Living a dignified life.


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Save the Children is the world’s leading independent children’s right organization with members in 30 countries and programs in more than 120 countries. Save the
Children fights for children’s rights and delivers lasting improvements to children’s lives in Nepal and around the world.

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Living a dignified life.

  1. 1. Living a dignified life
  2. 2. Save the Children is the world’s leading independent children’s right organization with members in 30 countries and programs in more than 120 countries. Save the Children fights for children’s rights and delivers lasting improvements to children’s lives in Nepal and around the world. © Save the Children 2014 ISBN: 8677-8-8 Photo: Bijay Gajmer
  3. 3. Save the Children works in partnership with local communities, networks, non-governmental organizations and government authorities to make sure children and families affected by HIV and AIDS can live positively and productively without stigma and discrimination. Our program reduces the impact of HIV and AIDS by increasing awareness of safe practices to prevent spread of HIV and access to HIV related services, food, health care and education. Save the Children is implementing Global Fund Round 10 HIV prevention & care programs in 48 districts with 57 NGO partners. Save the Children has supported 347,457 target population from 2011 - 2013 to live a healthy and dignified life.
  4. 4. Behaviour change communication through peer educators
  5. 5. Almost 90 per cent households in Parhoha VDC, Butwal are of migrant families. For women like Sita Neupane whose husbands work in India, their days are spent looking after their children, doing household chores and waiting for their husbands to come home. There are many women like Sita in Parhoha VDC whose husband’s work in India and some bring with them not just their earning and love but also HIV and other sexually transmitted infections (STIs). Chandramaya Khatri a peer educator from Nagurjuna Development Community, an NGO supported by Save the Children meets women like Sita in ParhohaVDC.“My husband who was a migrant worker succumbed to AIDS 3 years ago and later I also tested positive. It was a very difficult period for me, however, I have moved on. I now teach others on how HIV and STIs are transmitted and can be prevented. People in my community know about my status, however, that doesn’t bother me. I am happy that I can talk openly and raise awareness in the community.” Chandramaya is an active peer educator. She personally meets spouses of migrants who work in India and sometimes meet spouses in small groups to talk about pertinent issues regarding HIV and STIs and ways they and their family could protect themselves.Women do not hesitate to talk to her openly. Sita wasn’t aware about HIV and STIs.“When I learned how HIV and STIs are contracted I was determined to get my husband tested,” said Sita. Her husband Madan Neupane has been working in India for the past 15 years and although he assured his wife he didn’t need to test, he obliged to his wife’s request. Madan tested negative.“I know I don’t have HIV because I know what I am doing. I wanted my wife to be without worries and trust me and that is why I did the test for her, and she is happy,” said Bhumiraj. “One family at a time,” says Chandramaya. Peer educators like Chandramaya are making a difference in the lives of many. “I know I don’t have HIV because I know what I am doing. I wanted my wife to be stress free and trust me and that is why I did the test for her, and she is happy,”said Bhumiraj.
  6. 6. Community Home Based Care for people living with HIV
  7. 7. Save the Children is implementing Community Home Based Care (CHBC) services through 29 local partners in 25 districts. CHBC is a critical care and support intervention as it directly works with People Living with HIV (PLHIV) through regular home visits by CHBC teams who respond to the health, psychosocial, and spiritual needs of PLHIV.The medical team provide need based confidential service at the comfort of their living space. The CHBC have resulted in improved quality of life for 3,425 PLHIV in Nepal Pabitra Niraula, 39, is a PLHIV living in Pathari. She receives CHBC services in her home.“I am happy to receive care and support from CHBC. I don’t need to go to go the hospital for minor health concerns. I have now learned to take care of my health and feel encouraged to face struggles in life.” Kopila Sunar is 19, HIV positive and a single mother to a 4 month old baby girl. She lives in Buddhanagar, Butwal. During antenatal check-up, the attending doctor referred Kopila toVoluntary Counselling andTesting (VCT) centre operated by UNFL.There she learned of her positive HIV status and was referred to the hospital for antiretroviral therapy.Through the UNFL, she received information on prevention of mother to child transfer of HIV (PMTCT) services and support for safer delivery. “My baby has tested negative. Rita madam has advised to conduct two more test for my baby when she turns 6 months and then at 18 months. Rita madam visits me often at home and she answers all my questions,” says Kopila. “Kopila and her baby are doing extremely well. She receives counseling and support to take good care of her health and to pay attention to her daily food intake. She is happy,” Says Rita Katwal, CHBC staff, UNFL. “Kopila and her baby are doing extremely well. She receives counseling and support to take good care of her health and to pay attention to her daily food intake. She is happy,”Says Rita
  8. 8. People who once injected drugs leading a normal life
