Raden WASITO was born October 5, 1909 in the village of Sanden, Bantul, on the outskirts of Yogyakarta in central Java. At the time of his birth Java was, as it has remained, the most populous island in the Indonesian archipelago, with 17 of the 30 million inhabitants of what was then called the Netherlands East Indies.

WASITO's father, Djojowetjono, was a subdistrict administrator employed in the service of the Sultan of Yogyakarta. The position provided prestige but only a small salary. WASITO's mother bore the inherited title of Raden Ayu, which placed her and her children in the ranks of Javanese lesser nobility. Although enjoying the respect always given by the hierarchically minded Javanese to members of the aristocracy, the large family of seven children knew a certain amount of financial insecurity. The parents spoke only Javanese and therefore were unable to take advantage of the opportunities which the Dutch government, under its "Ethical Policy" formulated in 1901, was beginning to offer to educated Indonesians who spoke Dutch. There were no family lands and there were always debts. WASITO remembers that his mother often pawned her inherited jewelry. His father's modest salary of 60 to 75 guilders a month was not sufficient to educate WASITO's eldest sister, who never attended school; his elder brother and second sister were able to become teachers only by obtaining government scholarships.

When WASITO's turn came for education (he was the fourth child and second son), he was sent to learn Dutch at a local Christian missionary school for two years; his father wanted him to become a doctor, a profession which required studying in that language. Then, using the family's social prestige and rank, his father arranged for WASITO to attend the Europese Lagere School, a Dutch-language elementary school in Yogyakarta which trained the children of Dutch residents and officials. Only a few elite Indonesian and Chinese students were admitted to such schools, their numbers never reaching 20 percent of the student body. The schools promised an education identical to that received in the Netherlands and offered graduates an opportunity to proceed to secondary schools in Holland or Indonesia, or to lower positions in government service in Indonesia after passing the Lower Civil Service Examination.

WASITO commuted by train from his village outside Yogyakarta or his seven years of elementary education. He then entered the Meer Uitgebreid Lagere Onderwijs (MULO), an Indonesian three-year secondary school which prepared students for higher education. In WASITO's time fewer than 2,000 of his countrymen were enrolled in the MULOs; it was the exception to offer secondary education to Indonesians. The required curriculum included Dutch, Malay, German and English, besides the normal academic subjects.

There was no university in the archipelago but technical and professional schools of higher education had been established. When WASITO graduated he qualified for a full scholarship at the Nederlandische Indische Artsen School, the medical school in Surabaya, East Java, where, he remembers ruefully, his scholar's stipend was equivalent to his father's salary. The seven-year medical training conformed to the Dutch policy of producing Indonesian doctors trained in practical medical skills, including surgery, but offering no opportunity for specialization or research.

In addition to his studies WASITO found time for active participation in the community life of Surabaya. He was a leader of the Boy Scout movement in East Java, the chairman of the Medical School students Organization, and for two terms served as chairman of the Surabaya Medical Association. He was twice chairman of Yong Java, youth movement parented by and sharing the aims of Budi Utomo (High Endeavor)—the first Indonesian nationalist organization which had been formed in 1908 by intellectuals and members of Java's aristocracy to encourage respect for traditional Javanese culture, at the same time demanding equality with the Dutch in education and employment opportunities.

As a student WASITO was deeply influenced by Dr. Soetomo, his teacher, who was mentor and spokesman for the idealistic young Javanese who wished to educate themselves for a life of service to their country. As the historian Robert Van Niel has noted, "it is doubtful any one man was of greater importance in shaping Indonesian life during the 1920s," a decade of budding nationalism and of growing confidence among Indonesians, particularly Javanese, in their relations with the Dutch and the modem Western world.

When he graduated from medical school in 1935 WASITO was hired by the Muslim humanitarian organization, Muhammadiyah, as a mission doctor and sent to work among the Batak people at Tapanuli, in northern Sumatra. At the termination of his two-year contract he accepted the position of doctor on a large French rubber plantation in the same area. There he was in sole charge of a 240-bed hospital serving 15,000 plantation workers and was responsible for providing all necessary medical services, including surgery that ranged from amputations to eye operations.

