Situbondo – The East Java representative office of the National Population and Family Planning Board (BKKBN) held a vasectomy program free-of-charge on Saturday, December 5, 2020 as well as handing over donations of non-scalpel vasectomy (NSV) kits, hazmat suits, and face shields. The activity took place in the Military District Command (Kodim) 0823, Jl. PB Sudirman No. 30c of Patokan, Plaosan in Situbondo District of Situbondo Regency.
From BKKBN, the Head of BKKBN East Java Representative Office Drs. Sukaryo Teguh Santoso, M.Pd. and Coordinator of FP-RH program, Functional Officer Dra. Waluyo Ajeng Lukito Wati, S.St., M.M were present during the event.
Meanwhile, present on behalf of Commander of Kodim 0823/Situbondo Infantry Lt. Col Neggy Kuntagina was Interim Territorial Section Officer Infantry Capt. Hadi Sutjipto. Also present were Head of the Population Control and FP Agency (DPPKB) Drs. Imam Gazali, Head of FP-RH Section Desy Tariustanti, Assistant II of Situbondo Regency Government H. Imam Darmaji, M.Si. The procedure was administered by two physicians, namely Director of Besuki Regional Hospital dr. Sandy Hendrayono dan Head of Panarukan Primary Health Facility dr. Imam Hariyanto to 100 participants.
In his remarks, Head of Situbondo DPPKB Imam Gazali said that Situbondo has the highest rate of vasectomy participation in Indonesia.
“We carried out refreshment training for the providers. This event was scheduled to take place last Sunday, but Situbondo was still mourning the loss of its regent. So, we coordinated with East Java BKKBN and agreed to re-schedule the activity to today. We are not at all prepared to face the passing of the regent. He was a staunch supporter of FP programs and just recently gave 370 implants that we provided for free to the acceptors,” said Imam.
“The late regent’s commitment to FP program earned him the Manggala Karya Kencana award. During a national vasectomy deployment, Situbondo contributed 259 – the highest in Indonesia – out of a total one million acceptors. On World Contraception Day, we were entrusted to perform vasectomy to 250 acceptors, which was accomplished by two physicians in two days; dr. Imam handled central to eastern areas, and dr. Sandy covered central to the west areas. And today, we have 100 participants,” he said further.
Imam also mentioned some key factors that have been driving the success.
“We have strong community awareness. In 2011, Situbondo broke the record of highest FP participation and was recognized by the Indonesian Records Museum (MURI). Thanks to the work of our extension officers, we have been able to create a database of potential acceptors. The support of religious leaders is also valuable in driving the high rate of vasectomy participation in Situbondo. Our policy is that each extension officer must have one [vasectomy] acceptor and every week we conduct a meeting to share information. With these combinations of efforts, we have met our provincial and national targets,” said Imam.
Imam Darmaji, Assistant II of Situbondo Regency Government, emphasized the local government’s support to FP programs. “We support BKKBN’s programs through out DPPKB. Today’s activity attests to that support,” he said.
While preparing for the procedure, dr. Sandy confirmed that vasectomy would only take a short amount of time. He’s also experienced and have won some awards for his work.
“Vasectomy is a minor procedure. I’ve been administering it for the past several years and we’ve broken MURI records – Situbondo did that twice, and then Banjarmasin and Medan. Timewise, it would take just 12 to 15 minutes per procedure, depending on the patient’s condition. No scalpel is used, so you would see less than 1 cm mark. We use a clamp, so there will be no stitches, we just use adhesive bandage and then the patient is free to go home. During the procedure, I will locate the right and left vas deferens, cut, and then seal them,” dr. Sandy explained.
His colleague, dr. Imam Hariyanto, convinced that there will be no complication during the procedure. “We don’t expect any complication during the procedure. The patients have been screened. We only need to look for the vas deferens and seal them. The intended effect is to prevent the sperm from fertilizing the egg,” said dr. Imam.
Interim Territorial Section Officer Infantry Capt. Hadi Sutjipto conveyed the military’s support to the national FP program. “Today, we support BKKBN and Situbondo DPPKB in delivering the annual vasectomy activity. Kodim has always been supporting any policy of the BKKBN; together we can have a successful national FP program.”
Participant Achmad Nurul (35) shared his reason for coming to the event. “I do this voluntarily for my wife. I heard of this program and I was interested. We have three children; three is enough,” he said.
Achmad’s wife was especially supportive of her husband. “He has my full support. I’ve never used contraceptives for health reasons. I first heard about vasectomy three to four years ago and I offered it to my husband, but he refused [at the time]. There were concerns about the side effects and things like that. We discussed this with our extension officer and eventually my husband agreed to do this.”
Post-procedure, Achmad gave his testimony: “Thankfully it went for just seven minutes, thank God everything went OK. I feel comfortable walking now. It was smooth, I barely felt anything and suddenly it’s over. The agency gave me some medicines.”
Sarani (41), another participant, was also a father of three. He said that vasectomy made sense economically for his family. “Our reason is economy. My wife isn’t using any contraceptives and we have children already. We don’t plan to have any more,” he said.
Sarani wasn’t alone; Salehadi Siswanto (51) shared the same reason. “It’s about economy. Living cost is expensive and we have three kids already. That’s enough,” said Salehadi, who earns his income by driving a pedicab.
During interview, Drs. Sukaryo Teguh Santoso, M.Pd. from East Java BKKBN said this social program is the third that they organize during the pandemic.
“Today marks the third round of vasectomy service during the pandemic. Recently, during the National Family Day and the World Contraception Day, Situbondo was recognized for its highest vasectomy rate. For this reason, the Situbondo Kodim Commander received an accolade from the Regional Military Command Brawijaya V,” said Teguh.
“During the pandemic, the acceptance towards vasectomy service is especially high. Alternatively, there is also demand for tubectomy, another form of LARC methods. With this method, you don’t need to see the midwife every month, or every three months if you’re using injectables. Vasectomy is somewhat permanent, it’s more effective and efficient,” Teguh continued.
“There’s a particularly strong support to vasectomy in Situbondo. This comes not only from the community, but also the local government and religious leaders. This is unique, because not all regions have this kind of engagement with the religious leaders community– especially when it comes to vasectomy.”
Teguh further shared some strategies of East Java BKKBN to promote vasectomy in East Java in 2021. “First, we will educate more people about the value of vasectomy and that FP isn’t a women’s responsibility. And vasectomy is not the same as castration. This method has no effect to male’s sexual function,” Teguh clarified.
“Second, we will train vasectomy providers. In East Java, there are around 161 doctors that we have trained, but other areas still lack well-trained vasectomy providers. We also provide training refreshment, and we want every regency to have a dedicated vasectomy team,” he said.
Teguh also mentioned an especially important element to vasectomy’s success in East Java: budget commitment.
“Budget is essential, since this procedure is not covered by the national health insurance program BPJS. In BKKBN’s budget posture, to support FP delivery especially LARC methods, we use the Special Allocation Funds mechanism. We’re quite confident that we will be able to fully address the need in East Java, as we’re seeing a ten-fold budget increase from 2020. We’re grateful that the government still takes FP services seriously during the pandemic, as can be seen from the expanding, instead of contracting, budget. There will be more money spent for the people using the physical and non-physical Special Allocation Funds,” Teguh elaborated.
“Today, we’re in Pasuruan Regency and we’re heading to Pasuruan City tomorrow. We just finished service rounds in Blitar and Tulungagung before this. We’re nearing the end of a fiscal year and we intend to use all our budget for the greatest benefit and success,” Teguh closed.