The Enlightened Path For Equal Access To Healthcare For People Living With HIV (PLHIV)

In Indonesia, the fight for equal access to healthcare for people living with HIV (PLHIV) remains a pressing issue, especially in regions like Papua. For many, the journey is not only about receiving medical care but also navigating societal stigma and logistical challenges that hinder their access to essential treatment.

Dira, a 23-year-old woman from Jayapura, Papua, experienced firsthand the emotional and societal burden that comes with an HIV diagnosis. Two months into her pregnancy, Dira learned that she had contracted HIV from her partner. This revelation, which came at a time when she was preparing for an important civil service exam, felt like a dream slipping away. “I was devastated,” Dira said. “It felt like all my dreams crumbled in an instant.”

Papua, the province with the highest number of HIV cases in Indonesia, is home to over 18,700 people living with HIV as of September 2023. While the statistics are alarming, the real challenges lie in the stigma and barriers PLHIV face daily. Dira’s experience reflects the struggles many women in the region face, especially as they contend with not only the virus but the deep-rooted societal discrimination surrounding it.

Overcoming Stigma with Family Support

In the face of adversity, Dira found unexpected strength through her family. “After learning I had HIV, I was afraid to leave the house. It felt like everyone was staring at me with judgment,” she shared. However, her mother’s unwavering support became a beacon of hope. “My mother always told me, ‘This isn’t the end of the world. If you don’t fight for yourself, who else will?’”

Encouraged by her family’s words, Dira began visiting the community health center (Puskesmas) for treatment and education. To her relief, the care she received was supportive and nonjudgmental. “They explained everything in a way that was easy to understand, and most importantly, the medication I needed was always available,” Dira said.

Antiretroviral (ARV) medication plays a critical role in slowing the progression of HIV and maintaining the quality of life for PLHIV. However, ensuring consistent availability of these medications in Papua, particularly in remote areas, has been a significant challenge.

Addressing Logistical Challenges with Technology

The task of maintaining a consistent supply of ARVs in Papua is no easy feat. Sitti Subaedah Ikha Heryani, a health worker at the Imbi Health Center in Jayapura, spoke about the difficulties she faced in managing drug inventories. “In the past, I often struggled with discrepancies in drug inventory due to manual recording errors. I had to repeatedly recount the stock to ensure accuracy,” she explained. Additionally, inconsistent medication distribution from the local health office compounded these challenges.

In response to these issues, a technological solution has been implemented: the Electronic Logistics Management Information System for Health (SMILE). Developed through a collaboration with the Global Fund, UNDP Indonesia, and the Ministry of Health, SMILE was initially designed to support immunization programs. However, it has since been adapted to efficiently track and manage the distribution of HIV/AIDS medications, including ARVs.

SMILE: A Game-Changer in HIV Care

The SMILE system has revolutionized how health workers like Ida manage medication stock. It automatically alerts them when supplies run low, making it easier for health centers to monitor inventory. “With SMILE, I can check the stock of medications anytime and anywhere, without needing to constantly return to the health center,” said Ida.

Additionally, the system helps manage medication expiration by notifying health workers when drugs are nearing their expiry date, allowing them to prioritize their use and reduce waste. “Now, no medication goes to waste,” Ida added.

The introduction of SMILE has not only improved logistical efficiency but also boosted the morale of health workers. Ida, for instance, now feels more empowered to encourage and support her patients, like Dira. “I often remind Dira that if left untreated, her condition could worsen. I want her to know that she still has the chance to achieve her dreams,” Ida said.

Renewed Hope Amid Challenges

For Dira, the reliable availability of ARVs without fear of medication shortages has given her new hope. “Being diagnosed with HIV isn’t the end of my life—it’s the beginning of a new chapter,” she said. “I will keep fighting to achieve my dreams.”

As the battle against HIV continues in Papua and beyond, initiatives like SMILE demonstrate the power of technology in overcoming healthcare challenges. With continued support, people like Dira are finding a path forward, proving that with the right treatment and care, the future can be brighter for PLHIV across Indonesia.