Below is an update of Rtn. Ari Murti’s efforts expanding Rotary Club Bali Nusa Dua’s HIV / AIDS training of midwives Klungkung Bali.

There continues to be mounting evidence that HIVAIDS is spreading rapidly in the Balinese community, like it is in many other parts of the world. While there are many organizations, including the Indonesian government, that are making attempts to educate and slow down the spread of this disease, the plight of infants born to HIV infected mothers has received less than desirable attention.

The Rotary Club Bali Nusa Dua (RCBND), in cooperation with the National AIDS Commission (KPA) of Klungkung Regency, on the 27 -28 October 2011 had training focuses on teaching midwives to identify high potential HIV positive mothers and counsel them about what actions to take to prevent the spread of HIV to their unborn child. In many cases the midwife refers the mother to the Mother To Child Preventive Transmission Center (PMTCT) for blood testing and other counseling. Already 30 midwives have been trained since being opening by the deputy of Klungkung regency in Klungkung, Bali.

The programs are having success and will be an on-going effort by RCBND in 2012 for Bali in terms of deciding the chain of transmission of HIV/AIDS. As we know that the midwives are one of the spear heads to early prevention of transmission of this deathly virus which could undermine the innocent fetus.

Its willingness to be cast off in solitude,
braving obstacles, comes rain, comes storm, or burning heat.
Ever growing stronger, heavenward,
spreading wings of twigs and leaves.
As a green canopy of foliage so dense
becomes a cool shade for the shepherd to rest,
stalks and protruding twigs provide shelter to cultured beings.
Roots burrowed deep stand unmoving,
collect life-feeding water and buffering disaster.
While the fruits and blooms dispensing smiles amongst life,
those seeds spread out far and wide in this universe
and they remain but humbly still,
never offer a greeting, nor any claim to fame.
And yet all beings salute them in awe,
when aware of the dedicated piety.
Now, open the window to your heart,
and slip in that benevolent intention,
even for just one small seed….

This short piece of poetry is reflected by Rtn. Ari Murti to describe and honour the function of midwife, anthropomorphically, in a seed. Even though non-prominent, the midwife is able to create deep-felt effect widely in the health of mother and child, most importantly in cutting the chain of HIV/AIDS virus’ transmission from mothers to their babies.

The spread of HIV/AIDS does not happen solely by sexual transmission or utilisation of infected needles, it can come from infected pregnant mothers directly to her fetus.

Therefore, Rotary Club Bali Nusa Dua in collaboration with the Commission for AIDS Care Badung Regency, again rolled out the Training Program for PMTCT (Preventive Mother to Child Transmission) for midwives in trial program for PITC (Provider Initiative HIV Testing and Counselling) activities.

Previously the training was given to 40 midwives in South Kuta sub-district only, this time it was given to 40 midwives from whole area of Kuta sub-district. The trainings were given on Friday and Saturday, 29 and 30 April, 2011.

Rotary Club Bali Nusa Dua diligently programmes activities in the framework of cutting the chain of the deadly virus transmission. Rtn. Ari Murti, as a member of Rotary Club Bali Nusa Dua, is also very industrious in involving several institutions, prominently that of the state, to materialize the Bali program for prevention of the raise of number of HIV/AIDS victims.

It is not only the matter of fighting the HIV/AIDS transmission, but also for the care for HIV/AIDS victims, which is expressed in her book titled “Outcast” telling the reality of HIV/AIDS victims’ world. For this jilbab-wearing lady, the training for PITC should not be the prerogative of Rotary Club Bali Nusa Dua only. In fact, her own wish is to make Indonesian communities becoming free of the HIV/AIDS virus. “Up to date there is no cure found for HIV/AIDS yet. The most potent way (to stop the spread) is by cutting through the chain of transmission.

When Indonesia is able to hold down the number of HIV/AIDS victims, this would mean that the growth index of man in Indonesia will raise. This would be one of the factors necessary towards achieving success in the state’s program for MDGs 2020”, explained Ari Murti.

To involve midwives in cutting the chain of HIV/AIDS transmission from mother to fetus is significant, according to Ari Murti. As health personal having the closest relation with pregnant mothers, midwives are expected to advise them to have HIV/AIDS test by VCT (Voluntary Counselling Test).

Of course the expectant mothers should undergo this test willingly without any coercion whatsoever. The approach via the midwives will give a positive effect. After the training program, when previously no data regarding the amount of HIV/AIDS infected mothers was available, now, according to Putra Suteja, the Head of Health Institution Badung, from 164 registered expectant mothers, 4 of them were found to be infected by HIV. The total of HIV/AIDS victims at present in Badung is 635 individuals. “Were this fact of HIV/AIDS infected mothers known to us earlier, the effort to safe the fetus could be done by distributing medicines, or performing caesarian-operation” added Putra Suteja.

Badung, according to Putra, has prepared 4 VCT locations, they are: the Sekar Jepun clinic RSUD (Army Hospital) Badung, Semara Usadha at the Puskesmas (Local Public Health Service) in South Kuta, Rijasa Puskesmas Kuta I, and in Abian Semal.

According to Dr. Elly Swandewi, M. Kes., KPA secretary Badung Regency, early check ups or counselling tests are needed to prevent the spread of the virus from mother to fetus, it is called PMTCT (Preventive Mother to Child Transmission). To activate PMTCT programs, PITC (Provider Initiative Testing & Counselling) is provided for expectant mothers with the involvement of midwives, who are, as health personals, trusted by the public to give aid in pregnancy check ups as well as in deliveries.

Persuading expectant mothers to do the HIV test is not easy. Usually, according to Rtn Ari, HIV check test cannot take place due to financial want, the mother cannot afford the cost of going to VCT location. Furthermore, fear and shyness or embarrassments make them stay away from such a test. “In the local public health service (Puskesmas) in Kuta, a mobile clinic to reach the expectant mothers who wish to do the test is provided,” added Rtn Ari.

The stretch of Rotary Club Bali Nusa Dua activities is not limited to HIV/AIDS only. The Rotary Club Bali Nusa Dua also provides free cleft palate and harelip operations designated for deprived communities. Those who wish to use the service of Rotary Club Bali Nusa Dua program (in free harelip operation) should register themselves in the administration office of Public Hospital Sanglah with Prof. Dr. Asmara Jaya.

Our Club, in cooperation with a local Non-Profit Foundation has printed and distributed more than 1,000 colouring books to Elementary and Middle School children living in the the Nusa Dua area. These booklets focused on the potential dangers of drug abuse and HIV.

Currently two books, targeted at the grasss roots level are produced. They expalain the dangers of drug abuse and, in the case of HIV, offer guidance and direction to support groups. The club would like to expand its participation in this project by producing and distributing additional colouring books to schools throughout Bali. Additional books will be distributed through a wide network of supporters and government run health centers in rural villages.