Testimony

Last night, I got to participate in an amazing kelompok diskusi - the first I attended where we had someone with HIV come and give testimony. It had a powerful effect on people - to see that someone "like them" could be infected, and be healthy if they get on the antiretrovirals. A very interesting evening. The person giving testimony even pulled out the pills to show people what they were like, and talked about the importance of getting tested.

The AIDS support group

Had a nice day working in the office all day - mostly helping a couple people get in their proposals for the Asia/Pacific AIDS conference before the deadline tomorrow. These kinds of seemingly boring routines can be a gold mine for anthropologists, so it's still quite interesting to me.

Then tonight was something special - attending my first meeting of the AIDS support group. 12 people attending, all living with HIV. Some have an official AIDS diagnosis; a few are taking antiretrovirals, some not - mainly because due to the rationing of the free medications, you have to have a T4 cell count under 200 (which is quite low) to get access to them. Which is interesting in itself of course. I did an HIV 101 discussion and they were transfixed - their access to info is fairly limited. The GC staff know more but a refresher doesn't hurt them either.

I explained how reverse transcriptase and protease work in HIV replication - and how these are the two things that antiretrovirals work against. To explain protease I ran into the next room and came back with a pair of scissors, pretending to cut myself to show how T4 cells infected with HIV use protease to disassemble themselves to make new HIV unless there's a protease inhibitor. Folks wanted an explanation of resistance and don't ask me why, but what came to mind as an allegory was shooting rabbits in your yard and if you don't kill them all, the ones who don't get shot are probably the smarter ones so their baby rabbits will be smarter and harder to kill. They got it, so I guess it worked!

It was very interesting to see what kinds of questions they asked. Some had to do with injecting heroin, which is sadly really on the rise here and a major engine behind the explosive growth of HIV infections. Others had to do with things they'd read in the newspaper or had been told by quack doctors about "cures" for HIV/AIDS. Very frustrating. I talked about the difference between such false hopes and true hopes - like the potential for effective integrase inhibitors or CD4 blockers that could even represent a cure someday in the future. That was helpful to people.

They are very brave - they know that they have some serious issues to face with their HIV infection, but they are also committed to taking steps to protect their health. Though it's frustrating to see how many of them smoke still - smoking is such a problem here.

The Worst Movie Ever...

Spent the day today helping prepare abstracts and scholarship applications for GC staff hoping to attend the International Conference on HIV/AIDS in the Asia/Pacific this August - it's so complicated and must all be in English, I don't know how most organizations do it. Then tonight went to the mall for dinner and a movie, accompanied by Tiara, a waria friend and staff at GC. Had some nice Indonesian food. Then turned out the movie we'd wanted to see (some Indonesian horror flick) was sold out, so we saw "Badai Pasti Berlalu" (The Storm Will Pass), a romantic flick. It was incredibly cheesy and boring - people were making hilarious comments during the second half of the thing. In the final scene Tiara leaned over and whispered "I think this is the worst film I've ever seen," and I couldn't stop giggling. So a bad film, but a fun evening anyway.

Beach meetings

I had a wonderful time at the strategic planning meeting. We stayed at Tanjung Bunga, a resort beach just 5 miles or so from the GC office. The office rented two beach houses.


We were just 20 feet or so from the beach - beautiful sunsets with all of the little islands out in the Makassar Strait, and lots of ships too.


The beach wasn't the cleanest in the world but it was fine, the water was bathtub warm and very calm (the strait is a pretty protected waterway, nothing like for instance the beaches in south Bali, which face right out to the Indian Ocean).


Saturday night was particularly beautiful. We spent the day doing some really interesting planning for the future of the organization and also to pick a new director (Akbar is going to become more of a chair of the board of directors kind of thing, still coming to the office every day but freer to do more lobbying and training work). Here I am leading a session on HIV updates:


And here I am taking notes in a breakout group working on ideas to improve medical and social care for gay men and warias with AIDS:


Lots of productive discussions--it was a great opportunity to be involved, particularly since I'm one of 4 people currently on their advisory board!





