The Kanjuruhan Stadium Disaster: Tear Gas, Locked Gates and Who Answers for 135 Deaths

Timeline

1. Oct 1, 2022After Arema FC's 3–2 home defeat to Persebaya Surabaya, police fire tear gas inside Kanjuruhan Stadium; 135 people ultimately die.
2. Oct 14, 2022The joint independent fact-finding team (TGIPF) gives its report to President Joko Widodo, holding the PSSI executive board responsible and urging its leaders to step down.
3. Oct 18, 2022FIFA President Gianni Infantino meets President Widodo; the government says the stadium will be demolished and rebuilt to FIFA standards.
4. Mar 9, 2023The Surabaya District Court jails the organizing committee chairman for 18 months and the club security officer for one year.
5. Mar 16, 2023The court jails a Brimob commander for 18 months and acquits two senior Malang police officers.
6. Aug 23, 2023The Supreme Court overturns the two acquittals, imposing sentences of two and two and a half years.
7. Sep 25, 2023The Supreme Court increases the organizing committee chairman's sentence to two years.

The ethical issues

• Use of force by police at sporting events and the ban on tear gas in stadiums.
• Shared duty of care among police, clubs, leagues and governing bodies.
• Criminal negligence versus deeper institutional accountability.
• Victims' families' access to justice and transparent trials.
• Moral responsibility of football leadership when no individual is charged.

Stakeholders

Stakeholder	Interests & obligations
Victims and their families	Truth, accountability, compensation and prevention.
Fans across Indonesia	Safe stadiums and fair policing.
Police and security forces	Public order, and clear rules on force at matches.
Arema FC and the match organizers	Safe operations within capacity and safety rules.
PSSI and the league	Credible governance and the future of the competition.
FIFA and the AFC	Enforcing safety standards worldwide.
Government	Public safety, justice and Indonesia's international standing.

The case

On the night of October 1, 2022, Arema FC lost 3–2 at home to its East Java rival Persebaya Surabaya at Kanjuruhan Stadium in Malang, Indonesia.^[8] Within an hour, the stadium was the scene of one of the deadliest disasters in the history of football. Police fired tear gas, spectators crushed toward narrow and partly locked exits, and 135 people died, including more than 40 children.^[5][8]

Background

Football is a mass passion in Indonesia. FIFA President Gianni Infantino later called it “a football country, a country where football is a passion for over 150 million people.”^[3] The Arema–Persebaya fixture is one of the country’s fiercest rivalries, and away fans were banned from the match.^[6]

When the final whistle blew, home supporters went onto the pitch. Police called it a riot and said two officers were killed; survivors accused the police of overreacting, and videos showed officers kicking and hitting fans with batons and pushing spectators back into the stands.^[6] Police fired tear gas at people on the pitch and into the stands. Indonesia’s National Commission on Human Rights (Komnas HAM) estimated that about 45 rounds were fired inside the stadium.^[7] Fans fled toward the exits, where, according to Al Jazeera, some of the gates were locked.^[6]

Casualty figures rose over the following days. An official government report cited by FIFA counted at least 132 deaths, 96 people seriously injured and 484 with moderate and minor injuries.^[3] The final death toll most commonly reported was 135; 38 of the dead were under 17, and the youngest was three.^[6] The BBC described it as the second-deadliest football disaster in history, after the 1964 crush in Lima, Peru, in which 328 people died.^[5]

The rules and governance

FIFA’s stadium safety regulations prohibit the use of crowd-control gas at football matches.^[4][7] Those rules bind football bodies, but the police who fired the gas answer to the state. Indonesian prosecutors later argued that a senior Malang police officer had ignored the FIFA prohibition.^[8]

Responsibility for a match is shared. The home club’s organizing committee (panitia pelaksana) and its security officer are responsible for risk assessment, stewarding and exits; the national association, PSSI, runs the league and licenses competitions; and police provide public-order policing.^[1][2][9] In criminal law, the relevant charges were for negligence causing death and injury. Prosecutors did not charge murder, which carries a maximum of 15 years for non-premeditated killing.^[8]

The fact-finding report

President Joko Widodo created a joint independent fact-finding team (TGIPF), chaired by Coordinating Minister for Political, Legal and Security Affairs Mahfud MD. It delivered its report on October 14, 2022.^[1] Reconstructing footage from 32 security-force CCTV cameras, the team said the process by which people died was “more terrible than those circulating on television and social media.” Mahfud said that whatever further tests showed about the toxicity of the gas, “it cannot reduce the conclusion that the mass deaths were the result of tear gas.”^[1] The team found that the parties involved “shunned and traded responsibility,” shielding themselves behind formal rules and contracts.^[1]

