April 1, 2009
Sanam Chitrakar, a native of Kathmandu, has spent years working in the far west helping the local populations. Most recently, he has served as program directory for Gangotri Rural Development Forum (GaRDeF), Achham district. His work with youth, HIV/AIDS and the hazards of migration as a way of life, has given him a unique perspective on the interconnectivity of all three phenomena.
I had the opportunity to sit down and speak with Sanam two days ago in Kathmandu.
DUNHAM: You first started working in Achham in 1999, in the midst of the insurgency. What was the far west like in those days?
SANAM: In 1999, I could really feel that the insurgents were moving from the mid-west to the far west -- from Kalikot to Achham. The signs were everywhere. People were leaving Achham to get away from the unrest. By 2000, most of the people who went out of the district did not return. In February 2002, there was a big conflict in Achham in which 142 members of security were killed.
There were many kinds of threats facing the civilians. Abduction was one of them. The insurgents were targeting youths around the age of 15-16. This was the group that was also recruited as PLA. I found it quite surprising that the abductions were not being recorded well. After 2003-4, most of the human rights organizations really started to focus on the abductions. It was only gradually, after 2003, that this information of abductions came out.
At the same time, most of the youth in that area were in the habit of migrating to India, as seasonal laborers. The social phenomenon of seasonal migration is a long-standing one in the mid and far west. It’s more like a coping strategy for the people there -- to migrate to India. Even if they have a holiday for a month or so, they migrate to India. But after the insurgency, the migration trend drastically went up.
DUNHAM: Villages suddenly being emptied of their population?
SANAM: Yes, I can still recall a VDC [Village Development Committee] named Quika, in Achham: There were no males. No men in the VDC at all. Also, in the far west, women aren’t usually seen plowing their fields. But at that time, women started to plow. So, yes, some of the villages were empty.
As for the schools, I could see that government monitoring was very poor at that time. Even the district education office could not work properly in the conflicted areas. The Maoists came to the schools to do their programs, to indoctrination. The education sector therefore was very much troubled by the conflict at that time.
DUNHAM: Were the Maoists targeting the NGOs at that time?
SANAM: Some of the NGOs were very much targeted by the Maoists. Unfortunately, the organization I worked for was also attacked once. My general impression was, however, that individuals working in NGOs were targeted more than the NGOs themselves. There were examples of personal vendettas. That’s why some of the organizations were heavily targeted. Someone had a personal problem with an NGO, or something like that.
DUNHAM: Were you ever personally threatened?
SANAM: Yes I was. I was taken by the insurgents for five hours once. They asked me many questions.
DUNHAM: Were they interested in which country was funding the NGO?
SANAM: Yes, they were very much interested in that. They were particularly interested the fundings from the USA. They were very specific about wanting to know about any connections with the USA.
DUNHAM: Were they trying to extort money from you, personally?
SANAM: I was asked a few times to make donations, but I did not.
DUNHAM: Now the conflict is over. Has the migration reversed? Are people coming back to their villages in the far west?
SANAM: There has always been on-off migration in the far west. In some of the places in mid-west, the migration has been diverted to Middle Eastern countries. But when it comes to the far west, they are still migrating to India. They migrate during the summertime, and then come back in the winter. This seasonal migration increases their vulnerability to contracting HIV/AIDS, which, in turn, is then transmitted to women and children.
DUNHAM: When you first worked in the far west, what was the locals’ general knowledge about HIV/AIDS?
SANAM: The awareness was very low at that time. Discrimination was incredibly high. AIDS victims were socially excluded. They were not allowed to participate in social functions. Unfortunately, people from occupational castes…dalits…they were especially discriminated against because there is a high concentration of dalits who migrate because of the dire economic situations in Accham. In the late 90s, the dalits had very little idea how HIV/AIDS was transmitted. There were some incidents in which the corpses were just dug into the ground, not burned. There was this rumor that AIDS was transmitted through the air.
At first, the people believed that only those people who went to Bombay were infected by HIV. Of course we identified specific target groups within the migrant population -- truck drivers and highway hawkers – but we also had to include other sub-groups, so that the people didn’t fall into the illusion that, if they weren’t truck drivers, they weren’t at risk.
But now days, the situation is gradually changing. Now people know how HIV/AIDS is transmitted. NGOs have been very helpful on this issue, as well as the hazards of migration, especially in districts like Achham, Doti and Bajura.
Unfortunately, some districts have been largely overlooked.
DUNHAM: Which districts?
SANAM: Humla. Karnali.
