Badung as one of the districts in Bali which is famous for its tourism regions in the world. As a tourism area, Badung district must ensure that this region can control the progression HIV infections. Various prevention initiatives in response to the HIV epidemic have been conducted by the Badung regency, such as providing access to HIV tests at health centers, providing treatment services in hospitals, forming a satellite treatment at several health centers, developing local leaders of students and people who can respond to HIV situation in their environment, increasing the number of field officers, and the most visible is Badung government’s commitment to HIV is to synergize the activities in some of the regional work unit (RWU), not only in the health services; but also in all other aspects such as social welfare, education and economy. For example, the Education Office encourages various activities among students, while in Social Services, it focuses on strengthening the community and other departments. All those departments coordinate with the National AIDS Commission (KPA) of Badung city which coordinates all responses to HIV interventions.
The description above is an active role of the government, but what about the role of the community? As we know the measure of community involvement can be seen by the implementation of Greater Involvement of People Living with HIV/AIDS (GIPA). From establishing the role of the individual, along with the peer, the campaign’s role in society, everyone is involved as program implementers and leaders of community organizations and is involved in developing policies to involvement in the planning and monitoring of HIV prevention activities at all levels.
How to implement GIPA in the field? Implementation of GIPA being biased not only in Badung but nearly in all other districts in Indonesia. Because the role of the community is only until then, many field officers and companion must come from the background of the community. Whereas the purpose of support and assistance to people infected with HIV is that they can be productive again in society according to their ability and capacity so that it can contribute significantly. According to the principle of GIPA, their role can be further enhanced not only as executives in the program but to the extent involved in policy formulation, planning and monitoring of HIV prevention at all levels. Because they only serve as program implementers with the demands of the program targets high enough, it contributes to the high level of stress and risk of failure in their regular treatment. Many of the Field Officers, who are former drug users are slipping back to their old habit again and experience a decreased ability to adhere to prevention and treatment, the companion of HIV-infected people even have their own health rate decreased due to the high exposure of witnessing near-death experiences and many other examples. And worse, when this individuals are experiencing set back due to their old habits, the organization tend to find a shortcut by releasing their employment, despite the investment of time, cost and knowledge that has been made.
How exactly is the role of an ideal community? There is nothing wrong with the roles above, and indeed these roles must be performed by the community but not required. Because these roles can be done by other groups that have an interest to participate in the response to HIV. Bali Health Foundation (Yakeba) itself plays a role as a community-based organization for long enough. The Role performed is to create more spaces for learning for communities in accordance with the interests and talents. The pivotal role for the community is to take a role in advocacy, encouraging policy, planning and monitoring of prevention activities. For example, Yakeba in Badung provided trainings in strengthening the resource officer, when the health department and the KPA requires officers. Yakeba provides spaces for the Public Health Office Department and KPA to recruiting in accordance with the mechanisms and rules that apply. Where Yakeba role is? Is it just giving the names of officers from the community? No, Yakeba creates the process of education to officials who have been recruited and afterwards together with the Department of Health Office and KPA supervise the officers. If the officers are recruited, the names of the community which is recommended by Yakeba then this monitoring function will not be maximized if the role of implementing the activities carried out by the community, there would be a conflict of interest. Because of the planning, implementation, monitoring and evaluation of all the communities, the issue of HIV into an exclusive matter again. While our hope is to popularize the issue of HIV in order to decrease stigma and discrimination. So, Yakeba took the role as well as to provide space for the community to learn in its monitoring and planning of an activity. Since August 2016, with the publication of a decree from the Regent of Badung, Yakeba sitting in Badung regency KPA structure in the Planning and Monitoring. This is caused by the results of previous work together between Yakeba and the health department office and KPA Badung until today. As Yakeba’s involvement is increasing, the number of communities to access government services, determine strategic locations in satellite form of treatment and strengthening the cadre of students and society for the prevention of HIV care in Badung district are also increasing until today. By involving the community at all levels and provide space for them to get involved and know the process is done, this decree mandates to further enhance the role according to the GIPA principle above.
A significant role is how the community can play a role of planning and monitoring. While in the process of implementation, community must open itself by involving various sectors because the issue of HIV is a common issue not just an issue for people who have been infected with HIV.