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  • In Tanah Papua, the 260 or so indigenous Papuan tribes make up less than half of the 3,6 million inhabitants. HIV prevalence, however, is almost twice as high among indigenous Papuans than among migrants, and in some areas Papuans make up 80% of the positive cases. The feeling among Papuans that their traditions and cultures are slowly being eroded due to transmigration, rapid economic development, rampant resource extraction and the political climate is widespread. The increased reliance on money coupled with a lack of paid employment in rural areas has drawn many to the cities, severely impacting traditional social structures. Disorientation in the face of rapid changes are visible in all urban centres. Alcohol abuse, for instance, has become a rampant problem among the indigenous population.
    HIV/AIDS in Papua Broken Community.jpg
  • Most AIDS awareness raising campaigns are developed in offices in Jakarta, far from the cultural and socio-economic reality of Papua. They often replicate initiatives in place in the rest of Indonesia, where HIV is localised and concentrated among intravenous drug users, sex workers and men who have sex with men. It would be more useful to look at Papua New Guinea and programmes, which have proved successful there. Kalvari, a church based and locally run clinic in Wamena is one of the rare places which uses cultural references to explain the virus.
    HIV/AIDS Papua awareness raising.jpg
  • The HIV/AIDS epidemic in Papua is highlighting the inequalities between newcomers and the majority of indigenous people. The imposition of Indonesian and capitalist values, presented by colonial authorities as the new ideal for Papuans to follow, have severely impacted the faith in the worth of its own traditions. The political situation has brought about an unsustainable national development program, which is merely exacerbating corruption and inequalities. Urban centres are drawing away men and teenagers of both sexes further away from the poles of local traditional authority without a culturally suited alternative to sustain a healthy social lifestyle.<br />
For Papua's indigenous population to survive the threat of the HIV epidemic, a unified, culturally appropriate awareness raising campaign must be implemented from the bottom up, with the support of the Indonesian government. But an HIV campaign will only slightly slow the spread of the virus if no significant changes are done to improve health and social conditions as well as the recognition of Papuan norms, values and cultures as contemporary to the predominant Javanese-Indonesian norms rather than as the remnants of a backward culture that is threatening the unity of the country.
    HIV/AIDS Papua Pemekaran.jpg
  • In Timika, a mixed-churches youth organisation leads a participatory workshop with street children. The aim is to raise awareness about STDs and HIV as well as confidence and capacity building. Street children are becoming an important problem all over Papua, and HIV among them also. Organisation working with these children are rare to non-existent in most places.
    HIV/AIDS Papua Street Kids and Educa...jpg
  • All consumer goods and even some agricultural goods are imported from outside Papua.
    HIV/AIDS in Papua everything is impo...jpg
  • Indonesian newcomers control most of the commercial and economic activities and most indigenous Papuans are economically sidelined. Papua has a typical frontier economy, where very high returns can be made on small investments. The import of consumer goods has had a significant impact on nutrition, with many Papuans turning away from traditional agricultural produce to packaged noodles, oil and sugar. Proper nutrition is essential in checking the spread of HIV.
    HIV/AIDS in Papua Economic realities...jpg
  • Landing strips and roads are being built to allow access to the natural riches of the most remote parts of Papua. These developments allow newcomers to settle further in the island and indigenous Papuans to travel to towns.This increasing mobility further bolsters the spread of the virus.
    HIV/AIDS Papua increasing mobility.jpg
  • Sexual norms are rapidly evolving in Papua. Previously strong taboos and traditional rules are being eroded by the new values imposed through the Indonesian education system, churches and the influx of Indonesian migrants.
    HIV/AIDS Papua Youth.jpg
  • In Timika, the effects of the mining activities of the largest gold mine in the world, operated by Arizona-based company Freeport-MacMoran, are clearly visible. The course of the Aikwa river has been severely modified, as has the wildlife and flora upon which depended the indigenous population.
    HIV/AIDS in Papua environmental degr...jpg
  • Anti-retroviral therapy is available for free. However, there are very few places offering testing and counselling. Voluntary Counselling and Testing centres can only be found in urban centres.
    HIV/AIDS Papua access to medicine.jpg
  • In rural areas, health care services are few and far between. The majority of health care staff in the available centres are migrants from other parts of Indonesia who do not speak the local languages and have little affinities for indigenous cultural beliefs and practices. Most institutions, in particular the Ministry of Health, are still run by Indonesian migrants to the province. Many Papuans view government health care services, which remain riddled with corruption, a lack of proper follow-up procedures and poor training for the staff, as part of the Indonesian colonial machinery. Rumours are ripe that HIV was introduced in order to decimate the indigenous population. Trust towards government run hospitals is low and many will only go there as a last resort.
