Save the Children is the world’s leading independent children’s right organization with members in 30 countries and programs in more than 120 countries. Save the Children fights for children’s rights and delivers lasting improvements to children’s lives in Nepal and around the world.

1. Living a dignified life

2. Save the Children is the world’s
leading independent children’s
right organization with members
in 30 countries and programs in
more than 120 countries. Save the
Children fights for children’s rights
and delivers lasting improvements
to children’s lives in Nepal and
around the world.
© Save the Children 2014
ISBN: 8677-8-8
Photo: Bijay Gajmer

3. Save the Children works in partnership with local
communities, networks, non-governmental organizations and
government authorities to make sure children and families
affected by HIV and AIDS can live positively and productively
without stigma and discrimination. Our program reduces
the impact of HIV and AIDS by increasing awareness of safe
practices to prevent spread of HIV and access to HIV related
services, food, health care and education. Save the Children
is implementing Global Fund Round 10 HIV prevention &
care programs in 48 districts with 57 NGO partners. Save
the Children has supported 347,457 target population from
2011 - 2013 to live a healthy and dignified life.

4. Behaviour change
communication through
peer educators

5. Almost 90 per cent households in Parhoha
VDC, Butwal are of migrant families. For
women like Sita Neupane whose husbands
work in India, their days are spent looking
after their children, doing household chores
and waiting for their husbands to come home.
There are many women like Sita in Parhoha
VDC whose husband’s work in India and some
bring with them not just their earning and love
but also HIV and other sexually transmitted
infections (STIs).
Chandramaya Khatri a peer educator from
Nagurjuna Development Community, an NGO
supported by Save the Children meets women
like Sita in ParhohaVDC.“My husband who
was a migrant worker succumbed to AIDS
3 years ago and later I also tested positive. It
was a very difficult period for me, however, I
have moved on. I now teach others on how
HIV and STIs are transmitted and can be
prevented. People in my community know
about my status, however, that doesn’t bother
me. I am happy that I can talk openly and raise
awareness in the community.”
Chandramaya is an active peer educator. She
personally meets spouses of migrants who
work in India and sometimes meet spouses
in small groups to talk about pertinent issues
regarding HIV and STIs and ways they and their
family could protect themselves.Women do
not hesitate to talk to her openly.
Sita wasn’t aware about HIV and STIs.“When
I learned how HIV and STIs are contracted I
was determined to get my husband tested,”
said Sita. Her husband Madan Neupane has
been working in India for the past 15 years
and although he assured his wife he didn’t
need to test, he obliged to his wife’s request.
Madan tested negative.“I know I don’t have
HIV because I know what I am doing. I wanted
my wife to be without worries and trust me
and that is why I did the test for her, and she is
happy,” said Bhumiraj.
“One family at a time,” says Chandramaya.
Peer educators like Chandramaya are making a
difference in the lives of many.
“I know I don’t have HIV
because I know what I am
doing. I wanted my wife to be
stress free and trust me and
that is why I did the test for
her, and she is happy,”said
Bhumiraj.

6. Community Home Based Care
for people living with HIV

7. Save the Children is implementing
Community Home Based Care (CHBC)
services through 29 local partners in 25
districts. CHBC is a critical care and support
intervention as it directly works with People
Living with HIV (PLHIV) through regular
home visits by CHBC teams who respond
to the health, psychosocial, and spiritual
needs of PLHIV.The medical team provide
need based confidential service at the
comfort of their living space.
The CHBC have resulted in improved
quality of life for 3,425 PLHIV in Nepal
Pabitra Niraula, 39, is a PLHIV living in
Pathari. She receives CHBC services in
her home.“I am happy to receive care and
support from CHBC. I don’t need to go to
go the hospital for minor health concerns. I
have now learned to take care of my health
and feel encouraged to face struggles in
life.”
Kopila Sunar is 19, HIV positive and a single
mother to a 4 month old baby girl. She lives
in Buddhanagar, Butwal. During antenatal
check-up, the attending doctor referred
Kopila toVoluntary Counselling andTesting
(VCT) centre operated by UNFL.There she
learned of her positive HIV status and was
referred to the hospital for antiretroviral
therapy.Through the UNFL, she received
information on prevention of mother to
child transfer of HIV (PMTCT) services and
support for safer delivery.
“My baby has tested negative. Rita madam
has advised to conduct two more test for
my baby when she turns 6 months and
then at 18 months. Rita madam visits me
often at home and she answers all my
questions,” says Kopila.
“Kopila and her baby are doing extremely
well. She receives counseling and support
to take good care of her health and to pay
attention to her daily food intake. She is
happy,” Says Rita Katwal, CHBC staff, UNFL.
“Kopila and her baby are doing
extremely well. She receives
counseling and support to take
good care of her health and to pay
attention to her daily food intake. She
is happy,”Says Rita

