ALI ALATAS: VETERAN DIPLOMAT STILL IN THE RING

First published in The Jakarta Post, August 13, 2007

ALI ALATAS: VETERAN DIPLOMAT STILL IN THE RING

Alpha Amirrachman, Contributor, Jakarta

Ali "Alex" Alatas' tenure as Indonesian Foreign Minister may have ended in 1999 after the country's brutal exit from East Timor -- an event that deeply saddened him -- but this does not mean that he has retired entirely from diplomatic activities.

Through the transitional governments that led the country from authoritarianism to democracy, Alex, who graduated in 1956 from the Faculty of Law at the University of Indonesia, continued to play important roles in helping manage diplomatic affairs.

When Alwi Shihab was appointed Foreign Minister during Abdurrahman Wahid's presidency (1999-2001), Alex was assigned as special advisor to the minister. After the collapse of Wahid's government due to his erratic style, Alex was appointed foreign affairs advisor to President Megawati Soekarnoputri.

It was during Megawati's presidency (2001-2004) that Alex was sent to Sweden to discuss with that government the activities of the now defunct Free Aceh Movement (GAM), the leaders of which resided in that country.

Since May 2001, Alex has also been a member of the Experts and Eminent Persons Group of the ASEAN Regional Forum, which has recently succeeded in inserting a human rights clause in the would-be ASEAN charter, despite opposition from Myanmar.

In 2003, Indonesia dispatched Alex to the pariah state, which has been a source of ASEAN's embarrassment, to negotiate the release of Myanmarese pro-democracy leader and Noble Peace Prize laureate Aung San Suu Kyi. Though the obstinate junta politely refused the release of the "iron lady", they painfully assured Alex of the safety and health of this brave woman, who has galvanized democracy movements around the world.

From 2005 to 2006, Alex was a member of the UN High Level Group of the Alliance of Civilization, and was a special advisor to the UN Secretary-General in 2006.

And since March 2007, he has been chairman of the Advisory Council to the President of the Republic of Indonesia.

Born on Nov. 4, 1932, in Jakarta, Alex initially aspired to become a lawyer, but he was destined to be a diplomat. Journalism once thrilled this veteran diplomat too -- he was a journalist for the Niewsgierf daily (1952) and editor for the Aneta News Portal (1953-54).

Immediately following marriage, Alex was assigned as Secretary II in Bangkok (1956-1960), after which he held the post of Information and Cultural Relations Director at the Foreign Ministry (1965-66), then as Counselor of the Indonesian Embassy in Washington D.C. (1966-70).

Upon his return to Indonesia, he was again appointed Information and Cultural Relations Director, a post he held from 1970-72. His diplomatic star continued to rise as he was appointed Secretary of the Foreign Ministry Directorate General (1972-75), then Special Staff and Head of the Private Secretary to the Foreign Minister (1975-76).

Alex became the Permanent Representative of the Republic of Indonesia to the UN in Geneva from 1976-78, and on his return, was Secretary to the Vice President for four years. He was reassigned as Indonesia Permanent Representative from 1983-87, this time in New York.

He was finally appointed Foreign Minister for four administrative terms spanning 1987-99, under presidents Soeharto and Habibie.

His impressive career in diplomatic posts saw a string of critical events in Indonesia's road toward respectable statehood.

As the country's Permanent Representative to the United Nations, he had to tackle unrelenting international criticism regarding Indonesia's invasion of East Timor and the subsequent allegations of human rights abuses, an issue he once dubbed as a "pebble in our shoes".

Without his diplomatic skills, Indonesia's reputation might have sunk even lower, particularly following the Santa Cruz incident of Nov. 12, 1991, during which many Timorese were killed. The image of Indonesian soldiers gunning down peaceful protesters was beamed around the world, and Alex was forced to calm the fuming international community.

"Diplomacy is like playing cards. Don't show them all, but drop them one by one," he once said.

He was thus bewildered when then president Habibie, apparently without first consulting him properly, announced that Indonesia would immediately grant East Timor a referendum.

While Alex was trying hard to leave behind the "diplomatic incident" of the loss of East Timor and the ensuing calamity, he was offered the aforementioned appointments that again demanded his diplomatic expertise and skills.

And Alex has no lack in words when commenting on pressing, contemporary international issues.

"Religion has been exploited in many of the world's conflicts," he told a group of journalists on the sidelines of a public lecture held last Wednesday in Jakarta, by the Center for Dialog and Cooperation among Civilizations (CDCC).

"There have been tensions and conflicts between the faithful of three monotheistic religions -- Islam, Christianity and Judaism. Nevertheless, the root of the problem is not religion or culture, but political and economic grievances," he said.

