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  • Dessy's (24) diary entry of her daughter's death, Yhoana, who died from a sudden illness at the age of 2.  Dessy is HIV positive but she did not take ARV medications during her pregnancy nor gave birth via Cesarean Section to reduce the probability of passing on the virus to her child. Currently, Dessy is in poor health because she is still not taking ARV. Dessy's twin sister is also HIV- positive.<br />
<br />
In Papua there are more records of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  As a result, many pregnant women who are unaware of their infection often pass the virus to their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during prenatal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women have limited access to a clinic during their pregnancy.
    Against All Odds_32.JPG
  • Dessy's (24) diary entry of her daughter's death, Yhoana, who died from a sudden illness at the age of 2.  Dessy is HIV positive but she did not take ARV medications during her pregnancy nor gave birth via Cesarean Section to reduce the probability of passing on the virus to her child. Currently, Dessy is in poor health because she is still not taking ARV. Dessy's twin sister is also HIV- positive.<br />
<br />
In Papua there are more records of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  As a result, many pregnant women who are unaware of their infection often pass the virus to their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during prenatal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women have limited access to a clinic during their pregnancy.
    AgainstAllOdds_Color_33.JPG
  • Becky (24) hands off her newborn baby, Gabriel, to her twin sister, Dessy.  Becky and Dessy are both HIV positive.  However, neither of them had ever taken ARV even when they were pregnant.  Gabriel, who is less than 1 month old, often gets sick.  Dessy's daughter died the previous year at before age 2 and Becky's daughter Emma (1) recently died from a sudden illness.  None of their children have been tested for HIV because the test cannot be administered before the age of two.  However, their frequent illnesses suggest that Becky’s and Dessy’s children might have contracted the HIV virus from their mothers. <br />
<br />
In Papua there are more records of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  As a result, many pregnant women who are unaware of their infection often pass the virus to their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during prenatal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women have limited access to a clinic during their pregnancy.
    AgainstAllOdds_Color_02.JPG
  • Becky (24) hands off her newborn baby, Gabriel, to her twin sister, Dessy.  Becky and Dessy are both HIV positive.  However, neither of them had ever taken ARV even when they were pregnant.  Gabriel, who is less than 1 month old, often gets sick.  Dessy's daughter died the previous year at before age 2 and Becky's daughter Emma (1) recently died from a sudden illness.  None of their children have been tested for HIV because the test cannot be administered before the age of two.  However, their frequent illnesses suggest that Becky’s and Dessy’s children might have contracted the HIV virus from their mothers. <br />
<br />
In Papua there are more records of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  As a result, many pregnant women who are unaware of their infection often pass the virus to their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during prenatal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women have limited access to a clinic during their pregnancy.
    Against All Odds_02.JPG
  • Dewi's lifeless body is carried onto the cremation pyre by her uncle.   <br />
<br />
Dewi (20) was a young wife who died from AIDS after contracting HIV from her husband.  Dewi kept her HIV status a secret from her family.  Dewi's family, who were unaware of her real illness, used a traditional healing method of cutting parts of her body to let out "dirty" blood in an attempt to cure her.  Dewi's body was displayed in her finest clothes as family members and neighbors mourned her death inside her parents' honai.  A local NGO, called Caring Hands, has donated money to buy woods for her cremation since Dewi's family was too poor to have her buried.  Outside, men cut woods into smaller pieces and stacked them to prepare for her cremation.  A pastor led the ceremony and prayed before Dewi's body was place on top of the funeral pyre.<br />
<br />
Due to shame and fear of discrimination or punishment, it is common for husbands who are HIV positive to keep their status from their wives or vice versa.  Even after testing positive for HIV, many still disregard using condom to avoid drawing suspicion.  As a result, the HIV virus is often passed between spouses.
