A/HRC/44/40/Add.3 Paragraph 54 Some indigenous women described an appallingly authoritarian approach by health authorities to indigenous peoples. They were required to accept unwanted contraceptive injections or implants to which they had not freely consented. One woman described begging doctors to remove an unwanted and painful implant that prevented her from carrying out daily tasks, and said the removal cost her the equivalent of a month’s worth of household expenses. Comments from the Government of Malaysia: • Contraception is a method of choice for family planning practice by the Ministry of Health Malaysia for women including the indigenous people or the Orang Asli. The aim of offering injections or implants to the women is to ensure good spacing and readiness for the next pregnancy. Long acting contraception is offered to women with medical illnesses such as heart problem, chronic anaemia, poor spacing and bad obstetric history; without force. Explanation and verbal consent were obtained before contraception was administered. The implants effectiveness was up to 3 years duration whereas the injections were only for 3 months. The staff will entertain the request for early removal of the implants, if the women's condition is suitable for pregnancy. If not, she will be counselled and reassured. • The Ministry of Health has always committed and will continue to provide health services to all members of the community including the Orang Asli. The services is either provided through static facilities, for those Orang Asli community in village fringes, Mobile Health Team for Orang Asli for those localities that are reachable and Mobile Air Health Services for the remote localities in the interiors. The services provided are basic maternal and child health services including family planning, disease screening and treatment. • There are twenty Pasukan Bergerak Orang Asli (PBOA) team and one flying doctor services team providing health services to the Orang Asli • The choice of family planning methods for the Orang Asli women is similar to those offered to the general population. The SOP also universally expected to be practiced by all healthcare workers. Nonetheless, due to challenges faced such as whether and terrain, which will affect the frequency of services, a Long Acting Reversible Contraceptive (LARC), such as depo-injection, Intra-Uterine Device (IUCD) and Implanon, would be the best option method for the Orang Asli women. However, the choice still in the hands of the woman. An inquiry was made following the allegation “several who said they were required to accept contraceptive injections or implants that they did not want and had not freely consented to, among Orang Asli women in Hulu Perak District...” that went viral in several local on-line newspapers on the 9th-10th July recently. • The enquiry headed by a Family Medicine Specialist, who is from the Orang Asli ethnic, was conducted the following week, i.e on the 17th-18th July 2019. Twenty eight (28) women were interviewed, including the two (2) women who appeared in the newspapers. Findings were, family planning is a generally practiced by the Orang Asli women as a means of birth spacing and majority knew the side effects of the family planning. Orang Asli community are close-knitted community, and information on family planning is pass between them and between generation. As some of the younger community Orang Asli become more educated and well informed, some even opted to limit their number of children. In fact one of the two (2) women who alleged that she was forced to / not consented for the procedure, confessed had undergone Tubal ligation – a permanent form of contraception, at her on will, even after being refused by the attending Specialist. She was advised by her mother. • None of the women claimed that they were forced to accept family planning to control birth. • The statement about an attempt religious conversion is due misunderstanding of the parent with the school administration. As an example, the dressing code in the school seen as to convert the female student to Islamic religion. Whereby there is an option of wearing baju kurung or pinafore by the female student in Malaysia. • The Government had support the well-being of the indigenous student via numbers of initiatives and with many positive outcomes. 29