    HIV/AIDS Papua healthcare.jpg
  • Testing facilities are only available in urban areas and most of those who undergo testing do so because they are showing serious signs of reoccurring opportunistic diseases such as tuberculosis, dysentery or pneumonia, meaning that they are already at an advanced stage of the illness. Many people have to walk for days to the closest urban centre to get their monthly stack of ARV medicine. Stigma is also still widespread and many are reluctant to pick up their medicine for fear of others finding out their status. Although ARV medicine is free, other essential medicine such as Cotrimoxazole, used as a treatment of infections before antiretroviral can be administered, is not.
    HIV/AIDS Papua access to medicine.jpg
  • Indonesian peddlers set up their pop-up shops along the main shopping street in the highland town of Wamena. Most of the products they sell are meant to increase men’s sexual stamina, size and prowess. Talking openly about condoms and sex is still a problem in most churches and among cultural leaders.
    HIV/AIDS Papua Kondoms and Viagra se...jpg
  • The imposition of Western and Indonesian values are rapidly side-lining age old traditions and cultures. This has lead to an increasing disorientation for many indigenous Papuans
    HIV/AIDS in Papua lifestyle change.jpg
  • With the growth of any urban centre and natural resource extraction comes prostitution. In Timika, with a population growing by 10% every year, 600 prostitutes are officially registered. Most HIV outreach programs are focussing on prostitutes, following the national HIV program. Although attention to prostitutes and their clients is essential, it does not match the real needs. Among prostitutes working in semi-official brothels and massage parlours, almost all of whom are migrants from other Indonesian islands, HIV awareness and access to condoms are relatively good. However, street prostitutes, mainly indigenous Papuans, have access neither to condoms, nor do they have much awareness about the virus.
    HIV/AIDS Papua Prostitution.jpg
  • Portrait of a girl from Asei, close to Sentani, Papua province Indonesia
    Portrait Jayapura Papua.jpg
  • Bosnik beach Biak Papua
    Biak
  • Biak Fish market Papua
    Biak fish market
  • Aggressive development is taking place all over Indonesian Papua
    Aggressive development.jpg
  • The concept of paper money and commercial transactions are a relatively new concept in highland Papua. In a so called subsistence economy, transactions of goods were purely ritual (weddings, funerals, war payments etc)
    Barter.jpg
  • Imported apples
    Supermarkets in Papua.jpg
  • More and more Indonesians from other islands are moving to the highlands of Papua. <br />
<br />
Indonesians from other island are controlling all commercial activities.
    Transmigration Papua.jpg
  • On the beach in Bosnik - Biak island
    Biak
  • Biak fish market - pasar ikan
    Biak fish market - pasar ikan
  • Biak fish market - pasar Ikan
    Biak fish market - pasar ikan
  • Statue...
    Biak
  • Fish market Biak
    Biak fish market - Pasar Ikan
  • Shopping mall.jpg
  • Biak
  • In the highlands everything needs to be brought in by plane. Consumer goods leave a desert of rubbish behind
    Planes come in and rubbish stays.jpg
  • Supermarkets.jpg
  • Imported goods.jpg
  • Import of goods.jpg
  • playing games.jpg
  • Markets where indigenous Papuans sell local produce are pushed outside the urban centres
    traditional market.jpg
  • As nearly all commercial activity is in the hands of Indonesian newcomers, money transactions are one way.
    Money culture.jpg
  • Pigs are a source of wealth for highland Papuans
    Breeding pigs.jpg
  • Shopping malls sprout like mushrooms all over urban centres
    Shopping mall.jpg
  • Most shops and nearly all commercial activity is controlled by Indonesian newcomers. Indigenous Papuans sit outside the shops and sell a handful of betelnut or vegetables.
    Selling pinang.jpg
  • Only remote villages manage to still evade the onslaught of the global market forces.
    Honai.jpg
  • Mama-mama market Wamena.jpg
  • The island of Papua has a tremendous natural wealth (wood, gold, gas, copper etc) which is exported to the rest of the world. All consumer goods are imported from other islands in Indonesia
    Import of goods.jpg
  • Playing football video games is a favourite past time for many young Indonesian men. <br />
<br />
Transmigration is not organised anymore by the government, but everyday people from other islands move to Papua in the hope of making a lot of money fast. Indonesians already outnumber Papuans (51% of the pupulation).
    Video games.jpg
  • Baliem Valley
    Baliem Valley view from Kurima .jpg
  • Little M (8) brings the blood of her brother who is dying of AIDS related ilnesses in the hospital to the laboratory. By the time she ot there, all the blood had spilled out
    little sister bringing blood of her ...jpg
  • A girl in an AIDS shelter in Wamena
    A girl in an AIDS shelter in Wamena.jpg
  • When senior high school students were asked about HIV/AIDS modes of transmission during one of the rare awareness-raising workshop by a local NGO, a majority of them stated that the virus was transmitted through mosquitoes and were not aware that no cure for the disease has yet been found. A worrying amount of youngsters also believed that the virus could be transmitted through kissing and shaking hands.
    HIV awarness raising at a local high...jpg
  • One of the rare shelters for people with HIV/AIDS. This particular shelter is run with the private money of three NGO workers.
