Multicultural approach vital in dealing with HIV

On the sidelines of a seminar in Jakarta last week, Marina Mahathir, President of the Malaysian AIDS Council talked to The Jakarta Post's M. Taufiqurrahman last week about how reluctance to address the issue of multiculturism had aggravated the problems of AIDS in Malaysia.

Questions: How do you relate AIDS to the concept of multiculturalism?

Answer: I think it is very much a part of it, because Malaysia particularly, is a multicultural country and AIDS affects different groups in a different way. Whether culture is an element in the vulnerability is a question. And it is a question that people don't really want to touch. For instance, in Malaysia the largest group affected by HIV are Malays and by extension Muslims, a lot of that is related to drug use.

There are disproportionate numbers of Malays who are involved in drug use. Again, this is an issue that nobody approaches from a religious or cultural point of view, whether there is a connection between the Malay culture or Muslim religion that makes them vulnerable to drug use and therefore HIV.

This is not explored out of fear that it tell you about the wrong things in the society. We can only speculate why in a Muslim country, there are Muslims who are vulnerable to drug use and HIV. That is a question that needs to be answered, but nobody wants to address it.

In a conservative society like Malaysia, how serious is the AIDS problem?

It is a serious problem. The perception that Malaysia is a conservative society is the official view of the government, whether it is true or not depends on how you define conservatism. From my point of view, and that of the non-governmental organizations working at the grassroots level having dealt with drug abuse and HIV, Malaysia is not at all a conservative society. The AIDS problem is a growing one. It is very hard to say whether it is serious or not, but we are concerned because it has been growing steadily over the past 20 years.

It has been growing faster now, meaning that every year there are new people infected, which suggests that prevention measures we are taking are not effective. Why is that, perhaps because we are not doing the right type of prevention, perhaps there are deterrents to the right prevention method.

Officially it is consider a conservative society, and therefore with respect to the sensitivities of supposedly conservative people, we cannot talk about condoms, and at the same time how do people protect themselves if you are not giving them the means to do so. People are not behaving in a conservative way, but we insist that we don't want to offend the people who are living in a conservative way. It is contradictory.

How has such conservatism hampered the fight against AIDS?

There are indeed people who are conservative, the people who don't know anything, the one who sit in their offices who never go out. Religious leaders, we assume that they are conservative in the sense that they hinder the things that we want to do. We have trained religious leaders around the country and found that they are not conservative in the sense that they are willing to face reality, not least because they are already facing it.

They already know what is happening, they know that something terrible happens at the grassroots level but they are not equipped with the knowledge to deal with it. They then revert to the same old things that they were taught. However, they then begin to see that we are partnering with them to help them do their work and that means we can move forward and as long as people are in touch with reality, it is not so difficult.

How far have women gained a public roles and in the fight against AIDS?

Women in social life are very much out there in public life, 60 percent of university students are women and women also hold high positions in the Cabinet, the central bank etc. etc. Public life is not an issue anymore. What matters for us really is the private sphere, especially in terms of Islamic law, the rights to control our own private life, including the right to own our own body, the right to determine the course of our lives, rather than having it determined by others.

In terms of AIDS, the most invisible population right now is really the women who are affected and infected by AIDS. We have been talking about AIDS for years, but we always talked about drug users, gay men and if we talked about women it was always about sex workers. There has been neglect about the vulnerability of women and only now we are beginning to see a sharp rise in women getting infected, which is already alarming.

What do Indonesia and Malaysia have in common in terms of AIDS?

One of the things that we have in common is drug problems. In Malaysia, the drug problem is a growing one and HIV is following very fast and in Jakarta 50 percent of drug users are infected very quickly. It is happening far more rapidly in Indonesia, and it is very serious. On the solution side, I think what we have in common is that there is the possibility of harnessing religious leaders to help. We think that the training that we have been giving to religious leaders is something that we can share.

And what we can learn from you is that you are tackling HIV among drug users in a far better way than we are, far more realistically. I know that the harm reduction program is being instituted and supported by the government, which is very good. And we are using Indonesia's example as well as countries like Iran or Bangladesh as examples of Muslim countries that are instituting a harm reduction program for drug users. Because earlier, the argument that we used against the method was that it was un-Islamic.

How far has your campaign progressed in an Islamic state like Kelantan?

In Kelantan, it is a total denial at the official level. Actually a lot of our problems arise in Kelantan and Trengganu, on the east coast. In the regions, there is a lot of HIV cases and a lot of drug use and I think it is related to the slower economic development in those states. Whether the slower development is also related to the type of government that they have is another issue.

However, you need to deal HIV in a holistic manner, it is not just a medical issue, if you don't deal with structural reasons why people become vulnerable, you are never going to deal with it.