All throughout the 3 days we've eaten wonderful food - lots of fresh fish - looked by a lesbian friend of GC who is an amazing cook.



After the evening session where we picked the new director for GC (Azis, who's been with the organization since 1993 and is an old friend), we went outside to find the quarter moon above the ocean and beautiful white reflections on the waves, with tall pale white thunderclouds too. Distant flashes of lightning every so often, and stars above - it's nice to see the Southern Cross again, and Orion right overhead and the Big Dipper upside down on the northern horizion. A nice cool breeze and the squid-hunting fishing boats out on the water with their strong lights they use to attract the squid looked like a little village out at sea. Saturday night so lots of kids from town on the beach hanging out, playing guitar or chatting. Several of us thought we'd sleep out on one of the bamboo huts, so we just lay there for a long time talking and watching the waves. By about 1am though the beautiful sea breeze was getting stronger and the lightning more frequent - rain was clearly on its way, so we went inside - a good decision because it started pouring rain about 30 minutes later, quite a din on the tin roof of the beach house as I fell asleep thinking of my loved ones eating a sunny breakfast on the other side of the world.

At the Kafe Bibliotek

Friday morning, before heading off for the strategic planning meeting, I (and a waria friend from GC) went and spoke to a group of British and Indonesian university students about sexuality in Indonesia. The group is finishing up a 6-month exchange program (half in the UK, half in Indonesia) run through Global Exchange. The event was held at Kafe Bibliotek, which is a building out towards Hasanuddin University that's apparently owned by a Japanese guy living in town (connected to the consulate? need to learn more). It's got a nice little library and is open to all - you just pay for a drink and you can sit and read all you want, which is a pretty rare setup in Indonesia. Quite nice.

The discussion was great - the students asked great questions and we had a very lively and supportive discussion. My waria friend who came along really enjoyed herself and plans on going back there.

Karebosi

Today we did our 6th puskesmas visit. Perhaps the biggest so far, but only 3 people as usual to act as counselors, so it took almost 4 hours! GC will definitely add more counselors if this program gets extended.



It poured rain most of the time and we watched a couple kids playing in the rain from the veranda.



On the way home, I took a shot of this government sign to "avoid AIDS by being pious and informed," showing one woman helping another put on her prayer shawl (probably mother and daughter). Showed the picture to the 3 GC staff in the car with me - and the taxi driver - all were frustrated that the government was spending so much money on very vague public announcements that don't really say anything.

Tonight, I had yummy seafood near the beach with 3 friends from GC, and then we swung by Karebosi, the big park in the center of Makassar, about a quarter mile on a side (I wish Long Beach had that!). Saw some friends there and Andi (one of the folks with me, an old friend) and I pointed out the tree where gay men used to gather and hang out back in 1993.

Tomorrow morning I'm speaking to a group of university students about gay Indonesians, then in the afternoon I'm going to help Akbar try and get DSL for the office (yay!), and then around 4pm we're heading to the beach where GC is renting a couple little overnight stay buildings and the whole staff is spending Friday pm-Sunday am on a planning retreat. So it might be 2 or 3 days before I post again - I'll try to get some good photos from the beach! You can always send me a text message using your cell phone - send it to +61-81-399-712-782. For most phone plans in the US, the international calling code is 001 (but sometimes 011 or something else) - if 001 then you'd dial 00161-81-399-712-782.

Forced outside...

Did our 5th Puskesmas event today. The most successful yet - over 40 women got tested, but the facility provided was TINY! The room could barely fit 10 people. So we decided to do it outside, between two buildings. What a hoot!

It was a little on the hot side, but people took it all in good stride. Two observers from the Jakarta group that's behind this program (with the Global Fund) flew in and were very impressed. I may do some kind of report for them which they can use to try and get the program extended (just 3 more of these left to go in the pilot program).


I saw this on the back of one woman's shirt - "Converse All-Star" mistranslated. You see these kinds of mistranslations all the time - hee hee!

I didn't even feel it!

Some of you may have seen in the news that about 11pm California time, a 6.6 earthquake hit eastern Indonesia. It was hundreds of miles from me - I didn't feel a thing. On the map below, the blue circle is where I am and the brown circle is more or less where the earthquake was. Apparently there wasn't much damage - the quake was far from land - and no tsunamis either.

