Confronting Indonesias Asbestos Challenges
Since 2008, workers with asbestos-related diseases have been identified in Indonesia. The occupational injuries they suffered could have been diagnosed earlier if the occupational safety and health (OSH) climate in Indonesia had been more favourable to workers. Unfortunately, multiple factors prevented them from getting the help they needed earlier including: the high cost of annual medical check-ups, the application of outdated OSH management systems, the complexity of claiming benefits from health insurance and the inability to access compensation for work-related injuries.
The low awareness of OSH issues is exacerbated by weak government oversight, illustrated by the failure to renew OSH Law No. 1 (1970), and widespread ignorance amongst politicians, decision-makers and civil servants about the dangers of asbestos exposures to workers and members of the public. Preventing the public from learning about the asbestos hazard creates a climate in which the use of asbestos continues. In 2017, 109,000 tonnes of white asbestos (chrysotile) fiber were imported to Indonesia. This figure makes Indonesia one of the largest asbestos importing countries in the world. More than 90% of the raw asbestos imports were used for manufacturing roofing products. The rest is used for making insulation, clothes, water pipes and so on.
The Indonesia Ban Asbestos Network (INA-BAN) is an organization that is actively campaigning to ban asbestos. Research conducted by the Local Initiative for OSH Network Indonesia (LION INDONESIA), one of INA-BANs members, ascertained that by 2018, asbestos diseases of six asbestos factory workers had been recognized by Indonesias National Health Insurance for Labour. LION Indonesia argues that asbestos disease is a growing problem for those who are or were exposed. We believe that the human health hazard posed by asbestos is good grounds for banning asbestos. The owners of asbestos factories disagree, saying that none of their workers have ever contracted an asbestos-related disease.
On 13 October 2018, INA-BAN held a national seminar in collaboration with Binawan University, Indonesian Lung Doctors Association, Occupational Medical Association, Indonesian Thoracic Radiology Subspecialist Association, Persahabatan National Hospital and the International Ban Asbestos Secretariat (IBAS) entitled Update Diagnosis of Asbestos Related Disease at Binawan University, Jakarta. This seminar was intended for doctors and students of Occupational Safety and Health (OSH) at Binawan University. Presenters at the seminar included: Professor Jeung Sook Kim from Korea, Dr. Anna Suraya, Dr. Aziza G Ikhsan and Dr. Agus Dwi Susanto.
The first speaker was Dr. Anna Suraya. She explained the situation of asbestos victims in Indonesia. Dr. Suraya, who is a member of INA-BAN, had examined 26 workers in asbestos factories, 17 of them were diagnosed with asbestos conditions. Dr. Suruya told delegates:
Our research is done on the basis of voluntary work for asbestos workers. But not all those affected can be compensated. Only 1 person received compensation from the National Health Insurance for Labour and 5 new people received recognition from the state.
Compensation claims, Dr. Suraya told us, were very difficult because work-related illnesses, especially due to asbestos exposures, were still a foreign concept for workers and the government.
The second speaker was Dr. Agus Dwi Susanto. He discussed a case of asbestos-related pulmonary disease at the Friendship Hospital; unfortunately, he said, because of the lack of follow-up examination information about this case was incomplete. Since 1994-2014, Dr Susanto said there have been 20 cases of pulmonary disease in patients who have a history of exposure to asbestos. But we still need further examination. He concluded his presentation by answering questions from seminar participants.
The next speaker was radiologist Dr. Aziza who told us that asbestos disease cannot be detected by ordinary X-rays: Asbestos [diseases] can only be diagnosed clinically using HR CT Scan. Don't consider this a luxury for clinical diagnosis because this is the standard. For that doctors in Indonesia must know this [is a necessity for] clinical diagnosis.
The attendance at this event of Dr. Sjahrul, a scientist associated with the Fiber Cement Association (FICMA) a trade association representing asbestos factory stakeholders was an unwelcomed surprise for INA-BAN members as he is a defender of asbestos, maintaining that asbestos use is not dangerous, claiming: We still can fully control the asbestos. In the concept of Hygiene Industry, we developed a system that is safe for the workers. He was critical of Dr. Surayas findings.
Professor Kim was the seminars final speaker; she explained the latest news regarding the clinical diagnosis of asbestos-related illnesses in South Korea. She told seminar delegates: Regarding the latest diagnosis [techniques], we can share this knowledge with doctors in Indonesia because the location of these diseases could appear in many places upon initial diagnosis.
At the end of the seminar, Professor Kim discussed the history of banning asbestos in South Korea with INA-BAN members. She also knew about the history of one of the asbestos factories in Indonesia which had imported machinery to process asbestos into yarn from South Korea. Concluding the discussions she said:
In South Korea, we discovered, the importance of cooperation between NGOs and scientists in the ban asbestos movement. Its just certain that asbestos businessmen will fight back by hiring scientists to argue that asbestos use can still be controlled, even though its not at all possible.
October 17, 2018
1 The author is a founding member of INA-BAN.