The report held the PSSI executive board and its sub-organizations responsible, on both legal and moral grounds: “The people’s safety is the highest law,” Mahfud said.^[1] Noting that the government could not intervene in PSSI, it said that “in a country that has a moral and ethical basis,” the PSSI chair, Mochamad Iriawan, and the executive committee “should step down as a form of moral responsibility.” It urged an extraordinary congress to elect leadership “free from conflicts of interest,” and recommended that the top three leagues not be allowed to resume until significant changes were made.^[2] It also recommended criminal investigations.^[1]

FIFA’s response

On October 18, Infantino met President Widodo, ministers and the PSSI president in Jakarta. Widodo announced that Kanjuruhan Stadium would be demolished and rebuilt to FIFA standards.^[3][4] FIFA pledged a joint task force on stadium safety, police protocols, fan engagement, match scheduling and training of match-day security staff. “FIFA will stay and work here to transform Indonesian football,” Infantino said.^[3]

The trials

Trials began in January 2023 and were moved from Malang to Surabaya because of the case’s sensitivity. Families complained of closed hearings, and video appeared to show police heckling prosecutors outside court.^[5][6][7] In March 2023, the Surabaya District Court sentenced the organizing committee chairman, Abdul Haris, to 18 months and the club’s security officer, Suko Sutrisno, to one year, finding they had failed to put adequate safety measures in place. Prosecutors had sought six years.^[5][6]

On March 16, the court jailed Hasdarmawan, commander of a Brimob mobile police unit who ordered subordinates to fire tear gas, for 18 months, half what prosecutors sought. The judge said he failed to “predict a situation that was actually quite easy to anticipate,” but also that fans’ behavior may have contributed and that he had cooperated.^[5][6] The court acquitted two senior Malang police officers, operations chief Wahyu Setyo Pranoto and prevention unit head Bambang Sidik Achmadi, finding “no causal relationship” between their actions and the deaths.^[5] A mother who had held a photograph of her 16-year-old son throughout the hearing asked: “Many people have died, how come they are now free?”^[5] The head of the rights group KontraS called it “reasonable to suspect” the judges were acting unfairly.^[5]

Aftermath

Prosecutors appealed. In August 2023 the Supreme Court overturned the acquittals, finding both officers “legally and convincingly proven guilty” of negligence causing death and injury. Pranoto was sentenced to two and a half years and Achmadi to two years.^[7][8] On September 25, 2023, the court increased Haris’s sentence to two years.^[9]

Families were not satisfied. A mother whose 15-year-old son died called the result “a joke,” saying “It’s just like being punished for stealing a cow.” A father who lost two teenage daughters said the sentences “are not in line with what the police did.”^[7][8] Amnesty International Indonesia said the ruling brought “new hope,” but urged a broader evaluation of police use of force, noting continued indiscriminate use of tear gas at other gatherings.^[8][9] After the disaster, the national police chief removed the Malang police chief and relieved nine Brimob officers of duty.^[6] With criminal cases complete, some families turned to civil claims.^[7]

The core dilemma

Many people had some part in the night at Kanjuruhan: police who fired gas despite football’s ban, organizers responsible for exits and safety, a federation that ran the league, and a global governing body whose rules were not followed. The courts punished five individuals for negligence. The fact-finding team spoke of moral responsibility reaching the federation’s leadership. When a disaster has many causes, how should duty of care be divided among the institutions that control a crowd, and what does real accountability require beyond individual sentences?

Competing values

• Public order vs. spectator safety: police may need to restore order, but some tools endanger trapped crowds.
• Individual guilt vs. institutional responsibility: courts judge individuals, while failures often lie in systems.
• Legal responsibility vs. moral responsibility: leaders who are not charged may still owe resignation or reform.
• Closure vs. justice: quick verdicts end proceedings, but families may see them as a denial of justice.

Strongest arguments

Primary responsibility lies with the police. The fact-finding team and Komnas HAM concluded that tear gas caused the crush. Firing gas into the stands, against football’s own rules, turned a pitch invasion into a mass-casualty event. Sentences of two years or less understate that.

Responsibility is shared with football. Organizers controlled the gates and safety planning, and the federation was responsible for the league’s standards. FIFA’s rules exist, but rules without training, enforcement and licensing checks give little protection.

The legal system did what it could. The Supreme Court corrected the acquittals and increased a sentence. Negligence was the charge the evidence supported, and the deaths came from a chaotic situation that no single person intended. Lasting change, the argument goes, comes from reform rather than longer sentences.

Applying the frameworks

Ethics of care

Care ethics centers the relationship between those with power and those who depend on them. Fans inside a stadium depend completely on organizers and police for their safety; they cannot leave unless the gates open. A care lens would ask whether each institution treated spectators as people in its charge, and it would also weigh how families were treated afterward, in closed trials and in sentences they experienced as dismissive.

