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  • Dewi's body was displayed in her finest clothes as family members and neighbors mourned her death inside her parents' traditional hut.<br />
<br />
Dewi (20) is a young wife who died from AIDS after contracting HIV from her husband.  Dewi kept her status a secret from her family.  Before her death, Dewi's family used a traditional healing method of cutting her body to let "dirty" blood out in order to cure her illness.  Outside, men cut wood into small pieces and stacked them to prepare for her cremation.  A local NGO called Caring Hands donated money for cremation, since Dewi's family was too poor to have her buried.  A pastor led the ceremony and prayed before Dewi's body was place on top of the funeral pyre. <br />
<br />
It is common for husbands to keep their status from their wives or vice versa due to shame and fear of discrimination or punishment.  Even after testing positive for HIV, many still disregard using condoms to avoid drawing suspicion.  As a result, HIV is often passed on to their spouse.
    _MG_5012.jpg
  • Portrait Series.<br />
<br />
A family portrait of Mama Yuli (48) with her daughters Aldofina (22) and Sela (12) and granddaughter, Anace (8).  <br />
<br />
Mama Yuli was infected with HIV from her husband who later died. At one point she weighed only 30kg (66lbs) but she is now healthy to work and support her family. Although ARV is free in Papua, less than 12% of those infected with HIV/AIDS are undergoing Anti-Retroviral Therapy (ART). Mama Yuli opened her status by making testimony to the public in order to encourage others living with HIV/AIDS to take their medication regularly and prove to them that they could still provide for their family and live a productive life.
    MamaYuli_1.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
  • Dewi's body is cradled by her uncle as a pastor prayed and blessed her lifeless body.<br />
<br />
Dewi (20) is a young wife who died from AIDS after contracting HIV from her husband.  Dewi kept her status a secret from her family.  Before her death, Dewi's family used a traditional healing method of cutting her body to let "dirty" blood out in order to cure her illness.  Outside, men cut wood into small pieces and stacked them to prepare for her cremation.  A local NGO called Caring Hands donated money for cremation, since Dewi's family was too poor to have her buried.  A pastor led the ceremony and prayed before Dewi's body was place on top of the funeral pyre.  <br />
<br />
It is common for husbands to keep their status from their wives or vice versa due to shame and fear of discrimination or punishment.  Even after testing positive for HIV, many still disregard using condoms to avoid drawing suspicion.  As a result, HIV is often passed on to their spouse.
    AgainstAllOdds_Color_24.JPG
  • A family member finds a "worm" clinging to the wall of the pig's lungs that they believed to be the cause of HIV.<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.
    AgainstAllOdds_Color_23.JPG
  • Dewi's body is cradled by her uncle as a pastor prayed and blessed her lifeless body.<br />
<br />
Dewi (20) is a young wife who died from AIDS after contracting HIV from her husband.  Dewi kept her status a secret from her family.  Before her death, Dewi's family used a traditional healing method of cutting her body to let "dirty" blood out in order to cure her illness.  Outside, men cut wood into small pieces and stacked them to prepare for her cremation.  A local NGO called Caring Hands donated money for cremation, since Dewi's family was too poor to have her buried.  A pastor led the ceremony and prayed before Dewi's body was place on top of the funeral pyre.  <br />
<br />
It is common for husbands to keep their status from their wives or vice versa due to shame and fear of discrimination or punishment.  Even after testing positive for HIV, many still disregard using condoms to avoid drawing suspicion.  As a result, HIV is often passed on to their spouse.
    AgainstAllOdds_Final_24.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
  • Mama P. (43) carrying 60kg (132lbs) of crops.  She is a single mother and she sells the crops from her garden at a local market to support her 3 children.   <br />
<br />
Mama P. is HIV-positive and she has been taking ARV medication regularly for the last 3 years.  However, Mama P. still keeps her status from her children.  As far as Mama P' children knows, their mother is sick from a common illness but they still remind her to take medication and help get refills. Family support is important but due to fear of discrimination many people living with HIV/AIDS keep their status a secret.  Mama P. receives support from Jayapura Support Group (JSG) who monitors her health and provides rice, cooking oil, milk, and vegetables as well as counseling.
