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Risky Business: In Indonesia, AIDS Education Clashes With Islam
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As Disease Rapidly Spreads, Fundamentalist Clerics Stifle Safe-Sex Message --- Actress's Provocative New Role
By Cris Prystay and Timothy Mapes
1949 words
25 March 2004
The Wall Street Journal
A1
English
(Copyright (c) 2004, Dow Jones & Company, Inc.)

JAKARTA -- When Indonesian movie star Nurul Arifin speaks to community groups about HIV and AIDS, she aims to shock: She slips a condom over a prosthetic penis and explains in slang-laced language why people need to protect themselves against an incurable disease.

But when leaders of some of this country's Islamic fundamentalist groups hear about her tactics, they react with outrage. By urging people to protect themselves with condoms, they say, Ms. Arifin is promoting sinful behavior.

"This is not how to solve the root of this problem," says Neno Warisman, a popular singer of Muslim songs and former television star. A candidate for Parliament from the Prosperous Justice Party, which campaigns for Islamic causes, she says efforts to stop the disease's spread should focus instead on improving people's morality.

This debate is unfolding in Islam's most-populous nation as it struggles to prevent what threatens to become the world's next AIDS nightmare. Indonesia's HIV-infection rate has been historically low, but that is changing fast.

Infections are soaring among intravenous-drug users and coursing through the country's booming commercial-sex industry. Despite the country's strict public morality, Indonesia's Health Ministry estimates that about 10 million men visit prostitutes each year.

Nationwide, HIV infections jumped an estimated 62% to about 210,000 last year. The growth rate is so alarming that the World Health Organization recently ranked Indonesia an even higher priority than China and Thailand, where AIDS epidemics have ravaged millions.

Yet Indonesian AIDS educators find it increasingly necessary to water down their message to cater to the views of the nation's small but increasingly outspoken Islamic fundamentalist groups. AIDS activists worry that a window of opportunity to keep infections at a manageable level in this nation of 220 million is closing rapidly.

For two years Family Health International, a U.S. group that runs health-care projects in developing countries, has struggled to get a hard-hitting AIDS campaign onto Indonesian national TV. When a commercial depicting men patronizing prostitutes was broadcast briefly in 2002, the Indonesian Mujahiddin Council, an organization of fundamentalist Muslin clerics, sent a letter to TV stations claiming the advertisement could provoke the wrath of Allah. The stations immediately pulled the ad, even though Indonesian censors and the Health Ministry earlier had cleared it.

"In Islam, if someone has extramarital sex . . . he would be stoned severely," says Fauzan Al-Anshari, the council's spokesman.

The TV stations, meanwhile, say the best solution would be for the Islamic community to reach a consensus. "Muslim scholars need to decide," says Yanto Soegiarto, a spokesman for RCTI, the country's largest private TV station.

The activists' uphill battle contrasts sharply with Indonesia's forthright and successful family-planning campaigns during the 1970s and 1980s. Back then, former dictator Suharto kept an iron grip on the country's political and social life and was quick to suppress fundamentalist critics. To promote birth-control methods, he even involved the nation's powerful military, assigning it a role distributing literature and ferrying citizens to family-planning clinics.

Since Suharto was deposed in 1998, Indonesia's democratic government is increasingly decentralized. Fundamentalists represent only a tiny part of this vast and complex country's Islamic community. Yet fewer moderates are willing to challenge their hard-line views when the clerics weigh in.

Last year, for instance, the Mujahiddin Council forced TV stations to yank an ad made by Islam Liberal, a moderate think tank, that promoted religious tolerance. The group claimed that the ad's message -- that there are many acceptable versions of Islam -- was blasphemous. "The space for free dialogue and free discussion is shrinking because of these kind of threats," says Ulil Abshar-Abdalla, founder of Islam Liberal.

The country's much larger and more mainstream Muslim groups generally back the fight against AIDS, if quietly. But the radical minority has some high-profile advocates. The Mujahiddin Council is led by Abu Bakar Baasyir, an Islamic preacher who was convicted last year for treason related to a spate of bombings in 2000. While the treason conviction has been overturned, he remains in prison for violating immigration laws.

Indonesian and Western intelligence officials also allege that Mr. Baasyir is a leader of Jemaah Islamiyah, an al Qaeda-linked terrorist group blamed for several recent bombings in Southeast Asia, including the October 2002 bombing of a nightclub in Bali. Mr. Baasyir repeatedly has denied any links to terrorism.

The resistance the Indonesian activists now face comes amid similar clashes elsewhere in the world. Over the past 20 years, blunt messages from AIDS-prevention campaigns have drawn fire from religious and socially conservative groups. In the U.S., some AIDS activists have complained of problems getting public-service announcements broadcast, because TV-station managers feared upsetting their audience.

After its commercial was yanked, Family Health overhauled the ad. The group took out the most explicit sections, including a scene showing a pimp offering up a choice of Indonesian girls. In this first revision, the group inserted comments by a moderate Muslim, chosen for his religious and government credentials. A former religious-affairs minister, he cites both abstinence and safe sex, appearing before and after a scene in which two men approach prostitutes and one suggests the other uses a condom. Before the scene, the ex-minister exhorts abstinence and religious values as the best defense against AIDS. After it, he says that if individuals can't avoid having sex, they should use condoms.

