AIDS strikes small Irian Jaya community

AIDS strikes small Irian Jaya community

By Dini S. Djalal

MERAUKE, Irian Jaya (JP): As citizens of Merauke, Irian Jaya,
look forward to the coming year, they may look back on this year
as a year of disaster.

First, rain has been scarce for nearly a year, and crops are
suffering. Fortunately the rainy season will eventually arrive.
Unfortunately, the arrival of a cure for Acquired Immune
Deficiency Syndrome (AIDS), the fatal disease which has struck
this small community, has yet to be discovered.

In a nationwide survey conducted by the Ministry of Health,
Irian Jaya rates as having the second highest number of cases of
infection with the Human Immunodeficiency Virus (HIV), which is
the precursor to AIDS.

In July, official data reported 58 positive test results for
HIV (HIV-positive) in this immense but sparsely populated
province, a statistic second only to Jakarta's list of 75 HIV and
AIDS cases.

Jayapura, the provincial capital in the north of Irian Jaya,
has one HIV-positive case and Merauke, a harbor side town on the
south coast, has 57 cases.

Out of the 57 cases in Merauke, 50 were Thai fishermen in
Merauke on monthly work visits. After agreeing to be tested by
the local office of the Ministry of Health, and testing HIV-
positive, the fishermen were repatriated back to Thailand by
their employers. Yet the remaining seven cases of HIV among the
local population remains disproportionately high, considering the
remoteness and modesty of the locale and the population, which is
64,000 at present.

The newest data, as reported by Steve Osok, head of Merauke's
Health Office in November, shows an increase to three cases in
Jayapura, nine in Merauke, and one in Serui, a small town near
Biak Island in the north. In Merauke last month two of the HIV
sufferers died. They had lived quite healthily since their
diagnosis two years ago.

The surprisingly high statistics have created panic in the
community. A volunteer from the non-profit AIDS education center
Mitra Indonesia, Agus Triwahyu said, "Even people in the interior
(of Irian Jaya) are carrying newspapers. They put the papers on
bus seats because they think the disease can be transmitted by
any kind of contact," he explained.

Scapegoating

The panic has, in turn, resulted in a lot of finger-pointing
and increasing hostilities in an otherwise stable community.
Regent R. Soekardjo said, "Because you are dealing with a small
town, when an illness like this arrives, it feels especially
sinister."

Many accuse the Thai fishermen of introducing the virus,
claiming that otherwise Merauke would be free of AIDS.

For the most part, the Thai fishing companies have opted to
stay clear of the furor. Their Indonesian spokespersons
participated in the first day of a workshop held by Mitra
Indonesia on Nov. 29 and 30, but have since returned to their
headquarters in Timika, an hour away by plane. Mitra volunteers
claim that the fishermen are former criminals who provide cheap
labor for the Thai fishing companies.

There are other people who blame the Ministry of Health for
not handling the emergency at hand more carefully. There was no
quarantine policy prior to the present panic, and many Merauke
citizens feel the Thais should have never been allowed to leave
their boats, at least for not longer than an afternoon.

"The immigration authorities just check their passports and
let them go," local businessman Edo Maro claims. "There are four
sectors involved: the Ministry of Fisheries, the Navy, Customs
and Immigration, all with different agendas. The Ministry of
Health is in charge of the community's well being, but what are
they doing to ensure this?" Maro said.

Maro contends that the statistics would be higher if more
thorough testing is carried out. "Blood tests are really
expensive here because the samples have to be sent to Jakarta via
Jayapura. For that reason, tests are conducted on high-risk
groups only. Can you imagine the statistics if everyone here were
given blood tests?" Maro said.

Osok agrees that test procedures are inconvenient, often
taking up to three months to complete, but he said the Ministry
of Health is doing all it can to contain the virus. "The Thai
employers have tried to assure us that they will only send HIV-
negative workers, but we will go on to the boats and check for
ourselves," Osok said.

Sex and morality

While pragmatists may see health checks as the key issue, the
community's religious leaders see AIDS as a question of morality.
Representatives of the Catholic Church, for example, do not even
consider the provision of contraception, and regard the only
solution to be the elimination of prostitution. More
specifically, they are urging prostitutes to change professions -
disregarding the people who frequent prostitutes, or the economic
issues which bring about prostitution.

The Islamic community also sees prostitution as the problem,
although, in line with the national family planning program, they
are less conservative concerning contraceptives and will allow
condom dispersal for select parties, including prostitutes and
married couples.

The imposition of ethnocentric norms of the normal family --
ie. monogamous marriage -- has raised protests among indigenous
Irianese. Traditional local culture has less stringent rules on
sexual behavior, and men with more than one wife are commonplace.
Ferry Lechoi, Fak-Fak by ethnic origin, but a longtime inhabitant
of Merauke, admits that "the spread of HIV is not surprising
considering the sexual mores of the locals. You can prepare them
with medicines and contraceptives, but you cannot prepare them
mentally for the concept of safe, monogamous sex."

Lechoi's admission of free sexual behavior in this region may
prove helpful, because mainstream media focus on prostitution may
prove more dangerous than beneficial, as it creates the illusion
of safety for the community at large. Hudoyo Hupidio, director of
Mitra, said that in Indonesia, prostitutes account for only 20
per cent of HIV-positive cases. The rest are mainly heterosexuals
who contracted the disease by other means.

In Irian Jaya, the dilemma of scapegoating prostitutes is
exacerbated by the tendency to blame the transmigrant community
for proliferating prostitution. Many locals believe that some
prostitutes pose as transmigrants in order to receive residency
papers for Irian Jaya, while others claim that the poverty facing
newcomers forces transmigrant husbands to sell their wives as
prostitutes.

Prostitution, however, is an age-old alternative for the poor.
To address only prostitutes overlooks the need to address the
patrons of prostitutes as being equal carriers of HIV. Yenny
Sahetapi, a local social worker who has interviewed prostitutes
in Merauke, said that if these patrons are not instructed in safe
sex as well, then the hours spent in contraceptive instructions
and dispersion to prostitutes will bear little fruition.

More importantly, the virus is not contained within the
transmigrant or red-light district. The AIDS victim who died last
month in Merauke was not a prostitute but a 19-year-old high
school student. It was not explained how the girl obtained the
disease.

The issue here is the need for public education about safe
sex. HIV is indiscriminate in who it will strike. The only thing
one can do, regardless of one's sexual behavior, is to use proper
protection, specifically a condom. An equally important task is
the improvement of the Ministry of Health's facilities regarding
blood transfusions, another means of acquiring HIV.

Education

In coordination with the AIDS Awareness Festival across
Indonesia, Mitra Indonesia held a two-day AIDS-education workshop
and a three-day exhibition of posters and photos early this month
in Merauke. The workshop targeted influential members from all
sectors of the community, from youth groups to religious
organizations, so that they may continue the work once Mitra
leaves.

The exhibition was open to the public, and was opened on Dec.
1 by Regent Soekardjo. The Governor was scheduled to attend, but,
much to the disappointment of Merauke inhabitants, declined at
the last minute. A benefit concert was also held, featuring
reggae bands Abrezzo and Emergency.

The volunteers at Mitra realize the enormous task at hand.
One of their goals is to have an educational and counseling
center established in the near future. Mitra organizer Nur Kamka
explained that up until now the only AIDS-related service has
been the initial blood tests. Follow-up treatments, whether
medical or psychological, have not been available. For the HIV-
positive patient in need of sympathetic care and attention,
increasing public awareness and understanding of AIDS can only
bring greater good.