Antibiotic-resistant infections already cause at least 700,000 deaths globally every year.
Although the phenomenon is most concerning for serious infections people are admitted to hospital with, antibiotic resistance means common bacterial infections could one day be impossible to treat.
But antibiotic resistance in remote Aboriginal and Torres Strait Islander communities has garnered minimal attention. Remote Indigenous communities are not mentioned in the current National Antimicrobial Resistance (AMR) Strategy, for example.
It’s in these parts of Australia, however, that antibiotic resistance is arguably having the most significant impact.
A key example
Antibiotics are medications used to treat bacterial infections. But when bacteria are repeatedly exposed to antibiotics, they can adapt and survive against the antibiotics previously known to kill them.
Using antibiotics unwisely, for example for a viral infection, taking a low dose when a high dose is needed, or stopping a course of antibiotics before an infection has resolved, all contribute to antibiotic resistance.
In northern Australia, the bacteria Staphylococcus aureus, (or S. aureus for short, also known as golden staph) causes skin and soft tissue infections. When S. aureus becomes resistant to the antibiotics commonly used to treat these infections, we call it methicillin resistant S. aureus, or MRSA.
The rates of MRSA in northern Australia are significantly higher than elsewhere in the country. Recent government figures show among people with S. aureus infections, the rate of MRSA in remote and very remote areas was double that of major cities (roughly 40% versus 20%).
Australia doesn’t have a national surveillance system for monitoring rates of MRSA. So the figures can vary depending on the location, time period and the population studied.
What happens when the antibiotics don’t work?
Up to three-quarters of all people in remote Indigenous communities who attend a medical clinic each year present at some stage for treatment of a skin and soft tissue infection such as skin sores, boils or cellulitis.
The prevalence of MRSA in northern Australia means these people can no longer rely on simple, first line antibiotics for treatment.
Treatment failure because of antibiotic resistance means skin and soft tissue infections take longer to get better, and are more likely to spread to other people.
In more serious cases, the infection can invade past the skin and cause a bone, blood or lung infection. If this happens, the patient will likely need to be flown to a hospital thousands of kilometres away.
This issue is compounded when certain antibiotics are unavailable due to shortages.
Why is antibiotic resistance so much higher in remote Indigenous communities?
The heavy burden of infections such as skin infections (as many as one in two remote living Aboriginal children suffer from a skin infection at any one time), ear infections, pneumonia, and sexually transmitted infections, mean antibiotics need to be prescribed frequently and broadly. This allows antibiotic resistance to spread.
In addition to high levels of infection, underlying social determinants of health like household crowding and poor access to facilities such as working washing machines and showers facilitate the ongoing transmission of bacteria.
Antibiotic resistance and closing the gap
Health-care workers in remote clinics come from all across Australia and New Zealand, sometimes only for short stints. So it’s important they are educated about local antibiotic resistance rates and local treatment guidelines.
Similarly, doctors in remote clinics need to be able to access real-time local antibiotic resistance rates. Pleasingly, an online atlas for health practitioners of antibiotic resistance rates across northern Australia, called “HOTspots”, is currently being set up.
Addressing antibiotic resistance in remote Indigenous communities must be part of the ongoing effort to close the gap in health outcomes between Indigenous and non-Indigenous Australians.
Inclusion of remote Indigenous populations as a priority in the National AMR Strategy is essential. These groups are not mentioned in the current strategy (2015-2019) but we are hopeful they will be included in the new strategy, to be released soon.
Implementing the the National AMR Strategy for remote living Indigenous Australians must be a high priority to ensure antibiotics are available to treat infections among this already vulnerable section of our population.
Dr Lorraine Anderson, medical director at Kimberley Aboriginal Medical Services in Broome, Western Australia, contributed to this article.
Asha Bowen, Head, Skin Health, Telethon Kids Institute and Steven Tong, Associate Professor, The Peter Doherty Institute for Infection and Immunity
The antibiotic resistance threat is real. In the years to come, we will no longer be able to treat and cure many infections we once could.
We’ve had no new classes of antibiotics in decades, and the development pipeline is largely dry. Each time we use antibiotics, the bacteria in our bodies become more resistant to the few antibiotics we still have.
The problem seems clear and the solution obvious: to prescribe our precious antibiotics only when absolutely needed. Implementing this nationally is not an easy task. But Australia could take cues from other countries making significant progress in this area, such as Sweden.
The Swedish example
Antibiotic use was rising steadily in Sweden during the 1980s and 1990s, causing an increase in antibiotic resistant bacteria. A group of doctors mobilised to tackle this threat, and brought together peak bodies across pharmaceuticals, infectious diseases and other relevant areas to form a national coalition.
The Swedish Strategic Programme Against Antibiotic Resistance (Strama) was founded in 1995.
Since then, Strama has been working on a national and regional level to reduce antibiotic use. Between 1992 and 2016, the number of antibiotics prescriptions decreased by 43% overall. Among children under four, antibiotics prescriptions fell by 73%.