"We live in an increasingly complex and volatile world. Our societies are still afflicted by ethnic and religious strife, by intolerance and prejudice, by misunderstanding and miscommunication and by intra-state and interstate violence," he continued.

"Polarized perceptions, fueled by injustice and inequality, have often led to conflict, threatening international peace and stability. Events of recent years have exacerbated mutual suspicion and contention, especially between Muslim and Western societies. This environment has been exploited by extremists throughout the world. There can be no doubt that this has become one of the defining issues of our times."

There should not only be persistent dialog, he stressed, but also tangible collaboration between different civilizations, such as in the area of economy.

A number of recommendations of the UN High Level Group of the Alliance of Civilization -- of which Alex is a former member -- illustrate such an approach: the development of an objective and rational white paper on the Palestinian-Israeli conflict; the reinvigoration of the stalled peace process; renewed commitment to multilateralism; consistent respect for international law; avoidance of double standards; combating poverty and economic inequalities through effective and concerted measures within the framework of the Millennium Development Goals.

"Unfortunately, the recent UN Secretary-General (Ban Ki-moon) has not moved swiftly enough to heed the Alliance's recommendations," he lamented, and stressed that persistent publication of the recommendations needed to be pursued.

Alex might not be Foreign Minister any longer -- and old age is inevitably snapping at his heels -- but his highly active mind is still filled with clear ideas on how to help resolve conflicts and mitigate tensions in world politics.

His high-profile performance and established stature as a senior diplomat is a model for aspiring young diplomats who are eager to push the world's third-largest democracy in playing a more strategic role at both regional and international levels.

http://www.thejakartapost.com/news/2007/08/13/ali-alatas-veteran-diplomat-still-ring.html

RAISING AWARENESS ON CEREBRAL PALSY, ITS TREATMENT

First published in The Jakarta Post, August 8, 2007

RAISING AWARENESS ON CEREBRAL PALSY, ITS TREATMENT

Alpha Amirrachman, Contributor, Jakarta

Dina (an alias) experienced difficulties when delivering her first baby at a hospital in her hometown.

As the baby would not come out, the attending doctor decided to use a vacuum to extract it.

However, the umbilical cord had become wrapped around the baby's neck in her uterus, and during the procedure his oxygen supply was cut off. When the baby was finally born, he didn't cry and his body was convulsing. He had gone into a coma from oxygen deprivation and needed to be placed in intensive care for a month following birth.

Later, it was found that his brain had been infected with cytomegalovirus, a type of herpes virus that Dina might have contracted during pregnancy.

Now 4.5 years old, Rangga (alias) has quadriplegic cerebral palsy. Dina diligently brings her son for therapy at Keanna, a private rehabilitation center in Cilandak, South Jakarta.
His prognosis is not good, as he cannot move any part of his body, not even his eyes.

But Dina is an optimist. "There is progress," she told The Jakarta Post, adding that she was ecstatic when Rangga finally smiled for the first time at her touch.

Cerebral palsy (CP) is a physical disorder resulting from non-genetic factors that cause brain damage, such as oxygen deprivation, infection and physical trauma, during or after pregnancy.

"The brain damage itself is non-progressive, but it can cause physical disorders," said pediatric neurologist Dr. Irawan Mangunatmadja of Cipto Mangunkusumo General Hospital in North Jakarta.

"It is a persistent, but not unchanging, disorder of movement and posture appearing in the early years of life," he said.

Several viruses can cause in utero brain damage such as TORCH, which stands for toxoplasma, rubella, cytomegalovirus (CMV) and herpes simplex virus II (HSV-II).

Toxoplasma is a genus of parasitic protozoa whose best host are cats; however, the vast majority of warm-blooded animals can carry it. The disease it causes, toxoplasmosis, can have fatal effects on a fetus during pregnancy.

The rubella virus causes rubella, or German measles. The virus is hard to detect, as it usually exhibits only mild symptoms or is asymptomatic.

Cytomegalovirus (CMV) is an ordinary virus and hardly ever causes noticeable disease, but it belongs to the herpes family, while HSV-II causes excruciating sores on the anus or genitals and may be dormant in nerve tissues.

Oxygen deprivation and a lack of nutrition channeled from the placenta to the fetus are also cited as possible causes of brain damage in the uterus; these also can cause low birth weight, viral encephalitis, brain tumors, head injuries and meningitis after birth.

"Generally, cerebral palsy can be categorized by the tonus, or muscle rigidity, and areas of the affected body," said Irawan.

