NIRNAYA Nepal – supporting drug addicted people
By
Denise Nanni and Milena Rampoldi, ProMosaik. In the following our interview
with NIRNAYA, a Nepalese
organisation engaged in supporting people facing drug abuse and HIV/AIDS. Would
like to thank Samir Thapa for the detailled answers to our questions. ProMosaik
is convinced that social and health problems can only be solved if we compare
experiences and approaches all over the world.
Denise Nanni and Milena Rampoldi, ProMosaik. In the following our interview
with NIRNAYA, a Nepalese
organisation engaged in supporting people facing drug abuse and HIV/AIDS. Would
like to thank Samir Thapa for the detailled answers to our questions. ProMosaik
is convinced that social and health problems can only be solved if we compare
experiences and approaches all over the world.
How
was born NIRNAYA and with what aims?
was born NIRNAYA and with what aims?
NIRNAYA is
started by passionate group of dynamic youth sharing a common vision to improve
the socio-economic conditions of the marginalized communities, in particular
people who use drugs and those living with and affected by HIV and Hepatitis C
virus. We always strive to ensure that our service are evidence informed based
on human rights and connects with the local realities of the particular
communities. Basically Nirnaya is “by” the drug users and “for” the drug users
organization. Mr. Samir Thapa is the founder
chair of Nirnaya, Mr. Thapa is a media journalist too with the history of drug
use, and whose
mission is to help assure a healthier and sager world through drug prevention
and treatment efforts by promoting sound drug policies based on scientific
research, efforts to decriminalize drug use access to quality treatment for every
drug user. Being an ex-drug user, he has wide and adequate experience regarding
the issues of drug users and drug moment. Now he is actively working as an ED
in Nirnaya.
started by passionate group of dynamic youth sharing a common vision to improve
the socio-economic conditions of the marginalized communities, in particular
people who use drugs and those living with and affected by HIV and Hepatitis C
virus. We always strive to ensure that our service are evidence informed based
on human rights and connects with the local realities of the particular
communities. Basically Nirnaya is “by” the drug users and “for” the drug users
organization. Mr. Samir Thapa is the founder
chair of Nirnaya, Mr. Thapa is a media journalist too with the history of drug
use, and whose
mission is to help assure a healthier and sager world through drug prevention
and treatment efforts by promoting sound drug policies based on scientific
research, efforts to decriminalize drug use access to quality treatment for every
drug user. Being an ex-drug user, he has wide and adequate experience regarding
the issues of drug users and drug moment. Now he is actively working as an ED
in Nirnaya.
The organization was legally registered in
2010 under the NGO Act at Lalitpur District Administration Office [Regd. No
–3230] and is affiliated with Social Welfare Council and Ministry of Home
affairs, Nepal.
2010 under the NGO Act at Lalitpur District Administration Office [Regd. No
–3230] and is affiliated with Social Welfare Council and Ministry of Home
affairs, Nepal.
Currently
Nirnaya is providing following services:
Nirnaya is providing following services:
1. Residential Drug Treatment Centre
2. Skill
Development Training
Development Training
3.
Advocacies and Awareness
Advocacies and Awareness
4. Community Care Center For People living
with HIV
with HIV
Aim of our
organization is to Committed to ensure sustainable development of people who
use drugs, those living with HIV and their families by delivering quality
service and undertaking innovative programs and projects through linkages with
governments, private sectors and non-government organization, local and
international.
organization is to Committed to ensure sustainable development of people who
use drugs, those living with HIV and their families by delivering quality
service and undertaking innovative programs and projects through linkages with
governments, private sectors and non-government organization, local and
international.
What are the
current data about drugs abuse and HIV/AIDS incidence in Nepal?
current data about drugs abuse and HIV/AIDS incidence in Nepal?
Drug addiction is not a phenomenon in Nepal & has been a
problematic issue in the country especially with youths whom are the future
leaders of the nation. Drugs such as alcohol, Ganja (Marijuana or Cannabis),
bhang, cherish (hashish) have been widely used in Nepal. Other form of drug
heroines, injectable
pharmaceutical drugs such as buprenorphine, benzodiazepines, chlorpromazine and
dextropropoxyphene & non-prescribed tranquilizers are the common
drug which has been used by the drug users in oral way & by injecting.