    One of the very rare HIV-AIDS shelte...jpg
  • A member of YPKM, a local NGO, demonstrates the use of a condom during an HIV and STD awareness raising campaign at a local market. These kind of campaigns are still very rare.
    HIV:AIDS awareness raising at the ma...jpg
  • A (15) is on his death bed for AIDS related illnesses while his siblings play next to his bed. His mother and siblings have been living with him in the hospital for the past two months.
    Sigblings of A playing next to his d...jpg
  • Magda* (15), winces with pain as she takes her first walk out of her hospital room in six weeks. Her mother sits by her bed every day dreading the day she will lose the last of her children to the virus. Magda's two sisters and younger brother have already died, and her mother and uncle are also HIV positive. She died one month after this picture was taken.
    14 year old girl suffering from AIDS...jpg
  • A woman's disfigured hands tell a long history of loss. Traditionally Dani women amputate a finger every time a close member of the family passes away. Due to a lack of awareness, poor health services, stigma and misinformation, the number of undetected HIV cases is thought to be many times higher than the 2700 detected HIV cases in Wamena (Jan2013).<br />
<br />
<br />
Due to a lack of awareness, poor health services, stigma and misinformation, the number of undetected HIV cases is thought to be many times that the 2700 detected HIV cases in Wamena (Jan2013).
    Papuan woman with cut off fingers.jpg
  • Wamena cemetery<br />
Some priests claim during mass that AIDS is a punishment from God to those who have sinned. Churches are slow to tackle the problem, and it can still be a problem to find a priest to bury someone who has died of AIDS. A young NGO worker who studied theology tells us that he sometimes spends many days looking for priests to perform funerals for HIV patients, knocking on many closed doors and being turned back.
    Wamena cemetery.jpg
  • This 15 year old girl suffers from a rash all over her body since she started the ARV therapy
    side effects of the medicine.jpg
  • Two nurses insert an intravenous drip into Yulianus'* (23) hand. Yulianus has been undergoing ARV therapy for the past two years, but often forgets when he feels well. Feeling weak, with no appetite and coughing blood a local NGO recommended he should go to hospital. He was diagnosed with TB. <br />
<br />
Many Papuans are reluctant to go to hospital as most of the staff is non-Papuan leading to cultural and linguistic misunderstandings. The upheaval and the high costs incurred for the family to stay in town or to visit them is another deterrent.
    Wamena hospital emergency room 1.jpg
  • S (14) is lying in her hospital bed under her blanket. She has no appetite and sleeps most of the time. Everyday she gets weaker. She died a few weeks after this picture was taken
    positive is negative.jpg
  • Alince* and her two children wait for their HIV test results. They have reason to fear the worst as her husband died of AIDS related illnesses a few months ago.
    HIV test.jpg
  • Rubbish, contaminated needles, blood packs and other highly hazardous waste lie unchecked next to the public hospital vegetable garden in Wamena.
    Rubbish dump at the Wamena public ho...jpg
  • Agustina*, 19, speaks in a hushed voice as her baby sleeps in a hanging cot. She tested positive over two years ago. She gave birth to her son 18 months ago. He is HIV positive. Lack of awareness about the disease means many infants are infected through childbirth or breastfeeding. Although she knew of her HIV positive condition, Agustina was unaware of the implications for her child's health.
    HIV:AIDS infected infants.jpg
  • Bapak I during peace day discussions
    Bapak I - Peace Day discussion at th...jpg
  • Dead fish...
    Biak fish market
  • Advertisements promise new realities
    Advertisements and capitalism.jpg
  • Mama E cooking sweet potatoes
    Mama E cooking Ubi.jpg
  • Traditional Noken making is recognised in 2012 as a Unesco cultural heritage. A noken is a multifunctional woven bag.
    Nokken making.jpg
  • Dani woman at the market in Wamena
    Highland beauty.jpg
  • A Yali village three days walk from Wamena.
    Village life.jpg
  • Portrait of a Dani man
    Dani man.jpg
  • A Dani woman collecting wood for cooking
    Collecting wood.jpg
  • Due to the rapid changes, the community is falling apart in many places. Subsistence culture is being replaced by capitalism in less than a generation and  disorientation is widespread.
    Broken community.jpg
  • Biak
  • Biak
  • Working in the garden. Because of government hand outs of rice, many people have stopped working in their gardens. Especially close to urban centres many gardens lie fallow
    Working in the garden.jpg
  • The market place of Tiom is crowded with goats that belong to the Indonesian newcomers who control all the little shops surrounding the traditional market. Pigs, the traditional livestock of highlands Papuans are absent.
    Tiom market.jpg
  • There are currently about 700 street children in Wamena. Sniffing glue is widespread
    Street kids in Wamena.jpg
  • Kids playing marbles at the market place in Tiom
    Playing marbles.jpg
  • Traditional produce, such as locally grown tobacco, are pushed aside by imported cigarettes
    Traditional tobacco.jpg
  • Papua