Office work

Still doing a kelompok diskusi almost every night (just got back from an interesting one, with two waria who were 14 and 16 years old, just figuring themselves out and in desperate need of guidance), but I've been doing lots of office work the last couple days that will really fit into my research. I'm helping a bunch of staff do the insane paperwork needed to apply for the 8th International Conference on AIDS in the Asia Pacific, to be held in Sri Lanka in August. I don't know how they could do it without someone with serious internet and English skills - the barriers to access are amazing. I'm also going to be interviewing the GC staff this week in advance of a 3-day retreat this Fri-Sun. It will be great fun - we're going to a little resort on the beach kind of place nearby that the organization is renting, and it's a strategic planning retreat to plan the next few years of GC's growth. They purposely timed it so they could do it when I was here, so I could act as the facilitator. Since I helped form the group 14 years ago and have many years of experience with them in between, they thought I would work well as the facilitator. It will be very interesting and a lot of fun, I'm sure!

Getting into a groove...

I'm starting to settle into a pattern - doing these Puskesmas events (that's Dr. Yohana above, counseling a pregnant woman who's about to get an HIV test) and also group meetings in the evening with gay men and transgenders (harder to photo because at people's homes in small groups). I'm learning a lot from the conversations I'm having...



I'm also doing lots of stuff around the GC office; I'll write more about that soon. One of the big things is helping staff write abstracts and apply for the big HIV/AIDS in the Asia Pacific conference that's happening in Sri Lanka in August. The process is quite complicated and has to be done all in English, so I'm doing a lot of translating and helping people get their abstracts into shape, and also helping them register online and apply for scholarships.

As I'm settling into a pattern here I might start posting every other day more or less instead of every day more or less; we'll see, but in any case don't worry if you don't see a post for a day or two. You can always email me to check in (tboellst@uci.edu).

Yummy food

It rained most of the day today - just for fun, Dadang (one of the GC staff), who's from the Toraja region up north, cooked us some yummy Torajan dishes, including fried tempe and a noodle soup!

More Puskesmas, Kelompok Diskusi...

I've been settling into more of a pattern the last couple days. Today went to my 3rd Puskesmas event (here I am explaining how antiretrovirals work to a pregnant woman considering getting tested), and also my 3rd kelompok diskusi, with a really well-trained group that's been meeting for a year and is really motivated to protect themselves from HIV infection. Also doing lots of things at the GC office - I'll talk more about that at some later point. it's nice to be getting into a productive routine!

Back to Irvine email!

Last night I wasn't able to access my Irvine email (tboellst@uci.edu); now it seems to be working (and access to gmail (tboellst@gmail.com) is difficult!), so please use my Irvine email again. Sorry for moving back and forth; it's just an issue of which is easier to access. It's probably best to just email me at both email addresses to make sure one at least gets through on this dial-up connection halfway around the world.

Another Puskesmas visit

Today we had another very successful visit to a Puskesmas - about 16 women got tested. It appears that the husbands of some of the women may be injecting drug users, so there is a real risk for infection (some groups of injecting drug users in Makassar are getting infection rates of around 90%, which is very frightening). The staff and the GC folks were all very professional - the whole process went very smoothly. The women were a little shy to ask questions after the initial presentation, so they trotted me out as a "guest speaker" and I talked about HIV basics with the group for a few minutes, which helped break the ice. Tomorrow we'll be visiting still another Puskesmas.

Kelompok Diskusi

Tonight went to my first discussion group (kelompok diskusi or KD) of this trip, run by a very competent transgender staff of GC. These discussion groups have been running for about 8 years now in some cases, and bring together groups of gay men and transgenders from various parts of the Makassar metro area to talk about HIV/AIDS prevention and treatment. It's a powerful tool for building community and getting a long-term, detailed message through that can change behavior. This one I attended was in Gowa, the town right south of Makassar and a famous historical sultanate. Didn't get any pictures, but I'm going to another KD tomorrow - I'll be going to at least 5 a week - so eventually I'll get some good images, I'm sure.

