Save Papua

The health situation in Papua is indeed dire. The HIV epidemic in the two provinces that make up the Indonesian part of Papua has now been acknowledged as 'generalized', with estimates that 2.4% of the adult population are infected. And of course, the population is equally badly affected by all the other health blights, including TB, malaria, and malnutrition.

When the scale of the HIV epidemic started to become apparent in the southern part of the province in the mid 1990's, donors descended on Merauke, the district capital, in droves. Among them, MSF-Belgium did a quite exemplary job, including nurturing a peer support group which continues to thrive. MSF also did a great job of addressing stigma (although they did make the mistake of translating the slogan 'AIDS can be treated' in a way which left the impression that it could be cured).

Most of the other agencies concentrated on prevention, and I'm sure they worked hard. But at least from the figures. I'm doubtful that they made a significant impact.

Now one of the local papers has reported that the Minister of Health has launched a "Save Papua" movement. The first step, which should have already started, is to send out teams of five people to each of the 3,200 villages in Papua. Their task will be to go door-to-door and collect blood samples from everybody in their village; I guess that'll amount to around one million samples. The Minister is quoted as saying that from these samples, they will be able to identify who is infected by HIV or malaria, and who has TB.

Wow! No small task! And no small money - estimates of the cost start at nearly $80 million!

But what is more worrying is what will happen to those found to be infected. As one activist has reported, even the AIDS referral hospitals in the coastal towns are overwhelmed and under-resourced to respond to the relatively small number cases that appear now. Health care facilities in the interior are much worse resourced. How will they cope? And what about stigma and discrimination? In most parts of the interior, illness is deemed to be caused by curse of God or by black magic - the concept of germs is totally alien.

There is no doubt that Papua urgently needs more effective responses. But some may question whether this is the best approach.

Babé