Global AIDS - Papua New Guinea

Fr. Jude at the AIDS Summit

Fr Jude attended the July, 2004 International AIDS Conference in Bangkok, Thailand where he was invited to make a Special Presentation on his work.

1. Introduction

I must begin by expressing my surprise at being asked to speak at this International Conference. I will be speaking on Papua New Guinea and I must be the first to say that there are PNG's here at this Conference who can do a far better job at this than myself.

I went to PNG as a missionary in 1976, nearly 28 years ago now. When I arrived I was told that I would have to start again -do a Novitiate. I was a new boy -looked at as a novice missionary. For 6 months I would have to travel the diocese - visit most of the Mission tations learning the language: Tok Pisin and learning the culture. They told me to go and visit the villages - "the children will teach you the language". When I finished my novitiate, I was given an assignment - though the 'in-services' continued. After 3 years, I went home on holidays to my native Ireland and saw my own Celtic culture through new eyes. On returning to PNG, I felt that now I was ready to begin work. It took me 3 years to get going!

2. The Wantok System and Changes in PNG

A: The Wantok System

Culture is a powerful force in one's life. PNG has 800 languages. 800 languages and culture to go with it - what we call the "Wantok System". "One Talk" = one language. Let me explain! In PMG, one is born into a village/clan/ a wantok system. In that village you have your identity and security. All your needs are provided for, all you need for life. It does not matter if you are a success story, an ordinary run of the mill fellow or even a bit hopeless. You are accepted and looked after. The village or clan group will provide for your every need - even arrange for a husband or wife for you. But, there are obligations! There is a law and order system, customs to be observed, leaders to be followed.

Children are cherished, loved and cared for. They eat in whatever house they visit - they are cared for by everyone. They are the pride and joy of the village. This is very important when we are talking aout HIV/AIDS.

B: Changes in PNG

About 100 years ago, the culture of PNG began to change with colonial influences - German, British and then Australian. Independence came from Australia in 1975. This was followed by many good years of progress and development (with some problems of course) until about 1990. Then there began a downward trend which sees us today with many problems.

What affected the world in recent times has rubbed off on PNG as well: "the Modern World" and what's involved in that - the sexual revolution - individual freedom - the upsurge of violence & insecurity-power and money - dishonesty - gender issues and many other issues.

What changes did these bring to PNG?

• In PNG, urban drift has led to a new class of people with one leg in the village and the other in the town -with the next generation with two feet in the town and very little contact with the village. A big problem with HIV/AIDS now!
• Major changes in community and social life and who controls what now?
• Leadership confusion -who runs the village now? - Is it the local chiefs and Bigmen or the visiting politicians?
• Law and order at village level or the new court system?
• Communications problems with 800 languages and trying to get messages across in English, Tok Pisin and Motu.
• Downturn in the economy - breakdown in basic services - and poverty especially in the towns and cities.
• And then you toss in HIV/AIDS - which is a completely NEW phenomena - and you expect people to understand what it is!
• Many people in Port Moresby see HIV/AIDS: " as just another problem affecting their lives".

3 Simon of Cyrene - Day Care Centre A: Simon of Cyrene Centre When you speak of HIV/AIDS in PNG, you need to look at it from an Urban point of view or a Village point of view. Let me tell you about the Urban situation first because we can see the epidemic exploding in Port Moresby whereas there is still little of HIV/AIDS to be seen in most of the villages of PNG. We run a Day Care centre - Simon of Cyrene Centre - at Hohola, a Port Moresby suburb. The Centre is attached to a government run Clinic - St Therese Clinic. We offer the following services: information & awareness - counselling - HIV blood testing - medical treatment - resting facilities: meal, bed, shower and laundry - and more.

• Someone comes in: the first thing is to make him welcome - a drink or something to eat - small talk, establish a relationship.
• What's his ( or her) story - it's either medical (she is sick) or it is behavioural (took some risks and is worried)
• Get a medical book going - medical examination by a doctor - get the records right!
• Counselling - possible check for HIV, TB, malaria - treatment = building the relationship!
• If the person is sick- get them into bed at the Centre - transport them home - collect them and bring them back tomorrow - spend a day at the Centre.
• If they are at home = Home Based Care
• This includes visits, medications, food, protective gear for the family
• Building up a relationship with the Family - The family is going to care for the patient

B: Who Comes to Simon of Cyrene Centre?

