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  • Nurse Febe checks the tonsil of an HIV-positive patient at Kalvary Klinil during a health examination.<br />
<br />
Opened in 2006, Klinik Kalvary has been providing quality care to mostly indigenous Papuans in Wamena and they've helped hundreds of patients in the past.  They focus on diseases such as Tuberculosis, HIV/AIDS, and Sexual Transmitted Disease (STD). The clinic offers free Voluntary Counseling and Testing (VCT) for HIV/AIDS and ART (Anti- Retroviral Therapy).  Many indigenous Papuans prefer to go to here than the overcrowded government public health clinic due to its quality care and attentive staffs. Nevertheless, the clinic rarely receives government funding and relies mostly on foreign donors to continue opening its doors to provide medical care to those in need.
    Against All Odds_28.JPG
  • Pastor Leo prays for an HIV-positive patient with Tuberculosis at Klinik Kalvari. The pastor sole responsibility is to provide spiritual support for every patient before they leave the clinic.<br />
<br />
Opened in 2006, Klinik Kalvari has been providing quality care to mostly indigenous Papuans in Wamena and they've helped hundreds of patients in the past.  They focus on diseases such as Tuberculosis, HIV/AIDS, and Sexual Transmitted Disease (STD). The clinic offers free Voluntary Counseling and Testing (VCT) for HIV/AIDS and ART (Anti- Retroviral Therapy).  Many indigenous Papuans prefer to go to here than the overcrowded government public health clinic due to its quality care and attentive staffs. Nevertheless, the clinic rarely receives government funding and relies mostly on foreign donors to continue opening its doors to provide medical care to those in need.
    AgainstAllOdds_Color_35.JPG
  • Pastor Leo prays for an HIV-positive patient with Tuberculosis at Klinik Kalvari. The pastor sole responsibility is to provide spiritual support for every patient before they leave the clinic.<br />
<br />
Opened in 2006, Klinik Kalvari has been providing quality care to mostly indigenous Papuans in Wamena and they've helped hundreds of patients in the past.  They focus on diseases such as Tuberculosis, HIV/AIDS, and Sexual Transmitted Disease (STD). The clinic offers free Voluntary Counseling and Testing (VCT) for HIV/AIDS and ART (Anti- Retroviral Therapy).  Many indigenous Papuans prefer to go to here than the overcrowded government public health clinic due to its quality care and attentive staffs. Nevertheless, the clinic rarely receives government funding and relies mostly on foreign donors to continue opening its doors to provide medical care to those in need.
    AgainstAllOdds_Final_34.JPG
  • Nurse Febe checks the tonsil of an HIV-positive patient at Klinik Kalvari.<br />
<br />
Opened in 2006, Klinik Kalvari has been providing quality care to mostly indigenous Papuans in Wamena and they've helped hundreds of patients in the past.  They focus on diseases such as Tuberculosis, HIV/AIDS, and Sexual Transmitted Disease (STD). The clinic offers free Voluntary Counseling and Testing (VCT) for HIV/AIDS and ART (Anti- Retroviral Therapy).  Many indigenous Papuans prefer to go to here than the overcrowded government public health clinic due to its quality care and attentive staffs. Nevertheless, the clinic rarely receives government funding and relies mostly on foreign donors to continue opening its doors to provide medical care to those in need.
    AgainstAllOdds_Color_28.JPG
  • A man wearing the traditional Papuan attire from the village Asolo Gaima located 40km from Wamena is getting tested for Sexual Transmitted Disease (STD) at the public health clinic.<br />
<br />
Sexual Transmitted Diseases increase the transmission of the HIV virus. In Papua, education HIV/AIDS and STD as well as condom promotion is significantly low.
    AgainstAllOdds_Color_22.JPG
  • A man wearing the traditional Papuan attire from the village Asolo Gaima located 40km from Wamena is getting tested for Sexual Transmitted Disease (STD) at the public health clinic.<br />
<br />
Sexual Transmitted Diseases increase the transmission of the HIV virus. In Papua, education HIV/AIDS and STD as well as condom promotion is significantly low.