However, the types of drug use have been shifted since the last few decades
from cannabis to synthetic opiates /chemical substances i.e Heroin, Nitrazepam,
Buprenorphine etc & now gradually to methapedamines. Government of Nepal
formulated its Narcotic drug control act in 1976 AD for the first time &
later it was amended three times again. The drug act has prohibited all
activities including consumption, possession, production, cultivation,
distribution, trafficking, sale, and import/export of drugs. Also, the
mode of drug uses has changed from smoking to injecting and that has become one
of the major causes of HIV infection too. Besides that currently, Hepatitis C
has been a burning issue with Injecting drug users in Nepal where studies
reflect that 80 -90 % of Injecting drug users are living with Hepatitis C So,
drug abuse has become multi-dimensional problem in Nepal hindering Health
aspect of youths & socio economic growth of family/community. Thus, drug
control has been a challenge for the government. Drug control is a kind of
issues which can’t be whipped out completely but only can be controlled &
reduce drug related harms.
problematic issue in the country especially with youths whom are the future
leaders of the nation. Drugs such as alcohol, Ganja (Marijuana or Cannabis),
bhang, cherish (hashish) have been widely used in Nepal. Other form of drug
heroines, injectable
pharmaceutical drugs such as buprenorphine, benzodiazepines, chlorpromazine and
dextropropoxyphene & non-prescribed tranquilizers are the common
drug which has been used by the drug users in oral way & by injecting.
However, the types of drug use have been shifted since the last few decades
from cannabis to synthetic opiates /chemical substances i.e Heroin, Nitrazepam,
Buprenorphine etc & now gradually to methapedamines. Government of Nepal
formulated its Narcotic drug control act in 1976 AD for the first time &
later it was amended three times again. The drug act has prohibited all
activities including consumption, possession, production, cultivation,
distribution, trafficking, sale, and import/export of drugs. Also, the
mode of drug uses has changed from smoking to injecting and that has become one
of the major causes of HIV infection too. Besides that currently, Hepatitis C
has been a burning issue with Injecting drug users in Nepal where studies
reflect that 80 -90 % of Injecting drug users are living with Hepatitis C So,
drug abuse has become multi-dimensional problem in Nepal hindering Health
aspect of youths & socio economic growth of family/community. Thus, drug
control has been a challenge for the government. Drug control is a kind of
issues which can’t be whipped out completely but only can be controlled &
reduce drug related harms.
The
Nation has progressed a lot in the fight against HIV/AIDs relying to the
available data. Harm Reduction Program has been one of the instrumental in
declining the National HIV Prevalence Rate to 0.206 in adult population &
also the prevalence rate among IDU’s Population, which has dropped down to 2.8
compared to 4.6 back in 2012. As the country epidemic is defined as
concentrated epidemic having higher prevalence rate in key populations i.e
(Drug User (DU’s), Migrants, Female Sex Workers (FSW), Man sex with man (MSM),
Transgender TG) especially DU’s who are the major bridge in transmitting the
disease to general key population. Scale
up of Service Site as DIC, easy access of Opioid Substitution Therapy (OST),
Needle syringe exchange program (NSEP), HIV testing and counseling (HTC) Sites,
facilities for treatment in abscess & Overdose; Support has played a major
role to drop down the prevalence, death & new infection cases. Early diagnosis & access to treatment has
been a major factor. Country has disseminated its New HIV/AIDS Strategic plan
(2016- 2021) recently to end the HIV pandemic by 2030 in fast track as a part
of Sustainable development goal &
90-90-90 will be achieved by 2020.
Nation has progressed a lot in the fight against HIV/AIDs relying to the
available data. Harm Reduction Program has been one of the instrumental in
declining the National HIV Prevalence Rate to 0.206 in adult population &
also the prevalence rate among IDU’s Population, which has dropped down to 2.8
compared to 4.6 back in 2012. As the country epidemic is defined as
concentrated epidemic having higher prevalence rate in key populations i.e
(Drug User (DU’s), Migrants, Female Sex Workers (FSW), Man sex with man (MSM),
Transgender TG) especially DU’s who are the major bridge in transmitting the
disease to general key population. Scale
up of Service Site as DIC, easy access of Opioid Substitution Therapy (OST),
Needle syringe exchange program (NSEP), HIV testing and counseling (HTC) Sites,
facilities for treatment in abscess & Overdose; Support has played a major
role to drop down the prevalence, death & new infection cases. Early diagnosis & access to treatment has
been a major factor. Country has disseminated its New HIV/AIDS Strategic plan
(2016- 2021) recently to end the HIV pandemic by 2030 in fast track as a part
of Sustainable development goal &
90-90-90 will be achieved by 2020.
Currently,
the estimated population of People Living with HIV/AIDs (PLHIV) in Nepal is
39397 comprising of 24,449 Male i.e. 62%
of the total estimated population) & 14,947 i.e. (38% of the total
estimated population) Female living with HIV 14,947 (38%) as of July.
