Positive Is Negative

Collection with 8 media items created by U.S. Editor

15 Feb 2013 15:00

HIV/AIDS in the highlands of Indonesia Papua

The fact that HIV infection is higher among ethnic Papuans is representative of greater socio-economic inequalities. Much remains to be done to reach the United Nations Political Declaration on HIV/AIDS and the Millennium Development goals. In Papua, the severity of the situation has been completely underestimated by the authorities and so far, their response to the epidemic has been severely inadequate. In order to decrease dissatisfaction with their rule, a general attitude of the Indonesian government has been to provide local governments in Papua with large amounts of money. It is then assigned to various programs without proper preliminary research and subsequent monitoring. The actual causes of the problem however, are rarely tackled. The poor standards or complete lack of health services and education throughout the region not only facilitate the spread of the disease, they also severely impede any efficient response to the epidemic. Indeed, although the provincial governments have made HIV testing and treatment free, many Papuans do not have access to health care or education and are unlikely to be reached by awareness raising campaigns any time soon. In the meantime, the virus continues its deadly advance into the highlands.

Hiv/Aids Sexually Tra... Std Infectious D... Aids Awareness Health Educa... Aids Education Sex Education Testing Treatment Arv Therapy Epidemic Health Services Healthcare Health Education Southeast Asia Photo Collec... Photo Essay

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
01 Feb 2013

A women's disfigured hands tell of a long history of loss. Traditionally Dani women amputate a finger everytime a close member of the family deceases.

The fact that HIV infection is higher among ethnic Papuans is representative of greater socio-economic inequalities. Much remains to be done to reach the United Nations Political Declaration on HIV/AIDS and the Millennium Development goals. In Papua, the severity of the situation has been completely underestimated by the authorities and so far, their response to the epidemic has been severely inadequate. In order to decrease dissatisfaction with their rule, a general attitude of the Indonesian government has been to provide local governments in Papua with large amounts of money. It is then assigned to various programs without proper preliminary research and subsequent monitoring. The actual causes of the problem however, are rarely tackled. The poor standards or complete lack of health services and education throughout the region not only facilitate the spread of the disease, they also severely impede any efficient response to the epidemic. Indeed, although the provincial governments have made HIV testing and treatment free, many Papuans do not have access to health care or education and are unlikely to be reached by awareness raising campaigns any time soon. In the meantime, the virus continues its deadly advance into the highlands.

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
01 Feb 2013

A Papuan student eats his lunch of chicken and rice.
A lack of knowledge about the modes of transmission coupled with the long running political conflict and the climate of mistrust and fear it has borne, has led to many misconceptions and a number of conspiracy theories. The suspicion that HIV has been introduced specifically to decimate the indigenous population is widespread. A common belief among highland Papuans is that chicken served in restaurants (mostly run by non-Papuans) is injected with the HIV virus to intentionally infect them. These misconceptions about the virus have a direct impact on the lives and welfare of people living with HIV/AIDS.

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
01 Feb 2013

A member of YPKM, a local NGO, demonstrates the use of a condom during an HIV and STD awareness raising campaign at a local market. These kind of campaigns are still very rare.

Sexual health awareness is extremely low among the Papuan population as a whole.

Indonesian health officials often blame cultural sex practices such as 'wife swapping' for the rapid spread of HIV in Papua, but transmigration and large resource extraction projects have fed the sex industry, which has also been a major driver of the spread of the disease. The exclusion of large parts of the indigenous populations from development and access to the market economy has led increasing levels of Papuan women to engage in prostitution. Poverty is such that transactions often take place in unregulated open air or street dwelling sites with no safety precautions. One NGO worker said that some very young girls sell their bodies for less than 50 cent, for which you cannot even buy a packet of cigarettes or condoms. In semi official prostitution establishments, immigrant prostitutes (usually wearing condoms) charge 20 Euro upwards.

