Questions/Answers

Based on data from the Statistics Portal of the DKI Jakarta Province, in 2018 the province was in the 2nd highest position in Indonesia for the number of violence against women, namely 2,318 cases. The Integrated Service Center for the Empowerment of Women and Children (P2TP2A) also stated that the number of victims of violence against women and children in DKI Jakarta in 2018 was 1,779 cases, dominated by victims of domestic violence (811 cases) and sexual violence (761 cases). This shows that the handling of women and children as violence victims in DKI Jakarta Province is very urgent. Previously, the handling of women and children of violence victims in DKI Jakarta Province was carried out partially, so that when victims need various services such as psychologist counseling, they will be referred to other facilities. The Integrated Service Center for Women and Children Violence "Bunga Tanjung (Cape Flower)" is established as a response to provide access to comprehensive health services for them. Through Bunga Tanjung initiative, all (100%) of the victims/patients who come/are referred to Tarakan Regional Hospital receive comprehensive services on medical and psychological aspects, including the publication of post mortem using advances in information technology through e-visum. With the design of the spheres and services provided at Bunga Tanjung, victims of violence are more open to share their experience, thereby easing the collection of complete evidence to be followed up in the legal process by the Police. Furthermore, the handling in the form of assistance is carried out by the P2TP2A, so that traumatic healing for victims is handled professionally and continuously. In its development, Bunga Tanjung's innovation service has also been expanded with integration into the Jakarta Alert 112 call center as a citizen complaint service and the Ambulance Emergency (AGD) for victim pickup services.

Bunga Tanjung provides access to integrated and quality health services for women and children victims of violence as vulnerable groups who live in fear and tend to be apathetic to solve the problems they experience. This service can be accessed by anyone because it is free and user-centered where the priority for handling physical or psychological conditions is determined according to the conditions and readiness of each victim. To improve the effectiveness, it utilizes e-visum, which is not commonly used in Indonesia, as well as collaborates with the Police to integrate public access in obtaining Bunga Tanjung services digitally.

Violence against women and children is still an important issue for the world, including Indonesia. Jakarta as the capital city of the Republic of Indonesia takes a role in the global context of handling violence against women and children. “Bunga Tanjung” innovation contributes to the Global SDGs target number 5.2, which is to eliminate all forms of violence against women and girls in the public and private sphere, including human and sexual trafficking and other types of exploitation. However, this service has a more specific focus, namely on victims, so that their physical, psychological and civil rights can be saved, which are represented in the legal process by law enforcement officials until they return to the community. This is Indonesia's commitment through the national SDG target, namely increasing the capacity of institutions that provide protection for women from all forms of violence at the national and local levels with a target prevalence of victims of cases of violence against women receiving comprehensive services of up to 70% by 2019. In Bunga Tanjung, 100 % of victims received comprehensive services.

The sustainability of Bunga Tanjung initiative is supported by the regulations from the central government to province government level in terms of management and securing its budget. In addition, Bunga Tanjung also received social support from the Non-Governmental Organization Lentera Anak and the National Commission for Women, which are currently preparing to collaborate to expand the range of access to services for victims of violence against women. Patients also give testimonials, among others, that they can accept the violence they have experienced as part of their life and are committed to undergoing the healing process to completion.

Bunga Tanjung initiative becomes a liaison or bridge in the handling of victims carried out by the P2TP2A unit and the Police, which previously operated separately, so that there is integration of victim handling across government agencies. Currently Bunga Tanjung has also been integrated with the Emergency Ambulance, the Jakarta Alert 112 call center as well as the women and child violence complaint posts located in 19 Child Friendly Open Public Spaces (RPTRA) under the management of the P2TP2A unit. This collaborative governance model not only makes services to victims better, but also makes it easier for them. Once victims arrive at Tarakan Hospital, they do not need to spend time and energy accessing other services. The use of digital technology in the form of e-visum not only provides convenience but victims can also get services for free. On the other hand, hospitals also get convenience through this technology support in the form of a medical e-resume as a complete service billing file for the Jakarta Health Insurance scheme.

