RI slowly wakes up to AIDS reality

RI slowly wakes up to AIDS reality

By Prapti Widinugraheni

JAKARTA (JP): Indonesia finally woke up to the perils of
Acquired Immuno Deficiency Syndrome (AIDS) in 1994 after initial
confusion about the nature of the threat.

After a long delay, in June the government set up a commission
to coordinate efforts to stem the spread of AIDS and to expand
the anti-AIDS campaign beyond simply the people belonging to what
had officially been termed as "high risk" groups such as
prostitutes and homosexuals.

Despite the massive publicity about AIDS and its perils and
how other countries deal with the problem, Indonesia's reactions
have been irrational, to put it mildly.

Before the establishment of the commission, government
agencies were not united on the issue either.

"Magic" Johnson

The controversy over the planned visit by American basketball
star Earvin "Magic" Johnson at the start of 1994 illustrates just
how little Indonesians knew about the nature of AIDS.

Magic Johnson, selected five times as the most valuable player
in the National Basketball Association, retired from professional
basketball in 1991 after testing positive for Human
Immunodeficiency Virus (HIV) which causes AIDS.

His planned visit in January, intended as part of Indonesia's
anti-AIDS campaign, was canceled ironically because of objections
that his presence in Indonesia was seen as a threat to the
public. While the Ministry of Health gave its blessing to the
visit, the Directorate General of Immigration refused to give
Magic Johnson a visa.

This confusion prevailed despite widespread information
assuring that AIDS can only be spread through sexual contact, use
of a contaminated hypodermic needle, transfusions of contaminated
blood, or -- in the case of an unborn child -- from an infected
mother.

The government, judging by its policies at the beginning of
the year, appeared to be uninformed or was ill advised about the
AIDS threat.

The ministry of health in February for example disclosed a
plan requiring prospective expatriate workers to have medical
proof that they were not HIV positive. Foreign tourists would be
exempted because their stay in Indonesia was not considered long
enough to have sex with Indonesians.

The plan was shelved after it fueled another public uproar and
Minister of Health Sujudi later announced that the government
would study how other countries cope with the AIDS problem.

Other government agencies sought to stem the spread of AIDS by
extolling religious and moral values -- clearly yet again
targeted at prostitutes, their patrons, homosexuals and those who
constantly change partners.

Critics said this approach would not only fail, but would also
confuse the public even more because it is not putting the
problem in its proper prospective.

"Changing behavior is useless, religion has been trying to
change it for over 2000 years but there are still thieves and
killers," Kartono Mohamad, former chairman of the Indonesian
Doctors' Association, said.

It was a relief when President Soeharto issued a decree to
establish a commission to coordinate the efforts to counter the
spread of AIDS. It might have been a bit late, but it's an
initial start in the right direction. Coordinating Minister for
People's Welfare Azwar Anas was appointed to lead the commission
whose members include the Ministers of Health, of Social
Services, of Population and of Religious Affairs.

The government also appointed the Koja general hospital in
North Jakarta as the national center for AIDS treatment.

A month later, in August, Indonesia held its first national
workshop on AIDS which aimed at producing a concrete, applicable
five-year plan of action for all related institutions.

The government did not stop at planning and campaigning. It
also sought new, cheaper, made-in-Indonesia HIV-testing methods
which met international standards.

Cheaper

The "entebe dip-stick", developed by Hepatika laboratory in
Mataram, West Nusa Tenggara was announced in June but had yet to
gain WHO approval. If it is approved, the method will be cheaper
than the western blot method which is recognized by WHO and used
in many countries, including Indonesia.

True, Indonesia's official statistics on AIDS are not as bad
as many other countries. By November, only 266 people tested
positive for HIV. But government officials acknowledged that the
actual figure would be much higher, with estimates ranging from
50,000 to 100,000.

The health ministry has allocated some Rp 5 billion for this
year's anti-AIDS campaign, and over the last five years WHO has
extended some $3 million to help the anti-AIDS campaign in
Indonesia.

What do people who are actively involved with AIDS victims
have to say about all this?

"AIDS in Indonesia is now at the same stage it was in Thailand
five years ago. This is very scary," Nona Poeroe Utomo, the
director of the Indonesian AIDS Foundation, said last November.

Despite the government's year-round efforts, she considered
the key to the anti-AIDS campaign -- information and education --
"inadequate".

She also condemned the attitude of self-denial among
Indonesians, including public leaders, who dismissed lightly the
dangers and implications of AIDS by stressing that traditional
and religious values and the state ideology Pancasila could
shield the nation from the catastrophe.

The last, but not least, aspect which can be noted about the
problem of AIDS in Indonesia is the apparent lack of counseling
for AIDS victims and their families.

This is mostly due to the fact that many psychologists, who
would actually serve as better counselors compared to doctors who
are currently doing the job, prefer to work in better-paying jobs
that companies offer them as personnel managers and industrial
psychology experts.