Specter of AIDS looming over Indonesia

By David and Joyce Djaelani Gordon

BOGOR, West Java (JP): All across the entire greater Jakarta area the nightmare of addiction has fully awakened. We are now face to face with the haunting reality of addiction and addicts: HIV/AIDS and Hepatitis C.

There is no escape, there is nowhere to run, there is nowhere to hide. The nightmare is real, and the crisis of the addiction nightmare is as horrifying as your imagination can perceive. The epidemic of addiction and addicts and the pandemic of HIV/AIDS and Hepatitis stretches from Batam to Irian Jaya.

Promoting and emphasizing "drug supply reduction strategies" has not stopped addiction or these diseases from spreading into and across our communities.

The current estimation of people abusing drugs, and people who are addicted to drugs is now rapidly approaching 2 million.

Each and every day now at Yayasan Harapan Permata Hati Kita in Bogor, parents bring their children, boys and girls, into our recovery center. The fear, frustrations, tears and anger spill forth from the hearts, minds and lips of each of these parents. The young addicts sit quietly, staring at the floor, or playing with their fingers, and hating to have been brought to this place. Yet these young addicts know their lives have been wrecked by something: "the drug addiction" they can no longer control.

Yayasan Kita has only been open since last July. We have accepted 72 addicts and junkies into the Program for Detoxification, Treatment, Recovery and Aftercare. Of these 72 young (the ages range between 16 and 42) male and female junkies, 53 (more than 73 percent) tested Hepatitis C positive (a virus that with time causes cirrhosis and cancer of the liver). Eight have tested positive for HIV/AIDS. There is no cure for either virus. These viruses are highly contagious, and both are deadly. The numbers and percentage of this nightmare grows daily.

These viruses are mostly spread by sharing needles and having unprotected sex.

IDUs (Intravenous Drug Users -- people who are injecting drugs with needles) are becoming more and more common. More than 60 percent of the putaw addicts are now estimated to be IDUs. Drug abusers and addicts who use and share needles are the most susceptible to becoming infected with the HIV/AIDS and Hepatitis viruses. Drug users, abusers and addicts are now considered to be in the ultra high risk group.

We have had to look these young people in the eye and tell them: "not only are you an addict, you also have Hepatitis C, or you have Hepatitis C and HIV/AIDS." At first what you see in their juvenile eyes is disbelief. All time stops and freezes, then fear comes, then the tragic horror and truth of the nightmare sets in as they begin to realize that what we have just told them is: "you have an incurable virus, and it is going to kill you".

We have to tell these addicts that they need to stop using drugs, any drugs. Because continued use of drugs will aggravate their conditions. Recent studies in the U.S. have found that cocaine and shabu-shabu (crystal methamphetamine) speed up the replication process of these viruses. Alcohol is toxic to people, especially addicts, who have any type of liver disease.

We have to look the parents in the eye, exactly the same as we do with their children, and tell them the same thing: "Your son or daughter has Hepatitis C, or HIV/AIDS." The parents immediately stare into empty space, lose their breath, and all energy drains from their bodies; they slump down, limp from the words, and the tears begin to flow.

They ask us to repeat what we just said. They ask us to explain what we said, and explain what Hepatitis and HIV/AIDS is, and what each virus does.

The reality of these moments lasts a lifetime. This diagnosis is now becoming a daily occurrence at our center. Each time we have to tell someone they have Hepatitis or the HIV/AIDS Virus is heartbreaking for everyone. It never gets easier, only more difficult.

Most Indonesians truly do not understand the severity of addiction and addicts, or HIV/AIDS and Hepatitis, as of yet. The number of addicts is rapidly increasing, so are the reported cases of HIV/AIDS and Hepatitis. Statistics are only barely beginning to begin to record the number of people that have been tested, and are found to be HIV positive, those that have died, and are dying from AIDS.

Indonesia really does not report the number of deaths caused by drug overdoses (usually from Putaw/heroin), even though many young people are dying daily from overdoses.

Much is being shared today about drugs, addiction and these viruses in Indonesia. Still, hardly anyone truly understands what to do with addicts. This is a large part of the reason addiction is such a nightmare.

Parents and the general public think that detoxification, or a short-term stay in some hospital or institution, or counseling in some drop-in center will cure their child of addiction. Parents spend millions of rupiah on detoxification, then spend millions more on medication.

Parents do this over and over again, hoping in vain something, anything, will cure their children from this nightmare. Yet it does not work because addiction is not simply a physical condition. It is a physical, mental, emotional and spiritual condition. And because basic detoxification does not stop or cure the addiction, the nightmare continues and becomes worse.

Residential treatment programs, community-based self-help programs and the 12-step program of Narcotics Anonymous are the best ways to combat addiction today. HIV/AIDS and Hepatitis must be dealt with in the same way, because those involved at the core have the best, most current knowledge and information available for addicts, infected addicts and their families.

Indonesia has run out of time for both hope and guess-work. This is the time for combined and community action. Anything else, other than action only helps the nightmare to spread.

- The writers are program directors at the Yayasan Harapan Permata Hati Kita Recovery Center in Bogor, West Java.