Tuesday 3 February 2009

We cannot escape history

How important is history? There has been a debate about this over the last few days. On our web site, we have included a History of AIDS in Indonesia, based on the History pages on the Avert web site (which we have also translated).

In Indonesia, our report says that the history starts in 1983. It was then that Dr. Zubairi returned from post-graduate training in Paris where he worked under Prof. Mathe at the Institute of Cancer and Immunogenetics at the Paul Brosse Hospital. His task there was to learn about the immune system, and specifically about the sub-population of lymphocytes (white blood cells). This clearly awakened his interest in the newly identified syndrome just renamed AIDS. So on his return, he sought out any evidence that AIDS might have entered Indonesia.

Some may recall that the syndrome had first been identified in 1981 among gays in the US, although at that time the cause was not known. It was surmised that it was in some way connected with sex between men and men, so it was initially called Gay-related Immune Deficiency, or GRID, It was only in mid-1982 that it became apparent that it affected other groups, and so the name AIDS was coined. However, it was still seen as predominantly a disease of men who have sex with men (MSM).

So it was perhaps natural that Dr. Zubairi should search out a group of waria to test. Among MSM, waria were perhaps the easiest to find in Jakarta; the gay life was not particularly well-defined then. So he collected a group of 30 waria from Taman Lawang in Jakarta, still (I believe) their favourite stomping ground (if that's the right term!). He examined blood samples from the 30 in the lab at the central hospital. On the basis of symptoms and their low CD4 counts, he deduced that two of them had AIDS. Of course, at that time a definitive test was not yet available,

Were those the first identified cases of HIV infection in Indonesia? Clearly the Ministry of Health don't agree, since they always refer to the First Case as the 'notorious' Dutch tourist who died in Bali in 1987. But Dr. Zubairi is pretty convinced, although of course he cannot prove it.

This has just become an 'issue' (as things do in Indonesia) because a representative of a gay group has implicitly criticised Dr. Zubairi for picking on a group of waria, considering it to be discrimination. Why, he asks, didn't he pick on other groups? Clearly he was not aware of the history.

In responding, Dr. Zubairi made the point that what is more important now is to discuss how we can work together to address the challenges of HIV and AIDS in Indonesia. While I agree to a certain extent, I always remember the axiom in the subject...

Babé

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