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HIV spread in Indonesia

Indonesia is facing a huge challenge in tackling the spread of HIV virus in the country. Health agencies believe that the number of HIV-positive patients are bigger than currently reported.

HIV-positive patients are still feeling outcasted and discriminated in many healthcare centers.

The disease is still portrayed as a direct punishment from God for those who strayed from religious teachings.

Condoms are either frowned upon, ridiculed or condemned by religious organizations, making it difficult for the government to push its HIV prevention agenda.

Spreading fear among the youth

A widely spread wrong evidence can be deemed as the truth. This is what happened in Indonesia when a professor said that condoms couldn't prevent the spread of HIV virus because condoms have pores.

Chris Green on wrote his blog :

It was back in September 1995 that I first learned that condoms have pores. The report in the Republika daily, that condoms have holes 1/10 micron in diameter (whereas HIV is only 1/600 micron) must be correct because it was written by a professor: Prof. DR H. Dadang Hawari. […]

since then I have learned that Prof Dadang is typical example of our faith-based, rather than evidence-based, academics. And even IDI (writer's note: Indonesian Doctors Association) felt it must respond. So they arranged a debate on condoms, exactly 14 years ago today. This was held in the medical faculty of the prestigious University of Indonesia, and I was there. Prof Dadang was due to speak, presumably on the ‘side of the angels.’ However, he pulled out at the last moment, as he as always done when called upon to defend his position. So the debate went ahead, one-sided, without him.

[…]

The challenge of ‘pored’ condoms has since come up, it seems, at least once a year.

[…]

At least that was until this year. Now it's just gotten worse! I've just read in the Jakarta Post (Students told to nip bad habits in the bud) about a young high-school student who has become ‘one of the 92 ambassadors of the Jakarta Stop AIDS campaign.’ At 15 schools he has visited, he has told fellow students that “there is still a risk of contracting AIDS through the use of condoms because they have pores through which the virus can pass,” He says he learned what the Post rightly calls this ‘scaremongering information’ at a workshop organized by Unilever and Yayasan Cinta Anak Bangsa (an NGO doing outreach on drugs to youth), and ‘based on material from the National AIDS Commission.’

HIV epidemic in the easternmost provinces

Indonesian Papua,  dubbed the star of the eastern Indonesia thanks to its natural resources and its pristine forests is also home to rare and exotic austronesian animals and insects.

In Papua, where sanitary and clean running water are often seen as luxury, condoms are either too scarce to find or to expensive to buy.

The slow response of the central government provoked an accusation of ethnic cleansing among the Papuans by allowing the virus to spread.

Papuan children. Photo by Flickr user 710928003

Papuan children. Photo by Flickr user 710928003

Ronald Gunawan, a doctor working for World Vision, wrote an opinion in a local newspaper, and copied it on his blog:

[…] Kerap terdengar keluhan masyarakat atas lambannya upaya mengatasi masalah HIV/AIDS di Tanah Papua. Tidak jarang keluhan ini dilanjutkan dengan tuduhan yang mengarah pada kesengajaan pihak tertentu untuk memusnahkan orang Papua melalui virus ini. Kalimat-kalimat seperti ini bukan hanya terungkap dalam pembicaraan tidak resmi, tetapi juga dalam pertemuan-pertemuan resmi.

[…]

Tidak bisa disangkal, derap pembangunan di Provinsi Papua dan Papua Barat sangat lamban. Ini dapat dengan mudah dilihat dari masih banyaknya sekolah tanpa kehadiran guru-guru, banyak kampung belum terlayani pelayanan kesehatan, serta penyampaian informasi penting terhambat, karena terisolasi gunung, lembah, dan rawa- rawa.

[…] We often hear the people complaining about the government's slow response in tackling HIV/AIDS problem in Papua land. Often, these complaints also include an accusation that some parties are intentionally trying to eliminate the people of Papua through this virus. These accusations circulate not only in casual chats but also in official meetings.