In 1939 WASITO married Soeprapti Tjokrosepoetro, the daughter of a district official of Lumadjang, Java. During their engagement he and his prospective bride had written each other concerning their desire to plan the birth of their children and to limit their numbers to three, or possibly four. Their plans were thwarted by the lack of contraceptives during World War II and the immediate postwar period. Thus despite their desire to control the size of their family, WASITO and his wife found themselves parents of three boys and three girls.

After the defeat of Japan in 1945 Indonesia declared its independence from the Dutch and WASITO served (1946-47) as a member of the Komite Nasional Indonesia Pusat, the short-lived first Indonesian emergency parliament. This was his only venture into the political arena.

The lack of proper schooling in north Sumatra for his growing family led him in 1950 to seek a transfer to Java where he was appointed Junior Assistant in the national Venereal Diseases and Yaws Campaign, headed by Dr. Kodijat (who received the 1961 Ramon Magsaysay Award for Government Service "for his dedicated and skillful direction of the massive yaws eradication effort that is freeing his countrymen from a disfiguring and crippling disease"). The campaign was conducted throughout the islands where an average of 18 percent of the village people were afflicted with the disease. With the help of the World Health Organization (WHO) and the United Nations Children's Emergency Fund (UNICEF) the program eventually reached 13,000,000 persons and resulted in the virtual extermination of the disease by 1969.

WASITO worked in particular with UNICEF official Samuel Keeney in the campaign which concentrated on delivering information and treatment directly to the people in their villages, utilizing the village chiefs (lurahs). WASITO's energy and dedication to the enormous program were rewarded in 1956 by his receipt of a two-year WHO scholarship to study epidemiology at Johns Hopkins University's School of Public Health in Baltimore, Maryland, USA.

On his return to Java in 1958 WASITO became Director of the Venereal Diseases Institute in Surabaya and was later appointed Director of the Public Health Institute in the same city. His experience was further broadened when he was sent to Geneva, Switzerland, in 1963 to serve on a panel of experts discussing the integration of mass campaigns into general health services. In 1966 he served briefly as a WHO consultant in an Indian campaign against yaws, and from 1967 to 1970 was a WHO health officer in Nepal where he worked on a smallpox eradication program. Although retirement is compulsory from Indonesian government service at 55, WASITO was kept on four years bend retirement age to serve with WHO since he had had two years of training at WHO expense. He retired from the Indonesian government vice in 1968 and from WHO—which put him on their roster for two more years—in 1970.

In 1970 the Indonesian government, alarmed by the continuing problem of overpopulation on the islands of Java and Bali, and the predictions that Indonesia's population of 121 million would more than double by the year 2000 if current birth rates were not checked, threw its weight behind a program of birth control. A National Family Planning Coordinating Board (Badan Koordinasi Keluarga Berencana Nasional or BKKBN) with Dr. Soewardjono Soerjaningrat as Chairman was established. It had broad powers to conduct a program of family planning and focused first on the islands of Java and Bali. WASITO's long experience with national campaigns against disease led the BKKBN to appoint him Executive Chairman of the program in the province of East Java which was under the chairmanship of Dr. W. Bahrawi.

Family planning activities in Indonesia date back to scattered efforts in the early decades of the century to inform Indonesians of the perils of overpopulation. After independence President Sukarno, who objected to birth control on grounds that it was unnecessary and that it might undermine the morals of the nation, dealt with the obvious overcrowding on Java and Bali by an ineffective program of transmigration which encouraged the relocation of people from those islands to the sparsely populated outer islands of the archipelago. In 1957 the private Indonesian Planned Parenthood Association (IPPA) was formed which, with the assistance of the International Family Planning Federation (IFPF), set up family planning clinics in urban centers throughout the islands. It lacked government approval and support and hence had little effect.