    AgainstAllOdds_Color_01.JPG
  • Hospital staffs and family members carry Eddy's body to be transported back to his village.  <br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie did not seek medical treatment when he was diagnosed with HIV because he was afraid that his friends and family members would find out.  Instead, Eddie returned to his village when his health declined.  He stayed in his parents' honai but kept his illness a secret and did not seek clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became life threatening, his family finally brought him to the hospital and he arrived in critical condition.  His CD4 or white blood cell count was 1, when a typical count is 700.  Family members gathered everyday at his bedside, waiting and praying.  Despite doctors' attempt to stabilize his condition Eddie passed away in less than a week.  Eddie's body was brought back to his village. Family members, friends, and neighbors mourned his death.  The following day, Eddie was buried and hundreds of people, including colleagues and students, attended his funeral.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS.  This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
    AgainstAllOdds_Color_38.JPG
  • Doctor Zanty, one of only 3 doctors at main hospital, checks the condition of Eddie who is in critical condition from AIDS.<br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie didn't seek medical treatment for his HIV because he was afraid of friends and family finding out about his status.  Eddie returned to his village in Wamena when his health declined, and his immediate family cared for him.  He stayed in a traditional hut (honai) and avoided clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became critical, his family finally brought him to the hospital and he arrived on the brink of death.  His CD4 or white blood cell count was 1, when a normal person would have at least 700.  Family members gathered everyday at his bedside, waiting for the inevitable.  Despite doctors' attempt to stabilize his condition Eddie passed away within less than a week.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the Indonesian term used to label a person living with HIV/AIDS.  This label has negative connotations since HIV/AIDS is often associated with, and viewed as a curse or retribution for personal misconduct and deviant behaviors such as sinful acts, alcoholism, promiscuity, "free sex"  (seks bebas), and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Many who test positive for HIV do not seek essential care because they are afraid of stigma and discrimination.  Consequently, fear of abuse, persecution and ostracism from family members and the wider community has made secrecy the primary concern for ODHA, rather than getting treatment.
    AgainstAllOdds_Final_35.JPG
  • Dewi's lifeless body is carried onto the cremation pyre by her uncle.   <br />
<br />
Dewi (20) was a young wife who died from AIDS after contracting HIV from her husband.  Dewi kept her HIV status a secret from her family.  Dewi's family, who were unaware of her real illness, used a traditional healing method of cutting parts of her body to let out "dirty" blood in an attempt to cure her.  Dewi's body was displayed in her finest clothes as family members and neighbors mourned her death inside her parents' honai.  A local NGO, called Caring Hands, has donated money to buy woods for her cremation since Dewi's family was too poor to have her buried.  Outside, men cut woods into smaller pieces and stacked them to prepare for her cremation.  A pastor led the ceremony and prayed before Dewi's body was place on top of the funeral pyre.<br />
<br />
Due to shame and fear of discrimination or punishment, it is common for husbands who are HIV positive to keep their status from their wives or vice versa.  Even after testing positive for HIV, many still disregard using condom to avoid drawing suspicion.  As a result, the HIV virus is often passed between spouses.
    Against All Odds_01.JPG
  • Becky and Dessy (24) are twins and they are both HIV-positive.  However, neither of them had ever taken ARV even when they were pregnant.  Dessy’s daughter, Yhoana, died last year from a sudden sickness and Dessy’s health has declined significantly.  Becky recently gave birth to a baby boy she named Gabriel, and he often gets sick.  Becky’s one-and-a-half year old daughter, Emma, also gets sick frequently and she has spent many days in the hospital.  Emma died suddenly before she turned two years old.  None of their children have been tested for HIV because the test cannot be administered before the age of two.  However, their frequent illnesses suggest that Becky’s and Dessy’s children might have contracted the HIV virus from their mothers. Both Becky and Dessy died recently from their condition.  Becky's parents now look over her son Gabriel.
    ODHA_06.JPG
  • Becky (24) and her daughter, Emma, are seen inside their home.  Becky is HIV-positive but she did not take ARV during her pregnancy.  Emma died from a sudden illness before the age of two.<br />
<br />
In Papua there are more records of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  As a result, many pregnant women who are unaware of their infection often pass the virus to their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during prenatal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women have limited access to a clinic during their pregnancy.