But it’s not just about NGOs supplying information. The people now have the information. They know about condoms. What they need right now….I just had a group discussion with people with AIDS in the far west, just a few weeks ago…it was quite an amazing fact that they still go to brothels when they are drunk. I think alcohol abuse is one of the triggering factors of contracting HIV/AIDS. When they are in India, they visit brothels after they have consumed alcohol and engage in risky sex, even though Indian brothel owners are beginning to pressure the clients to use condoms.
DUNHAM: You say they know about condoms. But do the far west districts have adequate supplies of condoms?
SANAM: No. In those districts only 50,000 condoms are distributed per six months in the VDCs. That is very low. We have submitted a request to the government to increase that number in those VDCs.
There is no real resistance to using condoms. But if a woman asks her husband to use a condom, the men will think that they’re wife is having an extra-marital affair with someone in their village, or something like that. We have seen this happen.
DUNHAM: Today, when someone returns from India with HIV/AIDS, are they still stigmatized and separated from the rest of the population?
SANAM: That situation has definitely improved. And I think one of the main contributing factors to that improvement has been SOVHA, which we launched in 1999.
SOVHA (Social Volunteers against HIV/AIDS) is an organization comprised of volunteers in the local communities who are concerned about the HIV/AIDS issue in their communities. The strategy has worked out very well. It was funded by Save the Children UK. After 2003, Norway came in and SOVHA is now led by Save the Children Norway. We now have 5,500 social volunteers -- people from all age groups and professions, including politicians.
The volunteers work on a person-to-person basis. If they’re sitting in their bazaar for half an hour, they’ll just dig out the issue of HIV/AIDS for a minute or so. They just incorporate their volunteer work into their daily lives. The politicians who are attached to SOHVA, for instance, never fail to bring up the issue in their speeches.
This concept has worked out very well. Instead of NGO staff going out into the field –a system that has often failed – we empower the little guy to do something in his own community. Our program involves and activates the entire community. And they are motivated to join. These people have seen their relatives dying; they’ve seen their friends dying. They’ve seen with their own eyes what the disease can do. And we can approach the problem in depth and target a broad variety of people, including women – particularly women whose husbands have migrated to India. We are also targeting the youth who are vulnerable to migration.
Also the volunteers visit the AIDS patients during their leisure time. This has drastically reduced the stigma attached to associating with AIDS patients. Discrimination is reduced when the community sees people from their own community visiting the patients.
DUNHAM: What about AIDS patients’ access to medicine in the far west?
SANAM: Donors like USAID and FHI (Family Health International) -- we are working with them and we are monitoring the AIDS patients on their behalf. We also assist the patients when they need to go to public health centers. Gradually, the situation is improving. But public health infrastructure is very poor here in Nepal. And in the hilly areas, you cannot find even the most basic medicines. You are just given paracetamols for everything.
What we have managed to do in Achham is to initiate community-based care support for AIDS patients. Prior to this, the patients had to go to Kailali, Banke, and Bardiya districts to get health accesses. We are working very closely with the district public health office of the government coordinating to provide enough resources for these institutions.
DUNHAM: Do patients now have access to the appropriate medicines?
SANAM: Many patients have now been started on ARV (antiretroviral) medicines.
DUNHAM: Let’s talk about the numbers.
SANAM: There are approximately 600 AIDS patients in Achham. But the current trend shows that the number is increasing in what were once thought to be less vulnerable areas. The risk group has shifted from the migrant workers, to the migrant workers’ families – women and children. We are currently providing support to 32 children living with AIDS.
DUNHAM: What about future plans? Where would you like to see SOVHA go next?
SANAM: I would really like to see SOVHA duplicated in other districts. We started this program with very limited amount of money, and yet it’s done quite well. We are now covering 55 out of 75 VDCs in Achham. This could be duplicated in neighboring districts. That is my basic hope. But we have encountered obstacles in achieving this goal. We have not yet successfully advocated this idea to the national government.
DUNHAM: Why not?
SANAM: Because of the problems that are inherent in any bureaucracy. Leaders keep changing; keep being replaced by new people. Lack of continuity. And in general, we have not yet been able to sensitize them to the issue adequately.
And in the meantime, the migration has not stopped.
Of course, migration is always going to be there. And the migrants are not always informed. Very small things make them vulnerable to dangers. Like remittances: when they return to Nepal from India, bandits often rob them. If only the migrant workers were allowed to send their money from a national bank in India, the danger of robbery would be eliminated. But the Nepalese government hasn’t initiated all of these things.
DUNHAM: Early on, you mentioned that you are also focusing on the youth in the far west. Would you like to say a little more about this issue?