With the eclipse of Sukarno in 1966 the government changed its policy on birth control. President Suharto the following year signed the United Nations Declaration of Population which recognizes family planning as "a basic human right," and he publicly admonished Indonesians to "pay serious attention to efforts at family planning." An Ad Hoc Committee was formed the same year to present recommendations for a program of population control. In October 1968 a presidential decree created the semi-governmental Indonesian Family Planning Institute (IFPI) which began a loosely organized program to provide birth control services and to popularize the image of what was then considered the "ideal," an Indonesian family of four children. A publicity campaign was mounted using the endorsement of religious leaders and prominent personages.

The institute took over the administration of the existing 500 IPPA clinics in Java and Bali, although the IPPA continued to run the program in the outer islands and to be responsible for training and information. The institute's lack of clearly defined authority and goals led to somewhat disappointing results. At the end of its first two years only 87,000 of Indonesia's 25 million women of reproductive age had become family planning participants.

In the fall of 1969 a group of foreign experts—sponsored by the United Nations, the World Bank and WHO—was invited to make recommendations for a more effective national family planning program. The mission's report suggested a greatly enlarged and well-funded program and made detailed proposals for organization, staffing, personnel training and operation. It made specific suggestions on: 1) strengthening the administrative chain of command so that decisions could be made and carried out, 2) training field-workers and 3) motivating acceptors. It also recommended that the target for the next five years be doubled— to 6,000,000 acceptors—and the budget expanded to US$31,000,000. In making this last proposal the group indicated that foreign agencies would increase their funding to meet these goals.

The Indonesian government acted swiftly. In 1970, Presidential Decree No. 8 transformed the National Family Planning Institute into the fully governmental National Family Planning Coordinating Board (BKKBN), making it responsible for all family planning activities. Funding for the first fiscal year (1970-71) included an Indonesian government allocation of the equivalent of US$1,300,000 and matching grants from the U.N. and foreign donors of US$3,300,000; in 1972, by Presidential Decree No. 33, family planning became a national priority.

From the beginning the chairman of the BKKBN reported directly to the president and was authorized to draw upon the resources of all government ministries and agencies to ensure the success of the program. Directly involved were the ministries of Peoples Welfare, Health, Internal Affairs, Defence and Security, Education and Culture, Information, Religion, Social Affairs, Finance and the National Planning Board. The armed forces, police and government offices were instructed to set up family planning programs of their own, and the BKKBN was empowered to coordinate the family planning services of the clinics run by the military, the government and private organizations. It was determined that the campaign would be conducted in both urban and rural areas on Java and Bali simultaneously; BKKBN offices were therefore established in every province and regency (administrative division below the province) on those islands.

The province of East Java represented a formidable challenge for the BKKBN and Dr. WASITO. Established clinics had to be expanded, fieldworkers trained and midwives and health officers mobilized to work for the program. Distrust of, and possible religious objections to, contraception had to be overcome and, most importantly, attitudes had to be changed about desirable family size if the goals of the BKKBN were to be met. On the positive side East Java had a particularly receptive bureaucracy, with effective control over the administrative chain of command and good communications. Surabaya was Indonesia's second largest city, and light industry and specialized agriculture were growing segments of the economy. Nevertheless some of Indonesia's poorest farmers lived on the dry northeast and barren south coasts.

In order to reach East Java's 27 million people—of whom 95 percent were Muslim and almost 50 percent illiterate—WASITO felt it necessary to utilize every figure of influence, prestige and authority to transmit the message of birth control as a means of producing a society of "happy, prosperous, small families." An active information and education program had to be organized immediately.

The governor of East Java gave his full support. Political and religious leaders were asked to volunteer endorsements, and press, radio, film and television were used to publicize the family planning message. By decree officials at every administrative level—from the governor's office down through the provinces, regencies, districts and subdistricts to the village—were told to work for family planning and were made responsible for motivating participation. Contraceptive information and services were made available at the government health clinics on special "Family Planning Days" conducted several days a week, and clinics were kept open for additional hours.

