Suggested link:

The Highlands of Papua New Guinea are a daunting challenge for even the most adventurous and resourceful traveller. Getting around, even short distances, from village to village, is an arduous task. Not though for one of the world's most feared and hostile viruses. After taking hold in the capital, Port Moresby, HIV is now making short work of PNG's unassailable interior, claiming victim after victim as it reaches into the heart of a poor country.

Reported cases in PNG are approaching three thousand, with one prediction claiming one in four Papua New Guineans will be infected with HIV within ten years, more than one hundred thousand people.

Australia's helping with money but there's not enough for life saving drugs and medical expertise. And, of course, there are profound challenges to spreading the safe sex message beyond the cities. Eric Campbell on PNG's epidemic.

Ceremonial dancers at conference

Singing

00:00

Campbell: Late, perhaps too late, a warning is sounding across a troubled land.

The tribal sing-sing marks the start of one of Papua New Guinea's first major meetings on AIDS. The big men of health and government have come to confront an unprecedented crisis.

Funeral

Thirteen years after AIDS was first detected here it has begun to spread like wildfire killing as many women as men. For more than a decade the authorities ignored the problem, some hoped the isolation of their mountain and jungle villages would protect them from this global scourge. But suddenly they are facing a catastrophe.

00:35

Dr. Malau

Dr. Malau: If we don't do things innovatively and pro-actively in the country we will definitely have maybe much more problems than what's faced in Africa, I believe.

01:02

Campbell: Even worse than Africa potentially?

Dr. Malau: I would think so.

Map

Music

01:13

Tessie at hospital

Campbell: Tessie Soi has seen it coming for years. She's the social worker at Port Moresby Hospital and one of only a handful of qualified AIDS counsellors in the country. In a capital renowned for poverty and violence, AIDS is now the hospital's main cause of death.

01:30

Campbell: Her patient, Thomas, will be one of the next to die.

01:54

Tessie: He has terminal AIDS, AIDS now. He's actually lost a lot, a lot of weight as you can see. He's going down.

Agata

Campbell: Thomas' wife Agata knows she will eventually share his fate.

02:10

Person: They just got married six months before he started getting sick, yes.

Campbell: Right. Did she know he had HIV?

Person: No, she didn't that we know. But, you know, after she found out she's been very supportive of him.

02:22

Campbell: Both their families have shunned them since the diagnosis. The support from the state is almost nil. The hospital gives Thomas a place to sleep but there is no money for the retro-viral drugs that could keep him alive.

02:28

Tessie

Super:

Tessie Soi

Social Worker

Tessie: So that's the only support we can give him. But there's nothing in place with the government agencies, nothing at all.

02:42

Campbell: If you're overwhelmed in this early stage of the epidemic, what's going to happen in five years' time?

02:47

Tessie: I don't know. Maybe what they're going to do is we're just going to go under, you know.

02:51

Funeral

Campbell: But the social implications for this country could be even worse. Today, Tessie is burying her second patient in two days. Vincent was a 28 year old lawyer and the mainstay of his entire extended family. His death may have condemned them to a life of endemic poverty.

03:01

Crying

03:28

Campbell: In this close knit, village-based society, the loss of someone like Vincent is an agonising, devastating blow. Unlike Thomas and his wife Agata, Vincent had the love and support of his family. But he kept the true cause of his illness a secret, telling them he was dying from tuberculosis.

Tessie at funeral

Tessie: I don’t know whether everybody here knows what Vincent died of. Vincent is another young Papua New Guinean been claimed by this dreaded disease, AIDS, and it's sad that this type of disease if we don't try and do something about it will continue to claim our educated elite that we need for our country to keep on going.

03:28

Campbell: The family takes the news calmly, a rare sign of tolerance in a society where AIDS is a cause of shame as well as fear.

04:22

Tessie: We must make sure that we don't get it but if someone else gets it, we must make sure that we love them and care for them, because if we do that, they will live longer. So I would like to say God bless, bamahuta and goodbye, my friend.

04:30

Wailing

04:50

Campbell: One more death, one more funeral in an epidemic that may claim hundreds of thousands of lives.

Guys on trucks

Campbell: No one knows how many people are infected. Estimates range as high as 22,000 people with up to one in five prostitutes testing positive. But it's the rate of increase that has doctors so alarmed. The number of reported cases has doubled in the past 18 months. In the mathematics of death, HIV appears to have reached the critical mass for a year by year explosion.