Levels of antibiotic use and resistance in Sweden are now among the lowest of all OECD countries, both in humans and animals.
What has Australia done so far – and what more can we do?
In 2017, Australia’s chief medical officer sent a letter to all high-prescribing general practitioners. Over the following six months, this resulted in around a 10% reduction in antibiotic prescriptions among those GPs.
While an excellent start, this is just one of several interventions needed to avert the looming antibiotic crisis.
Audit and feedback
The idea of audit and feedback sees GPs provided with a summary of their antibiotic prescribing rates over a specified period of time.
In Australia, antibiotic prescribing data are currently collected by the Pharmaceutical Benefits Scheme (PBS) and periodically used by the National Prescribing Service (NPS MedicineWise) to provide feedback to some GPs.
In Sweden, regular meetings between local Strama members and primary health care clinics serve to reinforce treatment guidelines. Strama representatives review individual doctors’ antibiotic prescribing as well as trends across the area, and discuss targets for optimal prescribing.
This results in some decrease in antibiotic use; a small but desirable effect if combined with other interventions.
Restrict access to specific antibiotics
The Australian Commission on Safety and Quality in Health Care keeps a list of antibiotics that should only be used as a last line of defence. An example is meropenem, which is commonly used to treat infections with multidrug-resistant organisms such as septicaemia.
Current restrictions stipulate these antibiotics can only be used in hospitals under the supervision of a hospital antimicrobial stewardship team. This team usually consists of an infectious disease specialist, a microbiologist and a pharmacist. The team reviews the request and either approves it or recommends using another antibiotic.
Strama takes a similar approach.
But the way this is enforced differs between Australian hospitals. We may need to strengthen these restrictions if resistance continues to increase.
Stop default repeat prescriptions
Prescriptions which include a “repeat” could leave patients believing another course of antibiotics is needed, when this is not always the case. They may hold on to the prescription with a “just in case” attitude to take when they feel it’s necessary, or even give the prescription to someone else.
In Sweden, there are no default repeat prescriptions for antibiotics and this is reinforced by appropriate package size.
Pleasingly, Australia’s Pharmaceutical Benefits Advisory Committee has recently recommended the removal of default repeat options for a range of common antibiotics in high usage, where no repeats are deemed clinically necessary.
Delayed prescribing is when a GP provides a prescription during the consultation, but advises the patient to see if the symptoms will resolve first before using it (a “wait-and-see” approach).
GPs use delayed prescribing in situations of uncertainty as a safety measure, or when patients appear anxious and require additional assurance antibiotics are accessible in case the infection gets worse.
A systematic review found delayed prescribing resulted in 31% of people taking the course of antibiotics compared to 93% who were prescribed them normally.
In Sweden, national treatment guidelines for common infections in primary health care support GPs delaying antibiotic prescribing.
To change public attitudes around antibiotic use and preservation, it’s important to communicate the negative effects of the unnecessary use of antibiotics and the risk of antibiotic resistance for the individual as well as the community.
Continuous awareness campaigns are essential (for example, via the media) to keep the public tuned in to the issue. The French campaign “antibiotics are not automatic” is a good example.
Further, enabling patients to be involved in the decision of whether to use antibiotics or not encourages discussion between the doctor and the patient around the benefits and harms of potential treatments. Using shared decision making in consultations has proven effective in reducing antibiotic prescribing by about one-fifth.
Each of these strategies contributes a small amount to improving antibiotic usage. Like the Swedish Strama program, the combination will need to be sustained and reinforced over many years to reach levels of antibiotic use comparable to the lowest prescribing OECD countries, like Sweden.
Mina Bakhit, Postdoctoral Research Fellow, Bond University; Chris Del Mar, Professor of Public Health, Bond University, and Helena Kornfält Isberg, MD, General practitioner, PhD-student, Lund University
Imagine a world where your odds of surviving minor surgery were one to three. A world in which a visit to the dentist could spell disaster. This is the world into which your great-grandmother was born. And if humanity loses the fight against antibiotic resistance, this is a world your grandchildren may well end up revisiting.
Antibiotics changed the world in more ways than one. They made surgery routine and childbirth safer. Intensive farming was born. For decades, antibiotics have effectively killed or stopped the growth of disease-causing bacteria. Yet it was always clear that this would be a rough fight. Bacteria breed fast, and that means that they adapt rapidly. The emergence of antibiotic resistance was predicted by none other than Sir Alexander Fleming, the discoverer of penicillin, less than a year after the first batch of penicillin was mass produced.
Yet, contrary to popular belief, antibiotic resistance did not evolve recently, or in response to our use and misuse of antibiotics in humans and animals. Antibiotic resistance first evolved millions of years ago, and in the most mundane of places.
I am a bioinformatician, and my lab studies the evolution of bacterial genomes. With antibiotic resistance becoming a major threat, I’m trying to figure out how resistance to antibiotics emerges and spreads among bacterial populations.