    Against All Odds_22.JPG
  • A fresh-killed pig is washed with water and placed on top of a fire pit to burn off its hair.  After 3 days in the hospital, David who is in the late stages of AIDS insisted on checking himself out to perform "adat," one of the common traditional methods of healing to cure HIV/AIDS.<br />
<br />
Due to a lack of education about HIV, limited access to health services, and strong preexisting cultural beliefs about illness, many people who are desperate for a cure turn to traditional methods of healing.  This involves cutting different parts of the body to drain "dirty" blood believed to cause sickness.  Fruit potions such as the renowned red fruit potion (buah merah) are extremely popular. Holy water and prayers, and expensive Herbal Life vitamin supplements can also replace clinical treatments and ARV.  Sometimes people who are already taking ARV abandon it to take expensive alternative medications because they are promised an immediate cure.  <br />
<br />
One of the common practices in the highlands to try to diagnose and cure HIV is by conducting a traditional diagnostic ritual termed adat. This involves killing a pig and examining its blood, heart, lungs, and kidney.  The intention of this practice is to discover the causes of the disease.  After cutting the pig open and inspecting the pig's internal organs, the practitioners of adat remove what they interpret as parasites or cancerous parts that they believe caused the sickness. Cleaning the pig flesh by washing it with water would also "cure" the person's illness.  Making adat diagnoses and cures are expensive since a pig can cost hundreds of dollars.  The treatment does not work despite the strong cultural belief system that is behind it.  In the end, after killing numerous pigs and spending a fortune, many people give up hope, and when they finally decide to take the sick person to a hospital, the patient's condition is critical and they soon die.
    AgainstAllOdds_Final_27.JPG
  • L-R: Roni (26) and Mecky (18), each wearing an apron with a diagram of the male and female reproduction organs, participate in a sexual reproduction and HIV/AIDS educational training conducted by the Public Health Development Foundation (YPKM).<br />
<br />
In Papua young teenagers are already having sex but HIV/AIDS education are still lacking. GIDI Baptist Church invited teenagers from surrounding villages in Wamena for a weeklong crash course on sex education, family planning, condom, sexual transmitted diseases (STD), and HIV/AIDS. These young adults will return to their villages to serve as peer counselors and provide information and support. However, despite the program's effectiveness, YPKM is lacking funding to continue this important educational course.<br />
<br />
For many Papuan youths, their first sexual encounter can take place during their early teenage years.  Some are sexually active by the time they reach puberty.  Life Skills Education (LSE), a curriculum designed by UNICEF that provides education on human reproduction, pregnancy, sex, Sexual Transmitted Diseases, and HIV/AIDS is taught in many high schools throughout Papua.  However, this essential educational course is mainly available in schools located in cities but not in rural areas.  Moreover, LSE does not reach many indigenous Papuan youths because many of them are not able to attend high school.  In most cases teachers responsible for teaching this course lack sufficient training and essential materials, such as books with up-to-date information and visual aids, to adequately educate their students.  They often encourage their students to seek additional information on the Internet.  Also, detailed information on condoms is regularly excluded in lectures and reading materials because of the general perception that it will endorse pre-marital sex.  As a result, students carry incomplete information, misconceptions and misunderstandings into adulthood, which increases their vulnerability to the epidemic.
    AgainstAllOdds_Final_13.JPG
  • L-R: Roni (26) and Mecky (18), each wearing an apron with a diagram of the male and female reproduction organs, participate in a sexual reproduction and HIV/AIDS educational training conducted by the Public Health Development Foundation (YPKM).<br />
<br />
In Papua young teenagers are already having sex but HIV/AIDS education are still lacking. GIDI Baptist Church invited teenagers from surrounding villages in Wamena for a weeklong crash course on sex education, family planning, condom, sexual transmitted diseases (STD), and HIV/AIDS. These young adults will return to their villages to serve as peer counselors and provide information and support. However, despite the program's effectiveness, YPKM is lacking funding to continue this important educational course.<br />
<br />
For many Papuan youths, their first sexual encounter can take place during their early teenage years.  Some are sexually active by the time they reach puberty.  Life Skills Education (LSE), a curriculum designed by UNICEF that provides education on human reproduction, pregnancy, sex, Sexual Transmitted Diseases, and HIV/AIDS is taught in many high schools throughout Papua.  However, this essential educational course is mainly available in schools located in cities but not in rural areas.  Moreover, LSE does not reach many indigenous Papuan youths because many of them are not able to attend high school.  In most cases teachers responsible for teaching this course lack sufficient training and essential materials, such as books with up-to-date information and visual aids, to adequately educate their students.  They often encourage their students to seek additional information on the Internet.  Also, detailed information on condoms is regularly excluded in lectures and reading materials because of the general perception that it will endorse pre-marital sex.  As a result, students carry incomplete information, misconceptions and misunderstandings into adulthood, which increases their vulnerability to the epidemic.
