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Patenschaft
Nepal PATNEP (Sponsorship Nepal)
A
project for the improvement of living conditions of prostitutes in
Kathmandu
Nepal
is one of the poorest countries in the world. Nepal has hardly any
agricultural surplus, no natural resources, no industry (at least not much
that would feed the inhabitants) and virtually nothing that can be
exported. The average wage is around 200 US dollars per head per year,
child mortality is around 10% and literacy is less than 50% - with large
differences between towns and country and above all between men and women.
In rural areas, little more than 2% of women can read and write.
Nepal
is a stronghold of trafficking in girls and women: Every year an estimated
10,000 minors and young women are sold to Indian brothels. That brings the
families a sum of money equivalent to a year’s income; for a short time
they can escape the worst poverty and can afford a corrugated steel roof
to keep out the deluge from the next monsoon. As long as the girls and
young women are able to work, the brothels pay a similar sum of money
every two or three years to the families, whose survival is strongly
dependent on this income.
Nepal
is still a cheap tourist country, above all for drop-outs, nature freaks
and Himalayas trekkers of all ages. Although it officially does not exist,
prostitution is centuries old and well-established. The women are
beautiful and sex with them is cheap. Virtually anything can be had for a
price between a cup of tea and 100 US dollars, depending on age and
appearance. Insiders believe that Nepal could develop into a second
Thailand as far as international sex tourism is concerned.
Nepal
has (at the moment) a comparatively low incidence of HIV infection. Up
until February 2006 between about 70,000 and 120,000 persons were reported
as being HIV-positive and 3,500 persons as having Aids. The real number
may be significantly higher.
In
the face of the hopelessness of being able to offer the women a lasting
economic alternative to prostitution, the project which we have launched
has set itself a more modest target: to improve the living conditions of
the prostitutes, to organise them and, together with them, to develop
projects which correspond to their needs. For a socially isolated,
outlawed, starving woman, HIV is a big additional threat.
The
“Sponsorship Nepal“ project has been financed for the last seven years
by Aids Info Docu Switzerland. The basis of the project is a doctor’s
surgery which is modest, but equipped with all necessities. Here, the
prostitutes receive the most basic medical treatment and, above all,
advice on HIV and Aids. Up to now we have reached around 1,200 women with
this project. Naturally the women are also given condoms.
Since
1999, the project has been expanded by a sub-project to take care of the
children of prostitutes. The goal is to offer the children a roof over
their heads, regular nutrition and education. The joint project ”foster
families“ was developed for up to 10 prostitutes’ children. Each
family is supervised by a woman who is selected by the project leadership
and the mothers together. The foster families live in rented apartments in
an area close to the school.
One
of the project’s goals is to allow the children to grow up as near as
possible to their normal environment and not to socially uproot them.
In the meantime, the project takes care of three such families with 33
children in all. Apartments have been found and furnished for all families,
places at schools or nursery schools have been organised, as well as job
training for juveniles. Presently, more than 70 children are on the
waiting list and the number is growing. Many of these children are
infected with HIV.
Project
Laos
"Protection against STI, transmittal of HIV/Aids from pregnant women
to their children" in Vientiane, capital city, P.D.R. Laos
Initial situation:
Especially in southern countries, an important and often poorly-supported
aspect of Aids prevention is the prevention of the transmittal of the HIV
virus from pregnant HIV-positive mothers to their children.
Presently no reliable data exists regarding the incidence of HIV/Aids in
the Peoples’ Republic of Laos. Only virtual data exists from a study
carried out in 2002 and supported by Unicef, which estimates an HIV
incidence of 0.05 %.
In addition to the PatNep Project (Outpatient clinic for patients with
suspected sexually transmitted diseases, support of foster families) in
Kathmandu, Kingdom of Nepal, supported for the last 7 years by Aids Info
Docu, the foundation supports a further project in the Peoples’ Republic
of Laos, with the following goals:
Goals and key data of the project:
1. Rapid tests to determine the incidence of HIV on a voluntary basis (informed
consent)
for pregnant women,
for women who attend gynaecological surgeries,
for women with medically induced abortions with a high rate of
complications.
2. The project is carried out in accordance with the guidelines of the
National STI/HIV/Aids Commission.
3. The project budget is 43,300 US dollars.
4. The project is carried out at the Mother and Child Hospital, Vientiane.
This state hospital has over 70 beds. Every year 30 - 40,000 women are
treated as outpatients and between 2,800 and 4,400 women are admitted.
Around 4,200 births (year 2005) take place annually and 3,500 pregnant
women are treated as outpatients. In other words: between about 100 and
130 pregnant woman or around 50 women with suspected sexually transmitted
diseases visit the outpatient department of the Mother and Child Hospital
every day.