2016. However, the numbers gap between
the estimated no of PLHIV & reported cases i.e 22,267 as of July. 2016
indicates that still there are lot of Key population who aren’t accessed to HIV
testing & know their HIV status timely. Out of the reported HIV cases 2561
PLHIV come up with IDUs background i.e. (12% of the reported HIV cases). Latest
Integrated Biological and Behavioral Surveillance (IBBS) Survey conducted among
Female Injecting Drug Users (FIDUs) in Kathmandu Valley i.e Round I in 2016
indicated that the prevalence rate of HIV among FIDUs is 8.8% & 21.9% of
Hepatitis C. Likewise, IBBS carried out in Kathmandu, Bhaktapur & Lalitpur
district on 2015 indicated HIV prevalence among PWID as 6.4% & prevalence
of Hepatitis C as 22%. Thus, Hepatitis C has been an alarming & concern
issue to PWID in Nepal at the moment.
the estimated population of People Living with HIV/AIDs (PLHIV) in Nepal is
39397 comprising of 24,449 Male i.e. 62%
of the total estimated population) & 14,947 i.e. (38% of the total
estimated population) Female living with HIV 14,947 (38%) as of July.
2016. However, the numbers gap between
the estimated no of PLHIV & reported cases i.e 22,267 as of July. 2016
indicates that still there are lot of Key population who aren’t accessed to HIV
testing & know their HIV status timely. Out of the reported HIV cases 2561
PLHIV come up with IDUs background i.e. (12% of the reported HIV cases). Latest
Integrated Biological and Behavioral Surveillance (IBBS) Survey conducted among
Female Injecting Drug Users (FIDUs) in Kathmandu Valley i.e Round I in 2016
indicated that the prevalence rate of HIV among FIDUs is 8.8% & 21.9% of
Hepatitis C. Likewise, IBBS carried out in Kathmandu, Bhaktapur & Lalitpur
district on 2015 indicated HIV prevalence among PWID as 6.4% & prevalence
of Hepatitis C as 22%. Thus, Hepatitis C has been an alarming & concern
issue to PWID in Nepal at the moment.
There
has also been an increase in the younger age group of people, below 20 years,
starting to inject drugs. During IBBS survey carried out in West & Far
Western of Nepal , almost half (47.3%) of the People who inject drugs (PWIDs)
began to inject below the age of 20 years. Hence, there has been need of
integrating Harm Reduction curriculum in Secondary level. The total no of drug users in Nepal is 91,534
according to the study carried out by Ministry of Home Affairs in 2014-2015
which is nearly a double of 46,309 in 2008-2009. The no. of Drug Users had
increased by about 98% over the course of 6 years. Male have the overwhelming
majority among drug users i.e Out of the total population 85,204 (93.1%) are
male and only 6,330 (6.9%) are female. The highest number of the drug users are
found in Kathmandu valley (36,998) followed by Sunsari: 7,407; Kaski: 6917;
Morang: 6415; Jhapa: 6008; Rupandehi: 5997; Chitwan: 4515, Banke: 4050, and
Parsa: 2130. The other rest areas
constitute 11,097 drug users.
has also been an increase in the younger age group of people, below 20 years,
starting to inject drugs. During IBBS survey carried out in West & Far
Western of Nepal , almost half (47.3%) of the People who inject drugs (PWIDs)
began to inject below the age of 20 years. Hence, there has been need of
integrating Harm Reduction curriculum in Secondary level. The total no of drug users in Nepal is 91,534
according to the study carried out by Ministry of Home Affairs in 2014-2015
which is nearly a double of 46,309 in 2008-2009. The no. of Drug Users had
increased by about 98% over the course of 6 years. Male have the overwhelming
majority among drug users i.e Out of the total population 85,204 (93.1%) are
male and only 6,330 (6.9%) are female. The highest number of the drug users are
found in Kathmandu valley (36,998) followed by Sunsari: 7,407; Kaski: 6917;
Morang: 6415; Jhapa: 6008; Rupandehi: 5997; Chitwan: 4515, Banke: 4050, and
Parsa: 2130. The other rest areas
constitute 11,097 drug users.
What are the most important needs of people
who face drugs abuse or live with HIV/AIDS? How do you address them?
who face drugs abuse or live with HIV/AIDS? How do you address them?
As, the national data reflects huge difference in the total
estimated population & reported cases i.e 39397 – 22267, up scaling of
testing facilities is the foremost need to know their status earlier & get
accessed to care, support, treatment timely for the life savior of them. Both PLHIV
& People who use drugs face stigma & discrimination more oftenly.
