Jason A. Smith, IFRC communications manager, Asia Pacific zone
Jason Smith recently travelled with the South Asia regional delegation of the International Federation of Red Cross and Red Crescent Societies (IFRC) to observe HIV programmes run by the Nepal Red Cross Society.
The small village of Gajari sits perched on a hillside overlooking a deep valley in western Nepal. It is extremely remote; reaching it from Kathmandu requires a one-hour flight on a small plane, a ten-hour drive and a two hour-hike down a steep and rocky footpath. Yet, here in one of the most remote communities on Earth, Red Cross Red Crescent volunteers are saving lives, empowering villagers, and teaching future generations about one of the world’s most serious health risks.
Each year, many of Gajari’s young men travel beyond Nepal’s border into India to find work in its large cities. While away, some of these men seek the company of sex workers, contract HIV, and return to their village unaware that they have been infected or of their ability to pass the virus on to their wives.
Their wives contract HIV from their husbands, become pregnant, and in some cases they pass the virus on to their children. Because of ignorance or fear of stigma, those with HIV go untested, become sick, and only then seek help. Often, by this point, it is too late. Many have died and more remain extremely ill, struggling to survive in the face of limited food and scarce medical resources. Perhaps it is the widows who struggle most.
The widow’s story
Jagu Thapa is one such widow, and yet on this day, she is filled with passion and dressed in bright green traditional Nepali attire. She is, herself, living with HIV. For seven years, she has served as the village chairperson for Red Cross peer educators.
“Losing my husband and becoming involved with this programme has changed me,” she says. “At first, I was ashamed and fearful, now I know that it’s important to be open. We have to share our stories with others to help them make the right decisions.”
Having been touched by the tragedy of HIV, these widows and their teenage children form the corps of Red Cross Red Crescent volunteers who are working each day to turn the tide on this pandemic. For the past three years, under the leadership of the Nepal Red Cross Society and its district office in Doti, a highly effective programme has been under way to mitigate the impact of HIV on villages just like this one.
A three-part effort
The programme, supported by the International Federation of Red Cross and Red Crescent Societies (IFRC) and the Swedish Red Cross, has three key elements. First, peer educators are trained to spread the word on safe sex practices, the importance of testing, and where testing and other HIV-related resources can be found. These community-based volunteers are also reducing stigma and discrimination by providing accurate information about HIV and its transmission.
Second, the Red Cross administers voluntary counselling and testing (VCT) facilities in rural Nepal that serve hundreds of men and women each year. These VCTs serve as focal points for coordination and collaboration across several humanitarian organizations providing support to those with HIV. In managing these remote outposts, the Nepal Red Cross Society has positioned itself as a major facilitator of global development activity in the region.
Finally, the Nepal Red Cross provides supplemental nutrition support to those who have been diagnosed with HIV and are undergoing a complex prescription drug regimen. The medicines made available through government programmes require that those who take them eat regularly and that they consume high quality food. In collaboration with the government health department and its rural hospital in Doti, the Nepal Red Cross procures and provides this essential food.
Village-based
According to Dr. Sushma Bhusal Lamichhane, health programme coordinator for the Nepal Red Cross, this programme has been special from the very beginning.
“In the Red Cross Red Crescent, both here in Nepal and around the world, we seem to find the most difficult challenges in the places that are hardest to reach. We are the first to provide service, and we do it with and through the people living there. That’s why we’ve had an impact in Gajari.”
In her opinion, this insistence on sustainable, community based activity is one of the things that set the Red Cross Red Crescent apart from other international organizations.
As she sat with many of the widows in Gajari on a warm, bright afternoon, she heard the villagers reinforce her opinion. “So many of the men and women here in western Nepal tell us about the non-governmental organizations that visit for a day or two with cameras, put up signs, and then disappear. For them, the Red Cross Red Crescent has always been different, a part of their community,” she said.
Empowering young volunteers
Being such an integral part of the Gajari community is what appealed to 17-year-old Netra Kunwar. He stood before a group of more than 30 men, women, and children, most of whom are his fellow volunteers and described for them his work as a peer educator. He knows that his fellow young men will be the next one to leave the village in search of work and the better life that comes with it, and he desperately wants to have an impact on their actions.
“I come from a family of nine, with seven brothers and sisters. My parents were never able to help our village, so no one expected much from me, but I think I can do something positive,” he says.
“Becoming a peer educator has given me confidence and a sense of pride. I am small for my age, and before volunteering with the Red Cross other kids made fun of me. Now, I have their respect and I am helping people.”
Perhaps it is important to note that Red Cross Red Crescent programmes like this one can have unintended positive consequences as well. In Netra’s case, his volunteer experience has inspired him to pursue a career in public service or politics.
“I am devoted to the seven Fundamental Principles of the International Red Cross and Red Crescent Movement,” he shares. “Would I violate them if I went into politics?”
He was assured that, as long as he allowed those principles to help him in making wise decisions, a career in politics and service would be just fine.