8. People who once injected
drugs leading a normal life

9. OST involves substitution of injecting
opioid drugs with oral medication (such
as Methadone) that effectively minimizes
craving and withdrawals, and thereby
enables IDUs to stop injecting drugs.
Save the Children is supporting six
Social Support Units (SSUs) who work
closely with the medical unit government
hospitals to provide methadone to the
people who once injected drugs.
Rishi injected drugs for eight years.
He started using marijuana and other
stimulant pills which led to injecting drugs.
Rishi says,“I never thought I would inject, I
used to be proud I was only using brown
sugar and looked down upon those who
injected. I thought I could stop using
drugs any day I wanted to until one day I
was injecting too.”
Rishi reached a point where his family
locked him up so that he couldn’t go out
and do drugs. Finally his brother brought
him to an OST site in Kathmandu. He
was enrolled in OST and there he also
met his wife. Salina who had also used
drugs for 13 years.
Salina and Rishi fell in love and got
married.They have a healthy one year
old boy. Both want to lead a normal
life free from drugs and are tapering
down their methadone dose in close
supervision of the medical staff. Salina and
Rishi explain the benefit of methadone.
“Most importantly, we are disciplined
and focused.We come here because we
want stability in our lives. Methadone has
helped us stay away from drugs and the
chaos – we hope to be methadone free
very soon.”
Methadone is helping many people who
inject drugs live a dignified life in the
community.The people who injected
drugs relinquish the urge to inject which
would have kept them at risk of acquiring
blood borne infections such as HIV and
hepatitis.
“Most importantly, we are disciplined
and focused.We come here because we
want to be different and free.We are
trying..”

10. LGBTI community
informed and
empowered

11. “I know my
parents will never
understand me,
so I may never tell
them. But my sister
knows and she
supports me.”
Information is a powerful tool and when members
from Lesbians, Gays, Bisexuals,Transgender and
Intersexual (LGBTI) community feel they are alone
in their struggle to live a dignified life, counselling
provided by Save the Children’s Global Fund
program have made a difference. BirendraYadav,
Kiran Kuwar, Ratan Rana, Sunita Neupane are some
members of LGBTI community who are leading a
happy life due to risk reduction, care and counselling
support they received from the Blue Diamond
Society (BDS), partner of Save the Children who is
working for sexual minorities in Nepal.
Kiran is a former sex worker.While visiting a friend’s
place where all bisexuals often meet and exchange
information, he met an outreach worker from BDS
who informed him about the dangers of STIs and
HIV. Kiran learned about safe sex and risk reduction
and the importance of condom and lubricant use.
BDS has helped Kiran become financially secure too
as he now works as an office assistant in BDS.
Birendra works as a cook in Bhairahawa Medical
College.“My father knows I am bisexual but he is
happy I am married to a woman and I have two
children. I am aware of my rights and responsibilities
and always practice safe sex.”
Sunita works as a Regional Coordinator in BDS.“I
know my parents will never understand me, so I may
never tell them of my sexuality. But my sister knows
and she supports me.” Sunita, who excels in her
work, shares about her struggles and encourages her
friends to stay safe.
Ratan Rana is HIV positive but is living a dignified life.
He works for BDS in Bhairahawa where he works
effortlessly to inform LGBTI communities of their
rights and responsibilities, reduce risk and practice
safe sex. He is also grateful for the care and support
he receives from his circle at times of distress.
People like Kiran, Birendra, Sunita and Ratan are
passionate in providing lifesaving information to
LGBTI communities, who face social stigma and
discrimination, to empower them to safeguard their
health and human rights and to access services
and support when needed. Information indeed is
a valuable resource for the members of the LGBTI
community.

12. Living with HIV

13. A widow, single mother and HIV positive. Sanju and
Pratima share their stories, both living with HIV.
SanjuThapa’s husband died of HIV. On the 14th day of
her husband’s passing away she was also tested positive.
She has a son who was tested negative.
“She was so frail. During my counselling session I learned
that she was also suffering from vaginitis.With referral she
was put on ART and was also treated for vaginitis. She is
so healthy now it is hard to believe,” says Radha Bhattarai,
Counsellor, Nagarjuna Development Community, Butwal.
Sanju is now running a small eatery place and she
receives a lot of visitors along with outreach workers
who make it a point to talk about positive prevention and
on mending relationships with her family and community
members.
Pratima was married to a man from her neighbourhood
community who used to work in India.As a result he was
diagnosed with HIV and some years later passed away.
Pratima also tested positive and was referred to the
Community Care Centre (CCC) implemented by Dharan
Positive Group (DPG) in conjunction with Save the
Children.
She was put on ART immediately. Pratima stayed in the
CCC during the initial ART start up for observation,
where she also received other medical and emotional
care. She also received practical information about
taking care of her health, taking ART regularly and on the
importance of good nutrition and positive living.
Not only has her health improved, Pratima’s economic
state has also improved.“I live with my mother and brother.
We have a small farm and living off the farm is impossible.
I recently received a loan from the Dharan Positive Group
and with the loan I have started a small grocery store.”
The income from the store helps Pratima pay for her
household expense.
“We find a lot of change in her from the time she enrolled
at our centre for ART observation. At the time she had
fever and was underweight. She has been taking ART
regularly and her health has improved for better,” says
Astha Palikhey Rai, Program Coordinator, DPG.
There are 4,634 PLHIV like Sanju and Pratima benefitting
from services provided by 19 CCCs in Nepal supported
by Save the Children.

