AIDS AND ORPHANS IN NEPAL An orphan is defined as a child under the age of 18 who has had at least one parent died . No worth to explain what AIDS is .But regarding its impact on adults most researches are conducted and most of the intervention programs are focusing on different high risk adult groups in our country. These include female sex workers, injecting drug users , clients of sex workers , migrant labors , force , and vulnerable mothers. But the victims of AIDS children also which usually make them orphans and label them as AIDS orphans. Global estimated AIDS orphans are more than 11,500,000 according to UNAIDS report 2003. In South East Asia region the actual or expected data is lacking but the scenario may be worse than it is thought as AIDS is going on more increasing in this region .In Nepal , the present conflicting situation has shadowed the other health related conditions as well as other sectors . The data regarding the no. of AIDS orphans is lacking so , the actual data is yet to be investigated to get .The problem of AIDS orphans is expected to as growing as the infection due to HIV virus is estimated to be more than 63,000 also the most vulnerable as well as prevalent group of this infection is of reproductive age group this means that this group is more likely to have child than any other groups as well. The death due to this problem will certainly lead to a problem of AIDS orphan . The burden of the AIDS orphan in south Africa alone is 12% of all children ( 2.2 million) in 2003 will be expected to increase to 18% of all children by 2010 ( 3.2 million ) . The data regarding AIDS orphan still lacking in SEAR . PROBLEM IN NEPAL An estimated around 63,000 people in Nepal has got infection with HIV . The age group of this population is more in 15-45 yrs which are likely to have children may be one , two or three . As per common sense when the groups of people 15-45 yrs with HIV die then how much the orphans will be there .This is just for the consideration of the problem but Nepal still lacks the adequate data on AIDS orphans due poor registration system. WHY SHOULD THIS PROBLEM BE GIVEN PRIORITY? As presented above the global burden of this problem of HIV infection is increasing . This problem leads the problems in orphans as well as community as follows :- Growing up in deprived situation . Ignorance of the orphans . Low level of education and health care facilities in these group . High vulnerability of disease & malnutrition. Social stigma and Isolation. Facing more violence and abuse . Deprivation from their inheritance & property . Trafficking of these children is more likely . In case of conflicting situation children may be abducted and enrolled as soldier or driven to hard labour , sex-work , or life on streets. The vulnerability of the children due HIV infection also increased which is presented as below as cycle according to Williamson ,j. (2004),A family is for life . HIV infection Children may become care Increasingly serious givers illness Psychological distress Economic problems Death Deaths of parents & young children s of parents & young children Problems with inheritance Children withdraw from school Children without adequate care Discrimination Inadequate food Exploitation & child labour Problems with shelter & malnutrition Sexual exploitation Life on the street Reduced access to health care Increase vulnerability to HIV infection The actions to be implemted to address the problem: Most of the HIV and AIDS related problems in Nepal are focusing on the victims of HIV and AIDS , called PLWHAs . The need is also growing to address AIDS orphans .some of the strategies to address the problems are listed below , 1- Strengthening capacities of family to protect & care for children eg. keeping PLWHA parents healthy as far as possible ; Improving households money earning capacity. Provide children and caregicers with psychological and other support. 2- Mobilizing community based responses Household care givers mobilization. Establishing community based orphanages for sick and orphan children. Some vocational and income generating skills to ilder AIDS orphans to improve livings . Local food & materials donation programs . Reduction of stigma & discrimination related to HIV and AIDS. 3- National Action plan:- Without national commitment, the problem is not possible to be managed. State has responsibility for basic needs for AIDS orphans , and has to preserve their rights to access the services ie state should provide education , shelter heath care and security needs of the orphans .The followings are the recommendation for the national action plan ,according to UNAIDS, 1- Conducting participatory situation analysis. 2- Implementing a national policy & legislation review to better protect children. 3- Establishing national coordination mechanism for responding to the orphans and challenge . 4- Developing and implementing national action plan addressing both orphans prevention and need of orphans . 5- Implementing monitoring and evaluation activities based on indicators that specifically measures effects on the wellbeing of orphans and children made vulnerable by HIV and AIDS. According to UNAIDS in 2004 4th global report , 39% of countries with generalized epidemics have no national policies regarding the problems among them 25% have no plans to do. WHAT CAN BE DONE IN NEPAL AT PRESENT The problem of orphans in Nepal is not only due to AIDS but also due to 10 years" conflict in this country. There are more populations displaced than are killed . So before making another policies and programs the present government have to establish at least 5 rehabilitation centres / orphans house in each developmental regions should be started soon where there will be provision of housing , food , education , vocational training , income generating activities for more elder orphans , health care facilities , so that they can have their lives more secured, competitive and feel the state is responsible to them .This approach will lead to an integrated service for the orpans in country at a comparatively low cost than individual intervention. This will also lead to peaceful and responsible Nepal also. For this many humanitarian organizations, UNAIDS, UNICEF, WHO, WFP, EU etc can be called for help for a specific period of time with disintegrated responsibilities of each organization. Local community support, civil society movement and political commitment are the most for this Proposed approach. Refernces : world report on voilence and health , WHO, 2002. Prepared by : 2004 Report on the global AIDS epidemics. Vishnu khanal www.google.com Institute of Medicine , NCASC . Maharajgunj campus .
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