CP is mainly classified according to tonus into three types: spastic CP, athetoid CP and ataxic CP.

Spastic CP is regarded as the most common form, wherein the cerebral cortex -- the region of the brain that controls thought movement and sensation -- is damaged. In such cases, the arms are usually hang lifeless, and the hands are twisted against the forearm. Its effects on the legs can be noticed by the way the child walks, depending on the degree of severity.

Athetoid CP results in involuntary, uncontrolled and uncoordinated movements of the muscles, due to damage of the basal ganglion. Consequently, all limbs display jerky movements while the fingers and wrists are twisted. Due to poor coordination, the child might also stumble when walking.

Ataxic CP is the rarest of the three and results from damage to the cerebellum, which controls stability. A child with this type of CP will have difficulties with balance.

According to the affected areas of the body, CP is classified into hemiplegic CP, diplegic CP and quadriplegic CP.

Hemiplegic CP describes the condition when half of the body -- such as the right arm and right leg, or the left arm and left leg -- is affected. Almost all children with this form CP are able to walk, since spasticity mostly affects the arm.

Diplegic CP is indicated by the more severely affected lower limbs, which is commonly found in babies born prematurely, while in quadriplegic CP, all four limbs are severely affected.

Technology can help detect the degree of brain disorder through the computerized tomography (CT) scan or magnetic resonance imaging (MRI).

The position emission tomography (PET) scan is used to identify any specific chemicals in the brain while the electroencephalogram (EEG) can also be useful in detecting brain disorders.

Children with CP are found in both developed and developing countries. In the 1970s and '80s, the number of children born with CP in developed countries declined, but appeared to rise after this period.

In the United States, CP occurs in 1.5 to four children per 1,000 live births; in Indonesia, about 2 percent of babies are born with delayed development, including cerebral palsy.

Various forms of rehabilitation can be helpful to children with CP, such as physical therapy, a standing frame to reduce spasticity, or the Bobath Concept to help the child physiologically through play to improve posture and reduce stiffness.

Aside from private rehabilitation centers in Jakarta, many hospitals, like Cipto Mangunkusumo General Hospital, Fatmawati General Hospital and Harapan Kita Hospital, have rehabilitation and treatment wards for children with delayed development.

"But parents cannot depend merely on treatment here," said therapist Retno of Cipto Mangunkusumo. "We (also) give them exercises to be done at home."

While the child is encouraged to learn some skills, therapy is administered in stages.

"First, we have to relax their muscle rigidity through exercises before giving them functional exercises," said therapist Ahmad Syakib of Fatmawati hospital.

For example, he said, one patient with athetoid CP required exercises for coordination to treat involuntary movement.

"What we can do is to encourage them to be as independent as possible, since CP has no cure," said Ahmad.

As cerebral palsy is non-genetic, women with CP can still have healthy babies, and Ahmad gave as examples two adult female patients with CP who have normal and healthy children.

Nevertheless, some factors still hamper the proper treatment and handling of children with CP.

Irawan lamented that many parents appeared to have a low awareness of the condition, and when they notice that their children have some kind of delayed development, they preferred to adopt "alternative" treatments -- until it was too late for a professionally designated rehabilitation program.

He added that the parents' financial situation could adversely impact CP therapy, and supporting public facilities remained almost nonexistent in Indonesia.

"What is also important is their chance to go to school, to have an education," added therapist
Novi of Cipto Mangunkusumo hospital.

Children with cerebral palsy have various degrees of learning problems; the most common are visual impairment, hearing impairment and difficulties with speech and language. Some are good at mathematics and reading, but poor at perceiving shapes.

The average intelligence quotient of a child with CP is 100, with many registering in the 70-80 IQ range.

But those with an IQ of 119 or above are usually able to excel in school, said psychologist Annie L. Perbowo of Harapan Kita hospital and the Pela 9 rehabilitation center.

The government has campaigned for sekolah inklusi (inclusive school), under which normal schools are to accept children with special needs. In 2003, 21 schools -- from kindergarten to high school, including vocational high schools -- across the five Jakarta districts participated in the program.

The campaign, however, is yet to be followed by concrete support from the government.

For example, the Post observed that a state elementary school in Bangka, South Jakarta, that accepts around five children with special needs every school year is not yet equipped with supporting facilities such as a special ramp and toilet. The school also has to arrange a special education teacher on its own.

It appears that no minimal standardization of school infrastructure and teaching staff exists for special needs children, such as those with cerebral palsy.