Rights

A rights lens focuses on the right to life and bodily security and on limits to state force. Human rights bodies described the use of tear gas as indiscriminate and excessive. The same lens supports families’ rights to truth and effective remedy. A police defender might invoke officers’ right to safety, since police said two officers died, but the question is whether the force used was necessary and proportionate.

Justice

Justice asks whether accountability was fairly distributed. The heaviest sentences went to mid-level officials and club staff, while the fact-finding team’s call for the federation’s leadership to resign was a moral rather than legal demand. Retributive justice asks whether the sentences matched the harm; restorative and procedural justice ask whether families were heard and whether institutions changed.

Walk it through: the Simple Decision Model

1. Spot the issue. Take the seat of the match organizing committee before a high-risk derby. The issue is spectator safety; stakeholders include home fans, children in the crowd, stewards, police, players, the club and the league. The codes are FIFA’s stadium safety rules, league licensing and the stadium’s capacity and emergency plans.
2. Gather facts. What is the expected crowd? Which gates will be open, and who holds the keys? What equipment will police bring, and have they been briefed on the tear-gas ban? Watch for normalcy bias: past matches going smoothly does not prove the plan is safe.
3. Test options. Proceed with the standard plan; require a joint safety briefing and written agreement that no gas will be used, with all exits staffed and unlocked; or move, reschedule or limit attendance.
4. Check codes and law. FIFA’s regulations prohibit crowd-control gas; domestic law sets negligence standards; league regulations set licensing conditions. The spirit of all three is that fans must be able to leave safely.
5. Decide and document. Record the risk assessment, the gate plan and the agreements with police, and who signed off.
6. Communicate and follow up. Brief stewards and police together, publish safety information for fans, and after the match review incidents. After a disaster, cooperate with independent inquiries and keep families informed.

What’s settled and what’s contested

Settled

• After a 3–2 Arema defeat on October 1, 2022, police fired tear gas inside Kanjuruhan Stadium, and 135 people died in the crush that followed.
• The presidential fact-finding team and Komnas HAM concluded that tear gas was the main cause; FIFA’s rules ban crowd-control gas.
• Two club officials and three police officers were ultimately convicted of negligence; the longest sentence was two and a half years.

Contested

• Whether negligence was the right charge and whether the sentences were proportionate.
• How much responsibility the national federation and its leaders bore.
• Whether police practice on crowd control has changed since.

Why this case matters

Kanjuruhan shows how a sporting event becomes a public-safety disaster when force, crowd design and governance fail at the same time. It tests the idea of duty of care at the largest scale: the duty owed by everyone who controls a stadium to everyone inside it. It also shows the limits of criminal trials as a form of accountability, and why families, rights groups and football bodies keep asking what has changed.

Key terms

Duty of care

The responsibility of coaches, organizations and institutions to protect the health, safety and well-being of those in their charge. It is not a license for total control.

Institutional accountability

Structures that make a sport organization explain its decisions and face consequences: clear authority, transparency, appeals, independent oversight and enforcement.

Non-maleficence

The duty to avoid causing harm, often paired with care ethics when setting safety rules.

Prevent, minimize, mitigate, remedy

An order of priorities for harm: prevent it if possible, then minimize it, mitigate what remains, and remedy what has been done.

Stakeholders

Everyone with something at stake in a decision: athletes, coaches, parents, officials, fans, employees, sponsors, media, communities and regulators, including the less visible ones.

Crisis ethics

The obligations that apply when an organization is under pressure: honesty, timeliness, accountability and care for those harmed.

Definitions from the Ethics Cases glossary.

Discussion questions

1. FIFA's rules ban crowd-control gas in stadiums, but the police are a state body. Who is responsible for making sure the rule is followed?
2. The fact-finding team urged the federation's leaders to resign as a matter of moral responsibility. When should leaders resign even if they are not legally at fault?
3. Families said negligence charges were too lenient. Is criminal law the right tool for accountability after a disaster like this?
4. How should leagues and clubs weigh the risks of high-tension matches against fan access and revenue?

Sources

1. TGIPF holds PSSI executive board responsible for Kanjuruhan tragedy — ANTARA News
2. TGIPF Kanjuruhan Suggests Iwan Bule Step Down as PSSI Chair — Tempo
3. FIFA President vows to support Indonesia in stadium safety overhaul programme — FIFA
4. Indonesia to demolish stadium where more than 130 people died, president vows to 'transform' game in football-mad nation — South China Morning Post (Reuters)
5. Indonesia football crush: Families devastated as police acquitted — BBC News
6. Two freed, one police officer jailed over Indonesia stadium crush — Al Jazeera
7. Disappointment in Indonesia after football disaster appeal ruling — Al Jazeera
8. Indonesia court overturns acquittal of two policemen over stadium deaths — The Straits Times (AFP)
9. Kanjuruhan Tragedy, Supreme Court Increases Punishment for Arema FC Organizing Committee — Kompas