    _MG_8575.jpg
  • Eddie’s family members carry his body back to his village from the hospital.  <br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie didn't seek medical treatment for HIV because he was afraid that his friends and family would find out about his status.  Eddie returned to his village in Wamena when his health declined, and his immediate family cared for him.  He stayed in a traditional hut (honai) and avoided clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became critical, his family finally brought him to the hospital and he arrived on the brink of death.  His CD4 or white blood cell count was 1, when a normal person would have at least 700.  Family members gathered everyday at his bedside, waiting for the inevitable.  Despite doctors' attempt to stabilize his condition Eddie passed away within less than a week.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS.  This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
    _MG_7829.jpg
  • Back in his village, Eddie’s family members and friends mourn his death.   <br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie didn't seek medical treatment for HIV because he was afraid that his friends and family would find out about his status.  Eddie returned to his village in Wamena when his health declined, and his immediate family cared for him.  He stayed in a traditional hut (honai) and avoided clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became critical, his family finally brought him to the hospital and he arrived on the brink of death.  His CD4 or white blood cell count was 1, when a normal person would have at least 700.  Family members gathered everyday at his bedside, waiting for the inevitable.  Despite doctors' attempt to stabilize his condition Eddie passed away within less than a week.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS.  This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
    _MG_7920.jpg
  • Mama Yuli socializes with her friends after the Sunday sermon. <br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8303.jpg
  • Mama Yuli walks to church to attend the Sunday sermon.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8266.jpg
  • Portrait Series.<br />
<br />
A portrait of Mina (11) who is infected with the HIV virus after an older man raped her.  Mina found a sanctuary and support at the temporary shelter of Public Health Development Foundation (YPKM).
    AAO_Scans2_25.JPG
  • Eddie's mother and aunt mourn his lifeless body just moments after he died from AIDS.<br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie didn't seek medical treatment for HIV because he was afraid that his friends and family would find out about his status.  Eddie returned to his village in Wamena when his health declined, and his immediate family cared for him.  He stayed in a traditional hut (honai) and avoided clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became critical, his family finally brought him to the hospital and he arrived on the brink of death.  His CD4 or white blood cell count was 1, when a normal person would have at least 700.  Family members gathered everyday at his bedside, waiting for the inevitable.  Despite doctors' attempt to stabilize his condition Eddie passed away within less than a week.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS.  This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
    AgainstAllOdds_Color_37.JPG
  • Public Health Development Foundation (YPKM), a local NGO in Wamena, helps bring David who is in the late stages of AIDS to the Emergency Room for immediate medical assistance. Along the way, he walked past a grave of a baby who died a month earlier from a sudden illness after contracting the HIV virus from the mother.<br />
<br />
David has been HIV-positive for almost 4 years.  His wife is also HIV-positive and they are both taking ARV medication.  However, David did not take his medication properly and his health has declined significantly.  Living in a rural area of Lani Jaya, David's village lacks an adequate health facility, and he must travel hundreds of miles to Wamena to receive care.  Staying in a relative's honai or traditional hut, David's condition deteriorated.  YPKM or the Foundation for the Development of Public Health in Wamena chartered a vehicle to take David to the emergency room.  Frail and in poor health, David barely made it to the hospital.  His white blood cell count was dismal at 24, instead of the typical 700.  At the hospital, David received saline solution and medicines that significantly improved his condition.  YPKM also gave David rice and milk to help him with his recovery.  Nevertheless, after three days in the hospital, David forcefully checked himself out because he wanted to conduct the adat ritual, and the health staff could not prevent him from leaving.  David spent several hundred dollars to purchase two pigs for the ritual.  However, his health deteriorated to the point where he was unable to stand up on his own.  A week after checking himself out from the hospital, David chartered a vehicle to go back to his village to die.
    AgainstAllOdds_Color_32.JPG
  • Becky's newborn son, Gabriel, is cradled to sleep. Becky is HIV-positive but she did not take ARV during her pregnancy. Gabriel often gets sick and his frequent illnesses suggest that he is infected. <br />
<br />
In Papua there is a higher recorded number of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  Pregnant wives who are unaware that they are infected with HIV often pass the virus onto their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during pre-natal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women still have limited access to health services and pre-natal care.