SANAM: In our HIV/AIDS program, we really promote peer education. The youth are a great resource for us. They go to their peers and educate one another. We go to both the school systems and outside the school system -- because there are still children who are not part of the school system. Still, our primary focus is on the schools, because these children are in the position to most easily grasp the situation. Then we encourage them to return to their communities and spread the word to those children who are not in school – the very population of youths who will probably end up migrating to India – usually by the time they become 16 or 17.
DUNHAM: How old are they when you introduce them to AIDS awareness information?
SANAM: We have a children’s club associated with the organization I’m working for. We begin with children who are 12 or 13 or 14 years old. At this time the children also get information from government curriculum.
DUNHAM: In the far west have you seen a problem with child sex trafficking?
SANAM: No, not in the far west. This practice of luring young girls is found primarily in the mid-west and the eastern districts. In the far west, it is males who go to India to find jobs. The females mostly stay in the villages to look after the children.
DUNHAM: What about people from the far west migrating to Kathmandu and other urban areas?
SANAM: Oh yes. During the conflict, especially after 2001, I could really see the difference in the towns in mid and far west -- like Dhangadi, Attaria, even Nepalgunj – the population was rising dramatically in those towns. The IDPs were seeking protection in towns where the government was in control. But now that the conflict is over, many of the IDPs are returning to their villages.
DUNHAM: Migration, AIDS and youth: You really see a deep interconnection, don’t you?
SANAM: Yes. Migration is a coping strategy in the far west, and totally socially accepted within the communities.
And what’s interesting is that I’ve interviewed youths in the far west who don’t really have any reason to go to India. They could pursue opportunities here that pay as much. They just go to India because that’s what others have done before them. Unfortunately, they mostly end up in Bombay, and Maharastra [Bombay’s State] has one of the highest rates of AIDS in South Asia.
This is where my interest in youth is really focused: These youths are disengaged from their communities because the people from the older generation are not ready to hand over the activities like community development to youth. The youth are tokenized. They are blocked from significant community participation.
DUNHAM: So the marginalization they experience in their own community results in them going elsewhere.
SANAM: Yes. And it’s a very sad note that many of the organization are not focusing on this problem. They are targeting dalits, they are targeting children and very specific age group but they have failed to target youths – those are ready to migrate. Recently the government has stated that it is committed to youth policy but not enough is being done.
The issue of youths, as far as I have seen, has dramatically emerged after the comprehensive peace agreement.
DUNHAM: Why is that?
SANAM: Before the peace agreement, the age group primary targeted by both insurgents and security forces was Nepal’s youth. It is more a thematic target right now, they are not specifically targeting youth but they are thematically targeting them as peace building. I am quite worried about the marginalization of youth here in Nepal – a group that includes the rural youths, sub-urban youth, dalit youths and especially the women youths.
When we talk about Girija Prasad Koirala, he is 85 years old. Ram Chandra Paudel is the Youth Minister, despite the fact that he is already above 55 in age.
The entire problem starts from the fact that older leaders are not ready to hand over responsibilities to the youth. We have a very odd social structure of not believing in the younger generation. You can see youths are doing outstandingly well in each and every sector but they are still not well recognized or given their due.
The results of the general election in 2008 were a lot about the frustrations of the general public. The people were very much ready to vote for youths because they are the ones who best understand new technologies and many other things. Youths are the population who can readily accept the changes and old generation can not do that, especially in Nepal.
DUNHAM: Yet Nepal remains a patriarchal society. It is the old men who have the final say -- from the family unite to national government.
SANAM: So what do you see happening? You see the youth flying to Middle East and East Asia to work and they get as low as 8000 rupees per month. I have heard that they get even less then that - less than 100 USD. Apart from that they also have to pay for the flight.
Another problem that I have seen recently is about missing youth. It’s not just about remittance and money but also about the social cost to Nepal when the youth continue to vanish from this country. They will not be here to contribute to a future stronger Nepal.
DUNHAM: The brain drain.
SANAM: Yes. In general, I think there needs to be some major intervention for youth in Nepal.
DUNHAM: But how can any program be accomplished in Nepal before rule of law is achieved, before impunity is rectified
SANAM: We have this discussion in our youth forums regularly; the issue of impunity was raised after Maoist came in to the power. In fact, impunity was always prevalent in Nepal, even before Maoist came to power. You can see all these political youth activist riding without helmets, with three people on a motorbike – and in front of the traffic police – as long as they have their party logo printed somewhere. You can see the state of impunity spreading everywhere. Even bus drivers, truck drivers and even transportation workers do not pay any attention to the traffic police. Why? Because they belong to a union that will back them up. It is good that they have unions, but not when they regard them as trump cards, which allow them to do whatever they want.
The needs of the people are very basic. They feel that they are being overlooked.