Sitting with a beer and reflecting after a week at work has never been a particularly onerous task for me. Its therefore not entirely surprising that I’m sitting in the shade with a bottle of Nepalese beer (“Star Gold”, brewed in Hetauda if you’re interested!) and writing about my first full week at work since arriving in Nepal. (And as the title of this piece suggests, listening to Neil Young!). The mechanics of working for three days with Sakriya Plus Nepal, (to the west of Banepa) and two days with Navadeep Jyoti Kendra (to the east) are proving surprisingly easy. I’m currently living at the approximate mid-point of the two projects and have about a 1.5 km walk into work in either direction. I’ve found a dhera (flat) in Banepa, and hopefully will be moving to my own accommodation at the end of next week after living out of guest houses, training centres and a rucksack since arriving in Nepal! Fortunately this means that I will still be more or less at the mid-point between my two projects.It also means that I pass on a daily basis the preferred means of transporting goods around the town… converted Russian ploughs with trailers attached. Forget “Mad Max”, Nepal was here first!
The fact that I know this area, having undertaken some of my language training here is a real bonus, and I’m already running into people that remember me from my previous stay here. Staff at both projects have gone out of their way to make me feel part of the community and there are a number of local tea shops that look out for me passing and insist that I stop for a tea. I’ve also been “adopted” by the members of a “secret bar” in Banepa, which sells a particularly fine raksi (Nepali rice wine), which is brewed on the premises. (Many rural areas brew raksi of some description, and believe me some of it has the same properties of paint stripper… Oh and I have been given a Nepali name, Janak, (जनक), which you can find out more about here if interested.
Anyway, enough of the random thoughts…a few bits of information about HIV & AIDS in Nepal, which hopefully provide some background to the work I’ll be engaged in.
- Approximately 0.49% of the adult population of Nepal is HIV+
- This equates to approximately 70,000 people living with HIV
- Approximately one in three infected are women
- The highest prevalence of HIV is amongst labour migrants to India, and sexual transmission is the predominant mode of transmission in Nepal
- There is an expanding sex industry in the urban areas of Nepal, and there is a high incidence of trafficking of Nepalese girls and women to India
- The second most significant route of HIV transmission is through the sharing of injecting equipment by intravenous drug users. This is compounded by many drug users financing their drug habit through sex work.
Despite the current low prevalence of HIV in Nepal, it remains highly vulnerable to a significant degree of HIV infection amongst the population.This is compounded by societal norms which lead to stigmatisation of people living with HIV & AIDS (PLWHA’s). Although there are policies in place which ostensibly protect the rights of PLWHA’s, the enforcement of these rights is patchy to say the least.
In the Kavre district where I am based, there are around 200 individuals who are HIV+. Male migrant labour from the district and transport workers crossing the border with India are the most significant proportion of the HIV+ population, with IV drug users and female sex workers close behind. The knock on effect is that there is a high incidence of male workers becoming HIV+, and infecting their wives. Children being born HIV+ is not an uncommon event, and I’ve already met several children who are themselves HIV+, and who are themselves orphans as a result of their parents having died of an AIDS related illness.
Against this background both Sakriya Plus Nepal an Navadeep Jyoti Kendra are providing care and support to people who are HIV+, as well as delivering an educational programme entitled “Positive Prevention” in the surrounding villages and schools. Both projects employ PLWHA amongst their staff group.
And a final somewhat humbling thought…this is all done with extremely limited resources, and without an infrastructure that remotely resembles the UK. Next Friday for instance I’m heading out to one of the more remote Village Development Councils (VDC’s) in Kavre. We’ll be leaving at around 8.00am. There’s a one hour bus ride, followed by a two hour walk to the village, before the Positive Prevention programme can be delivered….
Somewhere in the dark recesses of my mind, I think I remember being told that VSO would be life changing…