Jamu: Why Isn't

Indonesia's Ancient
System of Herbal Healing
Better Known?
By Ian Lloyd Neubauer |Wednesday, Feb. 29,
2012

In 1990, Irish journalist Susan Jane-Beers

noticed an herbal-medicine clinic in the
corner of a hair salon in the Indonesian
capital of Jakarta, her adopted home. A
victim of age-related chronic knee pain
that conventional pharmaceuticals couldn't
numb, let alone heal, Jane-Beers decided
to try jamu traditional Indonesian
medicine.
The results astounded her. After three days
of taking only one-third of the prescribed
dose of herbal pills, the pain had vanished,
making her wonder if she'd found "the
magic bullet of all time."

An herbal seller gives a jamu drink to a

customer in Jakarta on Jan. 15, 2010. Many
Indonesians believe in its effectiveness as
health tonic, while men take it to increase
stamina and sexual power

A holistic therapy based on the notion that

if disease comes from nature, then so must
the cure, jamu uses a dazzling array of
teas, tonics, pills, creams and powders to
cure or prevent every ailment

imaginable. The ingredients are by

definition cheap, widely available and
simple: nutmeg to treat insomnia, guava
for diarrhea, lime to promote weight loss
and basil to counter body odor.
Jamu has also been used to treat cancer. In
her book, Jane-Beers writes of a traditional
healer in the city of Jogjakarta who
apparently cured what had been diagnosed
as a terminal case of cervical cancer with a
tea made of betel nut, Madagascar
Periwinkle and mysterious benala leaves.
By combining the tea with a strict soybean
diet, the patient was said to have made a
full recovery in 18 months.
Sound far-fetched? A 2011 study by
Virginia Tech's Department of Food
Science and Technology on the soursop
tree whose leaves are used to relieve
gout and arthritis in Indonesia found
evidence showing that extracts from
soursop fruit inhibit the growth of human
breast cancer. Vincristine, one of 70 useful
alkaloids identified in Madagascar
Periwinkle, radically ups the survival rate
of children with leukemia, while turmeric
is being looked at as a treatment for
Alzheimer's.
"Western medicine tries to destroy cancer,
but at the same time it destroys elements
of the body. Jamu helps the body produce
its own antibodies to fight the cancer by
itself," says Bryan Hoare, manager at
MesaStila, a wellness retreat in central
Java that serves jamu shots with breakfast
and employs a tabib, or indigenous healer,
for private consultations. "Coming from
the earth, jamu also makes you feel good.
When you take it you experience a positive
feeling."
But if jamu is the magic bullet, why isn't it
better known in the West, where natural

Asian medicines like India's ayurvedic

system and Chinese herbal healing have
been growing in popularity for years?
The answer can be found on the streets of
Indonesia, where jamu is consumed
regularly by 49% of the population,
according to the country's Ministry of
Health. Valued at $2.7 billion annually, the
industry covers an incredibly wide gamut
of products and regimens, including
homemade tonics sold by street hawkers,
slimming powders, cosmetics and jamu for
babies and postnatal care. Yet the best
sellers in terms of value are invariably the
dodgiest: those claiming to boost sexual
performance or suppress appetite.
"Indonesians may well have been amused
when Viagra was released in 1998," JaneBeers says, noting the popularity of brands
like Kuat Lekali (Strong Man), Kuku Bima
(Nail of God) and Super Biul Erection Oil.
"They have had their own remedies for
years."
Then there's the association between jamu
and white magic. Many indigenous healers
insist on dispensing jamu on auspicious
dates or in conjunction with animist spells
that predate the arrival of Islam in the
archipelago.
Mbah Ngatrulin, a Buddhist tabib I met in
Ngadas, the highest village in Java, told
me that spells are the key and that jamu
may as well be "mineral water." It's the
kind of comment that prevents many
physicians across Southeast Asia from
endorsing jamu lest patients take them for
quacks.
According to Charles Saerang, head of the
Indonesian
Jamu
Entrepreneurs
Association, the primary impediment to a
worldwide jamu craze is that locally