  9. 9. OST involves substitution of injecting opioid drugs with oral medication (such as Methadone) that effectively minimizes craving and withdrawals, and thereby enables IDUs to stop injecting drugs. Save the Children is supporting six Social Support Units (SSUs) who work closely with the medical unit government hospitals to provide methadone to the people who once injected drugs. Rishi injected drugs for eight years. He started using marijuana and other stimulant pills which led to injecting drugs. Rishi says,“I never thought I would inject, I used to be proud I was only using brown sugar and looked down upon those who injected. I thought I could stop using drugs any day I wanted to until one day I was injecting too.” Rishi reached a point where his family locked him up so that he couldn’t go out and do drugs. Finally his brother brought him to an OST site in Kathmandu. He was enrolled in OST and there he also met his wife. Salina who had also used drugs for 13 years. Salina and Rishi fell in love and got married.They have a healthy one year old boy. Both want to lead a normal life free from drugs and are tapering down their methadone dose in close supervision of the medical staff. Salina and Rishi explain the benefit of methadone. “Most importantly, we are disciplined and focused.We come here because we want stability in our lives. Methadone has helped us stay away from drugs and the chaos – we hope to be methadone free very soon.” Methadone is helping many people who inject drugs live a dignified life in the community.The people who injected drugs relinquish the urge to inject which would have kept them at risk of acquiring blood borne infections such as HIV and hepatitis. “Most importantly, we are disciplined and focused.We come here because we want to be different and free.We are trying..”
  10. 10. LGBTI community informed and empowered
  11. 11. “I know my parents will never understand me, so I may never tell them. But my sister knows and she supports me.” Information is a powerful tool and when members from Lesbians, Gays, Bisexuals,Transgender and Intersexual (LGBTI) community feel they are alone in their struggle to live a dignified life, counselling provided by Save the Children’s Global Fund program have made a difference. BirendraYadav, Kiran Kuwar, Ratan Rana, Sunita Neupane are some members of LGBTI community who are leading a happy life due to risk reduction, care and counselling support they received from the Blue Diamond Society (BDS), partner of Save the Children who is working for sexual minorities in Nepal. Kiran is a former sex worker.While visiting a friend’s place where all bisexuals often meet and exchange information, he met an outreach worker from BDS who informed him about the dangers of STIs and HIV. Kiran learned about safe sex and risk reduction and the importance of condom and lubricant use. BDS has helped Kiran become financially secure too as he now works as an office assistant in BDS. Birendra works as a cook in Bhairahawa Medical College.“My father knows I am bisexual but he is happy I am married to a woman and I have two children. I am aware of my rights and responsibilities and always practice safe sex.” Sunita works as a Regional Coordinator in BDS.“I know my parents will never understand me, so I may never tell them of my sexuality. But my sister knows and she supports me.” Sunita, who excels in her work, shares about her struggles and encourages her friends to stay safe. Ratan Rana is HIV positive but is living a dignified life. He works for BDS in Bhairahawa where he works effortlessly to inform LGBTI communities of their rights and responsibilities, reduce risk and practice safe sex. He is also grateful for the care and support he receives from his circle at times of distress. People like Kiran, Birendra, Sunita and Ratan are passionate in providing lifesaving information to LGBTI communities, who face social stigma and discrimination, to empower them to safeguard their health and human rights and to access services and support when needed. Information indeed is a valuable resource for the members of the LGBTI community.
  12. 12. Living with HIV
  13. 13. A widow, single mother and HIV positive. Sanju and Pratima share their stories, both living with HIV. SanjuThapa’s husband died of HIV. On the 14th day of her husband’s passing away she was also tested positive. She has a son who was tested negative. “She was so frail. During my counselling session I learned that she was also suffering from vaginitis.With referral she was put on ART and was also treated for vaginitis. She is so healthy now it is hard to believe,” says Radha Bhattarai, Counsellor, Nagarjuna Development Community, Butwal. Sanju is now running a small eatery place and she receives a lot of visitors along with outreach workers who make it a point to talk about positive prevention and on mending relationships with her family and community members. Pratima was married to a man from her neighbourhood community who used to work in India.As a result he was diagnosed with HIV and some years later passed away. Pratima also tested positive and was referred to the Community Care Centre (CCC) implemented by Dharan Positive Group (DPG) in conjunction with Save the Children. She was put on ART immediately. Pratima stayed in the CCC during the initial ART start up for observation, where she also received other medical and emotional care. She also received practical information about taking care of her health, taking ART regularly and on the importance of good nutrition and positive living. Not only has her health improved, Pratima’s economic state has also improved.“I live with my mother and brother. We have a small farm and living off the farm is impossible. I recently received a loan from the Dharan Positive Group and with the loan I have started a small grocery store.” The income from the store helps Pratima pay for her household expense. “We find a lot of change in her from the time she enrolled at our centre for ART observation. At the time she had fever and was underweight. She has been taking ART regularly and her health has improved for better,” says Astha Palikhey Rai, Program Coordinator, DPG. There are 4,634 PLHIV like Sanju and Pratima benefitting from services provided by 19 CCCs in Nepal supported by Save the Children.
