Part I: HIV/AIDS on Bali: The Key is Understanding
(for Bali Advertiser)
By Tara Khadro
My desire to write this two part article on the affluent life of the virus known as HIV on Bali arose after reading a succession of articles with staggering statistics revealing the rapid rise of infection among teenagers, mothers and babies. In a November 2010 Jakarta Post article Udayana University epidemiologist Dewa Nyoman Wirawan, an expert and long-time HIV/AIDS activist stated that “The fact that HIV has spread into the general population should be a wake-up call to many elements of our society that still believe the disease is confined to certain populations.’ Statistics serve to alarm and awaken. The next step is to understand the many dimensions of the human experience behind the numbers so that we may consciously choose how to respond from a place of love, instead of fear.
At the writing of this article, November 2011, the reported number of cases in the Denpasar area alone was 4552. These are reported cases. Lack of understanding and misconceptions about HIV-AIDS fuels discrimination, rejection and abandonment of a person who is living with HIV-AIDS. The strength of this stigma blocks people from seeking information, testing and treatment, fueling the flow of infection. Guess estimations from those involved in prevention and treatment of HIV/AIDS on ‘The Island of the Gods,’ say the numbers will rise to 7,000 by year’s end.
HIV- Human Immunodeficiency Virus- is brilliant. It cannot be caught by shaking hands, sitting on toilet seats or by washing a corpse with AIDS. This virus has more integrity. It finds its way into a person’s blood stream via bodily fluids-blood, semen, and vaginal secretions. Although it can be transmitted via sharing needles-intravenous drug users and insulin dependent diabetics- HIV loves to spread its deadly nature via unprotected sexual intercourse. I respect a foe that finds its entry point at the most intimate, and yet the most culturally, spiritually and psychologically layered of human interactions.
Once within the bloodstream, the virus attacks and slowly breaks down the immune system. The immune system is the body’s defense system. When the virus mutates into its crowning achievement-AIDS- Acquired Immune Deficiency Syndrome- the body is open for attack from every virus, bacteria and parasite flying around looking for a host. If we are to understand and defeat our foe, we first must accept its existence, honor its nature and seek understanding. The heartbreaking fact on Bali is that the majority of Balinese are ignorant of the virus among them. Although there are many outreach programs, there is no coordinated media blitz and the most common path of information dissemination is when a pregnant mother is tested, or a friend or family member is diagnosed as sick, dying or has died from AIDS.
Pak Nyoman, works in the agricultural division of the Indonesian government in Singaraja. He learned about the virus from his son-in-law who died from AIDS in 2004. “He was like a son to me. He was always sick. Twenty-five days before he died the doctors gave him a blood test for HIV. That was the first I heard of the virus. My 24 year old son-in-law was dying of AIDS. At that time my 22 year old daughter was tested and the results were positive.” Worya, a devoted husband and father is living with HIV-AIDS. He tested positive after his 8 month pregnant wife tested positive for the virus. His now 5 year old son is HIV free. Worya says that “At first I didn’t believe the tests. I didn’t feel sick. I was in denial.”
Testing, treatment and prevention organizations report antidotal evidence that HIV is on the rise within Balinese families. In a Sept. 7, 2011 Bali Advertiser news brief a ‘spokesperson’ for the Committee for Combating AIDS admitted it is common practice for married men to engage in sexual affairs with other women (foreign and Balinese) and/or sex workers then return home to have sex with their wife. What Mr. Spokesperson did not say is that it is also common practice for the men to refuse to wear condoms and for women to oblige. Abortion is also illegal in Indonesia. In Balinese culture if a woman becomes pregnant and is not married, the responsible male must marry her and a village wedding ceremony ensues. This scenario does not produce the conditions to grow a marriage where both partners find everlasting love and affection.
Dr. Emily Rowe is an anthropologist working the past two years as a program manager at Yayasan Kerti Praja in Denpasar. Yayasan Kerti Praja provides an outreach program for sex worker education, support groups for HIV positive people, an income producing program called ReLife, and free HIV testing and treatment. Dr. Rowe helps us to understand some of the underlying cultural beliefs that support what the chairman says is ‘common practice’ among Balinese men to have multiple sex partners:
“Extra/pre-marital trysts or infidelities are often dismissed with the expression, “dasar laki-lak – typical male!” a phrase that normalizes male promiscuity. In addition, many Indonesian ethnic groups share a hydraulic model of sexuality based on humoral medical theories of health and corporeality. In a hydraulic system, sexual desire is conceptualized as a strong inherent force that requires release or to somehow be controlled and channeled. The need for sexual release is considered essential for health, and is believed to be empowering for male health most significantly. Sexual interaction for males is regarded as vital for relieving stress and restoring potency, and also in keeping the body fresh and renewing energy. Women are expected to sit back and take it.”