produced jamu products

international manufacturing

don't

meet

standards.
That
hasn't
stopped
entrepreneurs from buying raw herbal
materials in Indonesia, processing them in
India and Malaysia and selling them in the
U.K. a market Indonesian-made jamu
products can't access. That's a double
whammy for Indonesia, which loses out on
value added by third parties and the chance
to promote the jamu brand name abroad.
It's impossible to say when, or even if,
jamu painkillers will be stocked at
supermarkets and convenience stores in
countries like the U.K. Yet inroads are
already being made by small businesses
like the Origin Spa in Melbourne. There,
highly skilled practitioners apply massage
techniques developed by 16th century
Indonesian royalty the founders of
modern jamu using creams and oils
containing turmeric, betel leaves and
crushed eggshells. There's a minimum
two-month waiting list for Origin's fiveday post-pregnancy treatment that is said
to help women regain their figures quickly,
improve lactation and dispel wind,
dizziness and aches and pains.
"It's surprisingly popular with the Asian
mums throughout Australia," says partner
Jessica Koh. "But it's still unfamiliar to
most of the locals."
With reporting by Theo Manday /
Ngadas

A problematic approach
Widodos tough approach does not only
apply to drug traffickers. The Indonesian
government, through its anti-drug agency,
the National Narcotics Board (BNN), is
pushing compulsory treatment for people
with drug dependence. This coercive
approach is jeopardising health gains made
by existing harm reduction programs and
is fertile ground for corruption and abuse.

Forced
rehabilitation of
drug users in
Indonesia not
a solution

BNN pledges to rehabilitate 100,000 drug

users in 2015. They aim to double the
numbers every year to 200,000 in 2016
and 400,000 in the year after that.
But there arent enough problematic drug
users in Indonesia to meet these targets.
According to estimates by the Ministry of
Health, Indonesia is home to about 74,000
injecting drug users. Only a fraction may
choose drug treatment at any given time.
Some civil society groups working on the
ground
consider
even
this
an
overestimation. National Narcotics Board
statistics claim a large number of crystal
meth and cannabis users, but Indonesian
academics argue these numbers have been
derived using questionable methods.

Earlier this year, Indonesia executed 14

people, including Bali Nine duo Andrew
Chan and Myuran Sukumaran, for drug
offences. President Joko Widodo portrayed
the executions as the ultimate weapon in
an expansive war on drugs deployed to
protect the countrys young generation
from
an
alleged
national
drug
emergency.
But his policy is harming the very people
he claims he wishes to protect.

There is a strong movement in Indonesia

opposing
the
governments
tough
approach. Activists in 15 cities in
Indonesia last week joined a worldwide
call for governments to end the
counterproductive war on drugs.

Mandatory rehab = incarceration

Last year, seven government bodies in
Indonesia, including BNN, the police, the
Ministry of Health, and the Ministry of
Social Affairs, signed a Memorandum of
Understanding promoting rehabilitation for
drug users. The memorandum appears to
promote a more lenient approach to
addressing drug use, calling for drug users

to
be
rehabilitated
incarcerated.

rather

than

But, in practice, BNNs special drug

eradication squad often seek out and
forcibly detain suspected drug users; few
people with drug dependence voluntarily
choose treatment under the agencys
programs.
Indonesia currently has more than 400
addiction treatment facilities in hospitals,
government
narcotics
clinics,
and
privately-run centres. But the country
lacks formalised national best practice
standards for addiction treatment. Options
range from medical detox in hospitals and
12-step programs, to religious or spiritual
centres that boast curing drug
dependence using magic, prayer, beatings,
and shackling drug users in cages with a
ball and chain.
Most share the same goal: abstinence from
drugs. And few independently evaluate the
effectiveness of their programs.
To meet the 2015 target, the government is
establishing additional drug rehabilitation
centres inside 60 prisons and 30 police and
military training academies.
It is hard to imagine how the substandard,
overcrowded conditions and limited health
facilities of existing prisons in Indonesia
can address the nations drug woes. Critics
claim sending people to rehabilitation
centres in prison is simply another form of
imprisonment or involuntary detention.