05:18

Dr. Malau

Super:

Dr. Clement Malau

Dir. National AIDS Council

Dr. Malau: I would say in the general trends of the epidemic would be the same as in Africa, like maybe 70 per cent in some population groups and so on.

05:50

Campbell to camera

Super:

Eric Campbell

Campbell: The situation here is desperate but not hopeless. Papua New Guinea is belatedly trying to tackle the crisis. The next 12 months will be critical to stopping an African level epidemic. But while intentions are good, resources are scare. For now, most of the fight against AIDS is in the hands of small groups of grassroots workers, facing extraordinary odds.

06:00

Papuan countryside

Music

06:24

Rita in car

Campbell: Rita Maruha is a latter-day missionary, spreading the gospel of good health and safe sex. Employed by the Seventh Day Adventist Church and funded by the Australian Government, her team travels as far as it is possible to go.

06:33

Rita: One of the biggest difficulties is the road. When it's raining, it's not accessible.

06:52

Campbell: It is the hardest country on earth to try to educate people about AIDS. There is no television outside the main towns and almost no radio. Communication must be face to face. It is painstakingly slow and unreliable but there is no alternative.

07:01

Rita in field

Even when she reaches villages there is no certainty she can talk to them.

07:25

Rita: Oh the women can't speak pidgin.

07:30

Campbell: Every few kilometres there's an entirely different language, even the lingua franca, pidgin can fall on deaf ears, particularly among women.

Rita

Campbell: So you've got 800 languages in this country?

07:41

Rita: More than 800. The last I've heard was 869.

Campbell: Right. So over the next hill there they may not understand the language of the people in this valley?

Rita: No.

Campbell: Bit of a problem for getting the message across?

Rita: It is a very big difficulty in educating the people about HIV AIDS. One of the difficulties.

07:53

Campbell: One of the many?

Rita: Yes.

Women in field

Campbell: Another is a deep taboo against talking about sex. Rita perseveres regardless. She'll have to hope the men translate it for the women later.

08:03

Rita

Super:

Rita Maruha

Adventist Aid Worker

Rita: Most of the people we have spoken to in the villages have heard the words HIV and AIDS, do not know the difference between HIV and AIDS, and are very frightened about the disease itself.

08:13

Play for villagers

Drums

08:26

Campbell: To help get the message across a troupe of travelling actors use comedy to present the things villagers don't like to talk about. A character called Uncle Condom shows the best way of protection against the disease known in pidgin as Sik AIDS.

08:33

Actor: If you drink… if you make love… Think condom! VD has medicine… AIDS has no medicine. If you want to have sex think condom!! Put a condom in your bag.

Campbell: Like all such programs, it's funded by Australia, pat of a $60 million AIDS prevention program from the development agency, Ausaid. The aid program is partly altruism, and partly self-interest.

09:13

Singing

Campbell: The call of Australia to help treat AIDS could eventually run into the hundreds of millions.

09:30

Actor: When I drink… when I drink I think only about women.

09:36

Campbell: This is racy stuff for a traditional conservative society.

09:44

Actor: I want to touch you, woman.

09:50

Campbell: The village clearly relates to the portrayals of drunken, one night womanising and laughs at the message. There's no telling how long they'll remember it. But what you're not yet seeing in the villages is widespread cases of people with full-blown AIDS. That's still a few years away. And until people see that, most simply won't take this seriously. By the time they do, it could be too late.

Workers at Port of Lae

Music

10:19

Campbell: Even in the cities, the message is barely getting through. This is Papua New Guinea's biggest port at Lae in the northern province of Morobe, one of the gateways of HIV infection.

Music

Campbell: Friday is pay-day and 26 year old Michael Habu and his fellow stevedores are deciding how they'll spend their wages. As always, sex is high on the agenda.

10:45

Michael: There are different kinds of men – some like to go with prostitutes… Some men go with prostitutes and then go back to their home and family. Other men have money, and they go out on the road

10:57

Michael

and they're just looking for sexual intercourse with anybody.

11:12

Prostitutes on Airstrip

Campbell: Many come here to a disused airstrip near the centre of Lae. It's a sad and seedy venue for open-air prostitution. Mary left her home in the Highlands after her husband decided to find a new wife. She survives by selling herself for less than two dollars.

11:29

Mary

Mary: People say there's lots of AIDS here. So I thought, I don't want to die – and I went to the hospital to buy condoms. They had no condoms and my brother said he was afraid for me. He said he had some in his store – so he sold me the condoms and now I use them.