A billion-years-old arms race
Most antibiotics are naturally produced by bacteria living in soil. They produce these deadly chemical compounds to fend off competing species. Yet, in the long game that is evolution, competing species are unlikely to sit idly by. Any mutant capable of tolerating a minimal quantity of the antibiotic will have a survival advantage and will be selected for – over generations this will produce organisms that are highly resistant.
So it’s a foregone conclusion that antibiotic resistance, for any antibiotic researchers might ever discover, is likely already out there. Yet people keep talking about the evolution of antibiotic resistance as a recent phenomenon. Why?
Resistance can and does evolve when bacteria are persistently exposed to a new antibiotic they have never encountered. Let’s call this the old-fashioned evolutionary road. Second, when bacteria are exposed to a novel antibiotic and are in contact with bacteria already resistant to this antibiotic, it is just a matter of time before they get cozy and trade genes. And, importantly, once genes have been packaged for trading, they become easier and easier to share. Bacteria then meet other bacteria, which meet more bacteria, until one of them eventually meets you.
The rise and fall of sulfa drugs
For all their might, antibiotics are not the only substances capable of effectively killing bacteria (without killing us). A decade before the mass production of penicillin, sulfonamide drugs became the first commercial antibacterial agent. Sulfa drugs act by blocking an enzyme – called DHPS – that is essential for bacteria to grow and multiply.
Sulfa drugs are not antibiotics. No known organism produces them. They are chemotherapeutic agents synthesized by humans. No natural producer means no billion-year-old arms race and no pool of ancient resistance genes. We would expect bacteria to evolve resistance to sulfa drugs via the good old-fashioned way. And they did.
Just a few years after their commercial introduction, the first cases of resistance to sulfa drugs were reported. Mutations to the bacterial DHPS enzyme made sulfa drugs ineffective. Then penicillin and the antibiotic era came about. Sulfa drugs were relegated to a secondary role in medicine, but they gained popularity as cheap antimicrobials in animal husbandry. By the 1980s resistance to sulfa drugs was rampant and worldwide. What had happened?
At odds with resistance
To answer this question our research team took sequences of sulfa drug resistance genes from disease-causing bacteria and compared them to millions of “normal” versions of the DHPS enzyme in nonpathogenic bacteria.
The team identified two large groups of bacteria that had DHPS enzymes resistant to sulfa drugs. By studying their DNA sequences, we were able to show that these resistant DHPS enzymes had been present in these two groups of bacteria for at least 500 million years. Yet sulfa drugs were first synthesized in the 1910s. How could resistance be around 500 million years ago? And how did these resistance genes find their way into the disease-causing bacteria plaguing hospitals worldwide?
The clues left in gene sequences are too fuzzy to conclusively answer the latter, but we can certainly speculate. The bacteria we identified as harboring these ancient sulfa drug resistance genes are all soil and freshwater bacteria that thrive under the well-irrigated subsoil of farms. And farmers have been adding huge amounts of sulfa drugs to animal feed for the past 50 years.
The sublethal concentrations of sulfa drugs in the soil are the perfect setting for resistance genes to be transferred from these ancient resistant bacterial populations to other bacteria. All it takes is for one lucky bacterium to meet one of these ancient resistant ones in the subsoil. They trade some genes, one bacterium to the next, and resistance spreads until a newly minted resistant bacterium eventually makes it to the groundwater supply you drink from. You do the math.
Nothing new under the sun
As for why sulfa drug resistance genes would be around 500 million years ago, there are two plausible explanations. On the one hand, it could be that 500 million years ago there was a bacterium that synthesized sulfa drugs, which would explain the evolution of resistance. However, the lack of remnants from such a biosynthetic pathway makes this unlikely.
On the other hand, resistant bacteria may have been around just by chance. The argument here is that there are so many bacteria, and such diversity, that chances are that some of them are going to be resistant to anything scientists come up with. This is a sobering thought.
Then again, this is already the baseline for antibiotics. Like climate change, antibiotic resistance is one of those problems that always seem to be a couple decades away. And it may well be. A turning point for me in the climate change debate was a decade-old opinion piece in New Scientist. It stated that we should make every possible effort to prevent climate change, especially in the unlikely case that it was not caused by man, because that would mean that all we can do is palliate a natural phenomenon.
Our research points in the same direction. If resistance is already out there, drug development can offer only temporary relief. The challenge then is not to quell resistance, but to avoid its spread. It is a big challenge, but not an insurmountable one. Not feeding wonder drugs to pigs would do nicely, for starters.
The link below is to an article reporting on the latest developments in the plan to arm Syria’s rebels.
Government punishes pastor for refusing to wear campaign T-shirt, amid other election abuses.
DUBLIN, November 18 (CDN) — Officials in Mergui Region, Burma, ordered a Baptist church to cease holding worship services after the pastor refused to wear an election campaign T-shirt supporting the military government’s Union Solidarity and Development Party (USDP).
The election commission summoned 47-year-old Pastor Mang Tling of Dawdin village, Gangaw township, Mergui Region on Nov. 9, two days after the election and ordered him to stop holding services and discontinue the church nursery program, the Chin Human Rights Organization (CHRO) reported yesterday.
