Papua

"This should not happen to people"

In honor of International Women's Day, our Country Director of Indonesia, Jo Ann de Belen reflects on those close to her heart and why she wants to be part of changing the world. I once knew a leper. He was close to me. Apart from his leprosy, he was just like any one of us. A creation made in the image of God. Without touching me, he taught me music, math, and how to laugh at myself. He contracted this dreaded illness when he was a child, at a time when there was no definite cure for it.

The stigma of the illness was so great, that his own family was ashamed to tell others. And so his parents kept this dark secret to themselves while they can. The teenage boy did not enjoy what others enjoyed. He was kept inside the house, not brought to big family gatherings or to be “displayed” publicly. He wore clothes that would conceal his open lesions.

Even when he was in a crowd, he felt alone. He suffered all this by himself, not understanding what it was. His parents, perhaps not knowing what to do, just pretended to the world that he did not exist. He grew up to be an adult and married and had children and tried to live a normal life. But the world wouldn’t let him. He died a lonely man, alone in a room, visited by only a handful.

As I remember this friend with leprosy and feel his isolation and pain, I remember the people we serve in the highlands of Papua. The ones infected with AIDS. What could they be feeling? Whatever it is, it couldn’t be much different from what the leper felt. Alone, isolated, shunned.

The stigma against AIDS is so strong, the oppression against people with AIDS so overpowering, that I ask…. What can we do? How can we change all this?

This should not happen to people, God’s own creatures made after His image and likeness.

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This is why I feel so strongly about God’s children learning to love those that the world has shunned, ridiculed, thrown away, isolated.

I long to see the church in Papua embrace back those who are afflicted with AIDS, to care for the children orphaned and made vulnerable by AIDS, and to make sure that this disease is wiped out of Papua.

I pray that God makes this happen soon. So that no one will have to suffer, and suffer alone.

Preventing, Not Just Treating, HIV/AIDS Must Be Our Priority

by Joanna Mayhew “The cusp of the end of AIDS.” That was theme echoed repeatedly at the International AIDS Conference last week in Washington, DC. The enthusiasm was palpable. The 23,767 participants from 183 countries represented the best minds addressing the epidemic around the world. Optimism abounded regarding the new era of using “treatment as prevention.” And it is well founded; we have much to celebrate. Recent medical advances hold much promise. The first pill that could prevent HIV in high-risk individuals was recently approved by the FDA. There is growing evidence that starting antiretroviral therapy earlier for HIV-positive individuals not only allows them to live much longer, but also makes them much less likely to pass on the virus to others. Eight million people now have access to treatment. And people with HIV are living far longer than we—than I—could have imagined.

I have been exposed to the ugliness of AIDS for a decade now. I first came face to face with it while living in Benin in 2003. I was there volunteering and writing a series of articles on the different facets of the epidemic through the stories of people living with AIDS. At that point, treatment was not widely available in many places. These individuals were being provided simply with Bactrim, an antibiotic used to treat basic infections. It was a band aid at best, given by health workers who had no better regimens to offer. And AIDS continued to take its victims without prejudice. Within three months of my leaving the country, every beautiful individual living with AIDS that I had met had passed away.

In contrast, today in the United States, if a 25-year-old individual discovers that he has HIV, the doctor is able say that with the right treatment he will likely live an additional 50 years. This represents incredible advancements. As Secretary of State Hillary Clinton said in her speech last week, “Caring brought action, and action has made an impact.”

Amid the hustle and bustle of the conference, with the long lines for Starbucks and the neatly dressed decision makers gathering in decorated halls, I couldn’t help but contrast the developments being lauded with the harsh reality of so many of the countries in which we work.

In Papua, Indonesia, the treatment-as-prevention approach simply won’t work, because even treatment for treatment’s sake isn’t available in many areas. And in numerous other countries where treatment is available, the poor have untold barriers accessing it. People are still dying, just like my friends in Benin. Last year the number was 1.7 million.

Despite our highest hopes, we will never be able to treat our way out of this epidemic. New infections continue to occur. Seventy percent of people living with HIV do not know their status.