    ODHA_24.JPG
  • The fire continued to burn into the night.  Inside the honai, sounds of crying could be heard as Dewi's family and friends mourn her death.<br />
<br />
Dewi (20) is a young wife who died from AIDS after contracting HIV from her husband.  Dewi kept her status a secret from her family.  Before her death, Dewi's family used a traditional healing method of cutting her body to let "dirty" blood out in order to cure her illness.  Outside, men cut wood into small pieces and stacked them to prepare for her cremation.  A local NGO called Caring Hands donated money for cremation, since Dewi's family was too poor to have her buried.  A pastor led the ceremony and prayed before Dewi's body was place on top of the funeral pyre. <br />
<br />
It is common for husbands to keep their status from their wives or vice versa due to shame and fear of discrimination or punishment.  Even after testing positive for HIV, many still disregard using condoms to avoid drawing suspicion.  As a result, HIV is often passed on to their spouse.
    AAO_Scans2_74.JPG
  • 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_Final_34.JPG
  • Mama P. leaves her house carrying 60kg (132 lbs.) bags filled with crops to be sold at a local market. As a single parent, she works hard to provide for her 3 children<br />
<br />
Mama P. is HIV+ but she has been taking ARV (Anti Retroviral) medication regularly for the last 3 years improving her health significantly. Mama P. receives assistance from Jayapura Support Group (JSG), a local community support group in Jayapura, who monitors her condition and provides rice, cooking oil, milk, and vegetables as well as counseling. Despite her excellent health, Mama P. still keeps her status from her children who only knows that she is sick but not from HIV. Nevertheless, her children still provide support by reminding her to take medication and help get refills. Family support is essential but due to fear of discrimination many people living with HIV/AIDS keep their status a secret.
    AgainstAllOdds_Final_02.JPG
  • Samuel (21) first discovered that he was HIV-positive at age 15.  He learned about condom for the first time when he was 17.  As for HIV/AIDS, he learned about them at age 18 from posters.  Despite experiencing rejection and physical threats, Samuel is open about his status.
    ODHA_04.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
  • 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 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
  • Unconscious, a tear rolls off Mandisa's face as she lay on the hospital bed at the brink of death. <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.<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 Voluntary Counseling and Testing (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.  In some cases, health care workers fail to monitor and maintain the availability of necessary supplies and medicines to avoid shortages.
    AgainstAllOdds_Color_21.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
  • Mountainous terrain of Papua seen from above.<br />
<br />
It is estimated that at least 3% of 2.5 million inhabitants in Papua is already infected with HIV/AIDS. However, the prevalence rate for HIV among indigenous Papuans is estimated at 7% and they account for 75% of the total number of recorded infection.The people of Papua are living and dying in the midst of the fastest growing epidemic in Asia.
    XD1A8320.jpg
  • Students rest on the way home walking from school in the mountainous region of Papua, Oksibil.  Here education on HIV/AIDS is not available.  LSE or Life Skilled Education is taught in high school. This curriculum designed by Unicef covers education on human reproduction, pregnancy sex, STD, and HIV/AIDS. However, the curriculum is lacking essential materials and only taught in a handful of schools in Papua.
    AAO_Scans2_128.jpg
  • A pig is used to perform "adat", a traditional healing ritual in Tanah Papua.<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.
    Wesley_Web_10.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
  • Papuan street prostitutes, B. (25) and N. (16) share a cigarette as they wait for potential clients.<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 STDs.  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_11.JPG
  • "Tembok" is a place that is dark and overlooking the ocean in Sorong.  At night, it is a popular spot get drunk and to buy and sell sex.<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 STDs.  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_10.JPG
  • Students listen to a lecture on HIV/AIDS at SMA Negeri 1, a government high school in Jayapura, capital of Papua. The course is taught by a teacher who only had 1 week of training and without books or visual help.<br />
<br />
For many Papuan youth, a first sexual encounter can take place during their early teenage years, and some are sexually active by the time they reach puberty in their mid-teens.  Life Skills Education (LSE), a curriculum that covers education on human reproduction, pregnancy, sex, STDs, and HIV/AIDS designed by UNICEF is taught in many high schools throughout Papua.  However, this essential educational course is only available in schools located in cities but not in rural areas.  Moreover, LSE doesn't reach many indigenous Papuan youth because many young Papuans are not able to attend high school.  Additionally, many teachers lack sufficient training and essential materials such as books with up-to-date information and visual aids to adequately educate their students.  Often, they encourage their students to seek additional information on the Internet.  Detailed information on condoms is regularly excluded in lectures and reading materials because of the general perception that it will endorse pre-marital sex.  Students carry incomplete information, misconceptions and misunderstandings into adulthood, which increase their vulnerability to the epidemic.