Further, several teachers at different schools did not have any understanding of cerebral palsy, merely grouping CP children among others with mental retardation or hearing and visual impairment.

http://www.thejakartapost.com/news/2007/08/08/raising-awareness-cerebral-palsy-its-treatment.html

MOTHERS STRIVE TO SUPPORT CHILDREN WITH CP

First published in The Jakarta Post, August 8, 2007

MOTHERS STRIVE TO SUPPORT CHILDREN WITH CP

Peni Kusumawati didn't think that her first child would be anything other than a healthy baby. When the estimated due date came, she didn't feel any symptoms of labor, nor was she severely ill, so her doctor advised that Peni wait a little longer.

"But my (uterine) membrane had ruptured before I delivered my baby girl, Yasmin Azzahra Rahman. Later it was found out that the amniotic fluid was contaminated by my daughter's feces. She was overdue," Peni told The Jakarta Post.

Yasmin was diagnosed with athetoid cerebral palsy (CP), which results in involuntary, uncontrolled and uncoordinated movements of the muscles. All limbs are affected with jerky movements, and the child might also stumble when walking due to poor coordination.

For years and almost daily, Yasmin has undergone intensive physio- and occupational therapy, mostly at Pela 9 rehabilitation center in South Jakarta. She has also been prescribed at-home rehabilitation exercises.

Neurologist Dr. Dwi Putro of Bintaro International Hospital said that Yasmin had the potential to walk, although she would not walk as normally as other children.

Recently, the 7-year-old took her first steps with a walker.

Yasmin, who has two healthy, normal younger brothers, just began school at SDN 04 Cipete Selatan State Elementary School in Cipete, South Jakarta.

The school is an ordinary one, but it accepts children with special needs under the government's sekolah inklusi (inclusive school) program.

Although government support is still limited, Peni is upbeat. "I am ready to cooperate with the school to provide more necessary support for my daughter," she said as she accompanied Yasmin to her first day at school.

With an IQ of 119, Yasmin has difficulty writing because of athetoid CP, but she is able to read and is considered able enough to compete among other students who have no physical disabilities.

That a child with CP can succeed academically is evident in the example of wheelchair-bound Susanne Ongkowidjaja, who recently graduated from the English Department of the Education Faculty at Pelita Harapan University.

Susanne has both quadriplegic and hemiplegic CP -- her four limbs are all affected, but the right side of her body is more severely affected.

Her mother, German-born Traute Ongkowidjaja, also had a ruptured uterine membrane prior to delivering Susanne, her first child. She was unaware that Susanne had cerebral palsy until her daughter was a year old.

"I gave my daughter therapy by myself," Traute said during an interview held at The Jakarta Post.

The treatment Traute administered comprised of Voita and Bobath. In Voita, she pressed certain spots of Susanne's body to stimulate the cells, while under the Bobath Concept she assisted Susanne in physical games and exercises to improve posture and reduce muscular stiffness.

Susanne, whose two younger sisters are health and without disabilities, attended SDN 09 Kayu Putih Siemens State Elementary School in Pulomas, East Jakarta. From the first to fourth grades, Susanne was accompanied and assisted by an aide studying at a teacher's college, who would lift up her body when she played.

"And I sat by the door of the class to help write the lesson," recalled Traute.

After undergoing an operation in Germany to fix her hip in 1993, Susanne attended the internationally oriented Cita Buana school in South Jakarta until she graduated high school in 2002.

"I had a difficult time as my (peers) seemed reluctant to approach and play with me, but my teachers were marvelous, as they treated me as if my wheelchair did not exist," the self-confident Susanne said in fluent English.

She finally earned her peers' respect during a fund-raising event at the Wisma Subud residential compound in 1999, when she succeeded in collecting a significant amount of money using a custom-designed tricycle.

Traute pushed her daughter to continue studying, and surveyed several universities in Jakarta -- only to find that they had too many stairs, which can be troublesome for her daughter. She said she then had a dream that "instructed" her to take Susanne somewhere in Karawaci.

So she enrolled Susanne at Pelita Harapan University, which had facilities that were more comfortable and suitable for her daughter.

"But I was bit shocked and sad during the first days at the university, because the lecturers always left the class immediately after lecturing," said Susanne, who turned 25 in March.

At university, Susanne regularly posted her essays on a "wall magazine" until people became aware of her potential.

She aspires to become an editor or translator, and added that she intended to submit some pieces to the Post.

She also participated in religious activities at Pelita Harapan.

"That is why Susanne has become very forgiving, particularly of her mother who has made a lot of mistakes...," smiled Traute, followed by Susanne's chuckling.

-- Alpha Amirrachman

http://www.thejakartapost.com/news/2007/08/08/mothers-strive-support-children-cp.html