5. About 5,000 women will be tested for HIV on a voluntary basis.
6. Professional advice is given before and after the HIV test or during an
Aids therapy.
7. Guaranteed Aids therapy for HIV-positive women during and after the
birth, including treatment of infants: the support of the Swiss Lao
Hospital Project (president: Dr. Urs Lauper, M.D.) has been pledged.
8. Gram colouration for TB diagnosis, syphilis screening: financed by the
Zurich Dermatological Society (Prof. F. Eichmann).
9. Provision of demographic data, including a statistical evaluation of
the incidence of HIV.
10. Personnel training.
11. Project duration: 2 years.
12. The project officially began in October 2005.
13. Responsible project leader and coordinator:
Prof. Hanspeter Rohr M.D., president of the Aids Info Docu Switzerland
foundation who, since the year 2000, spends several months (three times a
year) in Vientiane, the capital city of Laos. He lectures tropical
medicine, parasitology and tropical pathology at the Faculty of Medical
Sciences of the National University of Laos, at the Institut de la
Francophonie pour la Médecine Tropicale and at Mother and Child Hospital.
Some comments on the HIV/Aids situation and on healthcare in the Peoples’
Republic of Laos:
Although up to now, as opposed to the neighbouring countries of Thailand,
Cambodia, China and Myanmar (Burma), no hard data on the incidence of HIV
has been available, it may be assumed that the incidence of HIV and Aids
is low. No reliable details on the incidence of HIV exist (0.05 % has been
estimated!). However, the responsible authorities, especially the health
minister, Dr. Pomeneek Dalaloy, assume that the number of HIV-positive
persons will rise in the near future.
Prostitution in Laos is basically confined to beer houses and guest houses.
It is “strictly” pursued by the police. "Sex-working Women and
Men" are “reformed” on an island in the Mekong river. The number
of Laotian women who work illegally as prostitutes in Thailand is still
low compared to the Isaan women from north Thailand. The Laotian media
regular report on the daunting fate of Laotian women brought to Thailand by
people smugglers on the basis of false promises.
The rapidly growing north-south traffic – from China southwards – and
the regional border traffic via the Friendship Bridge, dubbed the Aids
Bridge by the people, have strongly increased. Sex tourism is still hardly
developed in the Peoples’ Republic of Laos. In the past two years,
however, a "sex man with falang man" tourism (falang/farangset =
westerner, originally Frenchman) as in Cambodia appears to have developed.
Generally, it can be said that the Aids problem is still largely
suppressed or underestimated in the Peoples’ Republic of Laos. An open
Aids prevention campaign, as is taking place exemplarily in Thailand in
the media, has only hesitantly begun in Laos.
Voluntary HIV tests, advice and therapy, which are all still at an early
stage, must be carried out according to the National Aids Commission’s
guidelines, which largely correspond to those of Unicef and the WHO.
As yet no request has been made to the Global Fund for the funding of the
HIV/Aids therapies. In Laos the Global Fund currently supports
preventative measures against Aids (such as distribution of condoms) as
well as malaria and TB programmes. These requests may be viewed in the
internet.
For the last two years, Médecins sans Frontiers has carried out a pilot
project for Aids therapy in Savannahkheth in the south of Laos. Around 400
Aids patients are being treated there. The border traffic with Thailand
and the junction with the north-south traffic lead to a suspected higher
incidence of HIV in Savannahkhet.
Medical treatment is not free in Laos (in a socialist, post-communist
country) and is therefore hardly affordable for women. A general health
insurance does not yet exist. This is still in the process of being
established. Insofar as their financial circumstances allow, the women
attend the many small private surgeries.
Nurses and midwives’ salaries amount to around 20 - 30 US dollars per
month whilst doctors earn 30 - 40 dollars. With the steady rise in the
cost of living it can be assumed that a family needs around 100 US dollars
a month. This means that almost everybody has to do a part-time job on the
side.
The health minister, Dr. Pomeneek Dalaloy, follows an open Aids strategy
and accords this project a high priority.
Key data for the progress of the project up to now:
The work for the project proposals was taken up from October 2004. The
signing ceremony took place on 8th July 2005 at the Mother and Child
Hospital. The project officially began on 01/10/2005.
After overcoming numerous problems which alone would fill a book, and
after a long learning phase regarding Laotian customs and practices, the
political necessities and the often almost intransparent personal networks,
the project now appears to be well assured. It enjoys the full support of
the minister, Dr. P. Dalaloy.
Prof.
Dr.med. Hanspeter Rohr
01/06/2006
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