    AgainstAllOdds_Final_12.JPG
  • Papuan street prostitutes, B. (25) and N. (16) share a cigarette as they wait for potential clients.<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 STDs.  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_11.JPG
  • Gary (11) in his school uniform.<br />
<br />
Gary is HIV-positive and lost both of his parents to AIDS. He has been taking ARV since age 4 and now lives with his grandmother and cousin.  In the past, Gary experienced discrimination when his teacher placed him in the back of the classroom due to his status.  Fortunately, a local support group, Sorong Sehati, educated his teacher and the rest of the faculty about HIV/AIDS that dispelled much of the misunderstanding and stigma.  Gary now sits in the front of the class.  He wants to be a doctor when he grows up because he wanted to help others who are also sick like him.
    ODHA_25.JPG
  • Cargos being unloaded at Oksibil airport.  Oksibil is a remote town in the mountainous region Papua reachable only by plane.  Goods from rice, fish, cement, gas, and household items are imported and sold at premium prices. Gas costs around $4/Liter or almost $20/gallon. Oksibil lacks sufficient health access including ARV for HIV/AIDS and patient must travel to Jayapura receive them and the cost for a round trip airfare is around $200.  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.
    AAO_Scans2_309.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
  • "Tembok" is a place that is dark and overlooking the ocean in Sorong.  At night, it is a popular spot get drunk and to buy and sell sex.<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 STDs.  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_10.JPG
  • Unconscious, a tear rolls off Mandisa's face as she lay on the hospital bed at the brink of death. <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.<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 Voluntary Counseling and Testing (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.  In some cases, health care workers fail to monitor and maintain the availability of necessary supplies and medicines to avoid shortages.
    Against All Odds_21.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
  • 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
  • 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
  • Gary takes a shower as he prepares to go to school. <br />
<br />
Gary is 11 years old and he is HIV-positive.  Gary lost both of his parents to AIDS and he has been taking ARV regularly since the age of four.  Currently, Gary lives with his grandmother and younger cousin.  To support her grandchildren, Gary's grandmother sells betel nut in front of the house earning $2-3 per day.  Due to her meager income Gary's grandmother is unable to buy wholesome and nutritious food and vitamins to help maintain his health and growth.  Last year the Department of Social Services had to suddenly stop providing milk for Gary.  Fortunately, Sorong Sehati, a local community group in Sorong financed by Yayasan San Agustino (YSA), came to the rescue and regularly provides Gary with bread, milk, and monetary assistance to pay for his schooling and transportation to the clinic for check-ups and ARV refills.  At one point, Gary experienced discrimination at school when his teacher forced him to sit in the back to isolate him from the other students.  Sorong Sehati intervened by providing HIV/AIDS education to the schools' faculty including Gary's teacher.  Now Gary sits in the front of the class and he hopes to be a doctor one day so he can help people like him.
    AgainstAllOdds_Color_19.JPG
  • Mama P. walks to the market carrying 50kg (110 lbs) of crops.<br />
<br />
Mama P. is HIV-positive and she has been taking ARV medication regularly for the last 3 years.  However, Mama P. still keeps her status from her children.  As far as Mama P' children knows, their mother is sick from a common illness but they still remind her to take medication and help get refills. Family support is important but due to fear of discrimination many people living with HIV/AIDS keep their status a secret.  Mama P. receives support from Jayapura Support Group (JSG) who monitors her health and provides rice, cooking oil, milk, and vegetables as well as counseling.
    _MG_0128.jpg
  • Food packages given by YPKM, which includes 2kg of rice, cooking oil, sugar, milk, and infant formula (costing approx. $25), to those who are in the late stages of AIDS and mothers who cannot breastfeed their infants.  The health condition of almost every person receiving this monthly food package has greatly improved.<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.