Publicis Groupe SA's Leo Burnett ad agency has shopped for airtime for the revised ad since December, with no success. Mr. Soegiarto, the RCTI spokesman, says the station's internal censors didn't like the former minister's suggestion that men use condoms if they "can't avoid" sex with a prostitute. "It sounds like promoting free sex," he says.

"They're afraid," says Elizabeth Pisani, an AIDS specialist for Family Health International. Her group now is planning more changes, including axing the controversial condom line. At the suggestion of Jusof Kalla, a senior government minister who oversees health and social services, the group also is considering featuring Buddhist and Catholic clerics alongside the former minister. "He wants a stronger moral message," says Steve Wignall, Family Health's Indonesia country director.

"Dealing with condom use is a controversial thing," says Haikin Rachmat, director of the Center for Disease Control within the health ministry. Health officials do promote condom use as a public-health necessity, but he says the effort has to avoid upsetting people. That generally translates into lower-profile efforts targeted at high-risk groups. "These ads need to be acceptable to the community," he says. "It's difficult."

Even some moderate Islamic groups find it tough to explicitly support the condom message. "In Islam, having sex outside marriage is forbidden. Since it is an illicit act, the use of condoms by an unmarried couple is also proscribed," says Ma'ruf Amin, the head of a commission at Indonesia's highest Islamic authority, the Indonesian Ulemas Council, which includes members from the country's largest Muslim organizations. The council urges Muslims to fight AIDS by "being more religious, and closer to family and society," he says.

AIDS groups taking a less-prominent profile include DKT Indonesia, a Washington-based family-planning and reproductive-health group. It works with high-risk populations such as truck drivers, sailors and prostitutes to promote condoms, including a line it produces and sells at discounted rates to encourage use. It also has placed a few condom ads with Indonesia's MTV affiliate, using cartoons of dancing strawberries, rather than images of people, to avoid giving offense.

To activists, Indonesia's huge sex industry makes the need for frank speaking especially urgent. In an industrial section of eastern Jakarta amid a collection of bamboo and tarpaulin shacks, Yuyun, 21, a divorced mother of a young girl, serves up to 10 clients a day. (Like many Indonesians, she uses only one name.)

Commuter trains occasionally whiz past and dusk settles in as some soldiers sit at a wooden table inside a shack, drinking whiskey and playing cards. The scent of their clove cigarettes masks a dank smell of urine and sweat. Outside, women cluster in twos and threes on a railway track, waiting for customers. A mournful call to prayer pierces the gloom, broadcast from speakers at a nearby mosque.

"Religion has no impact on the men who come here," says Yuyun, slim and soft-spoken, with high cheekbones and a black eye. "They still come here even though they're married."

Ms. Yuyun knows about AIDS, yet most of her customers don't wear condoms. Fewer than 10% of the men who visit prostitutes use the protection, according to Indonesian health authorities. Yuyun has never been tested for AIDS, fearful of what she might learn.

Amid the high levels of promiscuity, UNAIDS, an AIDS program sponsored by the United Nations and other groups, warned recently that Asian women face a high risk of infection from their husbands, because local cultures accept male infidelity but discourage women from questioning their spouse.

Juwaryanti, 36, was infected by her husband, a contractor who she says visited brothels. She passed the infection to her unborn son. Her husband died in 2002. Today, she counsels other AIDS victims at a local hospital. About a quarter of the women she sees also were infected by their husbands.

(MORE)

"People think it only affects Western people or gays," she says. "But what about all the housewives who get infected?" She is still healthy, thanks to a program of antiretroviral drugs subsidized by a French organization. Less fortunate sufferers often have trouble finding or paying for drugs in Indonesia.

The government says its national AIDS strategy won't be cowed by protests from fundamentalist groups. The health ministry has a multiyear plan for stronger education programs in schools, better training for health-care workers and more centers for voluntary HIV testing and counseling. Right now, there are only three centers nationwide, all in the capital city. Also in the works: rehabilitation and AIDS counseling and treatment for arrested drug users, rather than just jail.

Another complicating factor is that much of Indonesia's government spending on health care and education lies with provincial governments. There, some leaders share the views of the Islamic fundamentalist groups, while others don't see AIDS education as a top priority for a poor country facing basic-education needs and other equally pressing health-care problems.

Ms. Arifin, the actress, says she is always sizes up her audience before discussing condoms. Known for fairly risque movie roles in the 1980s, she took on AIDS-education work several years ago, after she played a doctor on TV and learned about the disease. Today she campaigns with several groups.

"Many people say AIDS is a curse from God because of your wrongdoing," she says. "Everyone is in denial."

One day recently, about 200 women and children packed a school hall in a dusty farm town about two hours outside Jakarta. Drawn by the opportunity to see Ms. Arifin -- a petite woman of 37 with cropped black hair and black horn-rimmed glasses -- they giggled as she asked whether AIDS could be transmitted through kissing. They then grew quiet when she turned to AIDS' tragic consequences.

"Remember, there is no drug to cure AIDS," she said. "Death is the only destination."

 

 

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