The issue of violence against women and children in Indonesia tends to generate perceptions of women and children as marginal groups in society, but with the innovation Bunga Tanjung can overcome this issue of gender inequality where on the one hand not only women as victims of violence get comprehensive services, but this innovation. also at the same time elevating the dignity and restoring the victim's confidence when interacting again in society. This innovation ensures the realization of equality for women and children victims of violence in society and encourages them that they are not alone in solving their problems.

The “Bunga Tanjung” innovation service is a medical and psychological service aimed at women and children who experience all forms of violence in public and private spaces, including human and sexual trafficking, domestic violence, and other types of exploitation. Victims can get access to the innovation service "Bunga Tanjung" through various channels, namely coming alone or escorted by family, escorted by the Police, escorted by P2TP2A unit officers based on reports from family/other community members, referrals from other health centers/hospitals, escorted by Ambulance Emergency Department who received reports from residents through the Jakarta Alert 112 call center, or were delivered by an NGO. With Bunga Tanjung's reputation as an integrated service provider, there has been an increase in the number of victims of violence against women and children who come to get access to the innovative service “Bunga Tanjung” from September 2019 to September 2020 by 243%. Despite the increase, all victims who came were served comprehensively and integrated with other stakeholders (P2TP2A Unit and Police).

In 2016 the Government of DKI Jakarta implemented the establishment of an organization and work procedure for the P2TP2A which is in charge of managing services, information, psychological and legal consultations, mentoring and advocacy as well as medical services and safe houses and solving problems faced by women and gender-based children. In 2018 the Governor of DKI Jakarta Province established the 13th Regional Strategic Activity concerning the Prevention and Handling of Violence of Women and Children through Quick Reaction and Safe Houses which was followed up by collaborating with Polda Metro Jaya to develop Integrated SOPs for handling victims of violence to women and children. The Health Office followed up by making a policy for the establishment of an Integrated Service Center in class B and C regional public hospitals in DKI Jakarta Province as a comprehensive and multidisciplinary involvement for health services for victims of violence against women and children. With technical assistance from UNDP, Bunga Tanjung as an Integrated Service Center for victims of violence against women and children began in 2018. In its journey, Bunga Tanjung's innovation continues to develop integrated services with the Jakarta Alert 112 call center and the Emergency Ambulance as a follow-up to the results of joint evaluation with the P2TP2A Unit in order to optimize the effectiveness of handling victims. The initiatives funding is from Jakarta budget which is managed by the Jamkesjak unit, so that the service is free of charge. Monitoring and evaluation of the innovation "Bunga Tanjung" is carried out at the internal level of the Tarakan Hospital and the Health Office. Of only 3 cases served in 2018, Bunga Tanjung handled 60 cases in 2019 and until September 2020 has served 85 cases.

The main problem faced during the Covid-19 pandemic was the risk of Covid-19 transmission to health workers who provided services to victims of violence. Regarding this, Tarakan Regional Hospital has undertaken mitigation by establishing a health protocol in the form of Covid-19 screening for victims before receiving further services. The next problem is swab examination of victims who pay for Covid-19 screening as a requirement for access to safe housing services. This was followed up by a policy of providing support in the form of free swab examination screening for victims of violence who needed services at Tarakan Regional Hospital.

Bunga Tanjung not only involves various medical specialists, in collaboration with P2TP2A and the Police as an effective collaboration, but also has 6 rooms in one area, consisting of a special room for legal and psychological consultations, examination of rape cases, making visums, medicolegal examination room and children playgrounds for victims who have difficulty telling the events they experienced, as well as the existence of different entrances and exits so that victims feel safe, comfortable and confidential. All of these are unprecedented measures in Indonesia. In addition, E-visum accelerates the issuance of visum from 30 to 2 days.

Bunga Tanjung innovation is inspired by a similar service in South Korea called Sun Flower. However, unlike Sun Flower whose interpretation of evidence is carried out by the Police, Bunga Tanjung’s is interpreted by a forensic specialist through the issuance of a post-mortem as evidence for the Police for legal proceedings. Hence, the initiative sees cases not only from a legal perspective but also from a human and social perspective so as to provide a sense of security, comfort and confidentiality of the handling process by the medical team as well as integrated services by P2TP2A and the Police officers.

