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May 5, 2011

Foucault suggests that all forms of power are ultimately manifested in their effects on the body.

Working from this proposition, the effects of military and political power in Papua, might be viewed not only in terms of violence and political control, but also in poverty and disease. Public healthcare has been neglected in Papua for several decades. The neglect has become particularly apparent as much of the rest of Indonesia has developed.

Public-health indicators, although incomplete, suggest
that the general health of Papuans is poor.5,6 Malaria,
upper respiratory tract infections, and dysentery are
major causes of childhood morbidity, with infant
mortality ranging from 70 to 200 per 1000.5 More than
50% of children younger than 5 years are undernourished,
and immunisation rates are low.5,6 Maternal mortality is
three times the rate of women in other parts of Indonesia.5
HIV/AIDS rates are 40 times the national average,7
and the epidemic is being fuelled by a burgeoning sex
trade, low levels of literacy, and inadequate services for
prevention and treatment of this disease.1

However, rather than positing Papuan miasma as exceptional2 – a radical deviation from a developmentalist norm – it makes more sense to see it as the far end of a continuum of healthcare neglect in late 20th century and early 21st century Indonesia. At a far end, private hospitals enjoyed by elites in Jakarta and Denpasar, and at the other, Puskesmas of rural villages in Papua and Nusa Tenggara Timur.

While foreign and Papuan activists have sought to link Papuan deaths to the Indonesian state, they have not always done so in ways that emphasise neglect over other forms of culpability. For this reason and others, the subject of health in Papua, and particularly the HIV/AIDS ‘epidemic’ has been politically sensitive. A number of diseases have been directly politicized, including cysticercosis (taenia solium) and cholera, while others again remain outside the purview of politics except as they relate to neglect in general senses.

S. Rees and D. Silove, “Speaking out about human rights and health in West Papua,” The Lancet 370, no. 9588 (2007): 637-639.
A subject I will return to.

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