Part II: HIV/AIDS on Bali: Communication is the Cure
(for Bali Advertiser)
The vibrant 15 year old boy in a white shirt, navy pants and blazer stands in front of his classmates with the confidence of a professional television announcer. As he unwraps a small package the size of a matchbook, he explains how a condom protects against HIV infection. In spite of his difficulty in opening up the packet, he is not deterred from his information dissemination intent. Finally, the condom is released from the envelope. The young man places it on top of the wooden dildo. “You must be careful while putting on the condom that it does not break.” As he says these words his hands expertly begin to slip the piece of latex over the tip of the dildo. It stretches halfway down the wooden penis then “SNAP!” The 59 students involved in the AYO! Kita Bicara HIV-AIDS education workshop burst out laughing.
Laughter is also the response when the children hear testimony from a classmate that a 16 year old friend recently passed away from AIDS. This laughter contains lack of empathy as well as fear- 48% of the HIV positive population of Bali are young men and women between the ages of 15-29. A program facilitator gently, yet firmly informs the students that they must break through the stigma and discrimination of living with HIV-AIDS, with empathy and understanding. Communication, empathy and understanding are keys to unlock the silence surrounding the spread of the HIV virus on Bali.
At the writing of this article in November 2011, Bali ranked second after Papua, New Guinea for the highest number of humans infected with HIV in Indonesia in relationship to the total population. At a 2008 seminar on the control and prevention of HIV-AIDS, Dr. Nyoman Mangku Karmaya, Chairman of the Committee for Combating AIDS warned that “The threat of drowning in Bali is not only posed by tsunamis composed of sea water, but also by a increasingly growing tsunami of HIV-AIDS sufferers threatening to drown and overwhelm the island.” According to Bali’s Commission of AIDS Prevention, the number of Balinese infected with AIDS may well rise to over 7,000 cases by the end of 2011. The tsunami has landed.
The stigma and shame associated with being HIV positive, combined with beliefs that HIV is one’s karma and destiny, a cultural expectation for men to have many sex partners and ignorance of the virus until AIDS symptoms arise or a person dies, prevent Balinese from seeking education, testing and treatment. As a result, silence spreads the virus. There is no vaccine or cure for the HIV virus. The way to halt its spread is through education and communication on how to prevent infection by this deadly virus that is infiltrating Balinese families. At this moment, there is no concerted media blitz about HIV-AIDS and condoms are not being handed out as guest gifts at ceremonies. There are many organizations on the island tirelessly devoted to spreading the word. Due to article limitations, I will share two organizations that are empowering teenagers, sex workers and their clients.
Ayo! Kita Bicara HIV-AIDS(Let’s Talk About HIV-AIDS)
AYO! Kita Bicara HIV-AIDS, an outreach initiative of the Bali Spirit Festival is dedicated to educating and empowering teenagers to communicate with each other, their families and communities about HIV-AIDS. AYO! Kita Bicara is the program of “Bhakti Social”, the service arm of the Bali Spirit Festival. A member of the Bali Spirit Festival team coordinates the logistics for this 3 hour “EduSpirit” facilitated in Bali high schools and the content and training of facilitators is provided by Yayasan Spirit Paramacitta and Yayasan KISARA. This joyful, enthusiastic group of heart centered humans provides a safe environment inviting honest communication using an interactive, creative teaching model that promotes listening, talking, sharing, caring and understanding. The three L’s- Love, Love ,Love-is the platform from which AYO! Kita Bicara HIV-AIDS arises.
Ayo! Kita Bicara HIV-AIDS is sponsored by and receives partial funding from DKT Indonesia, the makers of Condom Fiesta and Condom Sutra. They also provide the condoms distributed to the teenagers at the completion of the workshop. HIV prevention is all about a condom as it blocks the flow of HIV infected fluids between bodies. Teenagers are the most vulnerable to HIV infection due to their natural desire to experience sexual relations which can lead to unprotected sex. Balinese boys may have their first sexual experience with a sex worker for as little as 25,000IDR. If the sex worker is HIV positive and does not request her client to wear a condom, the infection now infiltrates the teenage population. Although the virus is spread in the most intimate of human interactions, it is a community concern. Ayo! Kita Bicara motivates teenagers to become change agents in their community.
Two girls, one Hindu the other Muslim, told me that after the workshop they now feel more empowered to tell a boy no ‘Free Sex’-sex without a condom. Each of them also said that they feel confident to share this information with family and friends. They also told me that their parents were very clear and firm in setting rules about sex and they were already in communication about this subject within their family. In perfect English Christopher Ebenezer Cornelis, a student in a Gianyar high school suggested that “teenagers make a community to talk about sex, and HIV-AIDS then give the information to adults and other teens in the neighborhood because it is better if teens hear it from teens rather than from adults.” The workshop gave Christopher the awareness of how important it is to learn how to navigate friendships between boys and girls.
