Kamala BK (not her real name) is HIV positive.
Her husband died about six years ago, although she didn’t know at the time that AIDS was the cause.
After marriage the couple had worked in India, but Kamala returned periodically to the family home in Doti, a hill district in Nepal’s far west. During one of their long separations, her husband became infected with HIV and, in turn, infected his wife when they were reunited. Kamala’s story, sadly, is far from a being unique in Doti, which has the second-highest HIV prevalence rate of any district in Nepal.
There are common elements to the stories of all the HIV positive women I spoke to there.
Food insecurity and lack of employment opportunities. Migration to nearby India. Unavoidable periods of estrangement between husbands and wives. Lack of knowledge about HIV and how it is transmitted. Increasing periods of ill health and physical incapacity. Lack of access to affordable and reliable medical information and health care.
UMN has been supporting community work among people living with HIV and AIDS in Doti for several years now. Things like skills training, medical advice, and improved access to health care. This year, we also worked to inform local communities about their rights under Nepal’s local governance laws, and help them participate in the local government planning and budget formation process. The result was a new sense of empowerment for the women living with HIV and AIDS, and a budget allocation to support them.
On paper at least, Nepal’s local governance law (Eng. pdf) is extremely inclusive and mandates the participation of every local settlement in drawing up plans and priorities for funding from the Village Development Council (VDC) or District budget.
Of course, implementation is everything; many communities are not aware of their rights under this law and local planning is often conducted behind closed doors by a handful of administrators and politically-connected people.
This year, though, we worked intensively to raise awareness about the local government budget and how to develop and contribute community proposals for funding. None of the communities had ever participated in this way before and I was excited to see newly empowered communities engaging in the political process in a way that earned the respect and support of the local administrators and political parties.
Through this community advocacy, as well as the roads, water sources, temples, classrooms and irrigation systems that were funded, the VDC budget allocated 26,000 rupees to support women living with HIV and AIDS. It’s a relatively small amount, but Kamala was happy with the result.
I am very happy. Often we can’t work. We can’t eat. Sometimes we are too sick even to take our medication. So the funds will be very helpful to improve our livelihoods and pay for medical care. We haven’t decided yet how we will use the money, but we will take that decision together.