Treatment Accessbility in Nepal.

[Advocacy Life]

IS THIS TOO MUCH TO ASK?
WHEN EVERY ONE IS READY TO HELP
WHY IS THE GOVERNMENT NOT RESPONDING?

Advocacy task force
"putting on the heat"
PEACEFULLY

Back ground: 
Nepal has more than 120,000 living with HIV and out of which more than 9000 people are living in the state of AIDS. These 9000 people if they are not provided with the life saving drugs of Anti retro Viral "ARV" drugs soon they will perish with in a year or two at the most. 9000 peoples are dying unless we do something about it. This situation is big enough for state of emergency. Teku hospital is Nepal's one and only Infectious Disease hospital and ironically Nepal's largest service provider for People Living with HIV and AIDS (PLHA) of Nepal. PLHA's when admitted to this hospital is treated in the same ward alongside other infectious disease patients. There is no closed ward or even a curtain to remote one patient from another. In average, at least three patients die in this hospital every week. More than 25 patients receive emergency care residentially, from this hospital every day. People are dying in this hospital not because of their diseases but because of the lack of facilities and services that could otherwise save their lives.

To address these and others many issues on HIV/AIDS, a Team led by Advocacy Task force (ATF) , whose members consist of Local healthcare activists, NGO staffs, Volunteers, People living with HIV and AIDS, Ex drug users, Gays and Lesbians of Nepal, has been demand the services provided here in Teku hospital to be upgraded in order to address the needs of the PLHA who are facing lives uncertainty once they get admitted here.

Government wants to shift the whole HIV department from this Infectious Disease hospital to other better facilitated normal hospitals keeping in mind that HIV is merely a communicable disease not infectious disease and the stigma and discrimination associated with treatment in infectious disease hospital. That is the great way to go. Advocacy Task Force agrees with the Government; but that shifting of HIV department from Teku hospital to other hospitals may take years, till than many people will have lost their lives from this hospital whose service is way below average.

Advocacy Task Force requests the Government to consider upgrading of the services in Teku hospital not just for the sake of saving hundreds of PLHA's lives but save other infectious disease clients as well.

We are conducting candle light demonstration in front of Teku hospital everyday from 4:45 till 5:45 PM in a peaceful and humane manner to address the need to provide better healthcare services from the Teku Hospital for all its patients. What we are trying to reflect by this demonstration is not Hatred for the Government or to anyone but love and compassion to the clients that we work for. We are not protesting against the government but we are trying to make the Government join hands with all the civil societies to fight against the HIV epidemic in Nepal.




 ADVOCACY Task Force "Agenda's"
 

We "request" the concerned Government officials the followings:
 
1) Separate ward for people living with HIV and AIDS with enough bed to address the average HIV patience turnover in the hospital.
 
Reasons:

•   PLHA patients admitted for emergency care in the infectious disease hospital should be separated from other infectious disease clients due to the nature of HIV infection. (WHO guideline clearly justifies this).
•   Unless better service options are available for PLHA in other hospitals Teku hospital should be responsible for these patients.   
•   The flexibility is required in the bed/ward usage by all the patients during the outbreak of other seasonal infectious diseases such as diarrhea.   
•   Other hospitals will not follow suit cause Teku hospital is the only infectious disease hospital.
 

2) Doctors, who are well trained in dealing with HIV cases along with the supporting staffs should be available as per the need.
 
Reasons:

•   Experienced doctors should have a phase out time before their transfer which gives them time to explain every individual's (ART patients) case to the incoming doctor and help them familiarize.
•   ART client's history and treatment procedure should be well informed to the incoming doctors and supporting staffs.
•   ARV adherence should be taken seriously at present, to avoid the spread of drug resistance virus in the future (CHBC Team supporting staffs recommended),which can be a   burden to the government in the case if the client has to go for second line regiment.
 

3) Social wing or a small room to be provided for volunteers with minimum office setup.
 
Reasons:

•   These volunteers are not just to help PLHA but to assist all the infectious disease clients who come to this hospital for treatment.
•   With the goal to help the PLHA's and others in their treatment process these volunteers deserves respect and should be treated well by the hospital as well as their organizations.
 

4) Hospital area (in the wards and toilets) should be kept clean and tidy for all the patient's well being while their stay in the hospital.
 
Reasons:

•   Hospitals settings as normally as they come should be clean and tidy, especially in the heart of the capital.
•   Certain amount of money should be spent in infrastructure maintenance and refurnishing (Painting and building well facilitated toilets.)
 

5) CD4 testing should be more frequent, well organized (Reliable) and also flexible in terms of timing.

 Reasons:

•   Till date we have only one CD4 testing machine. It's only logical that it operates well for the well being of more than 75000 people living with HIV and AIDS.
•   We don't have viral load machines available in the country so CD4 is the only measures to evaluate the condition of the client who is under the treatment of ART
•   NPHL (National Public Health Laboratory) has not been functioning well in the case of forecasting of the needed reagent to do CD4 testing as well as clinical staging of the recorded PLHA so that it could be easier to make a future plan and to know how much more clients are going to be enrolled in ART in future.
 

[sharkdiver]

I have travelled to Nepal and I have seen the affects of extreme poverty has had on their people. There are thousands of people living on the street and the "government" seems to be distracted by the Maoist  movement.  How can I, as an American help beyond my thoughts and prayers.