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
01 Feb 2013

HIV testing and ARV therpy in Wamena are free. Voluntary Counseling and Testing (VCT) in Wamena only started in 2007, at the initiative of a church sponsored clinic. This led to the public clinics and the hospital offering the service shortly afterwards. The latest statistics for the whole Jayawijaya region, from September 2012, show that 2504 (with a population of over 200,000) people have tested positive for the disease. However, the majority of cases stay undetected

Many people do not get tested due to the lack of services in their area, high travel costs or lack of roads. Local clinics (Puskesmas) outside of the city are often closed and the staff absent.

The prevalence rate among ethnic Papuans is almost twice as high as among the Indonesian newcomers . Contrary to the rest of Indonesia where the epidemic is mainly concentrated among high risk groups such as injection drug users and sex workers, in Papua transmission is almost entirely through heterosexual relations (97,1%) and has very much spread to the low-risk population.

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
01 Feb 2013

Two nurses insert an intravenous drip into Yulianus'* (23) hand. Yulianus has been undergoing ARV therapy for the past two years, but often forgets when he feels well. Feeling weak, with no appetite and coughing blood a local NGO recommended he should go to hospital. He was diagnosed with TB.

Many Papuans are reluctant to go to hospital as most of the staff is non-Papuan leading to cultural and linguistic misunderstandings. The upheaval and the high costs incurred for the family to stay in town or to visit them is another deterrent.

In the Papuan culture one will only seek medical attention when it is impossible to walk or work. HIV/AIDS is still a relatively new disease in the region, and people are still unaware of its modes of transmission and consequences.

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
01 Feb 2013

In the courtyard of the public hospital in Wamena, contaminated needles, blood packs and other highly hazardous waste lie unchecked next to hospital vegetable garden.

People from all over the valley have to come here for treatment, sometimes walking for days.

The poor standards or complete lack of health services and education throughout the region not only facilitate the spread of the disease, they also severely impede any efficient response to the epidemic. Indeed, although the provincial governments have made HIV testing and treatment free, many Papuans do not have access to health care or education and are unlikely to be reached by awareness raising campaigns any time soon.

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
01 Feb 2013

Jayawijaya regency with Wamena as the largest city in the highlands of Papua is one of the worst HIV affected areas in Indonesia. No roads connect the city to the provincial coastal capital of Jayapura, and everything needs to be flown in by planes. Data gathered by local NGOs in 2012 shows over 2500 people have tested positive with HIV since the testing started in 2007. These numbers, however, do not reflect the reality of the situation as many cases stay undetected.

In an attempt to ease Papua’s desire for independence and rectify some of the past abuses within the province, Special Autonomy (Otsus) was granted in 2001. Although this has greatly increased the funding to the region, very little progress has been made in crucial areas such as health and education and Papuan civil society seems to agree that it has failed to bring about the sweeping changes it was aimed to inspire. Development has profited to a select few and has further increased social stratification. Many communities still lack the basic infrastructures such as clean running water, sanitation and electricity and people in remote rural locations, where roughly 75% of all indigenous people live, have been largely left out by development. Access to quality health and education is a problem for large sections of the indigenous population, especially outside of urban centers.

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Positive is negative: HIV/AIDS in the...
Wamena, Indonesia
By Carolincik
26 Mar 2013

Among majestic mountains in the highlands of Papua, a generalised HIV epidemic is underway.

The island of New Guinea has been largely isolated from the influence of the rest of the world for thousands of years. In the western half (now part of Indonesia), in the Baliem valley one of the first agricultural centers developed over 9,000 years ago. It was only in the 1950s that the valley began to open up to the outside world with the arrival of the first European missionaries, following the 'discovery' of the valley in 1938.

Home to the world’s second largest rain forest, and some of the greatest natural reserves in gold, timber gas and fisheries, the two Papua provinces remain Indonesia’s poorest region. Ever since Indonesia controversially ‘integrated’ Papua in 1969 under the auspices of the UN, it has implemented an aggressive modernization campaign that maximizes resource exploitation. Apart from a small elite who could be said to have both participated in and reaped the benefits of this development, the majority of indigenous Papuans have remained at its margins.