Corruption and abuse

When Indonesia amended its narcotics law
in 2009, there was hope for a more
balanced response to drugs. The revised
law effectively decriminalised possession
of small amounts of drugs for personal use
by providing judges with the discretion to

divert drug users to treatment programs

instead of prison. But, in practice, the
criminalisation of drug use continued.
Some authorities use the new legal
provisions to extract heftier prices from
well-off drug users, and downgrade the
offence they were charged with. As of May
2015, 36% of prisoners in the countrys
427 overcrowded detention facilities are
serving time for drug use.
Working together with the Indonesian
Drug Users Network, I am documenting a
host of coercive and abusive measures
carried out by law enforcement in the
name of rehabilitation.
Health workers in Jakarta have reported an
increase in the number of drug raids since
January 2015 in known drug-use hot spots,
but also in apartment buildings, schools,
and community health clinics.
We found cases of forced urine testing,
corruption, extortion, intimidation, and
confidentiality
breaches.
Officers
photograph suspected drug users against
their will. They offer money in exchange
for snitching on friends and family
members who may use drugs. They
demand access to private client records at
methadone substitution clinics and other
organisations working with drug users.
The
government
should
seriously
reconsider this approach, as studies have
shown that criminalisation and punitive
law enforcement approaches can lead to
higher drug-related criminality and
increased risk of contracting HIV and
hepatitis C, among other unintended social
and economic costs.

Compulsory treatment is ineffective

Indonesias coercive measures are at odds
with a broader tendency in Asia to move

away from compulsory treatment and

transition toward voluntary, scientifically
and medically appropriate approaches to
managing drug use.
Compulsory treatment and rehabilitation is
costly and ineffective in addressing drug
issues; relapse rates are high. There is no
evidence that compulsory treatment leads
to positive health outcomes among drug
users or that it has any effect on drug use
rates.
Instead, compulsory treatment in countries
such as Cambodia, China, Malaysia,
Myanmar, Philippines, Thailand and
Vietnam has led to increased HIV risks,
added stigma and discrimination against
drug users, and human rights violations.
In July 2012, the United Nations issued a
Joint Statement calling for the closure of
compulsory
drug
detention
and
rehabilitation centres. They called
governments
to
adopt
voluntary,
evidence-informed and rights-based health
and social services in the community.

Alternatives
treatment

to

compulsory

Harm reduction interventions such as

needle syringe programs and methadone
maintenance therapy are some of the
worlds most effective and affordable
treatments available. If President Widodo
is serious about managing Indonesias drug
problem, he should urgently scale up these
proven strategies.
Methadone maintenance therapy reduces
heroin use, HIV transmission, criminal
activity and risk of drug-related death. The
expansion of such programs in Indonesia
has helped reduce HIV rates among
injectors from 42% in 2011 to 36% in
2013, bringing thousands of drug users
closer to health and support services.

Indonesia is also home to some of Asias

most successful voluntary, communitybased treatment programs for drug users.
These include Rumah Cemara and Rumah
Singgah PEKA, which are currently in the
process of being documented as best
practice treatment models by the United
Nations Office on Drugs and Crime
(UNODC).
These and more than a dozen programs
like them are based in non-government
organisations, often run by former drug
users and offering a menu of evidencebased harm reduction and treatment
options from which clients can choose.
The outcome isnt always abstinence from
drugs, but an improvement in the clients
social
function,
overall
health,
productivity, reduction in risky drug use
patterns, and personal goals.
From a public health perspective, drug use
is best portrayed as existing on a spectrum
from beneficial to problematic. The
majority of people who try drugs or use
them
occasionally
never
develop
dependence or problematic use patterns.
Leaders who want to support those dealing
with drug dependence should listen to their
needs and support them with strategies that
work, rather than instituting policies that
punish them.

that dealers dont shield themselves behind

the definition of a user, said Budi Waseso,
the new chief of the Indonesian National
Narcotics Board (BNN), who recently
proposed an end to BNN-funded
rehabilitation programs.
Despite being home to millions of drug
users, Indonesia has long been known for
its hardline attitudes towards drug-related
issues, ranging from its disproportionate
prison
sentencing,
problematic
rehabilitation
programs,
to
the
stigmatization and generalization of drug
use.

Indonesia and the New War on Drugs

24 September 2015| Dania Putri

Following the dramatic executions of drug
traffickers in April 2015, the Indonesian
government decided to step up its antinarcotics
efforts,
reinforcing
public
condemnation of drugs while slashing
activists' hopes for progressive reforms.