In these contexts, we have to return to a single truth: that we must address the structures, attitudes and behaviors that allow HIV to flourish in the first place. We cannot hide behind the incredible medical toolbox we now have to support and care for those living with the disease. We have to address root causes head on. We must mend relationships. We must protect women. We must continue to educate. We must go to the most vulnerable.

Prevention happens at all levels. It happens by teenagers and adults opting for healthy sexual behaviors—such as delaying sex, remaining faithful to one partner, and using condoms. But it also happens at much more rudimentary levels. It happens by children feeling supported, by teenagers choosing good friends, by adults learning how to spot traffickers, and by community leaders uniting to address poverty.

These interventions are always going to be at a much lower cost than treatment.

Churches can be the key to mending brokenness, to keeping families healthy and whole, to stopping abuse, to promoting hygiene and health. The Church is well positioned. She is in every community—from the metropolis of DC to the conflict zone in Congo to the remote highlands of Papua.

Last year Clinton said of AIDS, “The worst plague of our lifetime brought out the best in humanity.” Can it also bring out the best of the church? To truly see the end of AIDS, I think that it must.

Joanna Mayhew is World Relief's Asia HIV/AIDS Programs Advisor

Papua: Health on the Margins of Indonesia

By Catherine Patterson, Maternal and Child Health Intern for World Relief Indonesia Today began as Saturdays usually do in the highlands of Papua, Indonesia: with children calling at the front gate with berries and flowers.

Most are barefoot, wear ill-fitting clothes and come from the surrounding villages. Today, a little girl came with a badly infected lip. We sent her home with a tube of ointment and a few Rupiah in exchange for a bright orange and red bouquet.

Another boy came with juicy raspberries and one foot wrapped in a plastic bag.  After examining his foot, it was clear that jungle rot had started to take over his big toe.  We gave him sandals, provided a few antibiotics, and purchased his berries.

Indonesia has made great strides in addressing some of its most pressing health problems.  Since 1990, the number of children who die before age 5 has been reduced by half, and Indonesia is on target to meet many of its Millennium Development Goals.

Despite these advances, however, Papua Province continues to experience health standards below those in other areas. About 30% of children under age 5 suffer from malnutrition. While nationally, 17% of people live in poverty, in Papua, it is estimated that at least 30% of residents are poor. HIV is reaching epidemic proportions here with a reported 3% prevalence rate, and the situation is made worse by a lack of testing and treatment facilities.

The remote nature of this beautiful, mountainous land exacerbates the problems faced by people living with limited access to essential medicines and care. Stigma and fear of HIV/AIDS frustrates efforts to provide prevention and care. All too often, outbreaks of violence and tribal warfare interrupt regularly scheduled programs aimed at improving the health of Papuans.

Since 2008, World Relief has been reaching some of the most vulnerable in Papua’s Tolikara and Jayawijaya districts. Through its Mobilizing for Life:  Protecting Papua program and in partnership with the local church, local staff provide outreach and education to youth, men, and women on HIV/AIDS and teach communities how to protect themselves and stop the spread of the disease.

But there is still much to be done. Less than half of all births are attended by a skilled health worker, and far too many women die in childbirth each year. Despite substantial investments by foreign donors and the Indonesian government, Papua Province is the only area of Indonesian where the Human Development Index is falling. Our church partners have requested help to reverse this trend, and World Relief is currently exploring how we might reach this area with additional life-saving health messages.

As I think about the realities of Papua, my heart is hopeful. Her people are strong, proud, and resilient. They are eager to learn so they may take control of their health and strengthen their communities.

I think of the flower children, with their big eyes and bigger smiles. It is easy to be discouraged that at times, all we can offer is some ointment or antibiotics. But I am filled with hope and the knowledge that God offers much more through the love and grace of Jesus Christ. It has been my honor to stand with World Relief in Papua, Indonesia, as they seek to empower the local church to reach out to those who need health and healing in the highlands.

As World Health Day approaches on April 7, take a moment to stand with me for the health of people living in Papua and pray that God will bring healing and strength to all who need it in the mountains of Indonesia.

Photos from David Peth and Kirsten Pless

Catherine Patterson serve with World Relief as a volunteer. To learn more about World Relief Indonesia and the work happening there, click here.