Urmila  (name changed), 28, a resident of Oli Gaun of Accham district, lost her husband four years ago.  Rawal, a mother of two children, is infected by HIV. A dalit, Urmila has to face all kinds of discriminations in the village. Out of 3,504 people, there are 1,514 (43%) males, and 1990 (57%) females.

Urmila of Oli Gaun is not the only woman suffering that plight. A large number of women, particularly poor dailts, are the worst affected by HIV infections.

Despite several efforts of the government and non-governmental organizations, migrant workers continue to bring HIV infection and transmit it to their spouses. According to a recent report, 120 people have already died in Accham due to AIDS.

Little progress has been made in the isolated communalities in the remote areas as most of the uneducated people migrate to urban areas and Indian cities for greater economic and employment prospects leaving married women home. When these migrants return, most of them bring HIV to their wives. Women living with HIV of dalit community begin to face double discriminations.


As husband dies, the Women Living with HIV have to bear all kinds of economic burdens in the household. They have to go from house to house to seek support from all to save their children.

With the Human Development Index of Achham District at 0.325 and ranking of 69 among 75 districts of Nepal, Gender Development Index (GDI)) of Achham is 0.275, which one of the lowest of Nepal.

The biggest problems and issues of dalit, minority, women and youths are their ignorance and unawareness. The illiteracy rates for male are at 36.9% and for female at 83.8%, for dalit (untouchable castes) 68.5%  and for other ethnic and indigenous people at 54.8%. Dalits are treated as worse and excluded & discriminated from every social aspect. The stigma of HIV adds their burden further.

 
 According to Achham District Development Committee, poverty is rampant in Achham district, 75.1% people have income of less than Rs. 5,000 per year; 12.5% have income at Rs. 5, 000-Rs. 10,000 per year. Therefore, population below the poverty line is about 75% . Likewise, 18.21 % population of Achham migrate to India as unskilled labor.

A large number of widows, whose husbands died due to AIDS, have been living under a severe financial crunch. “Accham’s poor people who left for India to make a little amount of money end their life with HIV infection,” said Yogendra Oli of Bayalpata Village Development Committee.

At a time when Nepal is celebrating the World AIDS Day with the global slogan with Zero infections, the far western region is yet to see such a zeal. The current indication is that a large number of people here die due to AIDS.

Health officials in the district argue that they don’t have enough resources to start the programs. According to District AIDS Coordination Committee of Accham, there are 359 people living with HIV and most of them are migrant workers. The committee said HIV has already spread in all 75 villages of the district.

According to Regional Health Directorate of Far Western Region, the region is not getting enough resources to deal with HIV. “Some 10 percent of total population of Nepal lives in far west, there are highest number of HIV infected people,” said HIV section chief Dayakrishna Panta. “We don’t have enough budgets to carry out the work,” Panta said. According to a recent report, epidemiological region-wise analysis shows that the large amounts of funds were allocated for the highway district, 45 percent in 2009 and 53 percent in 2010 and followed by Kathmandu valley with 35 percent in 2009 and 25 percent in 2010. Far-western hills were receiving 10 percent of funds allocated for the districts.

There are 2 ART centers here. Five ART centers are in other eight districts. There are 26 VCT centers in district level hospitals. Seven VCT centers are run by non-governmental organizations. According to the report, 2,036 people living with HIV were taking ART in 2010 and now 4,610 people living with HIV are taking ART.

Although the world community is celebrating the World AIDS Day with the slogan of making HIV Zero, it will take huge resources as well as an awareness campaign to reach the message to Achham. If the far western region should have zero HIV, the high level of poverty should go away before real results come out.