Facing the AIDS scare

According to official figures the number of HIV/AIDS cases in Indonesia as of July 1995 was 316. But to judge by the experience gained in other countries the actual number is most likely to be many times that.

Given this, and of course the fact that there is as yet no cure for AIDS, it is no wonder that the disease seems to be causing a scare in this country. According to newspaper reports this week, the spread of the disease has given rise to dilemmas for several hospitals and health care workers which, in turn, have caused public confusion.

One hospital in Jakarta was said to have denied treatment to an HIV-infected patient. The hospital was also reported to have reprimanded one of its doctors for treating patients with HIV and AIDS. The hospital in question has denied the charges, leaving the public uncertain as to who is telling the truth.

HIV infection and AIDS are new, not only for hospitals, but for this country as a whole. No less important is the impression last week's reports have left with people because, after one medical institution has rejected an AIDS patient, other institutions, such as schools and businesses, might be more inclined to do the same.

Students and workers seem be afraid of infection from the HIV/AIDS carriers among them, although the health authorities have assured them that it is only through sexual intercourse or blood contamination that one can be infected with the virus.

While they may be ill-founded, people's fears become readily understandable if we consider the fact that most hospitals in Indonesia are not prepared to treat AIDS patients. A recent study by the medical school of the University of Indonesia found that many Indonesian doctors, particularly those working in community health centers, still lack knowledge about the disease.

The government, meanwhile, believes that appointing special hospitals to treat AIDS patients will not help the situation, saying that every hospital has to prepare itself to handle the disease. In the eyes of the authorities, then, no hospital should reject AIDS patients.

The policy makes sense, but enforcing it could prove difficult. What action will the government take against a hospital which turns away an HIV/AIDS patient? Where the hospital has done so out of a genuine fear that other patients or staff will become infected with the virus, what form of punishment will be appropriate?

The AIDS patients themselves are in a very difficult position. In the first place they have no clear legal protection. In the second place, they are -- understandably -- reluctant to have their identities revealed to the public.

It can take years before a person infected with HIV develops AIDS or is diagnosed as carrying the disease, meaning there is a high risk that he or she will pass it on to one or more other people.

Until the public has been better informed about AIDS and the fight against it has been taken up in earnest, the disease is likely to continue to scare people -- including doctors and other medical personnel entrusted with caring for the victims of the illness.