| Username |
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| Longwood Ave |
Posted
on 05-Jun-03 08:11 AM
Meeting with a group of 20 to 25 Female Sex Workers (FSWs) at 8:00 AM on a sunny mid-April in the Nepalgunj office of a local Non Governmental Organisation (NGO) was not a priority in my list of things to do that day. However, after we received both verbal and informed consent from the patients we drew blood from two children and seven women who had tested HIV positive in the past three to 12 months.
On this trip I was leading a team of physicians and pathologists from Boston, MA to collect blood samples from clinically confirmed HIV positive Nepali citizens living outside of the Kathmandu valley. This journey into the unknown would take me to the Terai Districts of Dang, Banke, Bardiya, Kailali and Kanchanpur districts in Mid and Far Western Nepal.
As we headed north on the Surkhet Road towards Kohalpur I had the opportunity to have a first hand look at the loading docks of the primary raw material for the end product which most of us commonly refer to as "momo". Any person that gets a first hand look of the sorrowful condition under which these he and often she buffaloes make their ultimate journey to face death on the banks of the Holy Bishnumati would make any person think of giving up buff momos once and for all. At this point of the journey we are stopped at the first of the two dozen or so security road-blocks we have to pass on this day. Since we are riding on a vehicle registered with the Committee of the International Red Cross we get free passage all the way to our end destination Mahendranagar. We arrive at the heavily fortified town built on the four-way junction, Kohalpur where a private medical college has built a new hospital. At the hospital we are escorted to the "isolation" ward where we take blood samples of two boys under two and a girl approximately six that have lost both their parents as a result of full blown AIDS.
We head westwards on the East West Highway and cross the bombed out Mana Khola bridge as we exit Banke and enter Bardiya district. We then stop to take a few pictures of the totally bombed out Police Thana at Basgadi, the first roadside town we cross in Bardiya. Upon arriving at Bhurigaon we have a true picture of the destruction rural Nepal has undergone as a result of the Maoist "insurgency" and the government's "counter-insurgency." At Bhurigaon there are two more vehicles of the IRC waiting to escort us to a settlement at the western banks of the Karnali (more specifically Geruwa Nadi) where we are to meet some 12 children and over 40 adults who have tested HIV positive. As a confused Neprican I consider my understanding of the HIV/AIDS epidemic in Nepal as something beyond my comprehension. However, after only a few days of stay in this part of Nepal, I begin to get the feeling that this epidemic is best left for Lord Pashupati Nath to tackle.
We unfurl the large IRC flag in the front and tail end of all three vehicles as we drive into the heart of Mao country in rural Bardiya. It takes over an hour to reach Kothiyaghat and have to encounter five "Mao checkposts" and prove that we are not the "spies" of the "state" a rival state that has ceased to accept the rule of Kathmandu. To our surprise we find some 32 children and another 82 adult HIV positive individuals in and around Kotiyaghat. We return to Bhurigaon and head west towards Chisapani. We again get off the highway and travel in the direction of Thakurdwar which is the gateway to the Royal Bardiya National Park. This is not a pleasure trip but rather a journey to encounter another seven children and some 62 adults from whom we take blood samples.
Upon boarding the plane on the flight to Nepalgunj three days back I was asking my self will I or will not - have a rare opportunity to see some relocated one horned rhinos on the Babai river. Well we were very lucky to see several adult and two well guarded baby rhinos bathing/having a drink in the mid April sun at Babai. We pulled over the vehicle and took lots and lots of pictures to e-mail to freiends and family. We finally cross the last of the four army check posts and race towards the Karnali Bridge.
With the exception of the three drivers, all of us get off the vehicles and walk to cross the bridge. There are several army jawans posted supposedly to avert an attack on the Karnali Bridge by the Maoists. As we walk across the 500 metre long bridge every one is silent. Then suddenly we run into a group of people from Kalikot district that have been displaced by the Maoists and are on their long journey to Tirupati in Andra Pradesh. I begin talking to a former VDC Chairman from Kalikot district and he explains "as majestic as this river looks at this point where the mighty Karnali enters the great Gangetic Plains, this river is the river of sorrow. At this moment, I felt that these few words from a less fortunate (socio-economically) fellow citizen of Nepal than myself has taught me more about life than all the books I have read during my undergraduate schooling in the Bay Area and my ongoing graduate schooling in Boston.
Well what more than this can I say --- The Mighty Kalrani Runs Through It --- I guess I am still left to ponder what that "IT" is!!!!!
This is the first of three short articles I hope to post over the next few weeks for the global sajha village and hope you enjoy my travel reports. I will be happy to answer any questions you may have.
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| OU812 |
Posted
on 05-Jun-03 08:38 AM
Longwood Sir, very informative narrative. Please continue posting your saga.
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| DWI |
Posted
on 05-Jun-03 08:59 AM
Longwood, did you have oppertunity to meet the tharu community in this particular journey? Do you have a rough statistics on the number of people affected by HIV/AIDS in this community?
Thanks for a well written narrative, hope to read more.
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| bhedo |
Posted
on 05-Jun-03 03:26 PM
Very interesting. I have a question though. How is Aids classified, epidemic or pandemic? Also, what's Nepal's HIV rate at present? I would have thought Nepal wouldn't be as much affected as, say, Thailand, because Nepalis are usually speaking not very sexually liberal, although not as conservative as Muslims. I mean, look at Muslim countries. They got very low HIV rates over there.
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| Gurl_Interrupted |
Posted
on 05-Jun-03 05:01 PM
Longwood Ave dai,
Enjoyed reading ur travel report. It was a good reminder of the realities and the flashbacks needed to keep my sanity.