Because of that, the accessibility of them in service facilities is relatively
low. Lack of friendlier environment creates discomfort to open up for
explaining their issues. Furthermore, there has been limited no. of CD4 sites
& Viral load testing sites to get tested in order to know their immune
power & level of viral load suppression which are the routine test to be
done in every 6 months & year respectively in case of PLHIV. Likewise, most of PLHIV are economically
backward, thus there is a huge need of programs with objectives to reduce poverty and improve livelihoods of HIV positive
persons through creating employment opportunities for people with HIV which
could play a major role later in declining Stigma & Discrimination by
uplifting their economic status because nowadays if you are wealthy, you get
respected whether you are PLHIV, Drug User, Kidnapper it doesn’t matter. The
insights & perception of people living in the society & community is
cheap. Police harassment has been an alarming issues faced by drug users. Like
wise policy barrier has been also a major problem to drug users. In the same
way, post rehabilitation programs are the most need of Drug users after
rehabilitation program to develop them as enter partnership in the future with
seed grant. Up scaling of Harm reduction facilities is essential to reduce
HIV/AIDs, Hepatitis C spread & drug related harms. National Network of Drug
User has conducted advocacy events with other key population led organizations
to amend the act regarding decimalization not criminalization, which are practiced
already by countries like Portugal. Concerned bodies should address early
diagnosis & treatment facilities of Hepatitis C, as Hepatitis C has been an
alarming issue to Drug User. In order to address all the above-illustrated
issues, the country response to HIV/AIDs is more dependent on foreign Aids so
we need to rely on foreign Aids to address the issues & needs. Few issues
have been addressed by using local government resources to limited number of
drug user & PLHIV.
estimated population & reported cases i.e 39397 – 22267, up scaling of
testing facilities is the foremost need to know their status earlier & get
accessed to care, support, treatment timely for the life savior of them. Both PLHIV
& People who use drugs face stigma & discrimination more oftenly.
Because of that, the accessibility of them in service facilities is relatively
low. Lack of friendlier environment creates discomfort to open up for
explaining their issues. Furthermore, there has been limited no. of CD4 sites
& Viral load testing sites to get tested in order to know their immune
power & level of viral load suppression which are the routine test to be
done in every 6 months & year respectively in case of PLHIV. Likewise, most of PLHIV are economically
backward, thus there is a huge need of programs with objectives to reduce poverty and improve livelihoods of HIV positive
persons through creating employment opportunities for people with HIV which
could play a major role later in declining Stigma & Discrimination by
uplifting their economic status because nowadays if you are wealthy, you get
respected whether you are PLHIV, Drug User, Kidnapper it doesn’t matter. The
insights & perception of people living in the society & community is
cheap. Police harassment has been an alarming issues faced by drug users. Like
wise policy barrier has been also a major problem to drug users. In the same
way, post rehabilitation programs are the most need of Drug users after
rehabilitation program to develop them as enter partnership in the future with
seed grant. Up scaling of Harm reduction facilities is essential to reduce
HIV/AIDs, Hepatitis C spread & drug related harms. National Network of Drug
User has conducted advocacy events with other key population led organizations
to amend the act regarding decimalization not criminalization, which are practiced
already by countries like Portugal. Concerned bodies should address early
diagnosis & treatment facilities of Hepatitis C, as Hepatitis C has been an
alarming issue to Drug User. In order to address all the above-illustrated
issues, the country response to HIV/AIDs is more dependent on foreign Aids so
we need to rely on foreign Aids to address the issues & needs. Few issues
have been addressed by using local government resources to limited number of
drug user & PLHIV.
Do you carry on awareness raising activities? If
yes, how has civil society been responsive so far?
yes, how has civil society been responsive so far?
Yes, we carry various awareness raising activities targeting
vulnerable population & areas. Street Drams, orientation, media campaigns
are carried out as a part of awareness raising activities. We also carry out advocacy events to
highlight the issues faced by both Drug Users, PLHIV also channelize the issues
to decision-making bodies. Civil society has been very positive & their
support is overwhelming till date. They get involved in our events for
solidarity to eliminate the issues especially the mother groups are the active
civil society groups who are closely working with us for longer period of time.
Furthermore, we also get involved in the social affairs of the society for
harmonization & to develop bonding.
vulnerable population & areas. Street Drams, orientation, media campaigns
are carried out as a part of awareness raising activities. We also carry out advocacy events to
highlight the issues faced by both Drug Users, PLHIV also channelize the issues
to decision-making bodies. Civil society has been very positive & their
support is overwhelming till date. They get involved in our events for
solidarity to eliminate the issues especially the mother groups are the active
civil society groups who are closely working with us for longer period of time.
Furthermore, we also get involved in the social affairs of the society for
harmonization & to develop bonding.
Do you cooperate with local authorities and
institutions? If yes, how?
institutions? If yes, how?
Yes we cooperate with local authorities & institutions through
various approaches. We conduct regular meetings with them to mitigate various
issues. Likewise we too report them on monthly basis regarding progress of our
programs. Furthermore, we also conduct joint monitoring programs to monitor our
work by local authorities.
various approaches. We conduct regular meetings with them to mitigate various
issues. Likewise we too report them on monthly basis regarding progress of our
programs. Furthermore, we also conduct joint monitoring programs to monitor our
work by local authorities.
