Harm reduction: Confronting HIV\/AIDS\/hepatitis<\/p>\n
David Djaelani Gordon, The Jakarta Post, Contributor, Jakarta<\/p>\n
By the latter part of the 1980s an increasing number of
\nvirologists and medical experts, along with a rapidly expanding
\nnumber of anxious governmental agencies, were alarmingly waking
\nup to the fact that HIV\/AIDS had, in only a few short years,
\nspread across most of world. Contrasting, yet hardening
\ninformation and evidence were already very clear on the
\nworldwide virus catastrophe that was developing.<\/p>\n
Particular groups at risk included gay communities -- and
\nlarge numbers of people who were actively engaged in casual and
\nopen exchanges of sex, the prostitution industry (both females
\nand males), drug users and abusers (especially IDUs -- Injecting
\nDrug Users).<\/p>\n
Also at risk were \"ordinary\" people (those in the heterosexual
\ncommunity) who had received \"tainted blood\" in hospitals and
\ninstitutions for operations and other applications where blood
\nwas transferred, and dentists' practices, where unsterilized
\ninstruments were being used with patients.<\/p>\n
By the latter half of the 1980's these groups were being mass-
\ninfected with HIV\/AIDS.<\/p>\n
Also, by the beginning of the 1970's much of the world,
\nincluding Indonesia, had already witnessed an astounding rise in
\ndrug abuse and addiction. In 1987 (officially) the first death
\nfrom AIDS was documented here in Indonesia.<\/p>\n
By 1991 the tentacles of a drug culture had opened a wide
\ngateway throughout the nation, spurred on by marijuana, ecstasy
\nand putaw (low-grade heroin). Shabu-shabu became popular in the
\nmid 1990s.<\/p>\n
In 1994 the beginnings of a National policy on HIV\/AIDS had
\nbeen organized, and in 1995 the AIDS Commission was established.
\nBy 1996 drug addiction was declared to be of epidemic proportions
\nin our country! Yet, as of now, little has been accomplished to
\nintervene in and defend our nation against HIV\/AIDS and Hepatitis
\nC, drug abuse and addiction.<\/p>\n
For many reasons, some credible and some not, harm reduction
\nmethods were not initiated, and today we lag far behind in the
\nrace to ward off the devastating effects that HIV\/AIDS and
\nhepatitis C, drug abuse and addiction are having upon the nation.<\/p>\n
Please note that wherever you find drug addiction you always
\nfind coexisting sexually transmitted diseases -- HIV\/AIDS and
\nhepatitis -- plus associated money problems, crime and violence.
\nHarm reduction strategies attempt to tackle all of these issues.<\/p>\n
According to the most reliable data being received from across
\nthe nation, the number one hot-spot is the Jabotabek area
\n(Greater Jakarta), while a \"wildfire and crisis\" now exists,
\nwith HIV\/AIDS and hepatitis C as well as drug addiction prevalent
\nthroughout the archipelago.<\/p>\n
There are today an estimated 4 million-plus active drug
\nabusers and addicts throughout Indonesia. Needle-use and needle-
\nsharing increase on a daily basis.<\/p>\n
In the Jabotabek Area, over 20 percent of IDUs are now
\ncontinuously testing positive for HIV\/AIDS and over 85 percent of
\nIDUs in the Jabotabek area are testing positive for Hepatitis C.<\/p>\n
These numbers and statistics will continue to increase, and
\nspread, throughout the nation!<\/p>\n
The most recent statistics indicate there are now over 20,000
\ndrug abusers and addicts already infected with HIV\/AIDS within
\nthe Jabotabek area alone at present. In addition, well over
\n100,000 are infected with hepatitis C at present.<\/p>\n
Harm reduction methods are regarded as some of the most
\nrespected and successful modes of intervention, education,
\nprogramming, and action -- which create a shield, an intelligent
\nand sustainable line of defense against viruses and drug abuse.
\nHarm reduction methods within our sex worker communities are
\nproving to reduce HIV\/AIDS infection and transmission, and are
\nhelping scores of drug abusers curb many of their most harmful
\nmodes of behavior.<\/p>\n
Presently the Asian Harm Reduction Network based in Thailand,
\nalong with several Indonesian partners, is pioneering efforts to
\nconstruct an \"Asian collective\" that will contribute to opening
\ndoorways to directly assist Indonesia in developing plans and
\nprograms that can successfully face these fateful issues.<\/p>\n
Government, NGOs, the medical, therapeutic and welfare
\ncommunities, along with the drug recovery community are intending
\nto unite in identifying harm reduction methodologies and
\nstrategies.<\/p>\n
Harm reduction -- both methods and programs -- builds a strong
\nbridge in shifting attitudes to unite people and organizations in
\nfar more positive and effective ways to challenge drug addiction,
\nHIV\/AIDS and hepatitis. This then increases awareness surrounding
\nthese issues, which, in turn, increases the response to these
\nissues.<\/p>\n
2002 and 2003 will prove to be a major pivotal point in the
\nbattle to take a stand against drug abuse and the viruses. We
\nmust work together to assemble a pragmatic multi-level program to
\nconfront these issues.<\/p>\n
Confrontation -- in the genuine sense of harm reduction --
\nmeans government, NGOs, the recovery community, the Ministry of
\nHealth, the religious community, the educational community and
\nthe general population must all work together.<\/p>\n
By concentrating our attention on applying harm reduction
\nmethods we will be able to slow down the rampage that addiction
\nand the viruses are having within our country. If we do not slow
\ndown the rampant spread of drug abuse and addiction and contain
\nthe spread of the viruses over these next two years by means of
\nstrong harm reduction strategies and programs, the losses will be
\neven more unimaginable than they are today.<\/p>\n
Today the losses we are facing are already unimaginable.<\/p>\n
Harm reduction must become a top priority in 2002.<\/p>\n
The writer is Director of Yayasan Harapan Permata Hati Kita -
\nBogor.<\/p>\n
Untuk ibox
\n----------------------------------------------------------------<\/p>\n
Harm reduction strategies can take the following forms:
\n* Policy and advocacy direction and leadership
\n* Dissemination of information through the educational system
\n* Hospitals and clinics, designated to assist and support those
\ninfected with the viruses, and needing medical treatment and
\nattention
\n* Rehabilitation and recovery centers, and aftercare programs for
\ndrug abusers
\n* Testing and counseling facilities for those wanting\/needing to
\nfind out if they are infected with a virus, and needing ongoing
\nsupportive counseling
\n* Community outreach service centers
\n* Self-help programs and support groups
\n* Therapeutic communities
\n* Condom-use education and community outreach programs supporting
\ncondom usage
\n* Needle exchange and drug substitution programs
\n----------------------------------------------------------------<\/p>",
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