    AgainstAllOdds_Color_26.JPG
  • Mama Yuli comforts her granddaughter Anace (8). They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    AgainstAllOdds_Color_17.JPG
  • Mama Yuli holds two ARV pills in her hands on the 8th year anniversary of undergoing Anti Retroviral Treatment (ART). In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    AgainstAllOdds_Color_18.JPG
  • Mama Yuli comforts her granddaughter Anace (8). They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    Against All Odds_17.JPG
  • Eddie's casket is lowered into the ground. Hundreds of people including family members, friends, neighbors, colleagues, and students attended his funeral.<br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie didn't seek medical treatment for HIV because he was afraid that his friends and family would find out about his status.  Eddie returned to his village in Wamena when his health declined, and his immediate family cared for him.  He stayed in a traditional hut (honai) and avoided clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became critical, his family finally brought him to the hospital and he arrived on the brink of death.  His CD4 or white blood cell count was 1, when a normal person would have at least 700.  Family members gathered everyday at his bedside, waiting for the inevitable.  Despite doctors' attempt to stabilize his condition Eddie passed away within less than a week.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS.  This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
    Against All Odds_38.JPG
  • Mama Yuli holds two ARV pills in her hands on the 8th year anniversary of undergoing Anti Retroviral Treatment (ART). In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    Against All Odds_18.JPG
  • Yayasan Harapan Ibu (Mother's Hope Foundation), a local NGO in Jayapura, demonstrates the use of a condom at public places to help prevent the spread of the HIV virus.<br />
<br />
In Papua, the majority of HIV transmission occurs through sexual encounters.  The consistent use of condoms is perhaps one of the most effective ways to reduce or prevent HIV infection.  Nevertheless, condoms are seen as taboo and frequently associated with sin, misconduct, and shame.  Condom usage is often opposed or disregarded by religious and community leaders, and rarely discussed in public.  Moreover, health staff endorses abstinence more frequently.  Due to the lack of low condom education and promotion, the use of condoms is extremely low since many people in Papua do not know how to use them and many of them are embarrassed to obtain it despite its availability.  More importantly, they do not understand the benefits of condom usage in reducing or preventing STDs and HIV infection.
    Against All Odds_12.JPG
  • Danita (21) has been positive for one year but she is not undergoing Antiretroviral Therapy (ART).  Her child died due a sudden illness.  <br />
<br />
In Papua there is a higher recorded number of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  Pregnant wives who are unaware that they are infected with HIV often pass the virus onto their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during pre-natal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women still have limited access to health services and pre-natal care.
    ODHA_03.JPG
  • Mama Yuli embraces her granddaughter Anace (8).  They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8382.jpg
  • A family portrait of Mama Yuli with her two young daughters and granddaughter, Anace (8). <br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8473.jpg
  • Mama Yuli embraces her granddaughter, Anace (8). They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8410.jpg
  • Mama Yuli greets the pastor after the Sunday sermon.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8293.jpg
  • Mama Yuli takes her ARV pills at eight o’clock every morning for the last eight years.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
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  • Eddie's casket is lowered into the ground. Hundreds of people including family members, friends, neighbors, colleagues, and students attended his funeral.<br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie didn't seek medical treatment for HIV because he was afraid that his friends and family would find out about his status.  Eddie returned to his village in Wamena when his health declined, and his immediate family cared for him.  He stayed in a traditional hut (honai) and avoided clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became critical, his family finally brought him to the hospital and he arrived on the brink of death.  His CD4 or white blood cell count was 1, when a normal person would have at least 700.  Family members gathered everyday at his bedside, waiting for the inevitable.  Despite doctors' attempt to stabilize his condition Eddie passed away within less than a week.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS.  This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
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  • 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.
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  • Yayasan Harapan Ibu (Mother's Hope Foundation), a local NGO in Jayapura, demonstrates the use of a condom at public places to help prevent the spread of the HIV virus.<br />
<br />
In Papua, the majority of HIV transmission occurs through sexual encounters.  The consistent use of condoms is perhaps one of the most effective ways to reduce or prevent HIV infection.  Nevertheless, condoms are seen as taboo and frequently associated with sin, misconduct, and shame.  Condom usage is often opposed or disregarded by religious and community leaders, and rarely discussed in public.  Moreover, health staff endorses abstinence more frequently.  Due to the lack of low condom education and promotion, the use of condoms is extremely low since many people in Papua do not know how to use them and many of them are embarrassed to obtain it despite its availability.  More importantly, they do not understand the benefits of condom usage in reducing or preventing STDs and HIV infection.
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  • Eddie's mother and aunt mourn his lifeless body just moments after he died from AIDS.<br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie did not seek medical treatment when he was diagnosed with HIV because he was afraid that his friends and family members would find out.  Instead, Eddie returned to his village when his health declined.  He stayed in his parents' honai but kept his illness a secret and did not seek clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became life threatening, his family finally brought him to the hospital and he arrived in critical condition.  His CD4 or white blood cell count was 1, when a typical count is 700.  Family members gathered everyday at his bedside, waiting and praying.  Despite doctors' attempt to stabilize his condition Eddie passed away in less than a week.  Eddie's body was brought back to his village. Family members, friends, and neighbors mourned his death.  The following day, Eddie was buried and hundreds of people, including colleagues and students, attended his funeral.<br />
<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS. ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS. This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex. Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS. Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
    Against All Odds_36.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.
