As part of the Makassar Writers’ Festival, I’ve been asked to give a talk about HIV in Indonesia at the faculty of public health at Hasanuddin University. I’m reluctant. I’ve been wandering Indonesia without any thought of focusing on HIV for over eight months now. In that time I’ve met a surprising number of widows, orphans and middle-aged couples who have lost a child. Only one of those deaths has been HIV related. The rest are all in traffic accidents, mostly involving motorbikes.
That’s not entirely surprising. Bike ownership in Indonesia is booming, with 8.1 million new motorcycles crowding on to the country’s shockingly bad (and already crowded) roads last year. It’s perfectly common to see primary school kids driving motorbikes; it’s very rare to see a primary school kid in a helmet. And the industry is not exactly doing a lot to promote norms of safe driving. Here’s how Suzuki was pimping its new (quite girly, automatic transmission) model in Bau Bau, Southeast Sulawesi, last weekend.
Reporting of road accident related deaths is even worse than reporting of AIDS deaths in Indonesia. But working on best estimates, death contracted on the roads far outstrips death contracted in bed or while shooting up. Some 32,000 people died because of road accidents in Indonesia last year alone, a quarter of them teen-aged boys, and 60% of them on motorbikes. Ten times as many were injured badly enough to alter their daily lives. That compares with just over 5,000 Indonesians reported as having died of AIDS, ever. Let me repeat that. Over 30,000 road deaths a year, versus 5,000 or so AIDS deaths over the last 25 years. And yet Indonesia spent US$ 69.2 million preventing HIV infections and AIDS deaths last year, 60% of it taken out of the wallets of taxpayers in other countries, much of it spent very badly indeed. Indonesia does have a national road safety action plan, but, according to the Director of Road Safety in the Ministry of Transport, it has no dedicated budget to cut death on the roads. If I didn’t know better, I might console myself that HIV is not much of a problem in Indonesia precisely because of the prevention spending. Sadly, that’s not true. I also recognise, of course, that death tolls are not the only basis on which to make public health decisions. But it doesn’t take a very sophisticated observer to see that HIV programmes in Indonesia are grossly over-financed relative to other important killers and maimers, notably road death. (Then there’s smoking, but that’s a whole nother post…)
It doesn’t seem like this problem is likely to evaporate. Though the motorbike industry is wringing its hands over the effect that a perfectly sensible new restriction on credit will have, I’m not seeing it in the field. The Suzuki mob were offering new bikes for a downpayment of just 350,000 rupiah (about US$ 38.00). If that meets the 25% deposit requirement of the regulations, which came into effect this month, then it is a VERY good value bike, despite being girly. Even by the most pessimistic estimates, there will probably be another 6.5 million bikes and over 800,000 more cars on the roads by the end of this year compared with the start. Remove the several thousand that will be reduce to scrap by crashes, and its still a huge net addition.
For an idea of how far Indonesia has to go in making its roads safe, check out this presentation by Eric Howard. There’s lots he doesn’t mention — the political incentives to finance the building of sub-standard roads, the fact that Indonesians think road safety campaigns are just another way for policemen to extract bribes — but there are some priceless photos that show just why for most Indonesians, it’s probably far more dangerous to make your way to work or to school than it is to have sex.