The CHRO works against human rights abuses, including religious discrimination, for the Chin people, a minority group in Burma’s northwest estimated to be 90 percent Christian.
Village headman U Than Chaung had given the pastor a campaign T-shirt to wear in support of the USDP, and when he refused to wear it, the headman filed a report with local authorities accusing him of persuading Christian voters to vote in favor of an opposing party.
Under Burmese law, religious leaders can be penalized for “engaging in politics,” giving the pastor a solid legal reason to decline the T-shirt. The law also bans leaders of religious groups from voting in national elections, according to the CHRO, although lay members of those groups are able to vote.
“The election law is quite vague,” a CHRO spokesman told Compass today. “One of the things we were watching out for during the election was to see if church elders or council members might be excluded from voting. But these people were able to vote. The law seems to apply only to pastors, monks and imams.”
Officials interrogated Mang Tling in Gangaw until Sunday (Nov. 14), when he was allowed to return home.
Meantime, the USDP won the election amid widespread evidence of “advance” voting and other forms of voter manipulation throughout Burma.
Previously known as the Union Solidarity and Development Association, and before that the State Peace and Development Council, the USDP was formed by a ruling junta composed largely of army generals. The junta has ruled Burma without a constitution or parliament since 1998, although in 2008 they pushed through support for a new constitution that will take effect following this month’s elections, according to the 2010 International Religious Freedom report released yesterday by the U.S. Department of State’s Bureau of Democracy, Human Rights and Labor.
The new constitution forbids “abuse of religion for political purposes,” the report stated. Election laws published in March also banned members of religious orders from voting for or joining political parties and reserved 25 percent of seats in the new parliament for members of the military.
The 2008 constitution “technically guarantees a degree of religious freedom. But then, it’s Burma,” a CHRO spokesman told Compass.
The Chin National Party defeated the USDP in three electorates in Chin state despite reports of widespread voting anomalies, some of which were outlined in a CHRO press release on Nov. 7.
In Tedim township northern Chin state, for example, USDP agent Go Lun Mang went to the home of a local resident at 5 p.m. the day before the election and told the family that he had already voted on their behalf in favor of the USDP. He added that soldiers in a nearby camp were ready to arrest them if they complained.
On Nov. 5, the local government had already ordered village officials to instruct residents to vote for the USDP. On Nov. 7, the day of the election, USDP agents in campaign uniforms stood at the gate of the polling station in Tedim and asked voters if they intended to vote for the USDP. Those who said yes were allowed into the station, while those who said no were refused entrance.
USDP agents also warned Chin voters in Thantlang town that they should vote for the USDP “while the door was open” or they would regret it, Burma News International reported on Nov. 5.
David Mathieson, a senior researcher for Human Rights Watch (HRW), said the intimidation indicated that the junta and the USDP knew how unpopular they were.
Reports by the CHRO show a long history of discrimination against the majority Christian Chin, including the destruction of crosses and other Christian monuments, state-sponsored efforts to expand Buddhism, forced contributions of finance and labor to Buddhist construction projects, arrest and detention, torture and particularly harsh treatment of pastors. In addition, officials have refused construction for all new church building projects since 2003.
A report issued by HRW in January confirmed serious and ongoing abuses against Chin Christians.
One Chin pastor interviewed by HRW described how soldiers held him at gunpoint, forced him to pray in a Buddhist pagoda and told him that Burma was a Buddhist country where Christianity should not be practiced. (See “Report Documents Abuse of Chin Christians,” Feb. 20.)
Suu Kyi’s Release Stirs Guarded Hope among Burma’s Christians
NEW DELHI, November 18 (Compass Direct News) – The release of democracy leader Aung San Suu Kyi from house arrest in Burma on Saturday (Nov. 13) has sparked cautious optimism about human rights among Christians and the country’s ethnic minorities even as the junta does battle with armed resistance groups.
Freeing her six days after elections, the military regime of Burma (also known as Myanmar) kept 1991 Nobel Peace Prize Laureate Suu Kyi from running in the country’s first election in 20 years, but ethnic minorities are still “very happy” and “enthused with hope and anticipation,” said Plato Van Rung Mang, who heads the India chapter of Chin Human Rights Organization.
Suu Kyi is the only leader from the majority Burmese community – predominantly Buddhist – who is trusted by the ethnic minorities, said Mang, an India-based Christian originally from Burma’s Chin state, which borders India.
“We have faith in Suu Kyi’s honesty and leadership, and she has been our hope,” he added.
The ethnic Chin, Kachin, Karen and Karenni people – many of whom are Christian – as well as mostly Buddhist ethnic Shan, Mon and Arakanese (some of them Muslim) people have been fighting for self-determination in their respective states and opposing the military junta’s policy of centralized control and Burmese dominion.
“We trust that Suu Kyi can fulfill her father’s ideal and political principles which have been subverted by the Burmese military junta’s Burmanization policy,” said Mang. Suu Kyi’s father, Aung San, was the nation’s leader at the time of independence and favored autonomy for ethnic minorities.
