http://www.plusnews.org/report.aspx?reportid=94480
Photo: Natalie Bailey/IRIN
UN report says women and children in Indonesia bear the brunt of HIV's
economic impact
The number of reported HIV cases has tripled in Indonesia in recent
years, curtailing productivity and trapping affected girls and women,
especially, in poverty, according to a recent UN Development Programme
(UNDP) report.
Women, representing a quarter of all people living with HIV in
Indonesia, shoulder family finances when their partners can no longer
work, or when they face education and employment discrimination, said
the report.
"Discrimination against people with AIDS is still very strong in
Indonesia, especially for women. Many HIV-positive women are being
called 'bad women' or 'bad girls', but at the same time, many of them
have to work more after their husbands were diagnosed with HIV," said
Chya Wibisono, an HIV-positive officer at the local NGO, Indonesia
Women's Positive Network.
Women in HIV-affected households put in longer hours but were less
likely to own their homes, livestock and vehicles. They were also more
likely to be widowed and denied inheritance rights - the case for 71
percent of all HIV-affected widows.
Across all countries covered by the study (Cambodia, China, India,
Indonesia and Vietnam), HIV-affected households experienced
significant drops in incomes, savings, assets, and ability to buy
protein-rich food.
Compared with non-HIV-affected families, affected families in
Indonesia were 38 percent more likely to live below the international
poverty line of US$1.25 per person per day - the second highest of all
the countries surveyed - with more than a quarter of these households
reporting having to sell assets to pay medical costs, the report says.
While antiretroviral therapy (ART) for HIV is provided free, the
medication has reached about half of patients in need, compared with
94 percent in Cambodia, where free ART coverage has proven to be
effective in reducing households' financial burden, according to the
UNDP report.
"Real [progress] has been made to improve ART coverage in Indonesia.
The percentage of coverage has increased significantly from 25 to 50
percent over the last three years, but this is still far from enough,"
said Nancy Fee, country coordinator of UNAIDS in Indonesia.
As of December 2009, some 18,000 people had reported HIV at an
advanced stage, of whom 6,653 were receiving ART, according to the
government.
People were going without medication mostly because they had not
tested for HIV and did not know their status; in addition, continuity
and availability of ART stock as well as availability of certified
health workers to administer the drugs were challenges, according to
the government.
Different for girls
Daughters in HIV-affected families were also more likely to be pulled
out of school than sons to take care of their sick family members.
"It is most often [girls] who are removed first. This is both to save
resources spent on schooling, as well as to utilize the girl child for
labour," said Clifton Cortez, health and development practice leader
at the Bangkok-based UNDP Asia-Pacific Regional Centre.
The UNDP report suggested conditional cash transfers - paying children
based on their school enrolment and attendance - to encourage parents
to keep children in school.
According to the World Bank, the risk of HIV infection is more than
halved for young people, particularly girls, who stay in school and
complete a basic education.
In Indonesia, 28 percent of women surveyed between the ages of 15-24
had not heard of HIV and had little knowledge of condom usage, said
the UNDP report.
"No discrimination"
However, Nafsiah Mboi, secretary of the government's National AIDS
Commission, dismissed concerns that women and children bore the
economic brunt of HIV.
"There is no specific scheme for HIV-affected families or women, but
everyone who is poor can ask for assistance. There is no
discrimination," she said.
While a National Social Security System (SJSN) has been in place since
2004 - a basic framework for reforming the country's social security
programme covering health insurance, employment injury, pensions and
death benefits - the International Labour Organization estimated 54
percent of the country's population (mostly workers in the informal
economy, employees without contracts and their families) were still
excluded in 2011 from the national social health protection scheme.
Instead of small government-funded isolated projects, Fee from UNAIDS
said the country needed a "universal social protection floor" - a
minimum level of essential social services and income security for all
in times of economic and financial crisis - to ensure everybody,
including those affected by HIV, had equal access to healthcare and
other social services.
Parliament approved legislation on 28 October that aims to implement
SJSN and provide universal health insurance coverage by 2014.
--
Truth resides in every human heart, and one has to search for it there, and to be guided by truth as one sees it. But no one has a right to coerce others to act according to his own view of truth. - Mohandas Gandhi
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