Our Perspectives


Hope for people living with HIV in post-earthquake Nepal

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Binod Kumar Tamang is receiving health care service at Trishuli Plus, Nuwakot. Photo: UNDP Nepal

In this blog series leading up to the World Humanitarian Summit, UNDP experts and practitioners share their experiences and views on responding to conflict and disasters.

A year ago, 20-year old Binod Kumar Tamang found out he was infected with HIV.  He lives with his mother in Nuwakot district in the central region of Nepal.

When Binod tested positive for HIV, one of the hospital’s staff introduced him to Trishuli Plus, a community-based organization that also serves as a community crisis center. It was established to provide HIV-related health services, support and home-based care for people living with HIV in the district and the surrounding areas. Binod started going to the clinic for treatment and support.

After the earthquake struck Nepal last April, Nuwakot district was one of the hardest hit regions. Hospitals and community care centers were among the most affected facilities and many were destroyed. The provision of health services was disrupted, leaving people in need of basic supplies and treatment.

The building in which Trishuli Plus was housed collapsed. The center was forced to relocate to a tent, but resumed its business with the little it was able to salvage.

While millions in Nepal were seriously impacted by the earthquake, the nearly 3,000 people in Nuwakot and surrounding areas living with HIV found themselves unable to access life-saving antiretroviral treatment.

The effects of natural disasters on people living with HIV can be particularly severe as they can destroy health infrastructure, interrupting care and treatment, or disrupt the supply chain management systems fundamental to the stocking of antiretroviral medicines.

Often in emergency responses, HIV is not adequately prioritized, largely because HIV is generally subsumed under other health concerns or is considered a development issue. This oversight must change in order to adequately treat people living with HIV and prevent further transmission. The right to health, including access to essential medicines, means we have to provide access to life-saving interventions for people living with HIV regardless of an emergency.

In Nepal, the Government and its partners urgently sought to ensure that community care centers were able to operate without further interruption and that antiretroviral treatment and HIV prevention services were made available.

As part of its recovery efforts, UN agencies including UNDP collaborated with many organizations and the government of Nepal to gather preliminary data on disrupted HIV services in the earthquake-affected districts. UNAIDS, UN agencies and development partners also supported efforts by Save the Children to mobilize $2.1 million in emergency relief funds from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

 The Mijay family received mattresses from Trishuli plus after the earthquake. They are standing in front of their house that collapsed as a result of the earthquake. Photo: UNDP Nepal

Trishuli Plus was one of the recipients of this support. It was able to relocate to a more permanent building and deliver earthquake relief materials such as food and nutrition items, mattresses, blankets, mosquito nets and water purifiers. It has provided mobile health services for people living with HIV and cash transfers for the educational and daily needs of children affected by HIV.

It is now developing a livelihood recovery program for those living with HIV who lost their businesses in the earthquake. The programme gives these entrepreneurs micro-grants of NRs 15,000 (approximately US$140) to support the restoration of their livelihood, which is crucial to feed their families and send their children to school.

In humanitarian emergencies, the focus is often on meeting the most basic needs of safety, shelter, food and water. But it’s just as important to think about long-term health effects in a crisis or disaster setting. Disasters can mean that HIV-related services are limited by logistical challenges on the ground, which pose risks for the discontinuation of HIV and tuberculosis treatment. Furthermore, the health needs of women and adolescents are too often neglected in humanitarian responses, even though their survival often depends on access to basic sexual and reproductive health services like midwives and HIV prevention.

Bharat Man Shrestha Blog post blog series Crisis response HIV and health Asia & the Pacific Nepal HIV AIDS Global fund Partnerships

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