Their tattooed skin hanging loosely from hollowed-out limbs, the young men in the clinic at the edge of Jakarta’s Cipinang Narcotic Prison lie limply across black vinyl beds.
The half-dozen inmates are in the advanced stages of HIV/Aids, and are part of a crisis that has seen the disease sweep through Indonesia’s overcrowded, squalid and corrupt prisons.
The root of the problem, activists say, is a war on drugs that treats injecting users — many of them already HIV positive — with the same harsh punishments as dealers, flooding jails where opportunities to get drugs and spread the disease are plentiful. “People who are selling drugs, buying drugs, bringing drugs, abusing drugs, whatever, are being locked in the same place in the same situation — no treatment, no nothing,” said Baby Jim Aditya, the head of Partisan, a non-governmental organisation dealing with public health.
A 27-year-old, HIV-positive former heroin addict who goes by the nickname Black is a recently released veteran of that system.
Arrested by an enraged crowd in 2007 as he attempted to shoot up with a friend in a quiet corner of a Jakarta market, Black spent 20 months in jail for possession of one-tenth of a gram of low-grade heroin, or “putaw”.
While in police detention, his friend, Rahman, died after being cut off from access to anti-retroviral medication and going through heroin withdrawal. Black then graduated to Jakarta’s Salemba prison.
“When I was still inside, there were lots of drugs, all sorts,” Black said.
Prison gangs would sell drugs such as marijuana, crystal methamphetamine and heroin with the connivance of guards, for very little difference in price compared to the outside world, he said.
A small packet of heroin that would cost 40,000 rupiah (four dollars) on the outside costs 50-60,000 rupiah in Salemba, and is usually better quality, he said.
Needles to shoot up are also readily available. A “used” needle costs 2,000 rupiah per shot, while a “new” needle — which does not necessarily mean it is sterile, but just that it is not yet blunt — is more expensive.
“For a putaw user, it’s like that. They use it once, twice and it’s still sharp so they see it as new,” Black said.
“(The dealers usually) have a stock of needles, let’s say 15. When they open it, 15 people will line up. When they finish, others will use them.”
In numbers, the HIV/Aids crisis in Indonesia’s prisons is striking. Roughly a third of the 254 prison deaths recorded in May this year were due to HIV/Aids, according to official statistics.
Nearly 12,000 people are locked up in Jakarta prisons built to house just 5,056 inmates. Almost 6,900 inmates — more than the entire Jakarta prisons system’s official capacity — are in for drug crimes.
The number of inmates infected with HIV/Aids is imprecise, but Partisan’s Aditya reckons somewhere between a quarter and 40 percent of prisoners locked up on drug-related crimes are HIV positive, and most of them are unaware of their status.
The authorities at Cipinang Narcotic — capacity 1,084, real population 2,297 — estimate 20 to 30 percent of their inmates are infected.
Those arguing for drug law reform in Indonesia say it should not be like this.
A war on drugs spearheaded by President Susilo Bambang Yudhoyono and an impending bill introducing heavy minimum sentences are part of a push that has seen prisons overflow, Atma Jaya University law lecturer Asmin Fransiska said.
“The policy on drugs is much harsher right now than 10 years ago. (Former president) Abdurrahman Wahid’s drug user policy put it as a social issue but since Susilo Bambang Yudhoyono, drugs have been put on the level of security,” Fransiska said.
Although in theory the law allows for light sentences and rehabilitation for addicts, in practice authorities opt for a tough line, she said.
“This has become a huge problem, because we know you can’t put a drug addict in prison and everything will be alright.”
While underfunded prison authorities are attempting to test and treat infected inmates, so-called “harm reduction” treatments to stop the spread of the disease inside are all but taboo, Aditya said.
“If we promote clean needles they will point at our face: ‘you’re promoting injecting drugs’. If you’re promoting safe sex it means you’re promoting free sex,” she said.
The head of Indonesia’s prison system, Untung Sugiyono, said the data showed the problem was not transmission inside prisons, but the fact that infected drug users were entering custody and promptly succumbing to the disease amid squalid conditions.
“A person comes in and before they know it, in one to six months, they get sick and die,” he said.
“It’s too extreme to say there are still a lot of drugs (in prisons). I don’t want to skim over it if there are any, but it is relatively small.”
Despite the grimness of its infirmary ward, Cipinang Narcotic is the closest thing Indonesia has to a model prison when it comes to dealing with HIV/Aids and drug addiction.
The prison conducts basic tests on all inmates for HIV, deals out anti-retroviral drugs and has a methadone programme.
But the prison’s chief, Ibnu Chauldun, believes the effectiveness of all this has been undermined by a dysfunctional system that has overwhelmed his jail with users who should not be there.
“What are they the victims of? They are the victims of drugs. They have to be rehabilitated, not jailed,” Chauldun said.
“You think we have a rehabilitation centre? We don’t have one. We’re not a rehabilitation centre. We’re an institute for reforming criminals.”