August 18, 2011

My first visit to Papua.

I started working on this project in 2009 after reading a short article on that caught my attention. The headline stated, “I would say 75 percent of Papuans don’t believe there is HIV.”  The article focused on Juliana Yarisetou, a housewife who contracted HIV from her husband.  She was told to go home and rest by a doctor when she came to the hospital for treatment.  At one point she weighed 22kg (48.5lbs). Her husband and youngest child died from AIDS and her community discriminated against her after discovering her illness.
I scoured the Internet to find more information on the spread of HIV/AIDS and its effects in Papua but discovered very little facts and images.  I emailed the reporter who wrote the article and he referred me to NGO Family Health International (FHI) in Jayapura, the capital of Papua.  A week later I met Juliana in person.  As it turns out, she became an AIDS advocacy officer for FHI and with their help she was able to gain back her health and has been open about her status.  She is one of the lucky ones.

Juliana Yarisetou works as an AIDS advocacy officer for the international NGO Family Health International in Jayapura. She contracted HIV from her husband in 2004. She is open with her status and often gives her testimony on living with HIV.
The body of a patient with AIDS covered with boils at a local hospital in Jayapura, capital of Papua. According to the doctor, he is in the advanced level of the disease though it's his first time at the hospital.  Awareness of HIV/AIDS within indigenous Papuans population is very low.

Due to economic disparity indigenous Papuans are most vulnerable to poverty, malnutrition, unemployment, and illiteracy.  However in Papua, only HIV/AIDS is perceived as equal to death.  Education and awareness of HIV/AIDS is very low among indigenous Papuans.  Limited accessibility to basic services and inadequate aids had made it difficult for them to get tested for HIV or receive proper counseling and support.  Only 31% of indigenous Papuans know where to get an HIV test and most clinics are located too far from those living in rural areas.  Also, availability of Anti-Retroviral drugs (ARV) is erratic and no medicine on hand for opportunistic infection such as Tuberculosis (TB) or dietary supplements to help maintain health.

The mountainous terrain of Papua is seen from above the clouds.  Papua is the largest province in Indonesia and it's home to approximately 1% of Indonesia's population. However, approximately 40% of all HIV/AIDS cases in Indonesia are located in Papua. Currently, Papua has the highest HIV/AIDS infection rate in the country, 15 times higher than the national average and the highest HIV/AIDS prevalence outside of Africa.

Market scene in Wamena, a developing town in the highlands of Papua.  Over 40% of people in Papua live on less than $1 per day most of which are indigenous Papuans.  Furthermore, Papua has the highest incidence of poverty that doubles the national average.

In Jayapura, I was introduced to a local NGO Yayasan Harapan Ibu (YHI) or Mother’s Hope Foundation.  They have about a dozen staffs mostly of Indigenous Papuans and very successful in educating their community on HIV/AIDS prevention through the use of condoms.  In Papua, less than 30% could identify a condom and only 8% have used it.  The use of condom is also perceived as a lack of trust and they are not widely available in rural areas.  Condom use is a key factor in prevention because HIV is transmitted through sexual intercourse in almost every case.

Yayasan Harapan Ibu (Mother's Hope), a local NGO, demonstrates the use of condom at public places to help prevent the spread of HIV virus.   Many men never seen or used a condom before and those who use condoms almost never do so consistently.  Obtaining condoms outside of urban area is also difficult.

Michael (17) turns his face away while getting tested for HIV for the first time at a local clinic in Jayapura.  There is a high probability that he has contracted the virus since his girlfriend is HIV positive and they don't use condom. 

A woman with AIDS gives her testimony in front of a support group.  Many people living with AIDS have to keep it a secret for fear of embarrassment or retribution from the community.

In Papua poverty has triggered and enforced the exchange of sex for goods, cash, or food in urban and developing areas as an accepted norm in both legitimate venues such as brothels and outside of “formal” settings.  YHI introduced me to Mama Fin, a social worker who opened up her home to young Papuan street prostitutes, most of them just teenagers already infected with HIV.  When I asked them about their future and what they wanted out of life, many wanted to go back to school and have a good job but they all wanted to be happy.  Papuan prostitutes are at the lower end of the industry.  They seek clients in public events, not in brothels. They have sex outside, by the side of the road, empty hut, urban dwellings, etc. They are more likely to find themselves at the bottom in terms of income earning a couple of dollars.  Also, they face the highest risk of personal safety and violence. Street worker intervention program geared towards Papuans has a condom use rate of less than 5% compared to 70% to its non-ethnic Papuans counterpart.

Street prostitutes, Betrix (25) and Natalia (16), both HIV positive shares a cigarette as they wait for potential clients in the capitol of Papua, Jayapura.  Teenage girls such as them sell their body for $2 per client.  They are poor and uneducated and prostitution is the only means to earn money to survive. 
An empty bottle of liquor and used cardboard. Indigenous Papuan sex workers are at the lower end of the industry.

I followed YHI for about a week as they go to markets passing out pamphlets, condoms, and demonstrating its usage to anyone willing to listen.  I also discovered that YHI is more successful because indigenous Papuans prefer treatment from indigenous staff rather non-ethnic Papuans who possess little knowledge of Papuan culture and values perpetuating miscommunication and mistrust and biased or inefficient delivery methods of service.  Many indigenous Papuans feared that the non-ethnic staffs could not be trusted in keeping their illness discreet.
Almost 90% of those who test positive with HIV in Papua flee without seeking care.  Fear of abuse, persecution and ostracism from community and family members have made secrecy the primary concern rather than treatment. There had been rumors that I heard while I was there that a child was buried alive by his own parents after they discovered the illness.  The same stigma also dictates social withdrawal and isolation are social sanctioned as common responses to dealing with HIV/AIDS.  In the end, deep-rooted stigmas sustain a lower quality life without respect or dignity that disenfranchised the well-being of indigenous Papuans living with HIV/AIDS.
A woman with AIDS living under a bridge in the city of Jayapura.  A social worker had been encouraging her to go to the hospital to get treatment but she refused.  90% of those who test positive for HIV flee without seeking care.  Social withdrawal is a sanctioned cultural response to a serious illness that is seen to be contagious.
Rejected by his family because he has AIDS, Daud (23) finds refuge at a local hospice in Jayapura.

Fastforward to 2011 and the situation has gotten worst as the most recent census shows the number of people with HIV/AIDS in Papua has jumped by more than 30 percent. I plan to go back to Papua this October to examine some of the factors responsible for the pandemic level of HIV/AIDS including economic disparity, lack of in HIV/AIDS education and awareness, insufficient service and support, discrimination in healthcare, and stigma.

I aim to  accurately illustrate the affects of HIV/AIDS among indigenous Papuans.  Ultimately, I seek to be a catalyst that raises an awareness of numerous flaws within the status quo and stresses a call for immediate actions to remedy the dire situation.  In the end, I want to promote the development of improved methods in preventing the spread of HIV and provide essential aid for indigenous Papuans living with AIDS.

Children playing jump rope during after Sunday school.

Thank to all of you who had supported this project.  I encourage to get involved and please help spread the word by sharing it on Facebook, twitter, tumblr, and other social media sites as well as to anyone who might be interested in getting participating.  I am contacting numerous NGO's and health organizations for possible sponsorships as well.  Please feel free to contact me if you have any questions.
This is the direct link to my crowdfunding campaign on



No comments:

Post a Comment