December 2006

Community radio combating HIV/AIDS

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Considering the developments till date it can be confidently stated that this radio initiative has managed to change people's lives, link families separated by migration, and improve awareness about HIV/AIDS

Migration and health hazards

Migration is a universal phenomenon.  People leave their villages and migrate to other cities and countries to improve their opportunities. Migration often separates families for long stretches of time. It has both positive and negative aspects. While on the one hand, it enable people to live in new condi-tions and improve their and the families living standards. On the other hand, it has many negative implications such as being vulnerable to alcoholism and other drug addictions leading from the frustration of living in difficult conditions in an unknown setting away from the family. These addictions have serious implications for the person and the family in terms of financial burden and the physical and emotional trauma it poses. The baseline studies about Nepali migrants conducted by Tata Institute of Social Sciences (TISS), Mumbai, Sathi Nepal Project, a Mumbai based NGO, and Equal Access, in collaboration, revealed that most of the migrants face severe difficulty in finding employment in the new place. They live in poor housing condition, lacking basic facilities. The major share of their income is spent on sustenance and they manage to send only 1/3 of it to their families in Nepal. 74 percent of respondents were married men who remain away from their family for long stretch of time, 79% of the respondents said that they consumed paan (betel nut), guthkha (chewing toba-cco), cigarettes, and alcohol. The respondents were within the age group 17-45 years from Nepalese migrant communities.

Migration into Indian cities from Nepal is common. This trend is especially high in the Far-West part of Nepal. The study conducted by Family Health International in 2003 to study recent migration trends and risk behaviour among migrant Nepali men in Mumbai revealed that approximately 120,000 people from Nepal migrate annually in search of work. Most of the migrants from Far-West Nepal shift to Mumbai in India. New Era, a research organisation based in Nepal, conducted a study about the vulnerability of migrants from this area to contracting HIV/AIDS. The study revealed that almost 10 percent of the returnees from India (the majority being from Mumbai) were found to be HIV positive and a significant number of people suffered from other sexually transmitted infections (STIs). These alarming facts and figures show that there is an urgent need to spread the awareness about HIV/AIDS amongst migrants, their families, and the community.

Learning from Achham district

The National Health Foundation (NHF), supported by Family Health International, took the lead in initiating information and community based education project on HIV/AIDS in October 2004 in the Achham District in Far-West Nepal. Equal Access, an international NGO, partnered with this project through the production of the Desh Pardesh (Home and Abroad) radio programme. In its approach, the project is aimed at reaching out to the migrants and their families both in Mumbai and Achham through the radio programme. In addition to these initiatives community mobilisation was carried out by NHF in Achham.

In the initial phase, TISS (Tata Institute of Social Science) and Sathi Nepal set up outreach sites in the areas of Goregaon and Thane in Mumbai where most of the Nepali migrants from Achham and other Far-West districts reside. The first phase of the project involved establishing direct links with 15 outreach groups in Mumbai. Surya Poudel, Training and documentation Coordinator at Equal Access, was surprised with the number of Nepali migrants from Far-West Nepal residing in Mumbai. He said, “They are all eager to listen to Nepali Radio programme, but it is non-available. During the training period, they learned to operate the receivers and were very happy listening to Nepali programmes through the satellite channel”.

Back in Nepal, in the initial phase, 10 RLG (Radio Listener Group) sites in Kailali and Kanchanpur and 15 RLG's in Achham were set up by Nepal Red Cross Society (NRCS) Kanchanpur and National Health Foundation (NHF), respectively. The 15 RLG sites in Achham were set up in its five VDC's (Village Development Committees), Ridikot, Nuwathana, Mastamandu, Jalpadevii and Siddheswor. This was done through providing each RLG that was formed in these areas with a Worldspace radio receiver. Each group consists of 25 people, mostly women. There is one facilitator in the group who organises the listening sessions and facilitates the discussions on the issues raised in the programme. These RLG facilitators were trained to equip them with facilitation skills, operate the radio receiver, record the aired programme onto a cassette tape and re use it for the listening at convenient hours. The training imparted the participants with facilitation skills as well as technical know-how to operate the receivers. At the end of the training, each group carried a receiver running on a set of dry cells and patch antenna. Desh Pardesh, thus started broadcasting in Achham soon after the training. Every Friday, a fresh episode of Desh Pardesh radio programme was broadcast through Worldspace satellite channel from 12:00 to 12:30 day time so that RLG facilitators carry out the listening sessions and it will repeat on every Sunday at 12:30 to 01:00 pm. This programme contained drama, messages, interviews, and local songs from Far-West people's voices and life experiences. 

