Remote Timika fights AIDS in its own way

TIMIKA, Irian Jaya (JP): Behind Timika Community Health Center, there is a small house measuring five square meters.

A billboard outside says "Reproduction Clinic, Timika Community Health Center" and beneath it are posters about the dangers of HIV and AIDS.

Inside, there are two counseling rooms with beds and medical equipment. Brochures, condoms and a wooden penis are strewn about the front desk.

"We've been running this clinic for three years now," said Nurlan Silitonga, who, with four staff, is in charge in the clinic, five laboratory technicians and two field staff.

Nurlan's appearance is not one of a typical doctor. Tall and slim, her straight hair falls to her waist. She wore a bright red blouse and miniskirt, complete with red lipstick and high heels.

She said she was afraid of reporters.

"I'm afraid they will twist the facts. HIV and AIDS are very sensitive matters, especially here in Irian Jaya," she said.

This easternmost province has the highest number of HIV and AIDS cases in Indonesia.

The Ministry of Health recorded from 1996 to July this year, 393 cases of HIV and AIDS in Irian Jaya, 19 more than Jakarta.

Irian Jaya, which has an area of 421,981 square kilometers, is three times larger than Java, and has a population of only 2,098,310, or almost a quarter of Jakarta's population.

Eighty-five percent of the people there live in rural areas which are difficult to reach.

Similar to general opinions about HIV and AIDS, many Irianese still think the condition is related to sexual behavior.

"Many also think it's a curse, or worse: they think some people deliberately spread the (HIV) virus to cleanse the Irian people," Nurlan said.

An hours' flight from the capital of Jayapura, Timika is ranked third in the incidence of HIV and AIDS after Merauke and Fakfak, according to the Ministry of Health's provincial office.

Up to July this year, there have been 43 cases of HIV and four AIDS cases in Timika, which has an area of 19,592 square kilometers and a population of over 100,000.

Timika is a stopover for employees of giant mining company PT Freeport Indonesia, located in the mountainous Tembagapura, some 70 kilometers from here.

It is a developed town, providing visitors with a shopping mall, five-star hotel and an international airport. All of which are similar to those in Jakarta, or even better.

"Every weekend, there are buses full of Freeport employees who came down here from Tembagapura. The residents here call the bus bis kerinduan (longing bus)," Nurlan said.

Some employees visit their families, but some just have a good time in bars and the red-light district.

"These people are at a high risk of being infected with HIV," Nurlan said.

That's why Nurlan, in cooperation with the local administration and non-governmental organizations here, conducts a safety program to give information to Freeport employees and people in Timika.

The clinic provides brochures and comic books which illustrate the danger of HIV/AIDS, and also gives out free condoms -- 16,500 so far.

Nurlan and her staff have also trained some 150 residents, including midwives, to inform the community.

"We haven't surveyed the program's effectiveness. But there are more people coming to our clinic for checkups or simply to ask for condoms. There has also been about a 16 percent decline in the number of people with sexually transmitted diseases in the past three years. We take that as a good indication," she added.

In the past three years, the clinic has been visited by about 19,000 people, with an average 600-700 visitors a month, ranging from prostitutes to employees and housewives.

"We also conduct AIDS awareness activities every year," Nurlan said.

What makes her worry is the high demand from local residents to close the red-light district and bars.

"It will be hard for us to control the prostitutes as they will work on the streets," she said, adding that most of the prostitutes come from other islands, such as Java and Sulawesi.

The ministry's Director General of Communicable Disease Control and Environmental Health Umar Fahmi Achmadi also expressed his concern.

"These areas help control the condition. Prostitution is a matter of people's behavior. How can we control people's behavior? It's a very personal thing," Umar said.

An official of the local Ministry of Health office, Didik Irawan, said it was unlikely that HIV and AIDS patients in Irian Jaya would survive more than a year, like in other provinces.

"The combination of poor health conditions and bad nutrition makes way for opportunist diseases that lead to AIDS and a quick death," he said.

-- Hera Diani