Papers

• End-of-Life Care in Indonesia: Silence, Narrative and Moral Personhood Annemarie Samuels Leiden University

  In our research project ‘Globalizing Palliative Care?’ we ask how the emergence of palliative care – as a professional form of end-of-life care – is folded into ongoing discourses on death and dying and practices of care for people with advanced illness in Indonesia, India and Brazil. Focusing on Indonesia, in this presentation, we will outline our research plans and reflect on how our questions speak to the analysis of silence, narrative and moral personhood at the end of life.

  We start by drawing on previous research in Aceh, where death and dying were rarely discussed during the last phase of life, whereas the practice of “narrating the good death” retrospectively played an important role in socially confirming the moral personhood of the deceased. This analysis raises several pressing questions, including: How are discussing and not discussing dying implicated in creating a “good death” in Indonesia? How does the social and moral valuing of silence and narrative impact clinical and family interactions, particularly concerning disclosure and decision-making? And how do practices of care and narratives of moral personhood in advanced illness unfold along lines of class, gender and religion?

  We will discuss how these questions inform our proposed research on palliative care broadly, and care trajectories of women with breast and reproductive cancer in Jakarta more particularly. With this research we aim to provide insight into processes of care and (non-)disclosure that are relevant both to the emerging practice of palliative care in Indonesia and to broader theoretical debates on morality, silence and end-of-life care.

• Marine protection, climate change, and ‘zoning’ as expertise in Indonesia and elsewhere David Kloos KITLV Yvonne Kunz KITLV

  This paper looks at confluences of and contestations between different forms of expertise in the context of marine protection and the climate crisis. Concretely, we focus on Marine Protected Areas (MPAs) and the specific practice of ‘zoning’: the allocation of different zones within protected areas for different purposes, differentiating between areas that may not be disturbed to areas in which certain economic activity, such as fishing or tourism, is allowed. While the effectiveness of MPAs as a governance tool has been hotly debated since their emergence in the 1980s, climate change has arrived as both an additional threat and a new raison d’être. Marine environments face immediate consequences of climate change, such as sea level rise, extreme weather events, and environmental degradation. Yet they are also seen as a crucial new frontier – from discourses about natural buffers to blue carbon – in both mitigation and adaptation efforts. This entails that conventional zoning practices might be fundamentally reformulated, shifting from a classic conservation paradigm directed at protecting ‘what was there’ to a more flexible, future-oriented practice that takes into account different possible impact scenarios. Our paper focuses on this emerging narrative and the forms of expertise, from conservation science to local knowledge, as its basis. We begin by introducing a new transdisciplinary research project on climate change and ocean governance in Indonesia and the Caribbean. We then proceed to discuss an experiment with a more flexible, climate-oriented management strategy at a new protected marine site in Maluku, Indonesia, to formulate pertinent questions about zoning as a form of expertise. What does planning for climate and its inherent uncertainties mean, both locally and for the future of the MPA as a fundamentally territorial, and therefore also inflexible concept? To what extent are these new management strategies based on scientific models and to what extent are they based on local expertise of climate in relation to cultural concepts of zones, territories, and space?

• To be equal to a doctor: Reflections on trust, expertise, and the professionalisation of midwifery in Yogyakarta, Indonesia. Catherine Smith Macquarie University

  This paper explores the relationship between trust and expertise, and asks how the foundations for trust in a group of healthcare workers might change through a process of professionalisation. It takes as its case study the ongoing process of the professionalisation of midwives in Yogyakarta, Indonesia, which is expected to accelerate over the next decade. After discussing the current dynamics of trust and mistrust in midwives, and the aspirations midwives hope to achieve through professionalisation, the article offers reflections on the possible effects that professionalisation might carry for midwives in the next decade. The paper reflects on the relationship between the enactment of trust and expertise, and the likely effects of the further integration of midwives into the health system might carry on both trust and the nature of midwives’ expertise.

• Trust me, I’m an influencer Fajri Siregar University of Amsterdam

  This study examines how the position of influencers in Indonesian public sphere has been solidified due to the endorsement of the state. Reflecting on the utilization of social media influencers in the handling of Covid-19 since its outbreak in Indonesia, I argue that the state has reinforced the questionable position of social media influencers. By endorsing influencers to disseminate important public service announcements during the pandemic, the state has proactively eroded the authority and role of scientific institutions such as the Eijkman Institute and other relevant organisations with a public health expertise. This paper also discusses how as a result of this shifting public reason, individual experts such as epidemiologists had to acquire new science communication skills in order to regain the scientific authority they have conceded to the state-endorsed influencers.

Abstract