Indonesia: Battling AIDS

Indonesia is technically a rich country. Oil and gas, copper and gold, timber and coal -- natural resources are abundant. The capital Jakarta has flashy skyscrapers, fancy restaurants, golf courses and huge mansions.

But in Indonesia, like in many developing nations, a few are extremely wealthy, most have just enough to get by and many are poor. In Asia’s only OPEC member country, half of the population lives on $2 a day or less.

Compared to other provinces, people living in the Jakarta area are better off. Much of the country’s business, finance and government operations are located here.

However, that doesn’t mean all is well in Jakarta. According to UNICEF’s John Budd, a growing issue in Jakarta is HIV/AIDS through intravenous drug use. With a total population of over 210 million people, an estimated 90,000-130,000 people are living with HIV/AIDS in Indonesia, says UNAIDS.

In Jakarta, the discos are packed with thousands of young people taking ecstasy pills and other illegal substances. With a police force that is bribed to stay away, waiters who take drug orders and deliver minutes later, it’s no surprise that almost half of Jakarta’s students try drugs. An increasing number even goes further and shoots heroin.

Intravenous drug use is the major reason behind Indonesia’s HIV/AIDS epidemic. Over 90 percent of intravenous drug users have been found to use unclean injecting equipment in three major cities.

At Yayasan Kita, an addiction treatment and recovery center outside Jakarta, UNICEF cooperates with former heroin addict David Gordon. He helps young Indonesian drug users to turn their lives around. His center includes a crisis prevention team. Gordon calls them "Junky Busters."

"If parents call and they’ve got a son or a daughter that’s out of control and they can’t work with them and can’t get them into recovery, they call us and we send our car out with five or six guys and bring them in," Gordon explains.

At the center, every newcomer is tested for HIV. In 1999, Gordon found that 14 percent of his patients tested positive. Now, only four years later, that figure has jumped to more than 50 percent.

"Not only are we in a crisis situation moving faster, another year from now, it will be much worse and two years from now, even worse than that," says Gordon. He thinks the number of HIV-positive Indonesians is far more than government estimates. "The official figures are 130,000, but it is much higher than that -- half a million."

Besides drugs, something equally popular is for sale in Indonesia: sex. The country’s sex industry is huge. Some prostitutes, male and female, are only teenagers. UNAIDS estimates that only 10 percent of their customers use condoms. Among sex-workers, HIV infection rates are estimated to be between five and 25 percent.

The Indonesian government says that overall, the country has very low HIV prevalence. Less than 0.1 percent of the population is reportedly infected. Yet Dr. Samsuridjal Djauzi from the Dharmais Hospital in Jakarta believes the actual rate is much higher. He has been treating HIV/AIDS patients since 1986.

"I think that the number of cases detected is low because the places where people can test themselves is very limited," says Djauzi. "In this hospital, around 15 to 20 patients come to our outpatient clinic every day. One third of them are new cases."

Java, Indonesia

With new, alarming data on HIV in high-risk groups that include young people, UNICEF recently revised its 5-year-plan for Indonesia, says Budd.

"We are regarded as having one of the largest potential problems in Asia," he says. "We have reprioritized HIV here. We are now going to develop a general awareness campaign targeting young people aged 11 to 17." UNICEF studies show that over 80 percent of Indonesians in this age group are not aware of HIV/AIDS. "They don’t know what the disease is even about."

A major problem is the lack of condom use. Although condom marketing and AIDS-awareness campaigns have been boosted since the late 1990s, condom use remains low, even in commercial sex.

Prostitution and increasing drug abuse are only one side of Indonesia, which in general, is a conservative country. The challenge is trying to present a fairly risky topic while also respecting local tradition and culture.

condom

Experts agree that an aggressive, government-backed condom campaign is needed to help prevent AIDS. But that is not possible yet, says Dr. Haikin Rachmat, Director of Transmittable Disease Control at the Indonesian Health Ministry. "I think it is a sensitive issue," he says. "There is a controversy with the norm, with the religion, with the culture."

UNICEF´S Rachel Odede, who heads the HIV/AIDS unit, hopes for change. "Indonesia should open up gradually. And I’m calling on leaders, I’m calling on policy makers, I’m calling on parents or significant others around people infected with AIDS to give them support."