dismal house. A group of men were chatting in the waiting room and were handing money to each other.
A friendly looking nurse approached us and invited us to sit. We told her we needed some information on abortion because our sister, who was waiting for us at home, was pregnant.
She smiled and seemed to be a very understanding person.
"The question is about the price, isn't it? Well, it depends what term the pregnancy is in. We cannot tell you now because it often happens that a patient says that she is two months into her pregnancy, but according to a medical check it is already three months. All right, if the doctor says it is around two to three months the price is between Rp 300,000 and Rp 400,000," she explained.
"Does it take long?" we wondered.
"No, 10 minutes for anesthetization, 10 minutes for the tindakan. And then you have to come back within a week for a checkup."
"Is it guaranteed to be safe?"
"Sure, the doctor is responsible for everything. If there is any side effect, it is usually only bleeding or an infection. The infection normally occurs because a patient has intercourse too soon," the nurse assured.
"Any papers required?"
"No, it is an accident, isn't it? So, she does not need a marriage certificate. Her parent's or sisters' identity card is sufficient. So, bring your sister immediately, we are open from 8 a.m. to 5 p.m.," she insisted.
Lolo (not real name), who recently had an abortion at Dr. Inge's place, told the Post that the doctor is very kind but at the same time very cold, especially when she asked for a discount.
"Well, she gave me a Rp 25,000 discount, so I paid Rp 250,000. That included the price of an IUD (Intra-uterine device) that I did not ask for. I don't like it because she put it in without my permission," said Lolo, a mother of three. She added that she could not keep her fourth child because the third was only 10 months old. She had to work while raising her three children by herself.
"I think it is a horrible place, inhumane. People there stared at me. I felt like a commodity, not a person, especially because some of the men in the living room talked about money. Now, I feel really empty," said Lolo, who got Dr. Inge's address from a middleman operating in the Raden Saleh clinic's parking lot.
"A clinic like that operates only for commercial purposes. It is pure business. No one advises you to reconsider (your decision); to think again," Boy confirmed.
"At the Raden Saleh clinic, before being allowed to have an abortion, you have to consult a psychologist first. They also ask for a letter of consent. Therefore, some vendors trading outside the Raden Saleh clinic can be hired to act as husbands. They can also provide you with any documents required," he added. (als/anr/sim)