We need to change the law. There should

be no more [distinction about] users so

It all began to intensify when President

Joko Widodo (Jokowi) declared war on
drugs. Jokowi, who was initially known
for his down-to-earth attitudes and
promises in regard with improving the
nation's welfare system and accountability,
suddenly decided to raise the issue of
drugs following the dramatic executions of
drug traffickers in April. Since then, the
largest Southeast Asian nation has
strengthened its anti-narcotics stance,
working together with other ASEAN
countries as one of the major supporters of
the outdated prohibitionist approach
towards drugs.
While facing criticisms, Jokowi argued
that 40 to 50 people died each day because
of illicit drug consumption, while 4,5
million Indonesians required rehabilitation
programs. Due to its highly problematic
research methodology, this statistic raised
many questions, expressed through an
open letter initiated by the Indonesian
Drug Users' Network (PKNI) which was
signed by 16 prominent academics, as well
as religious leaders and human rights
activists in Indonesia. Despite this, the
aforementioned number kept resonating in
the media, accompanied by the increasing

number of news reports on drug arrests

and seizures.

Indonesia's
framework

problematic

legal

According to the 2014 report released by

the BNN, amphetamine-type stimulants
(ATS) and cannabis are the most
commonly used illicit drugs in Indonesia.
Many of us know the enormous difference
between ATS and cannabis, yet as dictated
by the UN drug control system, both
substances are still listed as Schedule I
drugs. This not only results in unnecessary
punishment for non-violent drug offenders,
but it also perpetuates the notion that all
Schedule I drugs yield the same level of
physical and psychological harms.
Besides
classifying
psychoactive
substances, the current Indonesian antinarcotics lawpassed in 2009covers a
list of penalties for drug-related offences
including
production,
possession,
distribution, sales and trafficking.

rupiahs (about $550,000) in the case of

cultivation of more than one kilogram or
five plants. However, cannabis farmers,
who primarily reside in Aceh and other
parts of Sumatra, sometimes rely on the
protection of the Indonesian military,
according to a member of the Indonesian
Drug Users' Network (PKNI).
The BNN maintains that the anti-narcotics
law is supposed to help drug users and
addicts recover through rehabilitation
programs, and that prison sentences are
mostly issued for drug dealers and
traffickers. According to the PKNI
however, of the thousands of drug users
arrested in 2014, only 17 were sent to
rehabilitation centres, while the rest were
required to serve prison sentences, partly
contributing to the 145 per cent of prison
overcapacity since July 2015. Even if a
user or addict is transferred to a
rehabilitation centre, a PKNI member
explains, he/she is less likely to receive
scientifically- proven effective treatment.

Being vaguely defined, some of these

offences may often be interchangeable,
depending on factors such as the relevant
law enforcement official(s) as well as the
political situation at the time. Let's say a
group of three friends are planning to
smoke some cannabis together, yet only
one of them leaves the house to buy it
from a dealer nearby. If that person gets
caught by a police or BNN officer, it is
quite likely that he/she is arrested as a
dealer, as the purchased drug is intended to
be shared with two other people.

Indonesia's new war on drugs: a war

on drug users?

The law furthermore has its own

implications for farmers of crops for illicit
use, the crucial yet often marginalized
actors in the picture, as the law requires a
penalty of 5-20 years or life imprisonment
as well as a minimum fine of eight billion

Practices such as forced urine tests,

fraudulent sales of controlled medicines
where officials secretly record buyers'
personal
detailshave
been
quite
pervasive. The amount of anti-drug
propaganda also seems to have soared as

Jokowi's war on drugs has resulted in a

policy which authorizes the BNN and the
Ministry of Social Welfare to gather
100,000 drug users to be sent to
rehabilitation centres, the PKNI explains.
The implementation, however, has been
rather problematic. An official managing
to gather more people also receives higher
financial compensation; in sum, it's all
about the number and its consequent
financial reward.

more anti-drug slogans are shown on the

streets of big cities, while the new BNN
head Waseso has repeatedly referred to
drug users in pejorative ways, ranging
from broken people to train them so
these humans can be of some use. Of
course, he as an individual would not have
the ability to change the law, as it
undoubtedly requires examinations and
deliberations from both members of the
House of Representatives and the Supreme
Court.

Waseso's proposal to amend the antinarcotics law and penalize drug users was
also countered by government officials
such as the justice minister as well as the
former head of BNN, Anang Iskandar.
However, following the institutional
changes,
Indonesian
drug
policy
organizations such as PKNI, can only hope
that they will not have to start their
political efforts all over, especially
considering the strong influence of
draconian
drug
policies
in
the
neighbouring ASEAN countries.