25/11/08

Cry the beloved country: microchip madness from Indonesia

Two wrongs don’t make a right. And Papua’s “plan” to implant HIV positive people with microchips is definitely wrong.

As the Jakarta Post pointed out yesterday (in a profile that called me a “raging dinosaur” — a compliment, I think) I was wrong to dismiss Indonesia’s “anti-pornography” bill as so silly it would never get passed. (It did.) I had the same reaction when I heard several weeks ago of a bill to implant people with HIV in Papua with microchips. The brain-child of an Indonesian doctor who has served for years in the country’s easternmost province of Papua, it was too silly even to comment on. Apparently, I was wrong again.

The Post now reports that the bill has the support of local legislators, and may be passed into law. Not all people with HIV will get silicone implants, you understand. Just those who are “sexually aggressive”. Who qualifies as sexually aggressive? “Aggressive means actively seeking sexual intercourse,” the good doctor, one John Manangsang, is quoted as saying. Oh, so perhaps that is everyone, after all.

Predictably, and entirely appropriately, HIV activists are railing against the bill. So are many others, including Papua’s former Vice Governor Constant Karma, a very sensible vet whose position as head of the provincial AIDS council may be threatened because Dr Manangsang’s bill reserves the post for a medic such as, oh, himself perhaps. I’ve got nothing to add to their cries for common sense. This sort of nonsense is hardly worth commenting on from a public health point of view. But I think it might give pause for thought to those who are pushing rapid decentralisaton and local democracy as a development model.

Until 1999, Indonesia’s 13,000 islands were held together by one of the most centralised administrations in the world. Then, by fiat of the erratic and short-lived president Habibie, it decentralised, virtually overnight. Not to the level of the then 27 provinces, but to the level of the then 300-and-something and now 400-and-something districts (the total changes almost monthly as local luminaries seek to consolidate their power and their bank balances by heading up a new district). Pimps of decentralisation sell it as taking decision-making closer to the people — making administrations more responsive and accountable to the electorate and the tax-payer. Which is all well and good, provided you have an educated and informed electorate, and an administration which is willing to listen to them rather than to impose absurd (and sometimes populist) measures at will.

One hopes that the people of Papua will take their leaders to task for suggesting daft measures such as electronic implants. But Papua’s literacy rate is just 72%, against an average for the rest of Indonesia of well over 90%. It’s HIV epidemic is very different, too. In terms of patterns of both infection and sexual behaviour, it looks a lot like East Africa, circa 1992. Men who buy sex are most likely to be infected, but unlike the rest of Indonesia (where drug injection and sex between men compete with commercial sex to spread HIV) there is every indication that patterns of sexual networking may support the spread of the virus beyond high risk groups and their immediate sex partners. Most importantly, perhaps, the people of Papua have been too long accepting bad government. Bringing bad government closer to the people does not make it any better.

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This post was published on 25/11/08 in Ideology and HIV.

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