    AgainstAllOdds_Color_13.JPG
  • A field worker from Yukemdi, a local NGO in Wamena, educates the public on Sexual Transmitted Diseases (STD) and HIV/AIDS at a local market using the local dialects.<br />
<br />
Awareness of HIV/AIDS is very low among indigenous Papuans because educational materials remains inadequate and information is delivered inefficiently.  For example, billboards related to HIV/AIDS in Jayapura rarely mention condoms as an effective way to reduce or prevent infection nor do they provide locations to the nearest Voluntary Counseling and Testing center (VCT).  Therefore, despite their strategic placement in crowded markets and busy streets, billboards are not as effective in promoting awareness and providing reliable information.  Other HIV/AIDS educational materials used in Papua such as pamphlets are often ineffective in reaching indigenous Papuans because their content frequently uses images of non-Papuans, which Papuans do not relate to.  Furthermore, many indigenous Papuans have limited literacy and these booklets mainly use Bahasa Indonesia rather than the local dialects.<br />
<br />
Better methods of education and more effective ways of delivering information on HIV/AIDS need to be implemented in Papua in order to effectively raise awareness and provide accurate and reliable information.  This is an essential step to educate and empower the public to make informed decisions and reduce their vulnerability to HIV infection.
    AgainstAllOdds_Color_14.JPG
  • The lab's counter at the public health clinic in Wamena. There are only 3 lab technicians working in the lab who are overwhelmed with the responsibility to test for various illnesses including sexual transmitted diseases, Tuberculosis, HIV, etc.<br />
In Papua, all indigenous Papuans have access to health insurance, called Jamkesmas or Jaminan Kesehatan Masyarakat Miskin, provided at no cost by the provincial government. However, inadequate facilities, limited availability of medical equipment and medicines, and inexperienced health staff have made it difficult for indigenous Papuans to get tested for HIV/AIDS and receive quality assistance, counseling, and long-term care.  Many health staff in Papua still lacks medical training to run and manage VCT clinics.  In other places, even when health personnel have sufficient training, their clinics are often overcrowded and inadequate, lacking proper equipment such as testing reagents, centrifuge, HIV rapid tests, CD4 machines, and medicines to treat opportunistic infection and antiretroviral therapies.
    Against All Odds_30.JPG
  • The lab's counter at the public health clinic in Wamena. There are only 3 lab technicians working in the lab who are overwhelmed with the responsibility to test for various illnesses including sexual transmitted diseases, Tuberculosis, HIV, etc.<br />
<br />
In Papua, all indigenous Papuans have access to health insurance, called Jamkesmas or Jaminan Kesehatan Masyarakat Miskin, provided at no cost by the provincial government. However, inadequate facilities, limited availability of medical equipment and medicines, and inexperienced health staff have made it difficult for indigenous Papuans to get tested for HIV/AIDS and receive quality assistance, counseling, and long-term care.  Many health staff in Papua still lacks medical training to run and manage VCT clinics.  In other places, even when health personnel have sufficient training, their clinics are often overcrowded and inadequate, lacking proper equipment such as testing reagents, centrifuge, HIV rapid tests, CD4 machines, and medicines to treat opportunistic infection and antiretroviral therapies.
