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2014 QUARTERLY NEWSLETTER
VOLUME ONE - ISSUE TWO
Volume One Issue Two
 
Welcome to the official YBP Quarterly Newsletter; a place with all the latest news from our programs in Bali.  The first half of 2014 has been very busy: we published our first annual report, Klinik Anggrek celebrated one year in operation, and Jan Beagle, Deputy Executive Director of UNAIDS, visited Bali Medika to talk about HIV in Indonesia.  Furthermore, Klinik Anggrek tested their 800th patient; a milestone for the clinic - a success that has already exceeded our expectations.  
 
In this issue we catch up with Eka Sampurna, YBP Outreach Buddy, father and musician, to talk about his role and the challenges he faces working in a community where lack of awareness and stigmatisation are common.  We also take a closer look at the issue of HIV inside prisons, where rates of infection are significantly higher than in the general public.  Finally, DR Steve Wignall, founder and YBP medical director, provides an update from the field with what’s happening at the forefront of the global HIV response.
 
If you would like to contact us or join the conversation happening on social media, then you can find our links in the ‘Contact Us’ section.  Happy reading!

HIV Education

 
The YBP Education program aims to raise awareness for HIV and promote safe behaviours.  Our strategy involves zero-discrimination, as we believe that everybody regardless of their gender, orientation, economic or social status should have access to health education and services.  Currently the program is focused on high-risk populations in the Kuta and Gianyar districts.  The program is coordinated by Cipto Aryo Panenang and works in collaboration with village leaders, employers and school principles; all of which have show tremendous support for the initiative.  In 2013 the program reached approximately 3000 members of the Balinese community.  This year we expanded the program and as of the end of June we have already 32 educations sessions.

The spread of HIV through the Indonesian prison system is a salient issue and one that requires intervention.  The World Health Organisation considers prisons and detention centres as high-risk environments for the transmission of HIV.  Lack of access to prevention measures and prevalence of risk behaviours are two key issues.  Needle sharing between drug-users and unprotected sex are key behaviours that fuel the spread of HIV between inmates.  In 2010, 4.3% of inmates at Kerobokan, Bali’s largest prison, were HIV positive. Hepatitis C and rates of syphilis are also higher within the prison than in the general population.
Gianyar is a fast growing district in Bali situated north of Denpasar and Kuta beach.  The Gianyar District Prison holds a total of 83 inmates, which comprises of 78 men and 5 women who are kept in separate living quarters.  A total of 22 inmates have been incarcerated on drug related cases.  The prison staff provides inmates with information about HIV and STIs, however, the content is very basic and not well received.  Drug use and unprotected sex between inmates is common, two high-risk behaviours that increase the possibility of HIV and STI transmission.
On the 12th of June 2014, the YBP Outreach Team visited the Gianyar District Prison to raise awareness for HIV and promote safe behaviours.  Over 90% of the inmates attended the two-hour education session, which involved presentations on various topics, group activities and demonstrations.  In addition, the session also included question time, which gave inmates an opportunity to openly discuss HIV and health related topics with the YBP team.
This proved to be beneficial in clarifying many misconceptions about the disease and help breakdown some of the negative stigma focused on PLWH.  Participants also received a small workbook that included information about HIV and preventative methods.  Many of the inmates asked about our testing services, as they were eager to find out their HIV status.  YBP is in the process of obtaining a permit that will allow us to set up a temporary mobile clinic inside the prison, were inmates can get tested for HIV and STIs and access treatment where necessary, all entirely free of charge.  Please check the YBP Facebook page for further developments on this project. 

Public Service Innovation Award

 
Puskesmas Ubud II, Sayan, partner and host clinic of Bali Peduli’s Klinik Anggrek, is one of the top 33 winners in the competition for “Public Service Innovation Award” – an initiative of the Ministry of Administrative and Bureaucratic Reforms aimed at boosting efficiency and best practice among public service agencies.  The competition started with 515 proposals from all over Indonesia with 99 innovative ideas winning the first round. An independent panel of 11 judges, comprising noted researchers and academics from various disciplines then decided on the next 33 winners by way of unannounced visits to the facilities to observe systems and practices in-situ. Puskesmas Ubud II was chosen for their one-stop harm reduction program, which include the free, rapid testing for STI and HIV supported by Yayasan Bali Peduli.

Global HIV News


Dr. Steve Wignall is a HIV physician and clinical researcher.  His current roles include National Policy Advisor for M2M HIV policy to the Indonesian National AIDS Commission and Senior Medical Advisor to the Clinton Foundation’s efforts to increase access to treatment for HIV+ people in the Papua Province.  Dr. Steve Wignall’s knowledge and medical expertise have enabled Yayasan Bali Peduli to remain at the forefront of the HIV response in Indonesia.  Having lived and worked throughout Indonesia for over 20 years, he has a comprehensive understanding of the cultural and political challenges facing our efforts to prevent the spread of HIV in Bali and eliminate barriers to care. 

From Dr. Steve Wignall M.D. 
Improving HIV Services For Those At Risk
 
The WHO released new guidelines on 11 July directed at improving HIV related health services for men who have sex with men (MSM), transgender people, female sex workers (FSW), people who inject drugs (PWID) and people in prison – all of whom are considered most at risk for HIV infection but are often underserved and face major barriers to access to care. 
 