I asked Christopher if his parents talk with him about sex education. He said yes, and if he feels tempted to have sex, he will talk to his parents. I suggested that his hormones are very strong and can overpower his thinking and reasoning. If he is with a girl and feels sexual desire, does he feel confident to call his parents in that moment? He laughed, and I asked him to consider Mr. Condom as one of his trusted friends who can live in his pocket.
Kerti Praja Foundation
Yayasan Kerti Praja, a NGO founded in 1992 in Denpasar, provides an outreach education program for sex workers and their clients, sponsors support groups for HIV positive people, free HIV testing and treatment and an income producing program called ReLife for former sex workers and family members whose husbands or wives have succumbed to AIDS. Dr. Emily Rowe, program manager for the past two years at Kerti Praja helps us to understand Balinese cultural beliefs surrounding male sexual health: “We often see Balinese men dressed in ceremonial wear entering into a sex parlor. It is a cultural expectation that men, by the fact that they are male, will have greater sexual desires. Also, many Indonesian health systems are based on the humoral model- hot and cold. Within the humoral model it is accepted and expected for men to have sex to make themselves cold again- they need to release this heat. 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.”
The outreach program at Yayasan Kerti Praja is facilitated by 40 sex workers and former sex workers who are HIV positive. The outreach educators visit the red light districts, kafes and karaoke bars providing information, condoms, volunteer testing and information on where to seek treatment and counseling. They empower sex workers from the wisdom of their own experience. They teach a working sex worker ‘condom negotiation’ skills. However, many sex workers feel that they cannot force a client to wear a condom, for fear of losing business. I ask Renee who is HIV positive and currently working in the sex industry if she is a successful condom negotiator: ‘Yes, if a client refuses to wear a condom I will not serve him.” I also ask what her rules are regarding teenagers: “I do not engage in sex with teenagers because they are the age of my children.” Rene’s values, strength and integrity are admirable.
Although the sex work industry is illegal in Indonesia it is thriving. Not only are there designated red-light districts, but the island is populated with an increasing number of night-time venues and ‘kafes’ with sex on the menu. Many women work part time, preferring long term ‘boyfriend’ clients and do not perceive themselves as sex workers. Kerti Praja defines these women as ‘Indirect Sex Workers’ who mainly work in the entertainment/hospitality industry- in cafes, karaoke bars, clubs and massage parlors. This segment of the population is challenging for outreach workers to reach.
The outreach educators also target high risk men such as long-haul truck drivers, construction workers and university students by approaching them as they wait for a sex session. The Kerti Praja representative informs the client that he cannot tell if a woman is HIV positive by looking at her. The outreach worker provides condoms, volunteer testing on the spot, and information. She also suggests that it is his responsibility to not spread the virus to his wife or girlfriend when he returns home to have sex with her.
Many Balinese women operate on the false presumption that a condom is not necessary if she loves a man or if a man appears clean. Although many sex workers negotiate wearing a condom with a client, it does not necessarily mean that they do the same for their husband or boyfriend. The women feel that sexual intercourse with a special partner is an expression of love and intimacy.
For centuries sex has been a tool to manipulate and perpetuate the lust for power. Lust is a fear induced craving. The Balinese Hindu philosophy names lust as one of the 6 enemies of humanity along with greed, envy, intoxication, anger and confusion. These emotional states separate us from our innate divine authority, our True power. To create awareness of these animal urges within us, a tooth filing ritual is offered to Balinese males and females during adolescence. For USD $3,510, a high priest will file down the incisor and canine teeth, which represent our animal nature. At this price, I surmise that not too many teenagers partake in this ritual and as within many religions; these kinds of acts are symbolic and not taken to heart.
HIV is a great educator and equalizer offering Balinese and foreigners the opportunity to dialog, share feelings, experiences, illusions, delusions, awaken to conditioned beliefs and to examine unconscious agreements made to maintain the cycle of dominate/submissive power through sexual relationships. First we must accept that HIV exists, respect its nature and discover what maintains its power. Through this journey of understanding, we discover how our own conditioned and wounded parts of ourselves contribute to our suffering. The enemy is a part of us. We humans are mammals. What separates us from our animal brethren is our cerebral cortex. This part of the brain is programmed to embrace these “Six enemies” and transmute them into enlightened consciousness. Sexual intercourse creates new human life. It also has the power to create new consciousness.
Om Swastyastu
Free HIV testing: Clinic Amertha @Kerti Praja Foundation 0361 728 916 728 917
tarakhadro@yahoo.com