The use of information technology in Bunga Tanjung initiative in the form of an e-visum application that accelerates the service of issuing visums from 30 days to 2 days, thus providing certainty for victims for further handling by the Police. The speed of service is also supported by information technology in the form of a medical e-resume, thereby accelerating the submission of service bills to Jamkesjak and making it easier for victims to receive services at no cost. The service can also be accessed through Help RENAKTA, an application that can be downloaded on a cellphone.

Tanjung flower has been replicated in 7 other hospitals in DKI Jakarta. Innovation development is also optimized by building networks in 44 sub-district health centers spread across the DKI Jakarta area, so that victims can be handled comprehensively and reach all remote areas in DKI Jakarta. This policy is outlined in the Instruction of the Head of the DKI Jakarta Provincial Health Agency Number 4 of 2019 concerning the Preparation of an Integrated Service Center (PPT) for Victims of Violence of Women and Children in Class B and C Hospital of DKI Jakarta Province. Apart from the DKI Jakarta Health Agency, a Forensic Specialist is also a resource person at the West Java Provincial Health Office and the Indonesian Ministry of Health, as well as a speaker invited by the South Korean Government. Bunga Tanjung innovation received attention and appreciation not only at the national level but also at the international level through the visit of the South Korean Ambassador to Indonesia, the Head of the UNDP Asia Regional and the Head of UNDP Indonesia and the US Department of Justice, to see the advantages of the “Tanjung Bunga” Service compared to similar services in other countries.

This innovation is made easier to do because of the existence of regional strategic policies that orchestrate various regional apparatus organizations to work together to achieve the common target, namely the handling of victims of violence. With the collaboration model, operational costs are more efficient and victims, as service users, also receive quality handling. Another thing that is key to the transfer of ideas for this initiative is that it is not solely on the legal aspects but especially a humanitarian approach to enhance the dignity and civil rights of victims so that they can restore their confidence to interact in their environment. Provision of facilities, infrastructure and human resources by optimizing existing resources, making Bunga Tanjung innovation very potential to be replicated not only in Indonesia but also in other countries.

The implementation of “Bunga Tanjung” innovation is supported by a budget for the provision of facilities and infrastructure in the form of separate special rooms for post-mortem administrative services, psychological counseling, children's playroom, sexual examination, legal counseling and medicolegal examinations of Rp. 25,000,000.00. There are 10 human resources at Tarakan Regional Hospital consisting of emergency general practitioners, emergency nurses, forensic specialists, psychologists, psychiatrists, obstetricians, pediatricians, surgeons, dermatologists and genital specialists and administrative staff. In addition, it is also supported by P2TP2A officers, Police officers, Jakarta Alert Call Center 112 and Emergency Ambulance health workers.

The budget commitment to the sustainability of Bunga Tanjung is realized through DKI Jakarta Provincial Government's annual budget which is allocated to the UPT Jamkesjak of the Health Office with rates referring to the Governor Regulation on Visum Services for Victims of Violence against Women and Children. Institutionally, the innovation sustainability "Bunga Tanjung" is stated in the Joint Agreement between the DKI Jakarta Provincial Government and Polda Metro Jaya. Governor's Instruction in 2020 regarding Integrated Services for Prevention and Handling of Cases of Violence Against Women and Children further strengthens the integration of the P2TP2A Unit with Bunga Tanjung services.

Yes

The evaluation carried out by the Health Agency includes details of cases of violence such as the number and type of violence, age, education level, occupation, place of incident, impact, information on perpetrators of violence. The purpose of the evaluation is to find out the number of cases that have been handled, the suitability of the services provided, and the effectiveness of cross-sectoral cooperation in fulfilling health services for victims of violence against women and children. Tarakan Regional Hospital also carries out monthly evaluation of “Bunga Tanjung” innovation as part of the implementation of Hospital Accreditation Standards.

