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.