“Just as her father was trusted and held in high esteem by the ethnic people, Aung San Suu Kyi also has the ability to work together with the minorities to build a better, peaceful Burma where the human rights of all citizens are respected and protected,” said Garrett Kostin, a U.S. citizen who runs the Best Friend Library, built by a Buddhist monk in support of Suu Kyi, in Chiang Mai in northern Thailand.
While sections of the ethnic communities have been involved in armed resistance against the junta’s rule, many local residents in the region remain unarmed but are also at risk of being killed in the post-election conflict.
In the wake of the Nov. 7 election, as expected (See “Burma’s Ethnic Christians Fear Bleak Future after Election, Oct. 22), clashes between armed ethnic groups and the Burmese army erupted in three of the seven ethnic states – Karen, Shan and Mon – mainly along Thailand and China border, reported Thailand-based Burma News International. The violence has resulted in an influx of over 20,000 people into Thailand – the largest flow in the last five years.
According to US-based Refugees International, the Thai government forced many of the asylum seekers back.
There are also tensions in Kachin and Karenni states, which could erupt at any time, between the Burmese army and the Democratic Karen Buddhist Army, the Karen National Union, the Kachin Independence Army, the Shan State Army-North, and the Karenni National Progressive Party.
Rights advocates, however, were still heartened by Suu Kyi’s release.
It’s “a wonderful opportunity for the ethnic minorities of Burma to unify in support of each other’s rights and desires,” said Kostin.
In September 2007, many Buddhist monks joined democracy activists in street protests against the military regime’s decision to cut fuel subsidies, leading to a sharp rise in gas and diesel prices. Known as the Saffron Revolution, the protests resulted in hundreds of deaths as government security personnel resisted it militarily.
In numerous clashes between the repressive military regime and political opponents and ethnic minorities, over 3.5 million Burmese have been displaced and thousands killed over the years.
Suu Kyi will continue to enjoy the trust of ethnic minorities because “she has been working so hard since the beginning [of her political career] to speak out about the plight of ethnic people with an honest and sincere commitment,” said Bangkok-based Soe Aung, deputy secretary for Foreign Affairs of the Forum for Democracy in Burma.
Chiang Mai-based Christian relief group Free Burma Rangers (FBR) recalled that Suu Kyi, the general secretary of the National League for Democracy, along with allies won more than 80 percent of the seats in parliament “in Burma’s only truly democratic election” in 1990. “The military regime, however, did not recognize the results and continued to hold power,” it said in a statement.
Last week’s election was “neither free nor fair,” FBR said, adding that “thousands of political prisoners [estimated at 2,200] are still in jail, ethnic minorities are attacked [on a regular basis], and the people of Burma remain under oppression.
“Still, we are grateful for the release of Aung San Suu Kyi as she is a leader who gives real hope to the people of Burma.”
An FBR team leader who spoke on condition of anonymity recalled Suu Kyi requesting his prayers when he met with her during a brief period when she was not under house arrest in 1996.
“The Global Day of Prayer for Burma and the ethnic unity efforts we are involved in are a direct result of that meeting,” the leader said. “As she told me then, one of her favorite quotes is, ‘You will know the truth, and the truth will set you free.’”
Some Christians, however, remained cautious.
“Although San Suu Kyi wants Burma to be a true federal country, there is no certainty in the hearts of the Karen people because they have suffered for very long, and the so-called Burmese have turned their backs on them several times,” said a Karen Christian from Chiang Mai who identified himself only as Pastor Joseph.
La Rip, a Burmese activist in China, also said that while Suu Kyi deserved to enjoy freedom, she and her party “do not seem to have a clear idea on how to solve the long-standing issues” related to ethnic minorities.
For her part, Suu Kyi spelled out a plan to hold a nationwide, multi-ethnic conference soon after she was freed. Her father held a similar meeting, known as the Panglong Conference, in 1947. Aung San, then representing the Burmese government, reached an agreement with leaders from the Shan, Kachin and Chin states to accept full autonomy in internal administration for the ethnic controlled frontier areas after independence from Britain.
Suu Kyi’s planned conference is seen as the second Panglong Conference, but it remains uncertain if the new Burmese regime, which is likely to be as opposed to ethnic minorities as the junta, will allow her plan to succeed.
In the awaited election results, the junta’s proxy party, the Union Solidarity and Development Party (USDP), is likely to have majority in parliament to form the next government. Suu Kyi’s party had been disbanded by the military regime, and only a small splinter group ran in the election.
It is also feared that Suu Kyi, who was under house arrest for nearly 15 years since 1990 until her release last weekend, could face assassination attempts or fresh charges followed by another term under arrest.
Burma has a population of around 50 million, out of which around 2.1 million are estimated to be Christian.
Report from Compass Direct News
Authorities in Bekasi, West Java run into determined lawyer, congregation.
BEKASI, Indonesia, March 11 (CDN) — Efforts by local officials in this city in West Java to close a church met with stiff resistance this month, as a defiant lawyer and weeping women refused to allow it.
