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Brunei

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Revision as of 12:42, 11 November 2018 by Lani314 (talk | contribs)
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OVERVIEW

Flag of Brunei.svg.png

In Brunei, you will find a complex picture regarding health care access. On the one hand, Brunei provides fully subsidized and modern health care services to its citizens, and foreign workers can receive health care for a small fee. Despite the small size of the country, there are a wealth of public and private hospitals and clinics, and they generally tend to be very high-quality. Furthermore, Brunei is a diverse country. While the majority of the country is Muslim (79% of the country, as of 2017), there is also a fairly sizable Christian (nearly 9%), and Buddhist (nearly 8%) population. There is also a large international work force, primarily associated with the petroleum and natural gas industry.[1]

On the other hand, Brunei is a religious and conservative country, where the majority of the populace is Sunni Muslim and, at least publicly, follows Muslim laws. Officially called the Sultanate of Brunei, the government is controlled by an absolute monarchy, and the family that forms the monarchy has ruled the country for six centuries (though, from 1888-1984, Brunei was a British protectorate). In 2014, the government began to institute Sharia law (religious law based on Islamic tradition), including the banning of pregnancy outside of wedlock.[2]

In this conservative environment, it is important that one understands that certain sexual and reproductive health care options will not be available. You can purchase condoms at pharmacies and supermarkets without a prescription. You can also obtain birth control pills and other contraceptive options at pharmacies or clinics, provided that you have a prescription. However, emergency contraceptive pills (morning after pills) are illegal. Foreigners who test positive for HIV are typically expelled and abortion is generally illegal in most cases.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Brunei, you can purchase condoms without a prescription. However, for most of others forms of contraception, such as birth control pills, IUDs, contraceptive shots, or contraceptive injectables, a prescription is required[3] Some pharmacies will accept a prescription from a foreign country, but they will need to physically see the prescription or be sent a photographic image of it.

What to Get & Where to Get It

  • In Brunei, you can purchase condoms without a prescription. You can find condoms found in select stores, such as Hua Ho (a retail department store and supermarket chain that can be found in multiple locations throughout Brunei) and Guardian (the largest health, beauty and personal care chain in Brunei, with 21 stores nationwide). Durex brand condoms are typically sold. Since condoms and sexual topics are taboo in Brunei, the condoms in stores are often sold in less conspicuous locations, such as in the back of the store.
  • If you want contraceptive pills (birth control pills) in Brunei, you can obtain them at pharmacies, hospitals, and many (but not all) ptivate clinics. However, you will first need a prescription to present to the pharmacist or health care professional. If you're a foreigner, some pharmacies will accept prescriptions from another country, provided that you can show them the prescription in person or at least show a photo of the prescription.
  • If you want a contraceptive injectable, you may be able to get it at JPMC Medical Center.
  • If you want a contraceptive patch, you may not be able to find it in Brunei. However, you can cross the border into Malaysia, according to local sources, and purchase a patch there.

Costs

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

Emergency contraceptive pills (morning after pills) are available in Brunei, however a prescription is required. While some online sources state that there are no emergency contraceptive pills registered in Brunei [4] local sources have confirmed that they're available, as of May 2018.[5]

What to Get & Where to Get It

  • Emergency contraceptive pills (morning after pills) are available in Brunei, however a prescription is required. According to one Brunei local, "Morning after pills are not that difficult. You simply go to specific clinics, request to see the doctor and tell them that you need a morning after pill. Usually they will prescribe it to you. But it’s not widely publicized because the society here strongly discourages premarital sex, so information is not widely available." [6]
  • If you cannot access dedicated emergency contraceptive pills in Brunei, you can use regular birth control pills as replacement ECPs.
  • If you cannot access dedicated emergency contraceptive pills in Brunei, you can use get an IUD, which can prevent pregnancy for up to 5 days after unprotected sex.
  • If you cannot access dedicated emergency contraceptive pills in Brunei, you can consider crossing the border into Malaysia, where ECPs are available at pharmacies without a prescription.

Costs

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

If you are a foreigner who is visiting Brunei for a short-term stay, you may visit the country, regardless of your HIV status, though some precautions apply. While Brunei technically prohibits HIV-positive people from visiting the country, they do not ask for a medical certificate or proof of your HIV status. However, if customs and immigration authorities find evidence of an HIV-positive status (such as carrying antiretroviral treatment), they may not allow the traveling person into the country. We do not know the laws and typical behaviors regarding the scanning of bags and personal items, so we cannot say how comfortable and safe an HIV-positive traveler may feel in Brunei. However, according to HIVTravel, "There are no regulations concerning the import of antiretroviral medication for personal use."[7]

Meanwhile, if you are a foreigner who plans to stay in the country for a longer period, you will need to apply for a residence or student permit. To obtain a permit, you will be required to take two medical exams, first in your origin country, and then a second time when you reach Brunei. In both cases, your medical exams need to include HIV tests. If someone tests positive for HIV when they apply for a residence permit in their home country, their application will be automatically cancelled. If someone tests positive for HIV after they have arrived in Brunei, the Ministry of Health will be informed of their tests results and they will be expelled from the country.[8]

More information:

• Discussion about talking to doctors about STIs in Brunei

Testing Facilities

  • If you're a foreigner who is living or working in Brunei, you will need to get an HIV test prior to obtaining your work or residency visa. Once you are living in Brunei, you will need to get an HIV test every two years to keep your visa up-to-date.
  • If you're a Bruneian citizen or permanent resident, you can obtain an HIV test at any Government Health Centre or Pusat Kesihatan. To find the one that's closest to you, you can visit the Ministry of Health website. If you don't feel comfortable telling the general reception at the clinic that you want an HIV or STI test, you can tell them that you want a "general health check," and then specifically state exactly what you want when you are directly talking to the doctor.

