AIDS Prevention Initiative

A central strategy was approaching the subject of AIDS over a gradual process, due to the medical team's observation that there is reportedly no word for AIDS in this language, and people become nervous and fearful when it is mentioned. However, there is a lack of awareness about the disease that they felt needed to be addressed; for instance, while some understand that it is a sexually transmitted disease, many believe that it can be transmitted through mosquito bites or by sleeping in the same cottage. Thus, in designing individual and group consultations and in organising workshops with local people, they opted to focus first on issues such as diarrhoea, malaria, and polio/vitamin A vaccines through visits to hospitals and mother-child centres. These visits gave them the opportunity to inform 50 or 100 women at once, while building trust among community members. Only later would they begin talking about AIDS with the villagers through local workshops that addressed this, among many other general health subjects; over time, condom demonstrations began to be introduced into these sessions. (Reportedly, there was nervous laughter at first due to beliefs common within the Dani culture about condoms, but some women present asked their peers for silence, and the box of condoms was "always empty" at the end of the sessions).

Organisers also trained all of the approximately 300 medical personnel in this village on basic knowledge of AIDS, introducing them to ways to work safely within the hospital/clinic environment to protect themselves and patients from infection. They provided tools such as cardboard boxes to put used needles in, and plastic gloves. The idea was not that they would continue providing these items long-term; rather, they sought to raise awareness about simple techniques to prevent infection with the hope that the staff could implement these practices on their own, over time.

Printed materials have played a key role in the process of consciousness-raising among local people as well. The team developed 13 posters about different diseases and various handouts, in both Indonesian and Papua languages. They focused on providing information in simple ways - using mostly drawings and just a small amount of text - and always communicating the need to go to a health centre at the sign of symptoms of disease. They also developed 10 large drawings without any text at all, which were designed to be taken to even more remote villages outside Mulia. These colourful storyboards illustrate the experiences of a man who leaves the village for the city; he begins earning money, drinks alcohol, and has multiple sexual contacts. After returning to village he gets sick and comes to the understanding that he has been infected with HIV. The team used these posters to launch discussion among the villagers, with the goal of checking to see if they understand this sexual behaviour pattern and then highlighting the impact it can have. The team planned to return to the village to guide locals in giving such community workshops themselves; they have prepared manuals to facilitate this process.

According to Médecins du Monde, in Indonesia, 240,000 people died or were reported missing as a result of the tsunami of December 26 2004, and the whole population of Aceh province were hit hard with the destruction of medical infrastructure, a lack of healthcare staff, major population displacements, and psychological suffering. In addition, the AIDS epidemic is spreading quickly, especially due to increased use of injectable drugs and prostitution. An evaluation of the programme carried out in September 2005 highlighted the decline in access to healthcare mainly due to the decentralisation undertaken by the government since 2002 and to the conflicts between independence fighters and the army, which can prevent healthcare workers from travelling there.

A physician who worked with the villagers in this project indicates that Mulia has approximately 8,000 inhabitants, with 4,000 or 5,000 people living in small houses and the remainder living in isolated cottages which hold 15 to 20 people (this population has a high rate of migration, so some people sleep in a cottage with others they do not know). A common practice involves boiling a red fruit and drinking the oil in an effort to cure AIDS; this practice does have some nutritional benefit but does not cure the disease.