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Involve society in AIDS discussion


What are the government, society and NGOs doing to prevent and eradicate an AIDS epidemic? It is important to raise this question because official reports are showing that from year to year, the number of AIDS carriers continues to increase.Society is often criticized as being responsible for the slow progress in preventing/combatin g the deadly disease because they often stigmatize HIV positive people as being immoral. But is the allegation reasonable enough?If we look at the practice of AIDS alleviation programs in Indonesia, and probably in many "developing" countries, AIDS activities rarely involve the general communities, such as housewives, the traders across the street, school teachers and students.

The program often limits itself to a small number of NGO workers or individuals. This exclusive group propagates alien jargon and terminology without having done proper studies and taken the effort to root these terms in local cultures.People outside the targeted groups of drug users, sex workers or HIV positive people are not given the same opportunity to be educated on how to respond to an AIDS epidemic in their localities or how to appropriately interact with HIV positive people or with those at risk of being infected.Hence, it is no surprise that those at risk and the positive group feel socially excluded. Actually, there are no consistent efforts to have the general society support those at risk of infection.This situation worsens as time goes on. NGOs become accustomed to the comfort zone they have created with donors to the point they have forgotten their mandate as an NGO -- known in Indonesia as lembaga swadaya masyarakat/LSM which literally means "organization that creates a society that is self-reliant" .On the other hand, NGOs preoccupy themselves with providing free services for their target groups, as instructed by donors, instead of building an AIDS response mechanism within the public system (the government). Henceforth, these donor-dependent NGOs have distorted and privatized the AIDS (health) sector, and have forgotten the basic principles of public health: Accessible, widely available and publicly provided by the state as stipulated in our Constitution.The hegemony of technology and knowledge by a small group of people, represented by these NGOs, results in AIDS not being publicly discussed and solved.

The meaning of empowerment in the field of AIDS has been reduced to a mere transferring of terms to memorize rather than the ability to solve the problems that society is facing.At this point, the government has not been given the opportunity to perform its obligation as provider of health care including AIDS prevention and treatment, which is a basic right of all citizens.There is no general awareness and consensus created within society. As a result, NGOs become the voice of their targeted group: We see drug users represented by non-drug users, HIV positive people represented by non-positive people.They have taken on the role of service provider, which supposedly is the role of the government; they become the voices of AIDS-impacted groups without having to go through the difficulties of their living situation. Therefore, it is no surprise that society, the government and these NGOs enjoy this comfort zone which they have created, whereas through this individual approach, the obligation of the government -- the public system -- has been taken over by the private sector (not to mention foreign funds).

This is why the AIDS service supposedly provided throughout Indonesia by the government is available in only small pockets of the country, limited by private funds (local or international) .In fact, the provision of this health service is restricted to a small group of people who are controlling knowledge and technology. The question is how can society possibly control an epidemic that impacts the masses without actually transferring knowledge, technology and the ability to solve the AIDS problem at a community level? How can society demand the government to fulfill its obligation to provide health care -- including AIDS -- if society is not involved in the discussions?It is no surprise that after two decades since the first AIDS case was discovered in Indonesia, the epidemic is not showing any signs of receding even though public health clinics (puskesmas) are available in every single district across the country.The writer is a book editor. She can be reached at http://sg.f761.mail.yahoo.com/ym/Compose?To=sari.handoyo%40gmail.com
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