    AgainstAllOdds_Color_31.JPG
  • Mary (18) leans on her friend's shoulder as she waits for her HIV test results at a Voluntary Counseling and Testing clinic (VCT).<br />
<br />
For many young Papuan women in urban and developing areas, poverty and economic pressures have forced the exchange of sex for goods, cash, or food as an accepted mean for survival.  Unlike non-Papuan brothel workers, Papuan sex workers often seek clients in public venues and have sex outside, by the side of the road, or in urban dwellings.  Operating outside formal establishments, the exact number of Papuan sex workers are unknown but are estimated to be at least double the number of non-Papuans.  Despite their high numbers, intervention programs targeting Papuan sex workers have not been a priority and most of them rarely have access to information, preventive services and support for HIV/AIDS and Sexual Transmitted Diseases (STD).  With limited access to information and support, Papuan sex workers are less informed, have lower rates of condom usage (5% compared to non-Papuans with a 70% rate of condom usage), and are more likely to get infected with STDs and HIV than their counterparts in regulated brothels.
    AgainstAllOdds_Color_16.JPG
  • A portrait of  Mecky (18) wearing an apron with a diagram of woman's reproduction organ...In Papua young teenagers are already having sex but education is still lacking. GIDI Baptist Church invited teenagers from surrounding villages in Wamena for a week-long crash course on sex education, family planning, condom, sexual transmitted diseases (STD), and HIV/AIDS. These young adults will return to their villages and serve as peer counselors providing information support.  However, despite the program's effectiveness, YPKM is lacking funding to continue this important educational course.
    AgainstAllOdds_Color_13.JPG
  • Seen through a one-way mirror, sex workers wait to be chosen by a customer inside Bar Kharisma, a popular brothel in Jayapura, the capital of Papua.<br />
<br />
In Papua, prostitution is a profitable industry.  The influx of non-Papuan migrants into the region brings sanctioned prostitution.  Brothels, often disguised as clubs, karaoke bars, and massage parlors, hire mostly non-Papuan sex workers.  These formal establishments employ 4,000-plus sex workers who earn ten times more than their Papuan counterparts.  Above and beyond the financial discrepancy, the biggest difference between Indonesian brothel workers and Papuan sex workers is the disproportionate access to HIV preventive care and support.  Most HIV and Sexually Transmitted Diseases (STDs) intervention programs are geared towards sex workers in brothels.  For example, in Jayapura, the capital of Papua, there are over 30 brothels, and non-Papuan sex workers in these establishments undergo monitored testing and counseling for STDs every month, and for HIV every 3 months.  As a result, they are much better informed about HIV/AIDS and have better access to care and support than indigenous Papuan sex workers.
    Against All Odds_04.JPG
  • Mary (18) leans on her friend's shoulder as she waits for her HIV test results at a Voluntary Counseling and Testing clinic (VCT).<br />
<br />
For many young Papuan women in urban and developing areas, poverty and economic pressures have forced the exchange of sex for goods, cash, or food as an accepted mean for survival.  Unlike non-Papuan brothel workers, Papuan sex workers often seek clients in public venues and have sex outside, by the side of the road, or in urban dwellings.  Operating outside formal establishments, the exact number of Papuan sex workers are unknown but are estimated to be at least double the number of non-Papuans.  Despite their high numbers, intervention programs targeting Papuan sex workers have not been a priority and most of them rarely have access to information, preventive services and support for HIV/AIDS and Sexual Transmitted Diseases (STD).  With limited access to information and support, Papuan sex workers are less informed, have lower rates of condom usage (5% compared to non-Papuans with a 70% rate of condom usage), and are more likely to get infected with STDs and HIV than their counterparts in regulated brothels.
    Against All Odds_16.JPG
  • Seen through a one-way mirror, sex workers wait to be chosen by a customer inside Bar Kharisma, a popular brothel in Jayapura, the capital of Papua.<br />
<br />
In Papua, prostitution is a profitable industry.  The influx of non-Papuan migrants into the region brings sanctioned prostitution.  Brothels, often disguised as clubs, karaoke bars, and massage parlors, hire mostly non-Papuan sex workers.  These formal establishments employ 4,000-plus sex workers who earn ten times more than their Papuan counterparts.  Above and beyond the financial discrepancy, the biggest difference between Indonesian brothel workers and Papuan sex workers is the disproportionate access to HIV preventive care and support.  Most HIV and Sexually Transmitted Diseases (STDs) intervention programs are geared towards sex workers in brothels.  For example, in Jayapura, the capital of Papua, there are over 30 brothels, and non-Papuan sex workers in these establishments undergo monitored testing and counseling for STDs every month, and for HIV every 3 months.  As a result, they are much better informed about HIV/AIDS and have better access to care and support than indigenous Papuan sex workers.