Drawing on his experience in the 1950s with the village-to-village campaign against yaws, WASITO knew it was of utmost importance that the family planning message be brought directly to the villages. The lurah, the village chief whose authority represented a tradition dating back to the pre-Islamic period of Javanese history, held the key to the acceptance of birth control. Once having achieved the lurah’s support and the consent of the lemmas (teachers of Muslim religion and law) the program, WASITO felt, would be acceptable to the people. Nevertheless the message had to be delivered in terms consonant with their traditions, for example their strong village culture and their extra ordinary love of children. "Family planning," he noted, "should be come an aspect of the villagers' way of life, grafted on the trunk of the existing culture and living on the roots of the old."

It was also important that the message be delivered through personal contact and in the local language or dialect, a lesson WASITO had learned when speaking in a village where the lurah politely told him that his Javanese was "too high" and asked permission to address the people at a more appropriate level of that highly class-conscious language. Workers were instructed not to attempt to "teach" the ulema, but to "explain their duties as BKKBN officials, ask for his blessing," and let the ulema’s conscience determine whether he would give his support.

Village meetings were organized—conspicuously attended by uniformed military and police officers, government officials, religious leaders, and the lurah and his staff—to explain family planning aims and methods. Parents were exhorted to consider limiting the numbers of their children in order to provide their families with a better life. Uniquely Indonesian gamelan (gong) orchestras and troupes of entertainers accompanied mobile clinics from village to village. Knowing the Javanese penchant for "indirection" WASITO also arranged for special training for dalangs, the puppeteers of the Javanese shadow puppet theater, who inserted subtle hints on the impropriety of siring too many children into the well-known and loved wayang (traditional Javanese drama).

The growing corps of professionally trained fieldworkers collected vital statistics in the villages and made house-to-house visits to recruit and keep records on new acceptors of contraceptives. Fieldworkers' records were assembled at the local clinic and sent back to BKKBN headquarters in Jakarta by the fifth of every month. A rapid-feedback data system, started in 1971, digested the reports and within 30 days sent current summaries back to the field and to concerned government agencies to help guide and evaluate the program. Statistics soon proved that the most effective fieldworkers were women who were most like the acceptors themselves—married with limited education and of the same economic level.

At the beginning of the campaign fieldworkers were given small financial incentives for bringing new acceptors into the program, their compensation varying according to the type of contraceptive method chosen. These incentives were later abandoned as complaints began to be registered by some dissatisfied women. (A BKKBN monograph reported that one woman said, about her experience with an intrauterine device: "I get the pain, and she gets the money!") As family planning acceptance grew, incentive rewards such as sewing machines and kerosene lamps were given to acceptor communities.

Although modestly paid, fieldworkers proved to be enthusiastic and hardworking with a real sense of esprit de corps. Generally recruited from the area in which they worked, fieldworkers brought impressive numbers of contraceptive acceptors into the clinics. Their work was demanding. The Population Bulletin of November 1977 reported that "in 1976-77 it took an estimated six home visits to produce one acceptor, and each fieldworker also made an average of 170 revisits to deliver contraceptives or to encourage a continuing user to switch to a more effective method." As WASITO has said, "if a motivator repeats what he has learned from a teacher he is only a tape recorder, but if he is convinced that it is the truth, his words will have magic and penetrate the minds of the people"; most motivators demonstrably have been believers.

During the early years of the family planning campaign the BKKBN's aim was to promote the concept of an ideal family of four children—it soon changed to the more specific goal of reducing the 1970 Indonesian birth rate 50 percent by the year 2000. The new goal required reduction of the size of the ideal family to two children.

In 1973 the legislature unanimously endorsed family planning s a national policy, thereby ending what little public resistance had remained to the program, and the BKKBN extended its work to include the islands outside Java and Bali. Targets for new acceptors were stepped up and special drives were conducted throughout the islands modeled after the work done in East Java.

