Putaw and HIV/AIDS: The crisis worsens across the country

Putaw and HIV/AIDS: The crisis worsens across the country

David and Joyce Djaelani Gordon, Contributors, Jakarta

Recently, four addicts, putaw (low-grade heroin) users,
undergoing treatment for recovery from drug addiction in
Makassar, South Sulawesi, were tested for HIV/AIDS. (The testing
was consensual and was part of the program.)

Three of the four tested positive for the virus. In late 2004
another group of addicts in Makassar was tested for HIV/AIDS: The
results were nine out of 12 tested positive.

While these sample tests are small the rate of infection is
very high at 75 percent. In talking with the most recent group
tested, each mentioned that they had friends that were also
addicted, and all had been sharing needles together.

There is now ample reason to believe that as more individuals
test, a continuing (high) rate of infection will be discovered.
This data is extremely alarming, and these figures and facts
foretell future trends.

In these current times it is both well-known and documented
that when the "addicted population" of any country reaches the
level of 10 percent HIV/AIDS positive, the virus "explodes"
throughout the country.

This finding in Makassar represents hard data, and confirms
that putaw addiction has now become a full-blown crisis, and that
HIV/AIDS is now a full-blown-epidemic.

Whole nation affected

We believe that Makassar is not a unique example; it differs
merely because people there can monitor what is happening, and
report such findings. These findings, taken together,
substantiate that both addiction to putaw and HIV/AIDS are
spreading throughout other islands, and thereby, the nation.

Huge increases in drug use/abuse/addiction (especially the use
of putaw and shabu shabu) and rapidly increasing rates of
HIV/AIDS infection are now evident in Bantam, Medan, Bandung,
Yogyakarta, Surabaya, Singaraja, Makassar and Merauke.

Taking South Sulawesi as an example, families are bringing in
youth and family members from rural districts and small towns to
provincial hospitals and recovery centers -- so we are able to
verity that both addiction to putaw and HIV/AIDS are spreading
outside of the main cities.

Trafficking routes for drugs and lines of progression for
HIV/AIDS can now easily be defined and mapped across the nation.

This data also highlights another truth: If we are (currently)
unable to contain and reduce the spread of drug abuse and
addiction, and the increase in HIV/AIDS infections within the
most densely populated (better educated) areas of the nation, how
are we going to be able to thwart either in the smaller and more
remotely populated (i.e., lesser educated) areas?

'Putaw' "culture"

Putaw is problematic: It takes away (dissipates) all forms of
pain, anxiety and stress while, at the same time, gives one a
sensation of euphoria -- of calm and relaxation, along with an
enhanced feeling of well-being -- which lasts for several hours.

It is a drug that is most often used in the company of others.
Putaw is most often used in small groups, in which individuals
seek out the substance from dealers and share the drug with
others within their group. Today, the majority of putaw
users/addicts use needles, and they regularly share needles with
one another.

Needle-sharing is, in itself, also an interesting feature
because it is an inherent part of putaw "culture": Sharing
needles strengthens bonds and emphasizes the rite of passage
involved in the activity.

Injecting is also the most efficient way to become infected
and transmit the HIV/AIDS virus.

Drug abuse and addiction to putaw has now spread to all
sectors of the population, as has HIV/AIDS. Drug addicts,
especially injecting drug users (IDUs), sex workers, those in
prison and those referred to as transients and migrants remain at
the top of the nation's list of "high-risk" groups.

Although each of the above groups includes both males and
females, new data indicates that women in high-risk groups are
highly susceptible to drug abuse/addiction and becoming infected
by HIV/AIDS.

This drug and virus crisis might be better understood if it
were perceived as a smaller, less visible form of earthquake or
tsunami, yet it occurs far more frequently, and is much more
powerful and destructive.

Each and every day, across the entire nation, destruction and
death are a direct consequence of addiction to putaw, and of
AIDS.

Putting crisis in its context

The number of people infected, and those who will become
infected, those who have died, those who are dying and those who
will die from drug abuse and the virus is far, far greater in
totality than the deaths caused by earthquakes and the tsunami.

Drug abuse and addiction to putaw have steadily increased
since the early 1990s, and presently rage, uncontrolled and
uncontrollable, across the nation. Estimates of individual abuse
and addiction to drugs (mainly putaw, shabu-shabu and alcohol,
followed by ganja, ecstasy and tranquilizers/barbiturates) now
total millions.

HIV/AIDS is increasing at a great rate across the country;
estimates range from 150,000 to 500,000 infected people. While
numbers vary of total individuals infected with the virus, it is
generally agreed that by 2010 more than one million Indonesians
will be infected with HIV/AIDS.

Even as some departments within government, non-governmental
organizations, medical, health and welfare departments, education
departments, religious communities and the private sector are
evolving ideas, education and training and plans of action, and
some are providing action & programs -- still the nation, as a
whole, remains categorically weak and far behind in combating
addiction and HIV/AIDS.

Importance of education

The only combative resources that have an opportunity to
engage these massive destructive forces, face to face, are
education, intervention and harm reduction.

Education is the most logical defense that can be used today
when fighting the spread of HIV/AIDS. Education is the least
costly, most effective, most intelligent and readily available
weapon we maintain when addressing the issue of prevention.

There needs to be, as quickly as possible, an initiative that
specifically provides direct, open and honest education on drug
use, abuse and addiction, HIV/AIDS, hepatitis and tuberculosis.

There also needs to be education on sex, sexuality and
welfare, and issues pertaining to gender as part of the
curriculum in all junior and senior high schools and universities
across the nation.

Trained facilitators and peer-educators should teach the
teachers and educators, and then the teachers and educators
should teach the students. This is the most pragmatic approach
that can currently be developed.

With putaw users, abusers, addicts and other individuals
already infected with HIV/AIDS direct intervention (outreach) and
harm-reduction strategies, techniques or programs, along with
aftercare services and programs, and self-help programs and
curriculums, must be entirely utilized.

The connection between putaw and HIV/AIDS is no longer an
academic concept: It has already become a harsh reality that
demands appropriate action be taken immediately.

(The writers are directors of Yayasan Harapan Permata Hati Kita
and can be contacted at Villa Pandawa YAKITA, Jl Ciasin No. 21,
Desa Bendungan, Ciawi, Bogor, Jawa Barat, (PO Box 126, Bogor),
tel. (0251) 243069/243077, e-mail: wisma_srikandi@hotmail.com,
website: http://www.yakita.or.id)