Collective consciousness of NGOs

Surprisingly it was found that nearly 20 NGOs alone in Sanfebagar, a local bazaar with settlement of around 250 households, was working around raising awareness about HIV/AIDS and dissemina-ting information about the same. Most of them said that they are working in social and community mobilisation to reduce the chances of HIV/AIDS and to support migrants to remain safe and sound whilst they are working in India. Equal Access was too happy to share and discuss on their work experience with the fellow groups.

Much excited about the level of intervention of local organisations in this area, Equal Access approached the community members. But, to utter dismay, it was found that most of the people were panic-stricken with the entire information overload as most of the families had at least one member working in Indian cities. The information imparted without having any practical consequence ; had taken the form of the myth that all the migrants from India are HIV/AIDS infected. They even named HIV/AIDS Bambyalo Rog (Mumbai disease). More than panic-stricken, these people were helpless.  Even if they wished to have tests and ease out their doubts, they were not available, not even at Mangalsen District Hospital, four hours walking distance from Sanfebagar.

Unique approach

Equal Access team returned to Kathmandu taking with many new experiences from Sanfebagar, Achham. But, lack of experience on adequate services available for the people regarding HIV/AIDS left desolate. Once back in Kathmandu, discussions were held based on the findings with colleagues and counterparts. The team suggested a determined focus on service-based interventions including a logical link between delivery of information, education, and medical facilities made available in these villages. Mr. Deepak Deo Bhatta, Team Leader from FHI, acknowledged the urgency to deal with these issues and promised to take immediate action.

In March 2006, after the production and broadcast of the 50 episodes of Desh Pardesh, Sanfebagar was visited once again. This trip was meant to be a refresher training for new participants as well as a follow up visit from the last time. In the year long gap since the last visit, it was found that four facilitators had left to pursue higher education or for new job opportunities. New facilitators had taken up their place from the community. There was a new Swasthya Sewa Kendra (VCT/STI centre) managed by NHF in collaboration with HASTI AIDS (a collaborative institution working on HIV/AIDS based in Kathmandu, Nepal) through the support of Global Fund set up in this area. In the interactions, it was learnt that people were much better informed and educated about the issues of HIV/AIDS. The new set up, Swasthya Sewa Kendra (health centre), has been conducting voluntary counseling and testing (VCT/STI) services for 30-50 people on a monthly basis. Referring to the data of September and October of 2005, Dr. Ranga Raj Dhungana, Executive Director of NHF highlighted, “There were 80 persons tested and found 13 of the cases are HIV positive. This is 16 percent of the total test and it was alarming”. These services have had a definite impact on raising the awareness of HIV/AIDS among people. However, it is a very touching sight to witness someone being revealed of his or her HIV/AIDS positive status.

Encouraging results

The hard work and dedication of the RLG facilitators in the area was gradually acknowledged. These facilitators have moved beyond the single village and initiated mobile listening camps where they disseminate information about the centre as well as raising awareness about other HIV/AIDS related issues. It has increased the number of listeners of the programme substantially as well as who come and visit the centre for tests and counseling.

It was encouraging to see that the information delivered through the radio programme, Desh Pradesh, and the subsequent discussions held in the groups have helped to raise the awareness and led to actions including seeking services. Not only have the villagers been able to access services, they have also brought about the creation of new service centres in nearby villages too. This has helped them to seek services within their reach.

The Desh Pardesh radio programme has now reached its 69th episode and is broadcast weekly. The broadcast through Radio Nepal, Bageswori FM and Saipal FM, and Worldspace satellite channel has reached across Nepal as well as outside the country, especially in Mumbai. In its maturity, Desh Pardesh has contributed to reach out to the people in the Far West of Nepal in their local language with stories from their own localities. There is still a long way to go, with wider coverage across Nepal and the need to constantly raise these issues, but considering the developments till date it can be confidently stated that this radio initiative has managed to change people's lives, link families separated by migration, and improve awareness about the growing threat of HIV/AIDS.  

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