Multicultural approach vital in dealing with HIV

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.