    AgainstAllOdds_Color_04.JPG
  • A portrait of  Mecky (18) wearing an apron with a diagram of woman's reproduction organ.<br />
<br />
In Papua young teenagers are already having sex but education is still lacking. GIDI Baptist Church invited teenagers from surrounding villages in Wamena for a week-long crash course on sex education, family planning, condom, sexual transmitted diseases (STD), and HIV/AIDS. These young adults will return to their villages and serve as peer counselors providing information support.  However, despite the program's effectiveness, YPKM is lacking funding to continue this important educational course.
    Against All Odds_13.JPG
  • A field worker from Yukemdi, a local NGO in Wamena, educates the public on Sexual Transmitted Diseases (STD) and HIV/AIDS at a local market using the local dialects.<br />
<br />
Awareness of HIV/AIDS is very low among indigenous Papuans because educational materials remains inadequate and information is delivered inefficiently.  For example, billboards related to HIV/AIDS in Jayapura rarely mention condoms as an effective way to reduce or prevent infection nor do they provide locations to the nearest Voluntary Counseling and Testing center (VCT).  Therefore, despite their strategic placement in crowded markets and busy streets, billboards are not as effective in promoting awareness and providing reliable information.  Other HIV/AIDS educational materials used in Papua such as pamphlets are often ineffective in reaching indigenous Papuans because their content frequently uses images of non-Papuans, which Papuans do not relate to.  Furthermore, many indigenous Papuans have limited literacy and these booklets mainly use Bahasa Indonesia rather than the local dialects.<br />
<br />
Better methods of education and more effective ways of delivering information on HIV/AIDS need to be implemented in Papua in order to effectively raise awareness and provide accurate and reliable information.  This is an essential step to educate and empower the public to make informed decisions and reduce their vulnerability to HIV infection.
    Against All Odds_14.JPG
  • A young mother with HIV is seen wearing a necklace with a picture of Jesus Christ and a sweater that reads, “I love Papua.”
    _MG_3925.jpg
  • Terry’s mother looks after her son who is in the late stages of AIDS (Stage 4) inside the Emergency Room.  Terry (25) had stopped taking his ARV medication because he lived too far from the health center that provided refills and follow-up care.<br />
<br />
Terry traveled hundreds of miles from his village in Lani Jaya to reach the main hospital in Wamena.  His family paid over $100 to charter a vehicle for transportation.  Already in the late stages of AIDS (Stage 4), Terry was carried onto a stretcher because he was too weak to walk.  He had stopped taking his ARV medication because he lived too far from the health center that provided refills and follow-up care.   <br />
<br />
<br />
Many health facilities that provide services and support for HIV/AIDS are located mainly in cities, far away from the majority of indigenous Papuans who live in rural villages.  Due to Papua's arduous terrain, these health centers are often reachable only by planes or sport utility vehicles.  However, the high costs of fuel and expensive fare for transportation means that native Papuans living outside urban settings have limited access to essential care and treatment.<br />
<br />
In Jayawijaya, a mountainous region in central Papua, the average cost for a round trip on public transportation to a neighboring town could cost as much as one's daily earning.  Gas can cost up to $20 per gallon and one might have to travel a full day or more just to reach the nearest health center.  As a result, those who are too sick to make the long journey or cannot afford to pay for transportation end up without treatment.  And those who are fortunate enough to get to a clinic or hospital often wait too long before making the trip.  In many cases, they arrive at the medical center in critical condition with little hope of surviving.
