2004 Merauke, Indonesia

I worked in an HIV/AIDS treatment programme in Merauke of Papua, New Guinea and Indonesia from May 2003 to May 2004. This city accounted for over one-third of the total number of HIV/AIDS patients in Indonesia. With ineffective surveillance system and laboratories, exact data was poorly recorded. The HIV epidemics, poverty and poor medical system also caused anther problem-------tuberculosis (TB). Actually it was only the first year of our programme and we had started the HIV/AIDS training programme in the district hospital. We had found that the HIV/AIDS epidemics might be highly underestimated due to the poor quality of HIV tests and the wrong procedures of the staff doing the tests for the patients. Moreover, from the data of 2002 in the hospital, we had found out an extraordinarily high incidence of extra-pulmonary TB among the population, especially children under 4 years old, implying that a high proportion of children had lower-than-normal immunity, which might mean numerous of them had already carried the HIV virus and we couldn't imagine the number in the adult population. We had to move faster than we had planned so as to infiltrate the correct message into the community. Another challenge was the discrimination against HIV/AIDS patients. It came even from medical staff and made the patients afraid to seek help early. Sometimes doctors in countryside attended the patients too late. We hoped we could motivate the local staff to cooperate in playing a more active role in caring and learning about HIV/AIDS. With early treatment of opportunistic infections and then antiretroviral therapy we might save more patients. Hopefully later they could form their patient self-support groups to change the image of HIV patients and infiltrate more awareness of safe sex into the community. Tsz Wah

Dr Tse graduated from Hong Kong University in 1995 and had been working with United Christian Hospital since the completion of his internship. He has spent a year in London to do a master degree in Clinical Dermatology. After deciding to join MSF to become a field volunteer, he went to England again to receive training on sexually transmitted diseases and HIV/AIDS. He also managed to do some self-studies on tropical medicine during the period in order to get himself more prepared for the mission. He worked in an HIV/AIDS treatment programme in Merauke, Indonesia from May 2003 to May 2004.