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  • Becky's newborn son, Gabriel, is cradled to sleep. Becky is HIV-positive but she did not take ARV during her pregnancy. Gabriel often gets sick and his frequent illnesses suggest that he is infected. <br />
<br />
In Papua there is a higher recorded number of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  Pregnant wives who are unaware that they are infected with HIV often pass the virus onto their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during pre-natal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women still have limited access to health services and pre-natal care.
    Against All Odds_26.JPG
  • Mama Yuli eats lunch with her granddaughter, Anace (8). They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8441.jpg
  • Mama Yuli takes her ARV pills at eight o’clock every morning for the last eight years.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8208.jpg
  • Mama Yuli takes her ARV pills at eight o’clock every morning for the last eight years.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8209.jpg
  • Hospital staffs and family members carry Eddy's body to be transported back to his village.  <br />
<br />
Eddie (30) was a schoolteacher in Jayapura.  Despite his education and access to health facilities in the city, Eddie did not seek medical treatment when he was diagnosed with HIV because he was afraid that his friends and family members would find out.  Instead, Eddie returned to his village when his health declined.  He stayed in his parents' honai but kept his illness a secret and did not seek clinical treatment.  The virus progressed into the later stages of AIDS.  When Eddie's condition became life threatening, his family finally brought him to the hospital and he arrived in critical condition.  His CD4 or white blood cell count was 1, when a typical count is 700.  Family members gathered everyday at his bedside, waiting and praying.  Despite doctors' attempt to stabilize his condition Eddie passed away in less than a week.  Eddie's body was brought back to his village. Family members, friends, and neighbors mourned his death.  The following day, Eddie was buried and hundreds of people, including colleagues and students, attended his funeral.<br />
<br />
Stigma significantly reduces the quality of life and increases the likelihood of suffering and mortality for indigenous Papuans living with HIV/AIDS.  ODHA (Orang Dengan HIV/AIDS) is the term often used to label a person living with HIV/AIDS.  This label has a negative connotation since HIV/AIDS is frequently associated with dishonor and death and it is often viewed as a curse or retribution for sins or deviant behaviors such as alcoholism, promiscuity, and extra marital sex.  Thus, shame, guilt and death go hand in hand with how Papuans see HIV/AIDS.  Consequently, fear of abuse, persecution, and ostracism from family members and the wider community has made secrecy the primary concern for ODHA rather than seeking treatment.
    Against All Odds_37.JPG
  • Public Health Development Foundation (YPKM), a local NGO in Wamena, helps bring David who is in the late stages of AIDS to the Emergency Room for immediate medical assistance. Along the way, he walked past a grave of a baby who died a month earlier from a sudden illness after contracting the HIV virus from the mother.<br />
<br />
David has been HIV-positive for almost 4 years.  His wife is also HIV-positive and they are both taking ARV medication.  However, David did not take his medication properly and his health has declined significantly.  Living in a rural area of Lani Jaya, David's village lacks an adequate health facility, and he must travel hundreds of miles to Wamena to receive care.  Staying in a relative's honai or traditional hut, David's condition deteriorated.  YPKM or the Foundation for the Development of Public Health in Wamena chartered a vehicle to take David to the emergency room.  Frail and in poor health, David barely made it to the hospital.  His white blood cell count was dismal at 24, instead of the typical 700.  At the hospital, David received saline solution and medicines that significantly improved his condition.  YPKM also gave David rice and milk to help him with his recovery.  Nevertheless, after three days in the hospital, David forcefully checked himself out because he wanted to conduct the adat ritual, and the health staff could not prevent him from leaving.  David spent several hundred dollars to purchase two pigs for the ritual.  However, his health deteriorated to the point where he was unable to stand up on his own.  A week after checking himself out from the hospital, David chartered a vehicle to go back to his village to die.
    Against All Odds_31.JPG
  • Yukemdi hands out educational pamphlets on HIV/AIDS and condoms to Papuan men at Pasar Baru, the biggest market in Wamena. However, the text is written in Bahasa Indonesia and many people there are illiterate and speak mainly the local dialects. The pamphlet also does not feature Papuan people on its cover. Nevertheless, Yukemdi included their office telephone number and address in the back each pamphlet for anyone who wants to contact them directly for immediate assistance.<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_BW_MG_2241.JPG
  • Countryside Community Park
    _AWT6420-Edit.jpg
  • The Covid-19 pandemic is an unprecedented event affecting so many lives.  We are rarely confronted with the same threat and uncertainties.  Across the globe, we are undergoing a collective experience that forced us to alter many aspects of how we live, work, learn, and interact with one another.  The purpose of this project is to convey how during this pandemic individuals and families have coped and adapted to new sets of challenges and norms using visuals and personal testimonies.