    _MG_6630.jpg
  • A freshly killed pig that David purchased for $300 to conduct the adat ritual. <br />
<br />
One of the most common practices in the highlands to diagnose and cure HIV is by conducting a traditional ritual termed adat.  This involves killing a pig and examining its blood, heart, lungs, and kidney.  After cutting the pig open and inspecting its internal organs, the practitioners of adat remove what they interpret as parasites or cancerous parts that they believe caused the sickness.  Cleaning the pig's flesh by washing it with water would also "cure" the person's illness.  Performing the adat ritual is expensive since a pig can cost hundreds of dollars.  The treatment does not work despite the strong cultural belief behind it.  In the end, after killing numerous pigs and spending a fortune, many people give up hope.  By the time they finally decide to go to the hospital, their condition is too critical with little chance for survival.<br />
<br />
Due to a lack of HIV/AIDS education, limited access to health services, and strong pre-existing cultural beliefs about illness, many Papuans who are desperate for a cure turn to alternative medicines and traditional methods of healing.  Sometimes it involves cutting different parts of the body to drain "dirty" blood believed to cause the sickness.  Fruit potions such as the renowned red fruit potion (buah merah) are also extremely popular for its perceived healing capability.  In some cases, those who are already taking ARV medication abandon it to take expensive alternative medications such as Herbal Life vitamin supplements because they are promised an immediate cure.
    _MG_4598.jpg
  • David’s family members examine the pig’s internal organs to search for the cause of his illness during the adat ritual. <br />
<br />
One of the most common practices in the highlands to diagnose and cure HIV is by conducting a traditional ritual termed adat.  This involves killing a pig and examining its blood, heart, lungs, and kidney.  After cutting the pig open and inspecting its internal organs, the practitioners of adat remove what they interpret as parasites or cancerous parts that they believe caused the sickness.  Cleaning the pig's flesh by washing it with water would also "cure" the person's illness.  Performing the adat ritual is expensive since a pig can cost hundreds of dollars.  The treatment does not work despite the strong cultural belief behind it.  In the end, after killing numerous pigs and spending a fortune, many people give up hope.  By the time they finally decide to go to the hospital, their condition is too critical with little chance for survival.<br />
<br />
Due to a lack of HIV/AIDS education, limited access to health services, and strong pre-existing cultural beliefs about illness, many Papuans who are desperate for a cure turn to alternative medicines and traditional methods of healing.  Sometimes it involves cutting different parts of the body to drain "dirty" blood believed to cause the sickness.  Fruit potions such as the renowned red fruit potion (buah merah) are also extremely popular for its perceived healing capability.  In some cases, those who are already taking ARV medication abandon it to take expensive alternative medications such as Herbal Life vitamin supplements because they are promised an immediate cure.
    _MG_4718.jpg
  • Young Papuans play soccer in an empty field near the airport in Wamena.
    AAO_Scans2_343.jpg
  • Women from Pugima, a village in the Baliem Valley, are seen walking home.  Only vehicles with 4-wheel drive could navigate through the difficult terrain.<br />
<br />
Rough terrain, lack of transportation means, and the high cost of fuel and transportation are some of the biggest obstacles for people with HIV/AIDS to overcome in order to reach health facilities to get necessary care and medication.  Most Voluntary Counseling and Testing (VCT) clinics and ARV medication are available only in cities that are hundreds of miles away from villages.
    AAO_Scans2_106.JPG
  • Washing her own clothes is another way Meri makes an effort to be self-sufficient.
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  • A portrait of Meri; a loving sister and daughter, an independent and beautiful Papuan woman.
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  • With arms stretched out Meri runs to the top of the hill barefoot. <br />
<br />
For more information and to watch multimedia please visit this interactive website: <br />
<br />
www.Iampositif.org (English)<br />
www.Sayapositif.org (Indonesian)
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  • A portrait of Meri; a loving sister and daughter, an independent and beautiful Papuan woman.
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  • Meri attends the Sunday sermon.  She prays for strength herself and her friends who are facing the same struggle.
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  • A photo of Pak Jhon at a family function before making full recovery.
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  • To expand his busines, Pak Jhon is building a couple of additional rooms to his house to be rented out.
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  • Pak Jhon cleans his pigpen a minimum of five times a day to avoid bad the bad odors from disturbing his neighbors.
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  • Pak Jhon usually wakes up around 4 or 5 o’clock in the morning to feed his pigs.
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  • Yosua fills a bucket with water from the well so his sister could take a shower and get ready for school.
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Andri Tambunan

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