Women of the Huria Christian Protestant Batak Church (HKBP) cried in protest as officials from the Bekasi Building Department on March 1 placed a brown signboard of closure on the church building in Pondok Timur, Bekasi, 12 miles (19 kilometers) from Jakarta.
The seal stayed in place for about two minutes before some of the shrieking women tore it down. The sign was trampled as furious church members stampeded over it, shouting and screaming. Bekasi city officials turned and ran as the congregation fanned out.
The defiance followed a heated debate within the same church building minutes before, as the Christians had invited the Bekasi officials inside to discuss the matter when they arrived to seal the building. The discussion soon became heated as a city official asserted that the church did not have a building permit.
The church had applied for a worship building permit in 2006, but local officials had yet to act on it, according to the church’s pastor, the Rev. Luspida Simanjuntak.
At the meeting inside the church building, attorney Refer Harianya said that the sealing process was illegal, as it requires that public notice be given.
“HKBP has never seen nor received the formal order and has not acknowledged such an order by signing a receipt,” Harianya said. “In addition, public notice must be given in the form of formal reading of the order.”
Harianya added that the legal basis for sealing the church was weak. The Joint Ministerial Decree revised in 2006 clearly states in Paragraph 21 that when there is a problem with the building of a house of worship, it must be solved through formal consultation with local residents, he said.
“At this stage, resolution has not taken place,” he said.
Harianya said that in case such a consultation failed to resolve conflicts, then the mayor may consult with the Department of Religion – “in a just and non-prejudicial manner” – taking into account suggestions from the Interfaith Harmony Forum.
“On this point, up to March 1, the church has never been invited to talk with the mayor,” he said.
The Joint Ministerial Decree had not been correctly applied in the sealing of the church, Harianya concluded, adding that contested cases could always be taken to court.
“We still have some legal avenues open,” he said. “This is not the time for a surprise sealing.”
Harianya also cited Mayor Decree No. 16 (2006) regarding the construction of a house of worship in Bekasi City, where Article 11 states that before a building is sealed there must be three written notices given. This process also had not been carried out, he said.
“Because you have not followed the procedures which I have outlined, we will act as if the sealing never took place,” Harianya told city officials as members of the congregation cheered.
The sealing of the church would thus be illegal, so the government had broken the law, he said. Harianya said that HKBP members would not hinder officials from carrying out their duties, but that they would be named in a lawsuit.
One of the officials, identified only as Pemana, responded, “Go ahead and sue.”
“If the seal is in place,” Harianya said, “We can break it because the act of sealing is illegal. Agreed?”
“Agreed,” answered the 75 parishioners present.
With the meeting ending in a deadlock, city officials prepared to place the signboard to seal the church, with the ensuing tumult.
Mayor Fails to Show
Prior to the showdown, at 10 a.m. Pastor Simanjuntak, the Rev. Pieterson Purba and Harianya had a scheduled a meeting with Bekasi Mayor Mochtar Mohamad – promised by an official named H. Junaedi during a demonstration on Feb. 28 – only to discover that the visit had not been placed on the mayor’s schedule.
As they waited, Pastor Simanjuntak received a mobile phone call saying that city building officials were at the church site and had been there since 9 a.m.
The following day, March 2, the HKBP leaders and leaders from three other churches were able to meet the mayor, who promised to help them find new places of worship. While they waited for the new sites, the mayor suggested, the HKBP church could use a multipurpose room belonging to the Social Department starting March 7.
Subsequently, Pastor Simanjuntak and members of the congregation rejected the proposal, reasoning that moving somewhere else was equivalent to being ejected from their building.
Worship resumed as usual at 7 a.m. on Sunday, March 7, under the strict watch of police and soldiers who had stood guard all night. The service finished two hours later without incident.
“Because this was a congregational decision, from next Sunday onwards we will be holding services in the house of worship here at No. 14 Puyuh Raya Street,” said Pastor Simanjuntak.
Report from Compass Direct News
Fellowship in Tizi Ouzou received no police protection despite repeated violence.
ISTANBUL, January 21 (CDN) — Members of a church in Algeria’s Kabylie region gathered to worship last Saturday (Jan. 16) in their new building despite a protest, vandalism and a fire that damaged the building the previous weekend.
Local Muslims bent on running the congregation out of the neighborhood set fires inside and outside the building on Jan. 9.
Before setting it on fire, the assailants ransacked the Tafat Church building in Tizi Ouzou, a city 100 kilometers (62 miles) east of Algiers. The perpetrators damaged everything within the new building, including electrical appliances.
“This last Saturday the church held a service even though not everyone was present,” said Mustapha Krim, president of the Protestant Church of Algeria (EPA). “But they continue.”
The protests against the new church building were unique in the Kabylie region, where the majority of Algeria’s Christians live.
“We are outraged,” Krim told Algerian daily El Watan. “We believe that the degree of intolerance reached its climax. In Kabylie, this sort of practice is unusual.”