We get every possible mix from singles - to married couples - to widow/widowers. I must state that it is very important to get clear the status of the marriage/relationship because this will be a big factor in how the children will be treated.

• If they are "wantoks": the marriage is from the same language group - and recognised by the two families - then there should be good support and care for the children.
• If the marriage is mixed - mixed marriages or maybe mixed provinces - it depends on which of the two families the parents and children lean towards - that is where the children will go in times of crisis.
• If it is what we call a " city marriage" = two people living together - or a marriage that is not recognised - or a marriage of convenience - you will most likely end up with neglected people and neglected children. We have many of these marriages in Port Moresby!

Let me tell you a story of a "Wantok" marriage.

I can still see Jo coming into the Centre. Led by his brother, Jo was bent over - very low indeed! He had just got the word that he was HIV+ from a private clinic - no counselling! We made them both welcome and it took some doing to instil hope and point out there was a future and help available.

After meeting us - the family decided they needed to get together. They had a problem: "AIDS in the family". They made a commitment to meet for 7 nights in a row and work on this problem - they were all working people with day jobs. They did this. They thrashed it out for the 7 nights - in typically Melanesian fashion, and everyone said their bit. They decided that the children were the first priority - the extended family would care for the children: education etc. And also they would care for the parents and do their best for them. The Simon of Cyrene Centre would support the family with medicine etc and work with the extended family as well.

I must add here that the village "wantok system" is stronger and easier to apply.

That story sounds pretty good for Port Moresby - but in city life, many of the marriages are not solid. We seem to be bumping into people who have no one to care for them - and their children. Our policy is to try to keep ONE parent alive - it is usually the mother ( the man has died or abandoned them). Two points I wish to emphasize here:

• Most mothers who come to us have buried the last child ( or the child is sick) - we presume PMTCT (these are not recorded as such!)
• The danger point for children is when the mother is dying. She is unable to care for the children (weakness, money dementia) - and the children are neglected. A few months after the burial the children could be into malnutrition.

4: What do we do for the children?

The things children need:

• Care: basic needs of food, clothing, shelter, medical care.
• Education
• Protection from a life of prostitution & crime.

The children come when they are in need of something: food, a wash, clothing, understanding and love. Some kids now meet me every Sunday after Mass - I cook for them etc. There are no orphanages in PNG and we don't want any. We've never had orphanages because the children are always cared for by the "wantoks". Now I need to make a point: You can't just take children in PNG and say "We will look after them" Everyone "belongs" even if not been taken care of now. After all, children do have possibilities: girls and the bride-price - and boys the possibility of work and a wage. All the children say they want to go to school.

So - how do we look after the children - without setting up Orphanages?

So how do we provide schooling for children - yet keep them in the "wantok" system?
We (the Catholic church in Port Moresby) are thinking of a "Boarding School" arrangement. We would like to collect/take the children in on a Sunday afternoon - school all week as boarders - home to life with "wantoks" on Friday afternoon. We would look after the expenses. We are not "adopting" the children - they belong to the family! It would work for some children/families - not for others!

Conclusion - Summary

We are in PNG in 2004: we have 8,802 HIV+ people; the World Bank says we have 50 thousand. It's predicted that 20 - 25% of the population will be HIV+ in 10 years (our population is now a bit over 5 million now). Some points I see:

• There is a need to revitalise the wantok system in the whole of PNG. To strengthen the community family ties so that the sick are cared for and the children looked after. In urban areas there is a need for special support of individual families and special care of children.
• Individual donors need to look and see PNG where we are and begin to understand the cultural situation and complex social system in which children live.
• We do need outside assistance and are grateful for it. But more so we need people to help us better understand our experiences rather than give us programs designed in New York and with a use-by date set by Geneva.
• We need to get the message about HIV/AIDS across to all the people in PNG (towns and villages). We need to do this in PNG language and in programs designed and driven by Papua New Guineans.
• They tell us the HIV/AIDS epidemic is now in the general population in PNG. It is ours to deal with. "The answer lies within."