Yayasan Gaya Celebes

It's time I say just a bit more about Yayasan Gaya Celebes (The Gaya Celebes Foundation), where I'm staying. This group, which focuses on HIV prevention and AIDS care for gay men and transgenders (but as you can see now does a lot else too) was first formalized in my living room in 1993 when I was living in Makassar for the first time. So needless to say, I've got a long history with these folks. This is the third time I've lived in the GC office (here's a shot of the front). They do great work and are a perfect way to really plunge into my research on HIV prevention. And they are great people who have supported me so much over the years. Here's a great group photo they did last year, with a couple blowups so Bill can recognize many of the faces.

At the Puskesmas

This morning I accompanied a bunch of the GC staff to a puskesmas (community health clinic) way up on the northeast side of town, up towards the airport.


Because of the quality of its work over the years, GC got chosen to implement a new voluntary HIV counseling and testing program for pregnant women, despite the fact that their main target groups are gay men and transgenders.


It was very informative to participate in the event. (I'm third from the right in the pic below.)



The GC staff put up a sign outside the clinic and with the help of a woman who's a neighborhood leader in the area, about 15 pregnant women showed up. Akbar gave a presentation about HIV/AIDS and the importance of preventing mother-child transmission, followed by a question and answer session.


Even the GC were a bit taken aback that almost every woman participating decided to get tested - a real sign that the education is working.



As you can see, the puskesmas was so far out that there were a few cows wandering around, and a little tiger too.



And an elementary school across the field.

To my Second Life friends...

I'm not sure if any of my Second Life friends are still reading this blog, but just in case: I'm on a dialup connection here in Makassar, a SLOW dialup, so there's no way I can get back into Second Life until mid-April. In the meantime, I'm trying to read some Second Life blogs and news sites occasionally to keep up with everything, but even that's a bit difficult, between the demands on my time here and the slow connection. So don't forget about me - I'll be back inworld in mid-to-late April, and look forward to hearing your stories about whatever crazy things you've seen while I've been away.

Meetings and meetings

Today I attended a weekly staff meeting here at GC. It was a good opportunity to reconnect with everyone in a more structured manner and also explain what I would be doing for the next two months. One of the main activities GC does are these "discussion groups" where staff have regular meetings with groups of people in the community. I've been involved with the design of this program over the years, which has been a huge success and I think will be one of the things I really study. The great thing is how excited people are to have me come participate in their groups - by the end of the day we had a jam-packed schedule for me for the rest of the week. Things are going to get super-busy soon, I think. After the meeting I did an impromptu English class for the staff, which was great fun. They'd like me to do English classes at least once a week and I'm happy to oblige.

Then later in the afternoon Akbar and I attended a meeting at the Mayor's office that was a kind of wrap-up from the national meeting in Surabaya last week. It was interesting to hear about the various plans for moving forward. Compared to years past, the government is really taking an interest in responding to the epidemic and working with the nonprofits - it's very exciting in that regard. Then on the way back to the GC office we stopped by a nonprofit that works with drug users trying to break the addiction. They're getting 90% HIV infection rates amongst this group sometimes - it's just staggering.

Tonight Akbar and I had dinner with Ilmi, who's my academic sponsor for this researcher. Bill and I got to know Ilmi back in 2001 when I was going my postdoc at the Australian National University; Ilmi spent 4 years there doing her PhD in anthropology. She's interested in gender issues and also in starting research on HIV/AIDS, so it's pretty certain we're going to be collaborating into the future, which should be great. It's nice to have local colleagues, and she's wonderful for exchanging ideas.

No pictures today, but I'll be doing various things tomorrow that should be photo-worthy. I keep forgetting to take a picture of the front of the GC office - I'll try to do that tomorrow.