The pastor of the church, Mustapha Krireche, said that the fellowship of 300 members had constructed the church building in the neighborhood in order to accommodate their growing needs. They started meeting there in early November of last year.
A short time after the first services, they received a notice from police to stop activities, as local residents had objected to their presence in their neighborhood. The pastor said he refused to sign the notice that police handed to him. Some young people threw rocks at the new building, he said.
Troubles for Tafat ramped up on Dec. 26, when its members gathered for their Saturday morning service. More than 20 local Muslims blocked the entrance to the building, keeping church members from entering. Two days later, some of the protestors broke into the new building and stole the church microphones and speakers.
The following Saturday (Jan. 2), a group of protestors entered the building and stopped the service. That day church leaders had instructed children and women to stay home for their safety, according to Krireche. After protestors became violent and threatened the pastor, church members present decided to close the building so as to avoid more problems.
In the most recent incident, on Jan. 9 protestors entered the building and started to vandalize it, leaving after police arrived. But they returned in the evening to burn anything that they could, including furniture, appliances, Bibles, hymnbooks and a cross. Nothing inside the building was left standing.
Reuters reported that the attack in Tizi Ouzou came days after a spate of attacks on Christians in Malaysia and Egypt, “though there was no evidence of a direct link.”
“The devastation of our church in Tizi Ouzou, which coincides with events in Egypt where they burned churches, leads us to ask questions about the international Islamists,” Krim told El Watan last week. “Is this an example continuing here in Tizi Ouzou? The Islam of our parents is nothing compared to today’s political Islam. To the indifference of the authorities, it manipulates people against Christians.”
Christian leaders have said authorities have not taken appropriate steps to protect the church or bring justice to their claims. The church has filed half a dozen complaints with police on attacks against them in the last two months. Krim told The Associated Press last week that authorities don’t want to intervene out of fear of Islamist retaliation.
The EPA president told Compass that church leaders met with local authorities this week to file a complaint against a Muslim and his hard-line group said to be responsible for the attacks against Tafat.
As of this week, local officials had not responded to Tafat’s request for protection.
In February 2008 the government applied measures to better control non-Muslim groups through Ordinance 06-03. Authorities ordered the closure of 26 churches in the Kabylie region, both buildings and house churches, maintaining that they were not registered under the ordinance.
Despite efforts to comply with the ordinance, many Christian groups indicated they were blocked by lack of information, bureaucratic processes or resistance to their applications, according to the 2009 International Religious Freedom Report by the U.S. Department of State. None of the churches have closed since then, but their status continues to remain questionable and only valid through registration with the EPA.
According to a government decree dating back to June 2007, local officials can prohibit non-Muslim activities if they constitute a danger to the public order or if religious adherents move from their originally planned location, El Watan reported.
Some Protestants have estimated the number of Algeria’s Christians at as many as 65,000, though the U.S. State Department cites unofficial estimates of Christians and Jews combined as ranging from 12,000 to 40,000.
Report from Compass Direct News
Attacks on Christians seen as politically expedient in majority-Buddhist nation.
CHIANG MAI, Thailand, January 21 (CDN) — As Burma’s military junta gears up for its first parliamentary election in two decades this year, observers fear attacks on the Christian minority could intensify.
Mungpi Suangtak, assistant editor of a New Delhi-based news agency run by exiled Burmese journalists, the Mizzima News, said the Burmese junta has “one of the world’s worst human rights records” and will “definitely” attack religious and ethnic minorities more forcefully in the run-up to the election.
The military regime, officially known as the State Peace and Development Council (SPDC), pledged to hold the election this year, and analysts believe polls will be held after July in the country, also known as Myanmar.
Suangtak told Compass that the Buddhist nationalist junta would target Christians particularly in Karen state, bordering Thailand, and in Chin State, bordering India and Bangladesh.
Many Christians are part of the Karen National Union and the Chin National Front, armed resistance groups that have been demanding freedom or autonomy for their respective states for decades, and therefore the junta sees the Christian minority as a threat, said Suangtak.
There are over 100,000 Christian Chin refugees in India who have fled the junta’s attacks in the past two decades, according to Human Rights Watch.
Christians in Karen state are not safe. A Karen Christian worker living in the Mae La refugee camp on the Thailand-Burma border told Compass that ethnic Christians were facing human rights abuses by the junta “on a daily basis.” Most recently, Burma army soldiers attacked a church, murdered a local farmer and injured others in Nawng Mi village on Dec. 19, 2009, reported Burma Campaign UK.
Parts of Karen state fall under the “Black Zone” – identified by the Burma army as an area under the control of armed resistance groups where its soldiers are free to open fire on anyone on sight – and the junta has been launching indiscriminate attacks to take control of village after village, said the Karen Christian.
“Those who are not able to flee across the border during such attacks are either killed or forcibly relocated in and confined to temporary camps set up by the junta,” the Christian said. “Since the army litters surrounding areas with landmines, many local people die or get injured while trying to run away from or coming to the camps to look for their relatives.”