The “Bunga Tanjung” innovation performance indicator refers to the Provincial Minimum Service Standards, namely: 1. Doctor's service response time 2. Completeness of filling in medical records 3. All poor patients are served

The evaluation results of the Health Agency are that the violence cases has been handled as a whole, an SOP is exist and implemented, and the cross-sector collaboration between Bunga Tanjung and AGD, Jakarta Alert 112, P2TP2A units, and the Police and Health Centers are effective, and there is no gap in the implementation of the services which demonstrated by the increase in the confidence of hospital and puskesmas staff in serving women and children violence victims. The number of cases handled has also increased (85 cases in 2020) with service comprehensiveness reaching 100%. The evaluation results of Tarakan Regional Hospital on Bunga Tanjung initiative include the speed of response time for doctors services <5 minutes, 100% completeness of filling in medical records and 100% coverage of poor patients served, 100% availability of resources. Funding through the APBD provides certainty for the sustainability of Bunga Tanjung's initiative so that it has an impact on increasing the number of victims handled. The follow-up that needs to be done is feedback from stakeholders after the victim received services from Bunga Tanjung. In the future, further improvement is needed in the form of providing child psychiatrists and funding for psychiatric visums.

The evaluation results of the Health Agency are that the violence cases has been handled as a whole, an SOP is exist and implemented, and the cross-sector collaboration between Bunga Tanjung and AGD, Jakarta Alert 112, P2TP2A units, and the Police and Health Centers are effective, and there is no gap in the implementation of the services which demonstrated by the increase in the confidence of hospital and puskesmas staff in serving women and children violence victims. The number of cases handled has also increased (85 cases in 2020) with service comprehensiveness reaching 100%. The evaluation results of Tarakan Regional Hospital on Bunga Tanjung initiative include the speed of response time for doctors services <5 minutes, 100% completeness of filling in medical records and 100% coverage of poor patients served, 100% availability of resources. Funding through the APBD provides certainty for the sustainability of Bunga Tanjung's initiative so that it has an impact on increasing the number of victims handled. The follow-up that needs to be done is feedback from stakeholders after the victim received services from Bunga Tanjung. In the future, further improvement is needed in the form of providing child psychiatrists and funding for psychiatric visums.

Bunga Tanjung is an integrated service innovation in Tarakan Regional Hospital, DKI Jakarta Province. As a Technical Service Unit, the Health Agency of Tarakan Regional Hospital collaborates with the P2TP2A unit in providing services for victims of violence to women and children. Facilitated through technical assistance from UNDP, Bunga Tanjung of Tarakan Regional Hospital also collaborated with the Metro Jaya Regional Police through the Women and Children Protection Unit, which was stated in the collective agreement. "Bunga Tanjung" innovation also collaborates with Lentera Anak Foundation based on a cooperation agreement on efforts to prevent and control acts of violence against children, as well as the National Commission on Women. Women and children of violence victims as service recipients also provide feedback so that non-critical victim services can be accelerated in the IGD which is followed up by preparing a direct route to “Bunga Tanjung” service so that victims do not wait too long in the IGD and are quickly handled.

Bunga Tanjung provides a one-stop service, integrated with the P2TP2A unit and the Police so that handling is carried out quickly, safely and comfortably. Community members or victims can easily access the Bunga Tanjung service which has been integrated into the application for complaints of women and child violence "Help RENAKTA" developed by the Indonesian Police. The implementation of the Bunga Tanjung initiative provides inspiration to create a stronger effort for all stakeholders (Provincial departments and Police) after medical and psychological services through feedback after victim assistance by P2TP2A so that the traumatic healing process becomes effective for the continuation of the victim's normal life, as well as obtaining legal certainty for victims in breaking the chain of cases of violence by perpetrators by the Police, so as not to cause or prevent new violence victims. Services for women and children victims of violence can only be realized if there is multi-stakeholder collaboration, so that at this time what Bunga Tanjung is working on is strengthening synergies with work units/other related parties both within and beyond government to even enhance the performance of Bunga Tanjung in providing the best services for women and children victims of violence.