Far West, with the greatest proportions of seasonal migrants, needs special focus
Fourteen-year-old Kali Bogati was born in Doti’s Kadamadu VDC with HIV, passed down by her infected mother. The virus claimed her within a year of Kali’s birth and within the next three years, her father had succumbed too, leaving her without any loving caregivers. Stigmatised since birth through no fault of her own, Kali was eventually forced to leave her home under duress from her sister-in-law. Kali sought work and accommodation in the district, but to no avail. She eventually found kindness in one Motiram Kami, who put her to work raising pigs.
Kali is just one of 68 HIV-affected children in the district. Even as HIV cases are decreasing worldwide and across the country, infections are rising in Nepal’s Far West. Three years ago, there were 2,801 registered cases of people with HIV in the Far West; now there are 5,904, according to the Department of Health Services. These include 700 children born with HIV. Furthermore, those carrying the virus continue to face discrimination and prejudice from their communities, including outright hostility and a lack of employment opportunities.
The rising prevalence of HIV in the Far West has been attributed to the great numbers of labour migrants there. As the most underdeveloped region in the country with the lowest Human Development Index, a majority of working-age men in the Far West migrate to India and elsewhere for work. As much 90 percent of infections in the region occur through male labour migrants who travel to India for work, engage in risky behaviour there, and come back to infect their wives, who pass it down to their children, claim experts.
This at-risk group will need special focus from the government, especially given Nepal’s pledge to ‘end AIDS’ by 2030 at a UN inter-governmental meeting on HIV on Friday. This roadmap includes upgrading all health posts with qualified personnel to conduct HIV testing and providing anti-retroviral treatment with a special focus on key at-risk populations—intravenous drug users, men who have sex with men, transgender people, female sex workers, and male labour migrants and their families.
This commitment is laudable but much will need to be done to achieve its ends. Dadeldhura, Bajhang, Baitadi, and Darchula districts only saw governmental HIV services four years ago. For the region’s population of 2.5 million, there are only 24 sexually-transmitted disease treatment centres, 10 anti-retroviral treatment (ART) centres, and 28 testing centres—all located in district headquarters. Testing will need to penetrate further into the region’s hard-to-reach areas, where discrimination runs rampant and health services are meagre. It is also crucial to accompany testing initiatives with community-based awareness programmes that stress the ways in which HIV can and cannot spread. ART services will need to follow. AIDS is no longer the scourge it once was, but much must be done to ensure that new infections are curtailed and those infected are able to lead dignified lives.
Source – eKantipur.com