Over 150,000 refugees from Karen and neighboring Karenni states of Burma are living along the Thai side of the border, according to the United Nations High Commissioner for Refugees. More than half of them are Christian.
A representative of the Free Burma Rangers (FBR), which trains and sends teams of local people to help victims of the junta’s attacks inside Burma, said youths have been forced to become Buddhists in Chin state, where over 80 percent of the people are Christian.
Printing of Bibles is restricted, and churches are destroyed on a regular basis in the state, the source told Compass on condition of anonymity.
Access for foreign visitors to Chin state is, with some exceptions, prohibited, and the state is widely acknowledged to be the poorest part of the country, said Rogers.
“According to one Chin, the reason Chin state is denied resources, and foreigners are denied access, is specifically because the overwhelming majority of Chins are Christian,” stated a 2009 report by London-based advocacy group Christian Solidarity Worldwide (CSW). “The SPDC has, it is believed, taken a deliberate decision to discriminate against Chin Christians.”
The report cited a Chin Christian man who had served in the Burma army who faced discrimination.
“I had a colleague who was a Chin who became a Buddhist and he was promoted,” the Christian says in the report. “I was told to change my religion if I wanted to get promotion. I refused to convert.”
The report also quoted a Chin Christian as saying that students from a Christian youth fellowship at a university in Kalaymyo, in Chin state’s Sagaing Division, collected funds among their own community to construct a small church.
“However, in 2008 and again in 2009, ‘extremist Buddhists’ destroyed the church building, and when the students reported the incident to the local authorities, the youth fellowship leaders were arrested, detained and then released with a warning,” he said.
Suangtak said successive governments in Burma have promoted Buddhism since General Ne Win took power in 1962, leaving Christians insecure.
“There is a general feeling in Burma that the state represents Buddhism, and most Christians, particularly from conservative sections, cannot trust the regime,” said Suangtak.
Benedict Rogers of CSW said the junta doesn’t differentiate between individual Christians involved in armed struggle and ordinary Christians who have not taken up arms.
“And when it attacks villages in conflict zones, churches and pastors are often among the first to be attacked,” Rogers said.
A Christian worker from Burma’s Mandalay city, however, told Compass that thus far he has heard no reports of any major anti-Christian incidents there. He said he was hoping the junta would try to woo people with peace rather than violence.
“But nothing can be said about the unpredictable junta,” he said, adding that it was difficult to receive or send information in Burma. “Even in cities, the information infrastructure is limited and expensive, phones are tapped and e-mails are monitored. And the press is owned by the state.”
Rogers, deputy chairman of the human rights commission for the U.K.’s Conservative Party, said the Buddhist nationalist regime “distorts and perverts Buddhism for political purposes and is intolerant of non-Burman and non-Buddhist ethnic and religious minorities, including Christians and Muslims.”
Of the 56 million people in Burma, around 89 percent are Buddhist, with only 4 percent Christian.
Given that the junta merely uses religion for political power, it doesn’t target Christians alone, Suangtak said.
“The junta has no respect for any religion, be it Christians or Buddhists, and anyone who opposes its rule is dealt with harshly.”
Burma was ruled by military regimes from 1962 to 1990; at that point the National League for Democracy party, led by Nobel Laureate Daw Aung San Suu Kyi, won the parliamentary election. But the regime seized power again by imprisoning members of parliament after the election.
Rogers, who has co-authored a soon-to-be-published biography of SPDC chairman Senior General Than Shwe, said that while the armed groups are not perfect, they are essentially fighting to defend their people against a “brutal regime” and are “not in any way terrorists.”
“The armed groups have sometimes launched pre-emptive attacks on the military, but they have never attacked non-military targets and have never engaged in indiscriminate acts of violence,” he said. “Even the pre-emptive acts are conducted for defensive, rather than offensive, purposes.”
Rogers added that resistance groups were fighting to defend their people.
“Individual Christians who have joined the armed ethnic groups do so out of a perfectly biblical concept of just war, the right to defend your people from gross injustice.”
Added an FBR source, “In Burma, no one protects except the pro-democracy resistance groups, and all relief inside the country is only possible because of them.”
The 2009 annual report of the United States Commission on International Religious Freedom states that Burma’s military junta had “one of the world’s worst human rights records.”
“Burma’s Christian populations face forced promotion of Buddhism and other hardships in ethnic minority areas where low-intensity conflict has been waged for decades,” the report states. “In addition, a new law passed in early 2009 essentially bans independent ‘house church’ religious venues, many of which operate because permission to build church buildings is regularly denied.”
The report also pointed out that in January 2009, authorities in Rangoon ordered at least 100 churches to stop holding services and forced them to sign pledges to that effect. Burma, which the ruling junta describes as “The Golden Land” on its official website, has been designated as a Country of Particular Concern by the U.S. Department of State since 1999.
Even after the 2010 election, little is expected to change.
The FBR source said the election was not likely to be free and fair, pointing out that the new constitution the junta adopted after an apparently rigged referendum in 2008 virtually enshrined military power.
“However, having an election is better than not having one at all,” the source said.
Report from Compass Direct News