I am honored to be an intimate ear to a few young Balinese males. Each of them married and in their mid to late twenties. Each one shared with me feelings of guilt after entering into an extra marital sexual relationship. My heart broke open when I realized how each of them felt it their duty to engage in an affair. As an outsider as well as a woman with diametrically opposed cultural values, I simply held empathetic space for their pain. I also navigated the dialog so that these intelligent, talented young men might consider that they, as the new generation of Balinese, have the power to change directions.
This idea served to initially inspire and empower, however, months later when I encountered two of them and we began to converse, I discovered that they did not diverge from their original direction. Each of them felt it was a way to provide for their family, as well as to receive needed emotional and physical nourishment. To be clear, my young friends did not receive money for sex, rather the relationship with their Western lovers offered many other opportunities for cash advancement. Also, I know many Balinese who are in thriving, loving monogamous relationships.
Economic opportunity within any society is a prevailing motivating force for choosing one’s individual life path. Sunarti was born in Surabya, migrated to Bali and married a Balinese man whose income supported the family. When her husband died in a motorbike accident, Surbaya born Sunarti was left with nothing. She felt her only option to obtain enough money to support herself and her two children was to enter into the sex work industry. Fees for this service range from 25,000IDR at a girlie warung for low price to 450,000IDR for a more classier session-with higher class women. It is this need for a sustainable income that is driving the increase in numbers of sex workers on the island. Bali thrives on tourism and sensual massage parlors, Kuta Cowboys, red light karaoke, discotheques and kafe’s where the waitresses serve sex are all available for Balinese and to feed foreigners fantasies of experiencing sex, love and maybe marriage on an island paradise.
HIV PREVENTION: IT’S ALL ABOUT A CONDOM
We bring all of our former sexual partners into the sexual act we are experiencing in this moment. Have you experienced multiple partners simultaneously or random partners in succession? Or are you a human being living on planet earth who becomes overpowered by sexual desires and occasionally engages in sexual intercourse refusing or at best, forgetting to invite Mr. Condom to the party? Changing cultural paradigms can take a few generations. However, hitting the pause button to slip on a seductive, sensual, comfy condom can save many lives here and now.
I asked Worya, a courageous man who chooses to be a public voice for people living with HIV-AIDS “Why do men refuse to wear condoms?” He was silent for a few moments then simply stated: “It doesn’t feel good.” As a female on the receiving end of the condom coated penis I agree with Worya. As a female, my body is more susceptible to the HIV virus. I can’t control others choices, I can only be in charge of my own feelings, thoughts and desires. I am in charge of what goes into my body. I value my body and my life. Sexual penetration packs a huge energetic infusion for a woman emotionally, physically and spiritually.
However the use of a simple piece of latex or lamb’s intestine during sexual penetration allows freedom from fear of infection, shame and blame which can outweigh the transitory feel good of penetration without a condom. There are a multitude of ways to ‘feel good’ during sexual relations. Invite your imagination into the bedroom or take up some tantric sexual teachings. I was the messenger of new information for my young male friends about HIV-AIDS and condom use. When I told them the virus is not like rabies-no vaccine and no cure-and once it becomes AIDS it is likely a death sentence they became very, very quiet. There is free antiviral medication offered to Balinese that will strengthen the immune system IF he or she is aware that the illness arises from being HIV positive. However the shame of being a host for this virus is so great, that many who know they are HIV positive will only speak to a PLWHA or a person like Pak Nyoman who has a HIV positive family member and keep their status silent within their family.
Silence stimulates the spread of the HIV virus. Balinese are open minded yet are encouraged to listen and not invited to question. The family unit is a small community and it is from that community that we are shown how to treat ourselves and others. Whether we are Balinese or foreigners, each of us are a product of the past 5,000 years of living within a cultural paradigm founded in fear. We maintain silence through an endless cycle of internalized blame and shame which suppresses the voice of our innate divine wisdom, our True Power. The moment we choose to give voice to what we truly feel, think and desire is the moment we change directions from fear to love within ourselves. Communication from a place of love is the cure for halting the spread of HIV-AIDS on Bali.
Om Swastyastu
PART II: HIV-AIDS ON BALI: COMMUNICATION IS THE CURE
