Harm reduction, a work in progress in Kampung Bali
Leony Aurora, Jakarta
Indra, 24, went to the public health center in Kampung Bali, Central Jakarta on Thursday for one reason: free hypodermic needles.
He went to Iboy, a health worker for the Pelita Ilmu Foundation, which runs the harm reduction program, and took out a small package from a crumpled brown paper bag.
Iboy took it and gave him a fresh bag, with two disposable hypodermic needles and two small bottles of bleaching solution to sterilize used needles. On the back of the bag, a warning is printed that explains the various ways HIV can be transmitted.
"Many people perceive this harm reduction project as something that condones drug abuse," said Pungky Djoko, the foundation's program manager. Such a scheme provides injecting drug users (IDUs) with alternatives like methadone treatment and clean needles. "Actually, it (harm reduction) is the last resort."
Indra has been addicted to putauw (low-grade heroin) since 1996 after three years of being a regular marijuana smoker.
"In 1999, when putauw was more difficult to find, I changed methods from free-basing to injecting," he added. Taken intravenously, he only needed a small amount of the drug to get his "fix".
He found out that he had contracted HIV after taking a voluntary test last year. "Thank God, my wife is negative so far," said the father of a one-year-old baby, who has been found negative as well.
HIV is one of the concerns the foundation takes into account to determine who is eligible for the needle exchange program.
"They (drug users) must also go through detoxification and counseling first," said Pungky. "We need to establish their levels of addiction and their eagerness to stop, or at least reduce their usage."
Since the program started two years ago, 190 people living in the area, notorious for its drug activities, have been put on the list of those who are eligible for clean needles twice a week.
"But only about 15 people are active at this time," said Iboy. There were 13 clients in his book -- aged between 22 and 31. Next to the names, Iboy marks how many times a day his clients use drugs, based on their own admission.
"If the frequency doesn't decrease within two months, we stop giving them needles," he said.
Iboy, who himself used to be addicted to drugs, did not deny that most clients drop out after some time. "Some just disappeared, but some return."
The door to a legal harm reduction program was opened last December with the signing of a memorandum of understanding between the National Narcotics Body (BNN) and the government after a rise of HIV among injecting drug users in the last couple of years.
Before that agreement is signed, a needle on anyone could be used as evidence against them in the court. Indonesian law punishes not only drug dealers but also users.
BNN, working with several non-governmental organizations, has said that it is trying out the program to find an applicable model in the country.
"Needle exchange works here because it's a small-scale program and therefore can be monitored," said Pungky. "But I don't think such a program is ready to be applied nationwide."