Inter Press Service - May 3, 2004
Richel Dursin

Immediately after he spoke up, majority of the 15 chief prison wardens at the meeting started asking questions about basic facts on HIV/AIDS. They publicly admitted that they had no knowledge about the pandemic and needed urgent help to curb the rising number of HIV/AIDS cases in the penitentiaries they manage.

"Who can get infected with HIV/AIDS and how is HIV/AIDS transmitted?" a prison official asked.

"When can HIV become a full-blown AIDS?" another prison warden chimed in.

Another asked, "How can we know that a person has HIV/AIDS and how can we cure HIV/AIDS?"

"How do we conduct tests on HIV/AIDS and what should we do if an inmate has HIV/AIDS?" was yet another question. "Is condom use an effective way to prevent HIV/AIDS?" one prison official asked.

After learning about the chief prison wardens' insufficient knowledge about HIV/AIDS, health authorities and activists present at the seminar, organised by the Ministry of Justice and Human Rights on Apr. 13-14, were understandably quite worried.

"Prison wardens are not yet prepared to combat the rising number of HIV/AIDS cases among inmates. Their lack of basic understanding of the virus is a big problem," said Eka Viora, an official at the Ministry of Health.

Joyce Gordon, an activist working on HIV/AIDS issues, was more to the point. "How can prison authorities help curb the increasing number of HIV/AIDS and show compassion to inmates with HIV/AIDS when they don't know at all the basic facts about HIV/AIDS?"

Indeed, officials have reason to worry because statistics and results of HIV/AIDS tests in Indonesia's prisons show worrisome prevalence rates.

In the Salemba penitentiary in Central Jakarta alone, data from the Ministry of Health showed that of 251 inmates tested in 2000, 17.5 percent were HIV-positive. In 2001, out of 250 prisoners tested, 22 percent were positive for HIV.

Results of HIV tests recently conducted in Indonesia's penitentiaries showed that 24.5 percent of inmates in the capital Jakarta are HIV-positive, along with 10.2 percent of prisoners in Bali.

Prevalence rates in other provinces ranged from 5.04 percent of inmates in South Sumatra to 0.36 percent in Kalimantan.

An increase in the number of intravenous drug users (IDUs), sharing dirty syringes and unsafe sexual practices, particularly sex between male inmates, are some major factors behind the number of HIV/AIDS cases in Indonesia's 400 penitentiaries.

Most of the intravenous drug users are concentrated in Jakarta, West Java, East Java, and Bali, the island that is the country's prime tourist destination.

According to the Ministry of Health, the number of people living with HIV in Indonesia is between 90,000 and 130,000. "Between 12 million and 19 million Indonesians are vulnerable to HIV/AIDS," said Saiful Jazan, head of the AIDS sub-directorate at the Ministry of Health.

Worried about how to curb HIV/AIDS among inmates, the Ministry of Justice and Human Rights has decided to build 14 penitentiaries across Indonesia for drug-user detainees. Under the plan, drug user inmates would be given counselling by experts.

The government also plans to designate certain state-owned hospitals for the treatment of inmates who use illegal drugs.

But the first step to an intelligent and realistic response to the pandemic, in confined environments like the prison system, requires basic knowledge about it.

The lack of understanding not just of the health aspects of the pandemic but the social issues around it was also revealed in the comments of one prison official at the April seminar who asked, "Why should we be responsible if an inmate gets infected with HIV/AIDS?"

Still, acknowledging their lack of basic information about HIV/AIDS, the 15 chief wardens in the April seminar proposed a training session in July on HIV/AIDS, this time, for all prison workers.

"We have to focus on increasing the awareness of prison wardens and also the inmates on HIV/AIDS," said Soejoto, narcotics director at the Ministry of Justice and Human Rights.

Some prison authorities argued that their lack of basic information about HIV/AIDS stems from the fact that most of them are lawyers. "Our educational background is law and not health," conceded Fakih Fattah, chief warden of the Makassar penitentiary in South Sulawesi.

At the same time, one chief warden defended his ignorance of HIV/AIDS issues by saying that health matters are just one of the many problems officials encounter in penitentiaries across Indonesia, a country of 220 million people.

"How can we focus on HIV/AIDS when we also think of other complex problems like maintaining peace and security and providing food and space for inmates?" asked Asdjudin Rana, chief warden of the Medan penitentiary in North Sumatra, western Indonesia.

Most of Indonesia's penitentiaries are overcrowded, not to mention ill-equipped with vital health facilities. In a year, the health budget for one inmate is just one U.S. dollar.

Against this backdrop, coping with the HIV/AIDS pandemic poses a logistical as well as social challenge. "Indonesian inmates don't have access to basic health facilities and most of the country's penitentiaries don't even have doctors," Hendra Salim, an official at the Ministry of Health, said in an interview.

Argued Salim: "The government doesn't have enough funding for health." (END/IPS/AP/HE/HD/SD/RD/JS/04)

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