Tom Hyland, Jakarta – The relentless techno beat is so loud your insides vibrate. Strobe and laser lights flash out across the crowd of maybe 5000 that surges in waves across the vast dance floor. It's 2am on a Saturday and amid the noise and crush, the mood in this north Jakarta nightclub is a strangely mellow mix of joy and energy.
The bar is doing a slow trade; the preferred intoxicant among the young middle-class Indonesians who make up the crowd is ecstasy.
A few kilometres south, just off Jalan Thamrin – Jakarta's main avenue with its international hotels, restaurants and office towers – is Kampung Bali, a densely populated low-income area of simple houses, narrow lanes, mosques and food stalls.
For an increasing number of young people in this neighbourhood the drug of choice is low-grade heroin. Known as putaw, it is cheap, plentiful and potentially deadly in more ways than one.
The public health clinic in Kampung Bali recently tested 98 injecting drug users for HIV, and 93 per cent of them tested positive. Another Jakarta study found that, of 210 users, 88 per cent were sharing needles. "This means of course that all, eventually, will get HIV," says a foreign consultant working on HIV/AIDS prevention.
Indonesia faces a national health disaster, which belies its reputation as the conservative home of the world's largest Muslim community. A report this week in Tempo, a respected weekly magazine, referred to the country as "A Nation of Addicts".
"This is an extremely serious issue for us. It's a threat that could kill an entire generation," says Henry Yosodiningrat, a Jakarta lawyer who heads an anti-drugs lobby group and is a member of the government's National Narcotics Agency. "There's not a school or district anywhere across the country where drugs are not used," he says.
Broto Wasisto is head of the Health Ministry's committee on drug control and a member of the national HIV/AIDS control board. "Injecting drug use is a national emergency as far as controlling the spread of HIV/AIDS is concerned," Wasisto says.
Figures on the number of illegal drug users paint an alarming picture of what, until five years ago, was being called a hidden epidemic. In February last year, a report by Melbourne's Macfarlane Burnet Institute for Medical Research and Public Health estimated there were between 1.3 million and two million drug users in Indonesia, with up to one million of these injecting. Some local estimates put the number of users at four million – about one in every 50 Indonesians.
In 1996, Jakarta's RSKO hospital, which specialises in treating drug addicts, dealt with 2000 patients; three years later the number had risen to 9000. And experts say users are getting younger, with most now aged between 16-25.
In 1995, only 2 per cent of new HIV/AIDS infections nationwide were due to drug use; by 2001 this had risen to 20 per cent. In the same year, 47 per cent of injecting drug users at RSKO hospital tested positive for HIV. Similar findings elsewhere suggest needle sharing will soon surpass unsafe sex as the most common method of contracting HIV.
Five years ago, according to health workers and drug educators, Indonesia was in denial. Officials argued that the country was simply a transit point for drugs heading elsewhere. Not any more. Now, while there is still no agreed, coordinated strategy for dealing with the problem, there is a wider debate and greater public awareness.
The full range of drugs available in the West, and more, is used here. At the north Jakarta nightclub, ecstasy, heroin and methamphetamines are offered for sale. So is premium-quality marijuana from Sumatra.
Methamphetamine, a potent form of speed known locally as shabu-shabu, is a relatively new addition to the drug scene. As well as the physical and mental risks involved in taking it, health workers fear it, too, will add to the spread of HIV/AIDS.
Shabu-shabu, which can be injected, inhaled or taken orally, increases the duration and intensity of sex and reduces inhibitions, making users fearless and prone to risk-taking. It is said to be popular among prostitutes and their clients in Indonesia's massive sex industry and is cheaply produced in backyard factories.
There's a caste system among Indonesian drug users, says a foreign health worker. "The middle class use ecstasy, but lots of poorer people use shabu. It's the poor brother of cocaine," he says. "We have no idea what it's long term impact will be." Despite growing awareness of the problem, Indonesia faces unique obstacles and some reluctance in dealing with it.
"Although the use of illicit drugs is increasing, political conflict, power struggles and widespread corruption are influencing how the drug-related HIV/AIDS crisis should be tackled," the Macfarlane Burnet report said.
"The government needs to make a moral commitment to dealing with this problem," says Yosodiningrat, the anti-drugs campaigner. "But one obstacle to obtaining that commitment is that the syndicates have a lot of money to buy officials and this is a most corrupt country."
While the Indonesian press regularly reports massive drug seizures, and police stage well-publicised raids on some notorious nightclubs, big dealers are able to bribe their way out of trouble. Indonesia is a country where police and courts can be bought by the highest bidder.
Compounding the problem is evidence that elements of the underfunded police and military are themselves involved in the drug trade – and are willing to fight public turf wars for their share of it.
"There's a high sensitivity about the role of the army in the drug trade," says a foreign drugs expert based in Jakarta. "No one will talk about this." Sometimes, however, it cannot be hidden.
In October last year, at Binjai in north Sumatra, soldiers in an army airborne unit tied up their officers and attacked police stations using rocket-propelled grenades, mortars and automatic weapons, killing eight police and civilians. The soldiers, some of whom have since been jailed, were upset after the police arrested a drug dealer and seized 1.5 tonnes of cannabis.
The task of health workers to get politicians to focus on drug use is further complicated by the mind-boggling array of other social, economic and security crises competing for the government's attention.
Wasisto says the government's budget is stretched by too many other pressing health problems. There's a high death rate among mothers and new-born infants, as well as malaria, tuberculosis and a multitude of illnesses related to the lack of clean drinking water. "There are too many victims from all these other problems," he says.
But other obstacles in the way of those trying to grapple with Indonesia's drug problem are far from unique. Drug users remain socially stigmatised and, as in Australia, advocates of zero tolerance oppose harm minimisation policies, which they fear will ultimately lead to the legalisation of drugs. Even so, experts such as Wasisto see signs of progress.
He and his officials have studied Australian initiatives that reduce the risk to addicts, including free distribution of needles, which in Indonesia are officially available only from doctors and chemists with a prescription. He hopes to introduce two harm minimisation pilot programs in Jakarta and Bali this year.
"This is very controversial. As in many countries, people like religious leaders and police are often reluctant [to adopt harm minimisation practices]. But with intensive lobbying I'm optimistic they'll accept this method," Wasisto says.
Despite the vast cultural differences between Australia and Indonesia, the two countries face similar drug problems, according to the foreign drugs expert.
"The fact that Australians can be surprised by the extent of drug use here shows your misconceptions about the nature of this society and about your Muslim neighbours," he says.
"The problem here is the same as in Australia, only the extent is worse. People take drugs for the same reasons – they want to have fun or they want to escape from the pressures of life. But governments just won't accept that a lot of people want to take drugs."