    _MG_4173.jpg
  • Mama P. arrives at home carrying vegetables and fruits on her back.  She earns a living to support her three children by keeping a small garden and selling the crops at a nearby market.<br />
<br />
Mama P. is HIV-positive and she has been taking ARV medication regularly for the last 3 years.  However, Mama P. still keeps her status from her children.  As far as Mama P' children knows, their mother is sick from a common illness but they still remind her to take medication and help get refills. Family support is important but due to fear of discrimination many people living with HIV/AIDS keep their status a secret.  Mama P. receives support from Jayapura Support Group (JSG) who monitors her health and provides rice, cooking oil, milk, and vegetables as well as counseling.
    _MG_0079.jpg
  • Gary (11) arrives at his school.<br />
<br />
Gary is HIV-positive and lost both of his parents to AIDS. He has been taking ARV since age 4 and now lives with his grandmother and cousin.  In the past, Gary experienced discrimination when his teacher placed him in the back of the classroom due to his status.  Fortunately, a local support group, Sorong Sehati, educated his teacher and the rest of the faculty about HIV/AIDS that dispelled much of the misunderstanding and stigma.  Gary now sits in the front of the class.  He wants to be a doctor when he grows up because he wanted to help others who are also sick like him.
    AAO_Scans2_267.jpg
  • Gary takes a shower as he prepares to go to school. <br />
<br />
Gary is 11 years old and he is HIV-positive.  Gary lost both of his parents to AIDS and he has been taking ARV regularly since the age of four.  Currently, Gary lives with his grandmother and younger cousin.  To support her grandchildren, Gary's grandmother sells betel nut in front of the house earning $2-3 per day.  Due to her meager income Gary's grandmother is unable to buy wholesome and nutritious food and vitamins to help maintain his health and growth.  Last year the Department of Social Services had to suddenly stop providing milk for Gary.  Fortunately, Sorong Sehati, a local community group in Sorong financed by Yayasan San Agustino (YSA), came to the rescue and regularly provides Gary with bread, milk, and monetary assistance to pay for his schooling and transportation to the clinic for check-ups and ARV refills.  At one point, Gary experienced discrimination at school when his teacher forced him to sit in the back to isolate him from the other students.  Sorong Sehati intervened by providing HIV/AIDS education to the schools' faculty including Gary's teacher.  Now Gary sits in the front of the class and he hopes to be a doctor one day so he can help people like him.
    Against All Odds_27.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
  • Children playing jump rope after Sunday School in the mountainous region of Papua<br />
<br />
HIV/AIDS is spreading at an alarming rate impacting the general population including children, men and women, husbands and wives, young and old, families and communities.
    Against All Odds_07.JPG
  • Children and parents from the Husoak village outside of Wamena watch an educational movie on HIV/AIDS.  The film uses the local dialects and also entertaining and informative attracting hundreds of villagers to the showings.
    _MG_3104.jpg
  • Terry is seen inside the Emergency Room of Wamena’s hospital.  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_6666.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
  • 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
  • A teenager walking home in Wamena.<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_40.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), a Wamena based NGO.
    Papua_Portrait_2.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
  • Villagers in Pugima walking home. Only a vehicle with 4-wheel drive can navigate through the difficult terrain.   ..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
  • The least expensive method of transportation in Wamena is a "becak" or "bicycle taxi" costing $1 to travel 1-2km.<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_129.JPG
  • 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.
    AgainstAllOdds_Color_27.JPG
  • Children playing jump rope after Sunday School in the mountainous region of Papua<br />
<br />
HIV/AIDS is spreading at an alarming rate impacting the general population including children, men and women, husbands and wives, young and old, families and communities.
    AgainstAllOdds_Color_07.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
  • 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.
    AgainstAllOdds_Final_29.JPG
  • Hilda walked 5 days from her village in Yahukimo to reach the town of Wamena. Hilda said she contracted HIV at the age of 11 when an older man raped her.  When Hilda arrived in Wamena, she was already in the 2nd stage of HIV/AIDS, experiencing symptoms such as diarrhea and losing more than 10% of her body weight.  Fortunately, an NGO field worker discovered her at the local clinic and offered a temporary shelter in the back of their office.  The small room used to be a storage room but it now functions as a sanctuary for Hilda and another young girl.  At the hospice, Hilda received constant care and nutritious food such as rice, vegetables, and fish.  Within 2 weeks Hilda had gained 3kg (6.5 lbs.) and she had started taking ARV.
    ODHA_09.JPG
  • Terry is seen inside the Emergency Room of Wamena’s hospital.  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_6666.jpg
  • One of the first ARV medications provided by the government in 2003.  Only 7 packages were purchased then for all of Papua costing 375,000,000 IDR ($40,000).  ARV is now available at no cost in Papua but only 10-12% of people with HIV/AIDS are taking them.
    _MG_9432.jpg
  • Nickolas who is HIV-positive sits next to the grave of his newborn son who died from a sudden illness 2 months ago.  Nickolas' wife is also HIV-positve.  Currently, he is not undergoing Antiretroviral Therapy (ART).
    ODHA_08.JPG
  • Yalena (20) has been HIV-positive for over 2 years and she is undergoing Antiretroviral Therapy (ART) for almost a year.
    ODHA_16.JPG
  • David sleeps inside his honai as his wife smokes a cigarette next to him.  His condition has deteriorated despite conducting the adat ritual multiple times.<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.
    _MG_5543.jpg
  • Pak William (47) in his small garden in front of his house.<br />
<br />
Pak William has been HIV-positive since 2001 but he has never taken Antiretroviral medication.  When he feels sick, Pak William would take a knife, blade, or a sharp glass and cut various parts of his body where he feels pain to let "dirty" blood out of his body.  This is a common traditional method of healing still practice today in Papua.
    ODHA_22.JPG
  • Annie (16) sits next to a pile of fruits that she picked and ready to be sold at a nearby market.<br />
<br />
Annie found out that she was HIV-positive 6 months ago.  Her condition worsened and she spent 3 weeks in the hospital.  Fortunately, Annie received support and counseling from a local NGO, Public Health Development Foundation (YPKM).  With their assistance, Annie is currently on Antiretroviral Therapy (ART).
    ODHA_23.JPG
  • Natalia (30) who has been HIV-positive for over 1 year, with her daughter Paloma (15) outside of their honai (traditional house).  Natalia has been taking Antiretroviral for the last 6 months.  She earns a living to support her family by selling crops from her garden as well as sands and rocks that she gathers from a nearby river.
    ODHA_13.JPG
  • After the death of her husband from AIDS, Ilene discovered that she was HIV-positive.  Now a single mother with 3 children she struggles to stay healthy and to support her kids.  Her 6 months old baby boy often gets sick.  Ilene didn't take ARV when she was pregnant with him because she wasn't aware of her status.  She is currently on Antiretroviral Therapy (ART).
    ODHA_12.JPG
  • Edna (15) who has been HIV-positive for 6 months.  She is not currently on Antiretroviral Therapy (ART).
    ODHA_11.JPG
  • Husband and wife who recently discovered they are HIV-positive.  They must travel 70km roundtrip to reach the nearest health center for care and treatment.
    ODHA_02.JPG
  • Melina (25) and her daughter, Emily (9).<br />
<br />
Initially when Melina learned that she was HIV-positive she didn't believe it.  She neglected to get care and her health declined.  On the hospital bed when Melina's condition was critical, she gave directions to Emily, who was just 5 years old at the time, how to get home using public transportation just in case she didn't make it.  However, Melina made full recovery and is currently on Antiretroviral Therapy (ART).
    ODHA_21.JPG
  • Magdalena (21) with her mother.  Magdalena has been HIV-positive for 1 year and she has been taking Antiretroviral medication for 6 months.  Magdalena is the eldest out of 6 children and her mother supports her unconditionally.  Currently, Magdalena is finishing her 1st semester in college.
    ODHA_05.JPG
  • Nara (15) who has been HIV-positive for 6 months but she is not currently on Antiretroviral Therapy (ART).  Her father is also HIV-positive and he is in poor health.
    ODHA_10.JPG
  • Becky's daughter Emma died from a sudden illness before reaching the age of 2.  Becky was HIV-positive but didn't take Antiretroviral medication during pregnancy.