    _AWT1346-Edit.jpg
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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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  • Family members watch helplessly as Mandisa (25) lose consciousness. No doctor was available to provide medical assistance.<br />
<br />
Mandisa (25) who is in the late stage of AIDS clings to her life.  After being sick for many months, Mandisa's family finally brought her to the hospital to get medical treatment.  Due to a lack of experienced health staff, family and friends must stay by her side the entire time.  Her condition suddenly deteriorated overnight and her body went into a state of shock and she lost consciousness.
    Against All Odds_41.JPG
  • Hilda weighs herself inside the office of a local NGO in Wamena.  She has gained 3kg (6.5 lbs) and she has started taking ARV only after staying in their temporary shelter for 2 weeks.<br />
<br />
Hilda walked five days from her village in Yahukimo to reach the town of Wamena. Hilda said she contracted HIV at the age of 11 after an older man raped her.  When she arrived in Wamena, she was already in the second stage of AIDS experiencing symptoms of diarrhea and losing more than 10% of her body weight.  Fortunately, an NGO field worker from YPKM discovered her at the local clinic and offered her a room in the back of their office.  The small room was initially used for storage but now functions as a temporary shelter for Hilda and another young girl.  At the shelter, Hilda receives constant care and nutritious food such as rice, vegetables, and fish. <br />
<br />
Adequate long-term support for people living with HIV/AIDS is lacking in both cities and rural regions of Papua.  A hospice is essential in HIV/AIDS recovery because it provides a place where patients can receive constant care and support.  For patients who have to travel to cities to get treatment, a hospice provides a convenient temporary shelter.  At times, a hospice also offers a sanctuary for those with HIV/AIDS who are rejected or face discrimination due to their status.  <br />
<br />
One of the biggest obstacles to recovery and rehabilitation for indigenous Papuans living with HIV/AIDS is the lack of adequate nutrition.  Due to poverty and because many Papuans have moved away from a subsistence garden culture, many cannot afford to purchase or consume wholesome foods.  Papuans who are HIV-positive find it extremely difficult to work or tend their crops.  Consequently, indigenous Papuans do not receive sufficient vitamins, proteins and nutrients from their diet.  When they fall sick Papuans recover at a much slower pace and most find it extremely challenging to stay healthy.
    AgainstAllOdds_Color_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 />
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.
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  • Horseshoe Park
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  • Perry Park
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  • Cottonwood Park
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  • Davis Park
    _AWT8396-Edit.jpg
  • Horse Shoe Park
    _AWT7371-Edit.jpg
  • Elk Grove Laguna Creek Trail
    _AWT6966-Edit.jpg
  • Norman Waters Park
    _AWT6300-Edit.jpg
  • The Covid-19 pandemic is an unprecedented event affecting so many lives.  We are rarely confronted with the same threat and uncertainties.  Across the globe, we are undergoing a collective experience that forced us to alter many aspects of how we live, work, learn, and interact with one another.  The purpose of this project is to convey how during this pandemic individuals and families have coped and adapted to new sets of challenges and norms using visuals and personal testimonies.
    _AWT1469-Edit.jpg
  • The Covid-19 pandemic is an unprecedented event affecting so many lives.  We are rarely confronted with the same threat and uncertainties.  Across the globe, we are undergoing a collective experience that forced us to alter many aspects of how we live, work, learn, and interact with one another.  The purpose of this project is to convey how during this pandemic individuals and families have coped and adapted to new sets of challenges and norms using visuals and personal testimonies.
    _AWT1254-Edit.jpg
  • The Covid-19 pandemic is an unprecedented event affecting so many lives.  We are rarely confronted with the same threat and uncertainties.  Across the globe, we are undergoing a collective experience that forced us to alter many aspects of how we live, work, learn, and interact with one another.  The purpose of this project is to convey how during this pandemic individuals and families have coped and adapted to new sets of challenges and norms using visuals and personal testimonies.
    _AWT0545-Edit.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.”
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  • 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.
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  • 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.
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  • Young Papuans play soccer in an empty field near the airport in Wamena.
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  • 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 />
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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.
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  • 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 />
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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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Andri Tambunan

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