NEPAL: Migration takes its toll on villages hit by AIDS

Kathmandu, 22 May 2007 (PlusNews) - In the remote Accham district of Nepal, which for years has supplied cheap migrant labour to India's bustling commercial city, Mumbai, villages are waking up to the impact of HIV.

In the impoverished Ridikot village, nearly 800km northwest of the capital, Kathmandu, eight-year old Rajan Biswakarma takes out the only photograph of his parents, who both died of AIDS-related illnesses last year.

"It's really hard for him. I can't bear the pain myself losing my only son," said his grief-stricken grandfather, 67-year old Prasa, who has to work hard to feed and pay for the education of his three grandchildren.

According to a local NGO, Gangotri Rural Development Forum (GRDF), which supports HIV-positive people, the numbers of orphans and vulnerable children are steadily rising in this district, the centre of a localised epidemic in an otherwise low prevalence country.

In the nearby Kakadset village, there are nearly 20 orphans who lost their parents to an AIDS-related illness, and barely a few kilometres away in Payal Village Development Committee (VDC), the basic sub-district administrative unit, there are over 115 orphans in similar circumstances.

"It's a terrible tragedy that children suffer from extreme poverty and loss of their parents in addition to being left without support," said anti-AIDS activist Rupa Auji from GRDF. She added that some orphans and widows were taken in by relatives with enough income and farms, while many had to migrate to other villages to work as domestic servants, porters and farm labourers.

"Death seems a better idea than surviving with such misery," said 33-year old widow, Mansara Bhul, who is HIV-positive. A few months ago, she doused ago herself and her three children in kerosene and was about to strike a light, but was stopped by a neighbour who heard the children screaming. Suicide attempts are becoming common among villagers, say NGOs working in the region.

Bhul was kicked out of her house by her relatives after her husband died of an AIDS-related illness and now receives financial assistance from GRDF and the international aid agency Save the Children.

With no hope of getting any help from the government, HIV-positive widows in the area have formed the Single Women's Group with support from organisations like Social Volunteers Against AIDS (SOVAA) and GRDF.

There are now 20 such groups in 20 VDCs with nearly 200 members. "Although we have no hope of surviving long, we are working together to generate income," said 32-year old Kokila Bista.

Males seek greener pastures

Men have been leaving Accham to find jobs as porters and guards in Mumbai, India's commercial capital, for decades. Now increasingly they are returning with HIV, picked up in Mumbai's Nepali brothels.

The scale of migration is staggering. SOVAA found that all the men from nearly half of Accham's 75 VDCs, with a population of nearly 250,000, were in Mumbai, India's western port city.

"They go with dreams of becoming rich but come back infected with HIV [that] only impoverishes their families more," said local villager 17-year old Netra BK, whose brother and father are currently working in the booming city which generates 40 percent of India's foreign trade.

Alarming prevalence

Health workers are concerned about the high HIV prevalence levels in Accham, and female community health volunteers are desperately trying to reach every corner of the remote district to raise awareness and support people living with the virus.

Between 2005 and 2006, nearly 20 percent of the 500 people who had come for testing at the local Voluntary Counselling and Testing (VCT) Centre in Accham were found to be HIV-positive, according to Himalayan Association Against STI and AIDS (HAASA), a local NGO that runs the VCT facility.

Despite these figures, however, the district did not have "a single health post or hospital with antiretroviral (ARV) treatment facilities," said Krishna Rawal from HAASA.

"There are already 100 persons with HIV coming to us every week to seek our help for ARV treatment but we can do nothing but refer them to the hospitals in the cities," explained Rawal.

According to rough estimates by local NGOs, nearly 500 people have died during the last three years but their deaths have yet to be officially recorded as most of the relatives burn their dead relatives with their HIV medical reports, according to GRDF.

Nepal's HIV prevalence rate stands at 0.5 percent but UNAIDS has warned that the situation is changing rapidly, and the HIV epidemic is concentrated in two risk groups: injecting drug users, and commercial sex workers.

nn/kn/oa

Theme (s): HIV/AIDS (PlusNews),

[This report does not necessarily reflect the views of the United Nations]