Back in April, I won the International Women’s Health Coalition Young Visionaries 2010 contest and was awarded a grant to increase awareness of sexual and reproductive rights and health in rural Nepal. You can read my winning entry here. With the $1000 award, I organized a drama and conducted a one day free health clinic near my home village of Mrigauliya. I completed both projects this summer and learned a lot from doing them. In a future entry, I’ll discuss the drama in more detail, but in this first blog post, I’d like to share my experience conducting the one day health clinic.
In Nepal, we are politically and geographically divided into 14 zones, which each contain districts. Nationally there are 75 districts, and Morang is one of them. To break it down further – Morang has 69 village development committees (VDC) and Mrigauliya, where I live, is one of them. Mrigauliya has 10 wards, which each have a population of that ranges from 500 to 1000 people.
On Tuesday May 25, 2010, Kalpana Karki, who has been working in health sector for 7 years, and I went to visit a Dalit Community, people traditionally regarded as “untouchable,” or “outcast” in a village, Mrigauliya-5 to talk about HIV and AIDS. The community is very poor; only about 5% of the own their own land. We wanted to encourage women and young people from the community to get tested for HIV by holding a one day comprehensive and confidential health clinic in their local area.
The health clinic was conducted in collaboration with Purbanchal University college of Medicine and Allied Science, which is located at the centre of Mrigauliya, Sundarpur, Dulari, and Indrapur. The University staffed the clinic with two doctors: Dr. Robin Chaudhary and Dr. Mandip pd. Bhattarai, as well as two nursing staff: Niti Laxmi Gurung, Kamala Timsina, and senior nurse in charge Anita Thapa. The two medical lab technologists Rajan Guragai and Satish Chandra Chaudhary conducted the blood draws for HIV testing. The chief secretary of the computer department Niraj Guragai and his assistants were available full time during the group HIV counselling. Along with the university, there were many nonprofit organization which helped my project by providing their valuable suggestion such as Pahal, Yuba Dristi Samaj, Women’s Saving Club and Informal Sector Service Center (INSEC).
The main reason for selecting this community to focus on is that many of the men go to abroad (mostly to India) to work. Since there are not many income generating opportunities locally, men are forced to go to abroad in order to support their families. Only women, old men, and children are left in the village. The village situation is so dejected that there are no young men even to carry corpse (in Nepal, it is a common tradition for the sons and/or son-in-laws of the deceased to ‘carry the corpse’ to its final resting place). The people, mostly women, who remain in the village, work in the informal sector. There are about 250 women in the community, and over 20 percent of them consented to be tested. When we went to Mrigauliya VDC 6, 7, 8, and 9, some of the women got angry when we told them that we were there to talk about HIV and AIDS and test their blood if they were interested. It was very hard to convince those women. It took us a few days to make it happen, but by June 6, we were able to provide HIV testing for an additional 45 women. Some of the women thought that testing for HIV would put a question mark on their husband’s behavior and were scared of the potential for violence from their husbands and the respective community. Some worried that that we would publish their name if they were HIV positive, even though I told them that the test was confidential.
I have finished the project, but still there are many things we all need to consider regarding women’s reproductive health. While talking with about 300 women, I found that married women were more vulnerable to HIV than sex workers. This may come as a surprise, butmost of the married women never use condoms while having sexual relationships with their husbands, norhave they asked their husbands to use them. Some of them have never seen condoms and are not even aware of how they look. Some of the women who were interested in using condoms after our counseling said that they are unable to afford it. The cheapest condom called panther cost two rupees to buy one piece. How can a woman buy a condom when they don’t have a single rupee in their pocket? This is a big question we all need to think about. Yes, there are many organizations who organize 2-3 days campaign to distribute free condoms but how many days will these distributed condoms last?
Based on my time working on this health clinic, I realize that many issues like HIV and women’s health are connected to others, like access to condoms and ability to negotiate safer sex. If we truly want to address the HIV epidemic in communities like Mrigauliya-5, we all need to speak up to demand improved access to a full range of contraceptive services for women and girls in Nepal.