The guidelines recommend a number of activities to both increase access to care including testing and treatment for those infected and to reduce new infections and remove barriers – social and legal – that prevent access to services.  They point out that FSW are 14 times more likely to have HIV than other women; MSM are 19 times more likely to have HIV than the general population; transgender women are almost 50 times more likely to have HIV than other adults; and for PWID risk of HIV infection can be also 50 times higher than the general population. 
 
WHO has strongly recommended that sexually active MSM consider taking antiretroviral medicines as an additional method of preventing HIV infection in the form of pre-exposure prophylaxis (PrEP) along with the continued use of condoms and lubricants. Rates of HIV infection among MSM remain high almost everywhere and new prevention options are urgently needed.
 
YBP serves members of these risk groups in both it’s clinics in Kuta and Ubud and has recently applied for a grant to pilot PrEP among MSM accessing services in our facilities. 

Meet Our Team
Eka Sampurna

 
Eka Sampurna was born in 1980 in Timor Leste, but grew up here in Bali.  He is a husband, father and aspiring musician.  Eka enjoys playing in his band, singing, traveling and art.  He studied and graduated high school in Ubud, so knows the community in this region very well.
 
Eka has worked as an Outreach Buddy for YBP for the past 18 months.  His role involves working directly with new patients and PLWH, providing them with information about available services and medication.  In addition, Eka also provides non-medical support in the form of counselling and emotional care.  He regularly joins the YBP Education team on outreach programs, were he delivers presentations on HIV and STI prevention, to community groups and schools.









Eka spoke about the challenges he faces in this role and said that discrimination and a negative stigma towards people affected by HIV is common.  He believes that this notion comes from a place of ignorance and that misconceptions about the disease have caused a divide between PLWH and the general community.  Eka is passionate about his work with YBP because it gives him an opportunity to help people, especially those affected by HIV.  He believes that PLWH deserve the right to live happy, normal lives.  

Clinic Update

 
Clinical services are YBP’s flagship program and cornerstone of our mission in Bali.  We currently operate out of two clinics located in Kuta and Ubud.  The following section breaks down the testing and treatment statistics from January until the 30th of June 2014:

Bali Peduli Klinik Bali Medika – Kuta

Clinic Visits - 1823
New patients - 368
HIV tests conducted – 661 (80 HIV+)
STI tests conducted – 495 (119 STI+)
CD4 tests conducted - 236
Total Patients supported with ARV – 102
 


Bali Peduli Klinik Anggrek - Ubud 

Clinic Visits - 828
New patients - 434
HIV tests conducted - 395 (25 HIV+)
STI tests conducted - 548 (124 STI+)
CD4 tests conducted 77
Total Patients supported with ARV - 44

Positive Living Fund
 
Due to lack of education there is a prevailing negative stigma surrounding HIV and AIDS in Bali.  Unfortunately, this leads to people living with HIV (PLWH) being ostracised from their families and the community.  The Positive Living Fund (PLF) was created as a response to this situation and offers temporary non-medical support to people in these critical circumstances.  The objective of the program is to support and empower recipients to gain their independence.  In 2013 the PLF supported and re-established 23 women and children living with HIV.


In 2014, the YBP Outreach Team identified five clients in critical circumstances.  Subsequently, they were all provided with medical support and submitted into the PLF program. 
 
A mother of two had recently lost her husband to HIV related illness and was now facing poverty and isolation from the community.  Initially, YBP provided the young family with essential items and medical support.  After some months in the program, the woman was able to find work and regain her independence.  The Bali Children’s Project currently supports the two children’s education, and the family has since left the PLF program, as they are now self-sufficient and re-established within the community.
 
Unfortunately, cases where children have lost both their parents to HIV related illnesses are very common.  Currently, through collaboration between YBP and Taman Permata Hati, two orphan children are being provided with comprehensive non-medical support and care.  The children now live with their grandparents and are enjoying a normal life with a bright future.
 
The success of this program is a result of the collaboration between YBP, donors, the Bali Children’s Project and Taman Permata Hati.  The future of the PLF program is to continue identifying, supporting and rehabilitating people affected by HIV.  Wherever possible, YBP works with other stakeholders to maximize resources, therefore, enabling us to serve and support those in need.   
Breaking News
15 July 2014

In breaking news, YBP Founder and Medical Director, Dr. Steve Wignall, has been presented the Ksatria Bakti Husada Kartika Award in recognition of his dedication to HIV AIDS prevention in Indonesia.  The award is an initiative of the National AIDS Commission’s Quarterly Evaluation and was presented by the Minister of Health.  More details and pictures from the ceremony will be on our website soon: www.balipeduli.org   
Join Us
 
YBP relies entirely on the support of our donors and partner organisations.  In 2014 we have already achieved impressive results, but there is still more to be done.  The success of Klinik Anggrek has far exceeded our expectations.  In the first six months of 2014 we conducted 395 tests for HIV; more than double the total number of tests conducted in the previous year.  This sudden increase in the demand for our services signals that it is time to expand.  By the end of this year we would like to extend the clinic opening hours to 6 days per week, which will enable us to serve a wider range of the community.  However, to do so we need your help.  If you would like to contribute or make a donation, please contact: info@balipeduli.org or visit www.balipeduli.org.
Contact Us
 
We love feedback and we love to talk.  If you would like to contact us or join the conversation on social media, then please follow:
Yayasan Bali Peduli
@balipeduli
@bali_peduli
www.balipeduli.org