Did your team consistf only of the medical Doctors? or was it the combination of the health care team members? And are you planning on such trips in the near future also? And if yes, is it going to be in the same regions of Nepal or different region? You mentioned in your writing that you would collect the blood samples from the HIV positive clients, what was the reason behind that? To confirm they are indeed inflicted with HIV or for some other purposes? And I read somewhere that scientists have invented a medication that can cure aids, is it true?
Why did you keep the title of your report as "highway of shame?" Does it mean Nepal is ashamed? or of the Nepalis are ashamed? or does it mean that the global community should be ashamed for what is happening in the remote areas of Nepal where Living is not an easy task? Sorry for asking too many questions. Thank you once again dai. Take care.
Baini,
G_I
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| Longwood Ave |
Posted
on 05-Jun-03 07:33 PM
DWI ji
As of now the Tharu communities of the Mid and Far Western Terai regionof Nepal seem to travel for short, seasonal or long term employment in India less than other pahari communities and thus so far have been able to escape the curse of HIV/AIDS. Also, the Kamaiya system that was in place seems to have severely restricted both their horizontal and vertical mobility and thus prevented them from migrating to India for employment.
It may be appropriate to state that heterosexual sex outside the marriage, primarily with HIV infected female sex workers outside of one's house is the primary cause of transmission in Nepal.
GI Baini
Our team consisted two med students, two medical doctors, one epidemiologist and two clinical pathalogists from the Boston/Cambridge area. Yes, we will return to Nepal and take blood samples again exactly in a years time so that we can trace the progression of the disease where HAART therapy is not available in this case the patients we have been taking blood samples from. However, more importantly we want to document if there are variations in the strain of HIV here in Nepal like that in Myanmar. If there are then finding a proper therapy is all the more elusive. Nopes, there are no cure(s) for AIDS as of now. The closest thing we have is HAART Therapy and drugs to minimise vertical or mother to child transmission of the diseases. In my second article I will explain why the title of my article is "Highway of Shame." Well, the reason is that this is the most Moaist affected area in the Nepali Terai and possibly this area has more HIV/AIDS than rest of Nepal combined. And the East West Highway passes right through the heart of this area.
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| forget-me-not |
Posted
on 05-Jun-03 07:45 PM
Good article.
It remined of my trip to the terai, when I wnet to pay fees and other supplies to scholarship progranm that I as involved with.
Good info, will be waiting for your other articles to read.
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| Bhunte |
Posted
on 05-Jun-03 09:01 PM
Longwood Ave,
I briefly gleaned your travel diary, but I have few questions about your research about the HIV study.
The sample you selected is very biased and is not representative of the population residing in the vicinity of highways. Therefore, I would refrain to coin the title of article as HIGHWAY OF SHAME. The reason I say it biased is that you selected the site (districts) where there is high incidence of extra marital exposure due to socio-cultural reason. For example, Banke, Bardia, Dang, Kailali, Kanchanpur are also the home districts of the native 'Badis' who are famous for sex trade. Because of the socially accepted occupation with this tribal class and the people in these districts are most likely to get exposed to them is a primary factor for you to observe high incidence of HIV AIDS in the blood samples your team had there. HIV/AIDS is new to these people, but socially accepted extramarital sex with Badis isn't any new phenomena. You might have selected these districts for HIV study for some other political or donor grant reason, but that doesn't represents Nepalese highway community. Just think of people around Chitwan or Biratnagar or Butwal, etc. Do you think you will get same amount of exposure to HIVAIDS in these areas? Can you say people around these area as Shame of Highway? I suggest to refine the sampling process in your research.
By the way, it seems to me I had chatted with you in nepalnews chatroom sometime ago. Are you the guy working with Prof. Jeffery Scha at HIDS?
Anyway, good journal! Keep up the good job.
Bhunte
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| Bhunte |
Posted
on 07-Jun-03 10:30 PM
Longwood Ave ji,
This article may be of interest to you as it has some relevance to HIV/AIDS in the region you recently visited
bhunte
BADI WOMEN EXPRESS IRE ON NGOs, media
(from Kantipur online news....)
By Mohan Budha Aer
MUDHA (Kailali), June 8 - Females of Badi community in Mudha and Satti areas of Kailali district, who are involved in the flesh trade as their ancestral occupation are irked with numerous NGOs that have been exploiting their plights.
They have charged the NGOs and journals of making money by floating their stories. Badi women said that they no more want to continue the painful profession that is looked with contempt. However, there is no way out as they are left with no alternative.
Around 40 to 50 Badi families reside in Mudha while Satta has roughly hundred Badi families. We heartily welcome the revolution against the flesh trade. However, there should be other alternative measures to we people, who are land-less, was the echo reflected by the Badi women.
Even the 13 years old children are found employed in flesh trade in the community where their male members of the family act as pimps.
The NGOs are using our plights as the fat source of income. Newspapers are benefitting from higher circulation by twisting our stories. What else have we got out of these all? enquired Pramila Nepali in a bitter tone. Every Badi woman knows that flesh trade is not good. No one wants to garner hatred from society .
Of late, the Maoists have started an initation to put an end to the tradition. No one needs to attempt in banning our occupation. Provided a decent means of living, we are ready to abondon it most willingly, said Gudu Nepali.
Despiting their efforts the two NGOs: Commuity Help Committee and Regional Dalit Network, there has been no substantial change with Badi people.
However, there have been slight impacts of the NGOs in the community such as they have refrained their children from entering into the profession and use safety measures against the sexually transmitted diseases, according to concerned sources.
We have refrained the new generation from plunging into the hellish world. However, it cannot be ruled out that they may take the same course in the future, said Gudu Nepali. (yo)
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