The drives concentrated on one village or group of villages at a time, and doubled the number of acceptors in 1973 over the previous ear, but pressures on administrators and fieldworkers to meet targets produced some complaints of coercion. WASITO cautioned East Java officials "not to overdo" and to keep coordination in the hands of the lurah: "In a village, education, health, family planning, agriculture are like the fingers of a hand. That hand is the lurah. He is the key figure
all of this." The dates of the drives were changed to avoid a scramble

in the last month in which targets could be achieved, and later drives were devoted to specific purposes, such as encouraging acceptance of the intrauterine device (IUD), the most effective and least expensive method of contraception.

Despite efforts to promote the use of the IUD, East Java women have continuously showed a marked preference for oral contraceptives—the "pill." The problem of obtaining a resupply of pills monthly, which required either repeated visits to the clinics or increasing numbers of housecalls by fieldworkers, led in 1974 to an East Java pilot program to establish contraceptive supply depots within the village. These Village Contraceptive Distribution Centers (VCDC) were designed to serve both as distribution points and as a focus within the village for family planning information and follow-up. The operator of the VCDC was usually appointed from the lurah's staff and was responsible for keeping records, making referrals to the clinic and, with the fieldworker, acting as a motivator for family planning acceptance. Fieldworkers were thus freed to move out to subvillage communities to seek new participants who would be supplied from the center.

Although the VCDC worked under the supervision and guidance of the clinic, its establishment under village control represented a recentering of the responsibility for family planning in the village. In 1975 it was decided to establish VCDCs all over Java and Bali and by 1978 there were 30,000 centers in the islands as the BKKBN reached toward its goal of establishing one in every village.

Innovative means of popularizing family planning developed. Many villages started using a signature drumbeat on the village drum to communicate nightly the message that it was time to remember to use birth control devices. In some East Java villages a monthly "pill day" brought women together for contraceptive resupply and a lottery. As their names were called by the VCDC operator, women received their monthly cycle of pills and paid 35 rupiahs (about US$.09). Ten rupiahs were set aside for administrative costs and the remaining 25 were put into a lottery fund. A winner was picked each month until every woman had won. The drawing proved a powerful attraction. "Old acceptors encourage others to join in order to enlarge the payout. Young marrieds are eager to join in order to have a chance at the prize which would provide them with a welcome fund for starting off their new life."

WASITO's aim to transfer more and more responsibility for population control from the government to the people themselves required the participation and support of the village women. He urged his staff to "let the women come forward" to contribute to the program, not only as passive acceptors of birth control devices, but as active participants in motivating others.

Modeled after mothers' clubs first formed in central Java in the early 1970s, Family Planning Mothers' Clubs (Paguyuban Keluarga Berencana) and acceptor associations were established under the auspices of the Pembinaan Kesejahteraan Keluarga, the existing village women's organizations devoted to family welfare. The Family Planning Mothers' Clubs shared the parent organizations' goals and were open to all village women, married or unmarried, regardless of whether they had become family planning participants. The aim was to integrate family planning with other social and community activities designed to improve the quality of members' lives. By 1978 over 45,000 clubs had been organized in Java and Bali and they have proved to be powerful factors in internalizing the motivation and maintenance of the family planning program within the community.

Cooperating with the professional fieldworker and the VCDC operator in motivating and following-up contraceptive acceptors, the clubs provide a clearing house for birth control information and a referral point for women experiencing side-effects from contraceptive use. In addition, they offer opportunities for women to gather for constructive educational and social purposes. Traditional dancing and gamelan orchestras have proven to be popular and attractive magnets. Clubs have organized literacy programs and savings and lottery schemes and are the source of information on child care and nutrition, health practices and home economics. Efforts have been made to teach village women skills and handicrafts which could produce extra income. Emphasis is placed on improving the welfare of the existing children and enriching the lives of their parents.

It is the identification of family planning with the general betterment of the lives of women and their children that WASITO believes offers the best chance of ensuring voluntary and lasting commitment to the concept of small families. And when the journalist Richard Critchfield asked WASITO if family planning had become "women's liberation," WASITO replied that he took it to be "the natural course of things." He added: "Simply to propagate contraception is no longer so important. More important is to lower the number of drop-outs. If a woman feels and knows that the quality of her life is being improved she will not drop out." Since WASITO sees women as the natural guardians of tradition he believes their role is crucial in making family planning an integral part of Javanese life.

