“Indigenous peoples have the right to access, without any discrimination, to all medical institutions, health services and medical care.”

West Papua has the poorest standard of health in Indonesia. It has the highest infant and maternal mortality rates in Indonesia The ratio of doctors (both general practitioners and specialists) and dentists is just 1 per 10,000. Most people live in hard to reach rural areas and an estimated 20% of these suffer from some degree of malnutrition.

Infant health is poor - pneumonia is the leading cause of death in children below five. Partly this is due to the lack of vitamin A in many West Papuan's diets but also only 41% of Papuan children are vaccinated against pneumonia compared to a national average of 60%. (In 1999 AusAid reported an infant mortality rate of 98/100,000 in the highland Jayawijaya region compared to the Indonesian average of 40/100,000 - however official statistics are not very reliable - one Canadian study in the same area in 1995 found that infant mortality rates among the Dani are above 250 deaths per thousand live births and birth rates are low.).

Among adults the most common health problems are malaria (48%), respiratory infections (16%) and infectious skin diseases at 5.4% Although leprosy can be well controlled the average across West Papua exceeds 20 cases per 10,000 people (twice the Indonesian average) and it reaches 88/100,000 in some areas.

The provincial health budget is very low (in 1995 it was only $A 1.3 million). Income levels are also extremely low (a World Bank study in 1996 estimated that 53% of rural Papuans were very poor - far exceeding other parts of Indonesia). Low government spending and very low income levels make it very difficult to provide affordable health care for the whole population. This is also compounded by the lack of basic equipment such as refrigeration, vaccines and sterile vaccination equipment. Papua also has no medical school leading to a shortage of Papuan doctors who can understand traditional beliefs and practices.

The new threat to the population is the arrival of HIV/AIDS. Between 1996 and 2000, 393 cases were reported in West Papua - this was the highest number in the whole of Indonesia but it is undoubtedly only the tip of the iceberg. HIV/AIDS has been transmitted by the growth in prostitution and the arrival of foreign workers. It is particularly prevalent around ports and mining communities such as Freeport.

However one of the most insidious problems is the official emphasis placed on 'family planning" rather than on hospital or medical services. NGO's have noted that family planning programs are more focussed on indigenous women rather than transmigrants. In one region of West Papua near the Freeport mine, 100% of women of child bearing age in the mid 1990s were reportedly acceptors of family planning. Papuan women have also complained about incorrectly fitted IUD's and the general lack of information about the side effects of the injectable contraceptives, Depo Provera and Norplant. Norplant in particular requires regular medical check ups and the implanted capsules must be removed by a doctor after five years to avoid risks of ectopic pregnancies. Neither Depo Provera or Norplant offer any protection against STD's .

So Papuans face severe health problems from lack of adequate medical care for many common and preventable diseases and an emphasis on highly inappropriate forms of family planning. Indeed the official Indonesian emphasis on family planning programs is viewed with considerable suspicion by Papuans