11:52

Mary and prostitutes with WIlfred

Campbell: Few people are interested in helping the prostitutes. Wilfred Peter is an exception. He's been running an Australian-funded program to train women like Mary to teach the others about safe sex. But the seed money for the program has almost run out. At best, it will continue in a scaled-down form. Wilfred fears the hard won progress could be lost.

12:27

Wilfred

Super:

Wilfred Peters

Institute for Medical Research

Wilfred: Building a relationship in an area like this is very difficult. It takes an awful lot of time. It takes a heart to really get out there and be with the people. And to lose, you know, people we've had is another task to handle here.

12:50

Villagers

Campbell: Money is so short that Papua New Guinea has had to make a deadly choice. It’s put all its AIDS budget into education leaving nothing for treatment and the most vulnerable of all are paying the price. About ten per cent of AIDS transmission is from mothers to unborn babies. Drugs can have a dramatic effect in stopping this but there's just no funds to buy them. So every day babies are needlessly contracting HIV.

13:08

Dr. Malau

Dr. Malau: Yes, it's very difficult when you don’t have the resources to try and do everything. So those are the sort of dilemmas that we're faced with.

13:37

Congregation singing in church

Singing

Campbell: Some churches are trying to fill the gap. This is a deeply religious society. Rita Marahu who sees her work as both a Christian duty and a social imperative.

13:53

Rita: I am worried because I have a daughter, and if I don’t do something about it she may be one of those who will be infected.

Campbell: But for every Christian intent on saving lives, there are others with an eye on saving souls.

14:15

Pastor

Super:

Pastor Elijah Jordan-Som

Revival Flames Ministry

Pastor: I don't believe in safe sex because safe sex is still sin. It is sex outside marriage.

14:27

When young people are encouraged to live in sex through, through condom, it becomes a habit and you might …

Campbell: Pastor Elijah Jordan-Som of the Revival Flames Ministry is part of the burgeoning Pentecostal Church. He's at the forefront of a campaign to ban condom promotion. Today he's taking his message to Port Moresby University.

14:39

Pastor addressing men

Pastor: …taking the strong principle of the word of God to schools and the young people on the streets and telling them about the Word of God which speaks against living in sex outside marriage and I believe when we do that we can prevent AIDS because condoms, condoms is just encouraging young people to continue to live in sex again. So what do you think?

14:54

Campbell: On a western campus, he'd be eaten alive. Here no-one disagrees.

15:13

Man: Yeah, I think I do agree with you.

Man 2: I think using a condom will never prevent AIDS… because if God wants this to happen in its own time then condoms or whatever we use will never prevent AIDS.

15:22

AIDS education posters

Campbell: It's a view that pervades much of the government. There still no safe sex campaign on television or radio. Instead the Port Moresby administration erected this warning: Immoral sex kills.

15:35

Tessie

Tessie: They're going to actually drive people living with AIDS down even further because they're going to say, well, I must have done something wrong. Where really a lot of them don't, don't, are not into sex work, they're not into promiscuity, they're just the normal people who are trying to have a relationship.

15:49

Tessie and Campbell visit David

Tessie: Hello.

16:10

Campbell: Tessie took me to see another of her patients who's been driven to rock bottom.

Tessie: This is David.

Campbell: David is now in the terminal stage of AIDS. She came across him living alone without money or even food.

Campbell: Have his family been supportive or anything like that?

16:31

Tessie: We'll ask the ladies here. Has his family supported him?

Woman: No.

Tessie: No.

Campbell: He's now being cared for by single mothers from a self-help group with endless goodwill but no money either. Tessie has formed an AIDS charity called the Friends Foundation to try to raise enough funds to at least stop this, but she's still had to buy food from her own meagre wages.

Tessie: … being that I believe that giving people with AIDS the support will tell others, look, don't be like me, you know, I'm going through this and it's like hell, you know. Let's try not to, you know, spread the virus out to others.

17:00

Music

Campbell: Papua New Guinea is totally unprepared for what lies ahead. The village system has long made up for the shortfalls of government but fear and ignorance of AIDS has rocked people of even that support. It will take an unprecedented national campaign to prevent a social calamity. If Papua New Guinea can't stop this epidemic, God help its people.

17:19

Music

Credits:

Reporter: Eric Campbell

Camera: Mark Slade

Sound: Peter Dip

Editor: Stuart Miller

Research: Vivien Altman

Producer: Richard Dinnen