  14. 14. Crisis Response Centre protecting female sex workers
  15. 15. Crisis Response Center (CRC) provides rapid response to crisis situations which threaten the well-being of female sex workers (FSWs) and at times their children. CRC service ideally is a collection of integrated services available 24 hours a day, seven days a week to provide immediate, crisis-oriented services designed to improve or resolve precipitating stressful situations. The CRC operated by Indreni Service Society (INSES) in Itahari provides protection and counselling services to around 200 FSWs. Most of the FSWs visit the CRC with episodes of trauma, violence, sexual assault and rape. CRC provides counselling, legal support, shelter and care for up to 15 days minimum to those FSWs who have nowhere to go. Out of the 200 FSWs registered at the CRC, considerable numbers are very young. Kamala is only 19 years old and is an active FSW for the past 9 months. She came to the CRC when she was sexually assaulted by her client a few months back.At the CRC, she received trauma informed care, self care and risk reduction information. She refused to be photographed for the story for the fear of being recognized. Kamala often visits the CRC when she is not working. “I find solace here at the CRC because I feel comfortable here and I know I won’t be judged for what I do,” says Kamala. Rita ran away from home 4 years ago. Due to her family’s economic condition and her friend’s suggestion, she came to Kathmandu. Initially she was engaged in hotel work but motivated by her peers she got into sex work. One day during her work, Rita was beaten and robbed of her savings by one of her clients. She passed out during the incident. Beaten and bruised, she was left in a public park where one of her friends found her unconscious the next morning. Rita was hospitalized and when discharged she lived a life of perpetual fear as the offender repeatedly gave her threatening phone calls. After 3 days of the incident, a Community Mobilizer of Community Action Center - Nepal (CAC-Nepal) which runs a Crisis Response Center with the support of Save the Children, found her and brought her to their fold. Rita had severe anxiety disorder and feared anyone who came near her. The crisis response of CAC-Nepal has helped her deal with this violent incident. She has also learned about ways she could reduce risks in her profession. Rita received legal support and filed a case with the police and the offender was eventually nabbed. Rita regularly keeps in touch with the CRC and is doing well.
  16. 16. Post rehabilitation care ensures youths continue the right path
  17. 17. Post Rehabilitation Care (PRC) provides a platform and support to people who injected drugs to maintain their sobriety in most difficult circumstances. Sudesh had just passed his SLC exams when a friend offered him alcohol. He had never experienced alcohol before and readily accepted. During the same time, he ran into a few high school students smoking marijuana. In time he was also abusing other prescription drugs. “I was a good student so I managed to pass eleventh grade but during the twelfth standard I ran away. I wanted to be free,” says Sudesh. “One thing led to another and I was heavily doing drugs. In and out of rehab, I realized my life was slipping away. I took a stand, attended the PRC.” PRC provides recovering injecting drug users an opportunity to re-work on following critical issues: family integration; competency development – income generation training; self-empowerment; health risk management (including mental health); and recovery maintenance. “After I graduated from PRC, with the support of the PRC staff I applied for a counselling job at the District Police Head Quarter, Morang and I got the job. I get paid too,” smiles Sudesh. Sudesh is majoring in mathematics and will graduate college next year. Suren is 27 and HIV positive. His father died when he was eight years old and his mother left him shortly. He lived with his maternal grandparents and his younger sister. He blames himself for everything that has gone awry in his life for instance even his mother leaving him and his sister. Suren is also a graduate of PRC in Morang. Since he volunteers at the PRC he is given a room to stay as he has nowhere to go. “At the moment I am also attending house wiring training provided by the PRC and I will soon be working to earn a living.” “The most important change in my life is that my parents now trust me. I am so happy I decided to take charge of my life.”
  18. 18. 6,557 injecting drug users now use clean needle and syringes and 879 are now taking methadone. 405 Female Sex Workers have received crisis response. 62,855 total population tested for HIV and counseled.
  19. 19. 3,425 people living with HIV have recieved care and support services through Community Home Based Care. 16,314 men who have sex with men, male sex workers and transgenders have been reached through Behavioral Change Communication interventions. 122,140 male labor migrants have been reached through Behavioral Change Communication interventions.
  20. 20. Nepal Country Office Airport Gate Area, Sambhu Marg Kathmandu, Nepal GPO Box 3394 Tel: +977-1-4468130/4464803 Fax: +977-1-4468132 Email: