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Recently there has been many reports in the Indonesian press of a famine in Yahukimo District causing a reported 92 deaths in several sub-districts. The politicians are saying that this is due to failed harvest. Papua Partners main partner in Papua, Yasumat, says that the current deaths and many others not reported publicly are due to a crisis in the health system resulting from poor governance.
The food security system in Yahukimo is very fragile but has been managed by the local people for hundreds of years. However, it only takes one small event to break the safety nets apart. There is a cycle of food shortages (especially sweet potato) often occuring after the forest nut harvest as people are busy collecting nuts and don't prepare new gardens. There is also regularly a shortage in harvest based on heavy rains every two to three years. This cycle is well known in Yahukimo and the people generally get through this time by switching to other food stuffs such as Taro and other local vegetables. This year there are several villages, mainly in the higher ranges of the mountains, that have suffered partial harvest failure due to heavy rains however many of the deaths are caused by general illnesses which are not been cared for or prevented. Due to a lack in nutritional intake from the seasonal food shortage the people are not strong enough to combat the illnesses that are swamping their villages.
In areas that Yasumat works (21 sub-districts of Yahukimo District) we have recieved specific reports from 7 districts that 260 people have died between June and August 2009.
There are various factors that are leading to these deaths:
1) Outbreaks of various illnesses such as measles, worms, flu;
2) Imunisation has not taken place since the establishement of the new District and also the basic government primary health care program is not functioning;
3) Government health staff are not working at sub-district and village levels, prefering to remain in the towns;
4) Many local people are employed by the government for building airstrips, government buildings and therefore are not making their potato gardens;
5) TB, HIV and Malaria are causing many deaths but the situation has not been taken seriously by the local government.
Papua Partners and Yasumat have recently prepared a report for the government which analyses the current health crisis in detail. Please click here to download in Indonesian. The report will soon be available in English.
HIV/AIDS and TB a threat to the people of Yahukimo
Information on the HIV/AIDS situation in Yahukimo District is still very weak as there is no survellience system and no facilities for testing or monitoring. Papua Partners partner Yasumat, who work in Yahukimo District, are working together with the Wamena city hospital in neighboring district of Jayawija to identify people that are infected and support the patients with follow up counceling and care.
Based on Yasumat's work we are aware of 17 people from Yahukimo who have died from AIDS and opportunistic infections since 2007. At present, Yasumat are accompanying another eight people living with HIV and AIDS. There are many other reports of people who have tested themselves, never sought help and just go home to their village to die. The number of people infected has been estimated as as much as one thousand in Yahukimo by the government AIDS commission. The Yahukimo government has a budget to set up a local AIDS commission as well as a budget for a Voluntary Counceling and Testing Centre, but as of yet has taken no action to move forward.
This situation is very serious as the majority of people who test positive are never seen again by the hospital and therefore cannot recieve care. The knowledge of village health workers about HIV and TB is still very low and therefore patients cannot hope to recieve good care back in their village. Yasumat is observing increasing levels of stigma to AIDS sufferers who return home, especially women. They are often sent to live in a hut in the jungle until they die. Often village healthworkers charge extra for basic medicines to people they suspect of being HIV postive. Awareness raising carried out by Yasumat has really helped increase understanding on how to care for sick people and this has reduced stigma in some areas.
TB and malaria are also causing serious problems and have still to be taken seriously by the government. There is no TB program at a village level or in Yahukimo's main town of Dekai so all patients need to come to Wamena. The patients end up in cramped accomodation with students which causes more and more people to become infected. Many return to their villages before they are better as they dont have enough money to stay in the town while they take their treatment for TB which takes at least 6 months. Yasumat are currently accompanying 28 patients with TB but there are hundreds more that we cannot care for due to lack of funds and people.
Even though the new District capital was established in a Malarial region there is still no prevention program. Many people come down to the town of Dekai to carry out various tasks and end up getting malaria. They dont recieve proper medication in their villages and either end up dying in their villages or being flown out as an emergency case to Wamena.
Yasumat are also currently doing awareness raising on TB, HIV/AIDS and Malaria in remote villages for the local people and village health workers and already over 2000 people have received training since June 2009.
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