14. Crisis Response Centre
protecting female
sex workers

15. Crisis Response Center (CRC) provides rapid response to
crisis situations which threaten the well-being of female sex
workers (FSWs) and at times their children. CRC service
ideally is a collection of integrated services available 24 hours
a day, seven days a week to provide immediate, crisis-oriented
services designed to improve or resolve precipitating stressful
situations.
The CRC operated by Indreni Service Society (INSES) in
Itahari provides protection and counselling services to around
200 FSWs. Most of the FSWs visit the CRC with episodes
of trauma, violence, sexual assault and rape. CRC provides
counselling, legal support, shelter and care for up to 15 days
minimum to those FSWs who have nowhere to go.
Out of the 200 FSWs registered at the CRC, considerable
numbers are very young. Kamala is only 19 years old and is
an active FSW for the past 9 months. She came to the CRC
when she was sexually assaulted by her client a few months
back.At the CRC, she received trauma informed care, self
care and risk reduction information. She refused to be
photographed for the story for the fear of being recognized.
Kamala often visits the CRC when she is not working.
“I find solace here at the CRC because I feel comfortable
here and I know I won’t be judged for what I do,” says Kamala.
Rita ran away from home 4 years ago. Due to her family’s
economic condition and her friend’s suggestion, she came
to Kathmandu. Initially she was engaged in hotel work but
motivated by her peers she got into sex work. One day
during her work, Rita was beaten and robbed of her savings
by one of her clients. She passed out during the incident.
Beaten and bruised, she was left in a public park where one
of her friends found her unconscious the next morning. Rita
was hospitalized and when discharged she lived a life of
perpetual fear as the offender repeatedly gave her threatening
phone calls.
After 3 days of the incident, a Community Mobilizer of
Community Action Center - Nepal (CAC-Nepal) which
runs a Crisis Response Center with the support of Save the
Children, found her and brought her to their fold. Rita had
severe anxiety disorder and feared anyone who came near
her. The crisis response of CAC-Nepal has helped her deal
with this violent incident. She has also learned about ways
she could reduce risks in her profession. Rita received legal
support and filed a case with the police and the offender was
eventually nabbed. Rita regularly keeps in touch with the CRC
and is doing well.

16. Post rehabilitation care
ensures youths continue
the right path

17. Post Rehabilitation Care (PRC) provides a
platform and support to people who injected
drugs to maintain their sobriety in most difficult
circumstances.
Sudesh had just passed his SLC exams when
a friend offered him alcohol. He had never
experienced alcohol before and readily
accepted. During the same time, he ran into a
few high school students smoking marijuana.
In time he was also abusing other prescription
drugs.
“I was a good student so I managed to pass
eleventh grade but during the twelfth standard
I ran away. I wanted to be free,” says Sudesh.
“One thing led to another and I was heavily
doing drugs. In and out of rehab, I realized my
life was slipping away. I took a stand, attended
the PRC.”
PRC provides recovering injecting drug users
an opportunity to re-work on following
critical issues: family integration; competency
development – income generation training;
self-empowerment; health risk management
(including mental health); and recovery
maintenance.
“After I graduated from PRC, with the support
of the PRC staff I applied for a counselling job
at the District Police Head Quarter, Morang
and I got the job. I get paid too,” smiles Sudesh.
Sudesh is majoring in mathematics and will
graduate college next year.
Suren is 27 and HIV positive. His father died
when he was eight years old and his mother
left him shortly. He lived with his maternal
grandparents and his younger sister. He blames
himself for everything that has gone awry in
his life for instance even his mother leaving him
and his sister.
Suren is also a graduate of PRC in Morang.
Since he volunteers at the PRC he is given a
room to stay as he has nowhere to go. “At
the moment I am also attending house wiring
training provided by the PRC and I will soon be
working to earn a living.”
“The most important change
in my life is that my parents
now trust me. I am so happy
I decided to take charge of
my life.”

18. 6,557
injecting drug users now
use clean needle and
syringes and 879 are
now taking methadone.
405
Female Sex Workers
have received crisis
response.
62,855
total population tested for
HIV and counseled.

19. 3,425
people living with HIV have
recieved care and support
services through Community
Home Based Care.
16,314
men who have sex with
men, male sex workers and
transgenders have been
reached through Behavioral
Change Communication
interventions.
122,140
male labor migrants
have been reached
through Behavioral
Change Communication
interventions.

20. Nepal Country Office
Airport Gate Area, Sambhu Marg
Kathmandu, Nepal
GPO Box 3394
Tel: +977-1-4468130/4464803
Fax: +977-1-4468132
Email: post.nepal@savethechildren.org
www.nepal.savethechildren.net