Asia's fishermen at risk for unwanted catch: HIV

BALI, Indonesia (AP) — In appearance, they couldn't be more different.Ririn, with her warm brown skin and plump face, simply glows. Youngand sweet, just two months after giving birth to a baby girl.
Edi stands out as the roughest in a circle of men on the fishingdock. Streaks of motor oil mix with sweat on his chest and weather-beaten face as he puffs on a cigarette and talks loudly, not caringthat his frayed cutoffs are unzipped.
The two are part of an expanding nexus that's spreading HIV and AIDS.He's a deep-sea fishermen who spends his short time ashore prowlingfor sex; she's a woman in port who gets paid to provide a warm body.Bali is a famed tourist playground, but there's a side to the islandmost foreign visitors never see. Indonesian fishermen who oftenhaven't seen land for months put in at Benoa Harbour and makestraight for the closest bar with two things in mind: getting drunkand finding women.
These habits have put fishermen at high risk of getting HIV or AIDS -especially in Asia, because it's home to 2.5 million fishermen, orabout 85 per cent of the world's total. Yet fishermen have beenlargely overlooked since the virus began raging 21 years ago, withonly a handful of surveys focusing on them.
One report found that out of 10 poor countries, all but one hadfishermen with HIV rates four to 14 times higher than the generalpopulation.
Two studies of fishermen on big commercial vessels found over 15 percent were HIV-positive in Thai and Cambodian ports. That's more thanfive times the rate of other migrants at high risk for infection,such as truck drivers.A few programs in Papua New Guinea, Thailand and elsewhere in theregion are now working to reach fishermen, and the UN Food andAgriculture Organization earlier this year urged that they berecognized as high risk. But fishermen weren't even mentioned inUNAIDS' 630-page 2006 global report.
"I don't think there's been much targeting of treatment and healthservice availability," says Edward Allison, of The WorldFish Centerin Malaysia, who has researched HIV in fishermen.
The bulk of Asia's fishermen are small-scale operators who return tohome port frequently or stop at coastal fishing camps where women andbooze are readily available. Others work aboard bigger vessels formonths at a time.In Bali, most of the fishermen are bachelors in their 20s and 30sfrom Indonesia's main island of Java. Many come from conservativeMuslim farm families but have traded their traditions for a cultureof danger and machismo.
Some return to home port in Bali at voyage's end. Others fish wellbeyond native waters, docking as far away as South Africa, Sri Lanka,Spain and Panama. Either way, their pockets are filled with money andthe only women waiting ashore are those looking to get paid.
Ririn, who like many Indonesians uses only one name, grew up on arice farm with her parents and seven siblings on the island of Java.She dropped out of school in fifth grade.At 20, she was offered a chance for a better life, working as a maidon Bali, a neighbouring island she imagined was full of hope andmoney."I wanted to help my family back home," she says. "There's a lot ofmouths to feed."But after three months of cooking, cleaning and caring for someoneelse's children, she had only US$20.
Like many young women far from home, she was wooed by a man promising$40 to $50 a month for fewer hours. She would only do it for a littlewhile, she thought. Just long enough to save up for a small businessof her own.After six months as a prostitute, she learned about HIV - when shetested positive. She kept working until her sixth month of pregnancy.
There are no condom machines or AIDS outreach workers on the crowdedwharf in Bali. Some fishermen say they've had a disease "down there"or know someone who has, but many are convinced that certain women,mostly Indonesians, are free of HIV."This area is very safe," fisherman Herman Shokana said above theroar of boat engines. "But when we go abroad, we'll probably get it.
"Most sailors infected with STDs treat themselves with cheapantibiotics. They may take the wrong dose or stop treatment whensymptoms disappear, allowing STDs to linger, which makes it easier tocontract HIV. They also are misled by greedy peddlers.
"When the ships come in, medicine vendors or peddlers are alreadywaiting for them," said Made Setiawan, a doctoral student at theUniversity of Illinois, Chicago, who's researching fishing cultureand the risks of HIV in Bali. The peddlers' typical patterruns, "Here, take this medicine and go have sex in the brothels.
"In Thailand, most commercial fishermen are Cambodian and Burmesemigrants. They change boats regularly and go to different docks,making it difficult to visit clinics or get test results.At some Thai ports, outreach workers from the nonprofit Raks ThaiFoundation distribute condoms and talk to the men about AIDS. Somefishermen also are being trained to provide HIV education and helptreat STDs.
But experts say there's a need to establish STD clinics at ports andbetter educate the fishermen about everything from safe sex togetting infections at tattoo parlors."We're making progress," says Brahm Press, a program manager for RaksThai. "How much of that progress has been able to reduce the spreadof HIV, we're not certain.
"Edi, 20, is the shortest guy on the dock in Bali, but his muscles are the thickest. He's been on shore nearly two weeks after five straightmonths at sea fishing between Indonesia and Australia.
He brags he had sex with up to 10 women a night. His monthly pay ofabout $70 wouldn't have lasted long at the going rate of about $6 for15 minutes.
He usually doesn't use condoms, complaining it's not satisfying. He'snever been sick or tested for STDs, but points to a friend who's hadsyphilis."There's a medicine for HIV. There is a cure," he says. "Maybe itwill take longer to cure, but you will get better."While at sea, the men get little sleep and regularly risk injury or even death. They could be swept overboard in storms, get fouled inlines or cut off fingers while cleaning fish. They live in crampedboats smelling of diesel and gutted fish. Some question why theyshould lessen the little pleasure they get by wearing a condom.Some fishermen also insert BB-sized, glass or plastic pellets intocuts in their penises for enhancement. The wound is sometimes stillfresh when they make shore, but it doesn't stop them from hitting thebars lined with women in miniskirts."They don't have any self-esteem. They are ordered around by thecompany and the captain to do this and that," said Setiawan, who's researching the fishermen. "Sex workers can give them their self-esteem back.
"Ririn, 22, may sleep with up to 10 men a night. Many are fishermen.Worried she may infect a man who could then give HIV to his wife, shesometimes begs customers to wear condoms - which is more than anyonedid for her.
Most refuse.
"I tell them, 'I'm a working girl. There's a chance you might catchsomething from me,"' she says."The man says, 'That's tomorrow's problem.' "She fears, too, that her daughter Meisa may be infected, but it willtake 18 months for the test results.Now, Ririn's back on the street, still trying to earn enough to opena small shop. She hopes she can quit within a year, but realizes itwon't be easy. Especially with a hungry little one at home and asteady stream of fishermen like Edi, all in search of love for sale.
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