Support

  • Brunei Darussalam AIDS Council: "A Non-Profit Organisation where our main objective is to raise awareness on HIV & AIDS in Brunei Darussalam. We aim to educate the public on related issues, the likes of Sexually Transmitted Infection, Teenage Pregnancy & Social Issues. The Council uses multiple approaches in reaching its objectives; youth work & trainings, youth & community participation, outreach programmes, voluntary work, media coverage, collaboration with other agencies etc." Email: penyinarbdac@gmail.com Facebook: https://www.facebook.com/bdaidscouncil/
  • HIV Brunei: This organization helps gay men living with HIV in Brunei, but it is located in San Diego, California, USA. "Our mission is twofold: Destigmatise people living with HIV (PLWH) [and] Prevent HIV. It’s hard enough being gay in Brunei, but having HIV as well? So we’re here so you breeders have something to read about, refer to and understand. But mostly we’re reaching out for our queens and bros, okaaaay!" Address: 3999 Mission Boulevard, San Diego CA 92109. Phone: 1-202-555-1212

Costs

  • The government of Brunei provides free HIV treatment to its citizens.
  • You can expect to pay up to BND$250 for an HIV test at a private clinic, as of 2016,[9] but you may also be able to get an HIV test for free, depending on your citizenship/visa status and health insurance. You can ask the clinic for details about prices.

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • If you have a yeast infection, you can go to the pharmacy for medication. You can ask the pharmacist for Fluconazole, which is the type of medication used to treat fungal infections. While they may not specifically have Fluconazole, they may have similar products that you can use.
  • If you have a urinary tract infection (UTI), we're not sure what is normal protocol in Brunei. You may want to contact a local clinic or physician for details. Also, if you know how to get UTI treatment in Brunei, please update this section.
  • In Brunei, there has been a nationwide HPV vaccination program since 2012. It is also estimated that about 44% of women(ages 15-49) in Brunei have ever been screened for cervical cancer, but we could not find data on the percentage of women who have received the HPV vaccine.[10]
  • There is currently no Pre-exposure Prophylaxis (PreP) program in Brunei, as of May 2018.[11]

Costs

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas

What to Get & Where to Get It

  • In Brunei, the most common form of menstrual products are pads/pantyliners. You should be able to find them in supermarkets, pharmacies, and online shops. You can also buy organic and reusable pantyliners online from LiveLoveLuna, an online retailer that is based in Singapore and sends products to Asian countries, including Brunei. They specialize in eco-friendly menstrual products.
  • While tampons are less common than pads, you can find them sold in Brunei at certain supermarkets, pharmacies, and online stores. For example, you can find tampons sold online at Nasser Pharmacy and Wafi, both which are online retailers that specially provide for the Bahraini market. You can also find organic tampons sold through online vendors, such as iHerb, Desert Cart, and UBuy. If you are interested in sea sponge tampons, you can find them sold on the LiveLoveLuna website.
  • You can find menstrual cups sold through online retailers, such as LiveLoveLuna, which is a Singapore-based company that ships products to many Asian countries, including Brunei. They carry menstrual cup brands such as Super Jennie, LENA, Lily Cup, Merula, Lunette, etc), and deliver to Brunei. They also have an article on how to pick your first menstrual cup on their website.
  • You can find menstrual underwear sold on the LiveLoveLuna website. They can ship the menstrual underwear to Brunei.
  • You can also find alternative menstrual products, such as menstrual cups, sold in Malaysia and Singapore.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

  • Jerudong Park Medical Centre (JPMC): This private specialist hospital is considered one of the best medical facilities in Brunei. They have an obstetrics and gynecology clinic that provides a variety of services, including: General Gynae Check-Up, Gynaecology Disorders Assessment & Treatment, Menstrual Disorders, Menopause, Abnormal PAP Smears/Colonoscopy, Pelvic Floor Prolapse, Fibroids, Ovarian Cysts, Cancer Screening, and Trans Abdominal & Trans Vaginal Unltrasound, and Surgery. They also have a Family Planning Clinic. It's located in Jerudong, which is about 20 kilometers from Bandar Seri Begawan. Address: Jerudong Park Medical Centre, Jerudong Park BG 3122, Brunei Muara, Brunei Darussalam. Phone: +673 261 1433. Email: inquire@jpmc.com.bn
  • Dr Prema Clinic: "Dr. Prema Clinic is Brunei's premier Gyne clinic. We offer a range of gynaecological and obstetric services. Please contact 2421727 for our menu of service." Address: No 5 Bangunan Hasbullah 1, Kampong Gadong, Brunei. Phone: +673 242 1727
  • Suri Seri Begawan Hospital: This public hospital is considered one of the best in the country. They provide specialist services in obstetrics and gynaecology. "The Suri Seri Begawan Hospital is Located in Kuala Belait, 107 km from the capital. With 183 beds, it is the second largest hospital in country and serves the people of Belait District. It was established in 1972 and is currently undergoing a multi million dollar programme of phased renovation which will give it facilities comparable to the best in the region."