    ODHA_07.JPG
  • Ophira (18) has been HIV-positive for 1 year.  She is recovering from her injuries after getting drunk and falling off her motorcycle.  Despite her condition, Ophira doesn't take her ARV medication regularly and she rarely comes to the clinic for her check-ups because she is afraid others would find out about her status.
    ODHA_01.JPG
  • The statue of General McArthur at Imbi Park, a popular place to buy sex in Jayapura.
    HIV/AIDS_Papua56.jpg
  • The body of a patient with AIDS covered with boils.
    HIV/AIDS_Papua66.jpg
  • An empty bottle of liquor and used cardboard. Street sex workers and their clients often have sex in public because it's cheaper than renting out a hotel room.
    HIV/AIDS_Papua55.jpg
  • A brothel worker shows pictures of her son.
    HIV/AIDS_Papua48.jpg
  • Yayasan Harapan Ibu (Mother's Hope), a local NGO, visits local brothels regularly to encourage condom usage to sex workers. However, most sex workers don't enforce condom usage with their clients especially when they offer more money.
    HIV/AIDS_Papua45.jpg
  • Linde, age 10, a victim of rape, waits for her blood result at a local hospital.
    HIV/AIDS_Papua35.jpg
  • Nomina, age 20, has AIDS finds refuge at a hospice in Jayapura.
    HIV/AIDS_Papua30.jpg
  • Sex street workers Natalia (16) and Arken (17).
    HIV/AIDS_Papua06.jpg
  • Rika receives her medication from a local clinic.
    HIV/AIDS_Papua79.jpg
  • Linde, age 10, a victim of rape, waits for her blood result at a local hospital.
    HIV/AIDS_Papua72.jpg
  • Market scene in Wamena.
    HIV/AIDS_Papua67.jpg
  • Rejected by his family because he has AIDS, Daud (23) finds refuge at a local hospice in Jayapura.
    HIV/AIDS_Papua64.jpg
  • A nurse checks on Brothel Workers of Tanjung Elmo in Jayapura.
    HIV/AIDS_Papua61.jpg
  • Barbie (14), waits for her turn for a blood test at a clinic in Jayapura.
    HIV/AIDS_Papua59.jpg
  • Mama Fin, a worker for a local NGO, Yayasan Harapan Ibu (YHI) or Mother's Hope, follows a trail with thick vegetation in order to visit young woman with AIDS living under a bridge in the city of Jayapura.
    HIV/AIDS_Papua54.jpg
  • Living under a bridge in Jayapura.
    HIV/AIDS_Papua53.jpg
  • Mama Fin works for local NGO, Yayasan Harapan Ibu (YHI) or Mother's Hope (right) visits a young woman with AIDS living under a bridge in the city of Jayapura (middle).
    HIV/AIDS_Papua50.jpg
  • A VIP room at Bar Kharisma that also functions as a brothel.
    HIV/AIDS_Papua44.jpg
  • The hallway of Bar Kharisma and entrances to VIP rooms.
    HIV/AIDS_Papua42.jpg
  • A TV screen inside a popular "Karaoke" bar that also functions as a brothel.
    HIV/AIDS_Papua28.jpg
  • Brothel workers waits to be picked by a potential client.
    HIV/AIDS_Papua24.jpg
  • Brothel workers waits to be picked by potential clients.
    HIV/AIDS_Papua22.jpg
  • Betty (15) teenage street prostitute, waits for potential client near Imbi Park, a popular place to buy sex in Jayapura.
    HIV/AIDS_Papua20.jpg
  • In the middle of the cold and wet night, Betrix (25), Marsela (14), Barbie (14), and Natalia (16) walks the empty street looking for potential clients.
    HIV/AIDS_Papua18.jpg
  • Betrix (25), Marsela (14), Barbie (14), and Natalia (16) finds refuge from the rain under the tent of a street food vendor.
    HIV/AIDS_Papua17.jpg
  • Mama Fin, a worker for Yayasan Harapan Ibu (YHI) or Mother's Hope, provides shelter and education to sex street workers.
    HIV/AIDS_Papua08.jpg
  • Papua from above the clouds.
    HIV/AIDS_Papua81.jpg
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Andri Tambunan

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