[…]

Undeniably, the development in West Papua and Papua provinces is extremely slow.  This can be easily seen through schools that have no teachers, villages without basic healthcare centers, and the slow spread of important information, and isolation which is mainly due to the mountains, valleys and swamps.

On his blog, Ronald uploaded an ilustration based on true events that says some youths in Papuan village use plastic to replace the scarce and expensive condoms.

Women are largely at risk

Poverty in many areas in Indonesia forced parents to trade their daughters for money. Prostitution is a risky industry that is publicly condemned but generate a healthy sum of income for many people and a fertile ground for HIV virus to grow and spread.

According to Dr. Nafsiah Mboi of the AIDS Prevention Committee, 9 to 12 million lives are at risk due to the spread of the HIV virus in Indonesia. The country also witnessed the jump in number of housewives and women infected by the incurable disease mostly because the risky sexual behavior of their partners.

The following is an interview video of Dr. Mboi:

Stopping the disease religiously?

According to the Ministry of Health, until September 2009, there are about 18,422 HIV/AIDS patients. While Indonesian AIDS Foundation (YAI) said that until March this year, the number of HIV/AIDS patients in Indonesia is reaching 23,632 patients, a jump from 22,262 in 2008.

The government implements the ABCD (Abstinence, Be Faithful, Condoms, and Drug-free) program to stem HIV spread in the archipelagic country, but according to Kholda Naajiyah on Hizbut Tahrir website, the program is ineffective and making condoms available everywhere means endorsing acts of promiscuity.

[…] dengan kampanye kondomisasi misalnya, masyarakat seolah diajari untuk melakukan seks bebas karena sudah dijamin aman dari HIV/Aids asal memakai kondom.

with condom availability campaign for instance, it means that the people are thought to commit extramarital sex because they're guaranteed to be HIV/AIDS free as long as they're using condoms.

Naajiyah said that  imposing fines and punishment are important:

[…]

Para pelaku yang terlibat dalam jaringan bisnis narkoba harus dihukum berat. Pecandu yang sudah tobat harus diawasi agar tidak kambuh lagi dan yang belum tobat diberi sanksi agar jera melakukan hal yang sama.

[…] Those who are involved in drug cartel should be punished severely. Former junkies need to be watched so they won't return to their old habits and those who haven't quit should be punished to stop them from doing drugs.

He also said that closing the red light districts could help stop the spead of disease:

Penularan HIV/Aids melalui hubungan seks bisa dicegah dengan menutup lokalisasi pelacuran yang selama ini menjadi lokasi berisiko tinggi terjadi perpindahan virus HIV. Para pelacur yang biasa beroperasi harus diberi sanksi tegas karena telah melakukan perzinaan yang melanggar tata susila di masyarakat.

HIV/AIDS spread through sexual intercourse and can be prevented by closing down the red light districts where HIV virus transmissions take place. The sex workers should be harshly punished for breaking moral codes and committing adultery.

The central government lack of political will is partly due to religious groups which see condom distribution as a symbol of moral regression.

Blogger Patung, elaborates:

In Medan, North Sumatra, the provincial government distributes free condoms to prostitutes in red light districts.

The parliamentary faction of the Justice Party/Partai Keadilan Sejahtera (PKS) however is not happy about it, with PKS spokesman Zulkarnain saying the distribution of, so far, 2,880 condoms was not a good way of dealing with HIV/AIDS, since contraception was intended to prevent pregnancy, not to stop spread of disease.

Zulkarnain hoped new governor Syamsul Arifin would stop the policy and instead focus on helping prostitutes to reform themselves and find other work.

In the capital Jakarta, condoms can be found easily at pharmacies, automatic vending machine and even 24-hours convenient stores, however a report [id] said that the use of condom is still low, about 1,3% of birth control users.

On Monday the government launched Condom Week as part of  national  HIV/AIDS prevention program.

http://www.flickr.com/photos/purwateja/

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