Costs

Pregnancy

Laws & Social Stigmas

In Brunei, if you are pregnant and unmarried, you may face legal repercussions. According to a Brunei local, such laws depend on your religion: "If you’re Muslim, it’s illegal to have sex before marriage and unmarried couples will usually be fined and will be required to attend religious counseling... If you’re not Muslim, it’s not really a problem. However a single pregnant woman will also have social stigma as it’s a very conservative and family oriented country."

What to Get & Where to Get It

Costs

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Brunei, abortion is generally illegal, and it only permitted to save the life of the pregnant person[12], according to the Penal Code of Brunei Darussalam (Articles 312-316). In all other cases, abortion is illegal. This means that abortion is not legally allowed in order to preserve the physical or mental health of the pregnant person, when the pregnancy is the result of rape or incest, if there is risk of fetal impairment, for economic or social reasons, or upon request. The pregnancy must seriously endanger the life of the pregnant person in order to be considered for a legal abortion.[13]

If someone illegally receives an abortion in Brunei, they may face up to three years in prison and/or a fine. The person who illegally performed an abortion could receive up to ten years in prison and/or a fine. If someone induces an abortion on themselves, they may also be subject to ten years in prison and/or fines.[14]

To read about Brunei's Penal Code, as related to abortion law, click here.

What to Get & Where to Get It

  • If you are pregnant and wish to obtain an abortion, your best option is to seek an abortion outside Brunei. While there is an underground illegal abortion industry in every country, it's not safe and not recommended. Rather, you may consider traveling to countries like Vietnam, Cambodia, or China, where you can legally obtain an abortion upon request.

Costs

  • If you are pregnant and considering getting an abortion outside Brunei, you will need to consider the following costs: visa processing costs, transportation to the country where you will be obtaining an abortion, hotel or accommodation costs in that country, cost of the abortion in the country and the total amount of days you may need to be in the country both before and after the abortion.

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

  • Ambulance – 991
  • Police – 993
  • Fire & Rescue – 995
  • Search and Rescue – 998
  • Brunei National Call Centre – 123
  • Welfare/ Children – 141 – If you suspect that a child has been abused, you may call this number and remain anonymous. The authority will investigate.
  • Flight information – 233 1747
  • Search and Rescue Centre – Air and Sea – 233 2600

Costs

List of Additional Resources

  • Click here to learn about LGBTQ rights and laws in Brunei. Please note that, as of May 2018, homosexuality is illegal and, if found to be homosexual, someone may face imprisonment as punishment, according to the Penal Code of Brunei. It is illegal to change your gender as well. There are no legal protections against housing or employment discrimination for LGBTQ people. Conversion therapy is not banned.
  • The Council of Women of Brunei Darussalam: "The Council of Women comprises of 13 national women's organizations representing the views and aspirations of all women in Brunei Darussalam with the main objective of improving the status of women in all areas such as education, economy, welfare, culture and social. The Council also strives for gender equality and the promotion of women's roles in national development." Address: 12, Simpang 32-669 Jalan Stadium Negara Hassanal Bolkiah, Brunei. Phone: 673 340524. Fax: 673 340525
  • UNDP - Malaysia, Singapore, Brunei Darusssalam: "UNDP coordinates global and national efforts to integrate gender equality and women’s empowerment into poverty reduction, democratic governance, crisis prevention and recovery, and environment and sustainable development."
  •  Brunei News from Feminist Majority: This is the link to Brunei-related news from the Feminist Majority blog.
  • Women in Brunei: "A compilation of related written publications, literatures, storied, interviews and editorials about women in Brunei. This site has been created to share to the rest of the women around the world the changing role of women in Brunei at the turn of the new millennium, the status of women's contribution to national development and a discussion on what defines the new generation of women in Brunei Darussalam."
  • Human Rights in ASEAN - Brunei Darussalam: This website and organization focuses on human rights in the ASEAN region, and they also have some information tat is specific to Brunei.
  • Amnesty International - Brunei Darussalam: This international organization focuses on human rights (and human rights abuses) around the world. You can check out their Brunei page to learn more about their coverage and analysis of the country.
  • Human Rights Watch - - Brunei Darussalam: This international organization focuses on human rights (and human rights abuses) around the world. You can check out their Brunei page to learn more about their coverage and analysis of the country.
  • Business & Human Rights Resource Center: This international organization focuses on human rights (and human rights abuses) around the world. You can check out their Brunei page to learn more about their coverage and analysis of the country.

References