An Arisan

Today GC had an "arisan" for a group of women helping GC with their new program for getting pregnant women in Makassar access to HIV testing and, if they are HIV positive, antiretroviral medicine which not only helps preserve their health but drastically reduces the chance that their children will be infected with HIV when born. An "arisan" is a kind of rotating credit association - these are found all over Indonesia and indeed all over the world. In Indonesia as in many places, they are for women. Basically, a fixed group of women meets every week and puts a fixed amount of money into a pot. A name is drawn and that woman gets the money. The next week the winner has to keep participating, but her name is taken out of the running until all of the other women have won. So it's not really gambling - it evens out in the end - but it's a way for women to get a larger sum of money at once every so often to use for household purchases, for instance - almost a kind of savings account. And it's an occasion to get together and gossip with friends.


This particular arisan served as the occasion to plan a program for 8 areas in Makassar so that the local health clinics can refer pregnant women to GC for testing. This program was pioneered in Jakarta by another organization, which with support from the Global Fund to Fight AIDS, TB, and Malaria, is being extended to other parts of Indonesia. The women will keep meeting regularly for the arisan and to make sure the program moves forward - should be good.


Tonight I went with a couple friends to the waterfront here in Makassar. The city is really trying to spruce up the waterfront - they've moved all the food stalls down to one end and have added a big plaza. It should have spectacular views of the sunset - I'll try to check that out soon. One of the folks who came with us is a person living with AIDS who's getting support from GC staff. I won't reveal anything more about the person on this blog to protect confidentality, but it was very interesting to learn a little about what the person is experiencing. Sadly, this is a change from when I was doing HIV/AIDS work here 14 years ago, 7 years ago, even just 3 years ago - more and more persons are getting diagnosed with HIV, getting ill with diseases to the point they get defined as living with AIDS, and even passing away. It lends a new urgency to what I'm trying to do here. Just in the last two days I'm already getting a bunch of interesting ideas for how to focus my research.

New book cover

I've just received the first image of the cover for my new book A Coincidence of Desires. I like it - like I requested, it's very simple and clean. Here's a first look! There's some fine tracing on the white background you can't see well on this small image. The book should be out by April or so.

A Wedding

My first full day in Makassar has gone great - got my little room all set up. Here's my bed and the little desk that will be my office for the next two months:


So a little more on Makassar. If you look back on one of my first entries from Dec 2006, you'll see a map of the island of Sulawesi, with Makassar (known from about 1975-1995 as Ujung Pandang) down at the bottom of the southwestern "arm" of the island. Makassar is a very important city historically - here's a little blurb from Wikipedia:

"Beginning in the sixteenth century, Makassar was the dominant trading center of eastern Indonesia, and soon became one of the largest cities in island Southeast Asia. The Makassarese kings maintained a strict policy of free trade, insisting on the right of any visitor to do business in the city, and rejecting the attempts of the Dutch to establish a monopoly over the city. Further, tolerant religious attitudes meant that even as Islam became the dominant faith in the region, Christians and others were still able to trade in the city. With these attractions, Makassar was a key center for Malays working in the Spice Islands trade, as well as a valuable base for European and Arab traders from much further afield."

Here's a basic map of the old part of down - I've put in a blue circle down south at the approximate location of the Gaya Celebes office:


So today I mostly just hung out in the office and caught up with folks, which was great fun. Everyone was asking about Bill so I did my best to let them know how he was doing and that he wished he could be here. And people were excited that my mom is coming at the end of March!

Then tonight a bunch of us went to the wedding reception of a friend's relative. Indonesian wedding receptions usually take place outdoors under a big tent (like this one) or in a big reception hall if the families are well to do. There's a fairly set, formal routine: the bride and groom sit up on a little stage, very stiff and formal and made up, with relatives from the families on each side. You come in and are greeted by a row of family well-wishers, then make your way to the bride and groom, shaking hands along the way. There's a place where you drop a little money for the couple (usually in an envelope that makes up part of the invitation). Then you get in line for a buffet dinner (almost always very good) and sit for a bit and chat with the other folks attending (but not the bride and groom and their family; they sit formally in front, continuing to greet new arrivals). People have a good time chatting, and you often just stay for 30 minutes or so, though there's usually live music and some folks stay late into the night. It's considered good luck when people come from afar for the reception, so foreigners are usually particularly auspicious, and over the years I've been invited to zillions of these things - I'm happy to oblige!