In the wake of several human rights officials being denied entry to West Papua, The UN Special Rapporteur for Health, Dainius Puras’, officially visited West Papua last week. Human Rights Watch notes, “Indigenous sex workers in West Papua are being impacted by a HIV epidemic and lack of adequate healthcare amidst wider systematic denials of human rights and violence perpetrated by the Indonesian military and mining companies.”
Free West Papua, an activist group who has spoken out against violence carried out by the Indonesian military and government, says 100,000 people have been killed or have "disappeared" since 1962. Furthermore, other actions such as the systemic destruction of village gardens by the Indonesian military in the 1990s caused widespread famine and death. Now, West Papuans are facing an increasing HIV epidemic and a healthcare system that does not meet their needs.
Against this backdrop of human rights violations West Papuans have previously voiced their concerns “that the government intentionally leaves the disease to spread widely without taking serious measures to overcome the problem.”
HIV rates in West Papua are of “epidemic” proportions. According to the UN, rates of HIV are 15 times higher than anywhere else in Indonesia. However, there is only one hospital in the region, which means that many people in West Papua continue to lack adequate access to culturally safe healthcare including specialist HIV care.
Pak Yoram, from a local HIV prevention organisation explains “a successful response to the HIV crisis in Papua must be based on the knowledge of the civil society and local best practices. We must take example on what has been done in Papua New Guinea, not in Europe or Jakarta.” Carole Reckinger points out that culturally aware and Indigenous-oriented economic and social development of the region is therefore paramount to building a successful long term programmes for the prevention of HIV in Papua.
The UN acknowledges the importance of such approaches with the special rapporteur noting that “cultural and religious norms need to be taken into account in all contexts. However, when their interpretation is such that it generates discrimination on different grounds and reinforces harmful practices […] it seriously undermines the effective realisation of the right to health and it is not acceptable.” Unfortunately, reports by a Catholic group from Australia last year perpetuated problematic narratives portraying sex workers as "vectors of disease”. The report framed sex workers living with HIV as contributing to ‘worsening’ of the ‘HIV problem.’
The Report from the UN Special Rapporteur is significant in many aspects:
- It notes existing barriers in law and practice and sexual and reproductive rights exist, and makes clear that a rights based, community lead approach is urgently needed and the best way to support health outcomes.
- It acknowledges the way in which West Papuans are disproportionately affected by HIV/AIDS. The health ministry's own study found that more than 85 percent of those who tested positive for HIV while participating in the survey did not know their status beforehand, "thus indicating a huge need for increased targeted HIV testing programs."
- Finally, it called for special attention and efforts from all stakeholders to build trust amongst service providers and users, and enhance access to treatment and services in a culturally-sensitive manner.
Indigenous peoples at the 2016 International AIDS Conference in Durban noted colonialism has played a pivotal role in risk to HIV. Colonialism has also shaped the conversation around HIV. Up until now the government’s oppressive approach in Papua has hindered the development of civil society, branding their activities as separatist. Activists are hopeful this recent visit may represent the beginnings of a shift by the government to move at least on some of its positions and make way for improved policies and health approaches in the region.
The UN Special Rapporteur will present their preliminary findings in April and a full report to the UN Human Rights Council will be submitted in June 2018.