Although many factors—including passing laws raising the minimum age for marriage and cutting off government subsidies after the birth of a third child—have affected birth rates, the subtle but pervasive effect of rising awareness of women to the material benefits of limiting the numbers of their children is probably the most important cause of the growing acceptance of birth control. Family planning is becoming the fashion in East Java; when the "fashion" becomes the "custom," as WASITO hopes it will, then the BKKBN's work will be over.

In 1978 WASITO retired from his position with the BKKBN, leaving his staff with the dream of achieving a stabilized East Java population by the end of BKKBN's Third Five-Year Plan (1980-1985). At the time of his retirement 38 percent of the province's eligible couples were participants in the family planning program, the average age of women acceptors was decreasing and the birth rate was dropping fast. Many of his campaign techniques had been adopted on a national scale and were proving effective in other areas of Indonesia. That the concept of family planning has taken root in East Java was demonstrated by the latest 1979 statistics from BKKBN's superb data system which reported that the number of eligible couples participating had risen to 52 percent, well on the way toward reaching the 72 percent participation which, with some migration from the area, is necessary to achieve WASITO's goal.

The results of the Indonesian population control program have been hailed by Dr. Reimert T. Ravenholt, Director of the Office of Population, U.S. Agency for International Development (USAID), as making it the "foremost fertility control program in the free world." A dramatic fertility decline has been achieved from 46 births per 1,000 in 1971 to approximately 32 per 1,000 in 1979. However Dr. WASITO warns that the death rate has fallen even more and the East Java population is still growing at around two percent per year.

The BKKBN's campaign has been ably administered and well funded and supported by the Indonesian government and by international agencies. According to a 1977 publication of the Population Reference Bureau, USAID has provided over 150 million monthly cycles of oral contraceptives, along with additional financial assistance and technical expertise. Other organizations—including the International Planned Parenthood Association, Population Council, Ford Foundation, United Nations Development Fund, United Nations Fund for Population Activities and various foreign governments—have provided financial and technical aid. The Indonesian government's funding for the program exceeded US$34,000,000 by 1978. Support and cooperation have been received at every level of the Indonesian government and private Indonesian philanthropic and religious organizations, such as the Muhammadiyah, have encouraged the acceptance of family planning.

The success of the BKKBN's program has heartened population experts and caused rethinking of the classic theory of demographic transition which postulated that economic development brings about a fall in mortality rates, followed by attitudinal changes and a decrease in fertility rates. The East Java program has illustrated that it is not necessary for economic development or urbanization to precede a reduction in births. A strong village culture can be approached directly in the implementation and maintenance of population control, and the practice of contraception can itself be a factor in changing attitudes; attitudinal change need not precede practice. It has also demonstrated the importance of involving women, even those of traditionally male-oriented religions and cultures, as active participants.

Dr. WASITO now lives in modest retirement with his wife at their home in Surabaya. His children—all educated, married and well settled— have offered to supplement his small government pension to afford him some luxuries. He has refused their aid while appreciating their generosity. Although proud of being Javanese he modestly prefers not to be called by his title of raden, rejecting it as "feudalistic."

WASITO is grateful to those factors which have formed his character and shaped his career—to the Javanese village culture in which he lived as a child and which gave him his sensitive insights into the Javanese mind; to the missionary school he first attended for introducing him to the Ten Commandments and the gentle teachings of the Sermon on the Mount; to the Dutch who gave him his education; to his family, his teachers and others with whom he has worked during his long career.

Although he draws his deepest satisfaction from his Javanese background, WASITO is a well-traveled professional, quite comfortable with men of other languages and customs. When interviewed recently he quoted the Chinese writer Lin Yutang to express his own philosophy: "Enjoy the small things in life and you will be happy." And then he sang a line from a Dutch song he had learned as a child: "Happy is he who gives what he has and feels himself rich."

September 1979 Manila

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Interview with Raden Wasito and letters from and interviews with those knowledgeable of his work.