Richmond Fellowship Center

Today I visited another female rehabilitation center called the Richmond Fellowship Center. This center is complimentary to the Richmond Fellowship Center for males, but is located in Kathmandu to serve the female population. However, we were surprised to find that not only did they look different, they seemed to be functioning very differently. This center was originally supported by the Elton John Aids organization, but has been supported by UNDP since 2006. It is a 10 bed rehabilitation center for women and children who are injecting drug users. The average recommended stay is 3 months, however, women usually end up staying as long as 8 months. While at the rehabilitation center, women are provided with counseling, HIV/AIDS education sessions and basic education classes. The Richmond Center for women is actually known for the fancy candles that they make for income source. The current staff are also made up of ex injecting drug users themselves, and they keep certain positions within the organization available to ex IDUs. There is also a complimentary Drop In Center by Richmond Fellowship, where clients are referred for testing and health check ups. During our visit, we learned about the extremely low rate of recovery for women IDUs. Only 10 of the 100 women who have gone through this rehabilitation center have fully recovered. The majority of them end up relapsing and return to the centers or go back to their previous lives. The staff raised the same concerns about creating a sustainable program where women can have something to do after recovery. The candle project has thus far been successful but is only a small scale project and can not be a major income source. Some of our own personal concerns were that because HIV/AIDS testing can not be mandated, awareness about the importance of testing needs to be taught in the center. We were alarmed when 0 clients from the center have been tested this year. Since the start of this program, only 7% of IDUs go for testing.

UNAIDS on Richmond Fellowship Center and Women IDUs:

Intravenous Drug Use Accelerates HIV/AIDS Epidemic in Asia

When Rita arrived in Kathmandu from her home in Kalimpong (India) to work in a casino, she dreamt of a secure future. The casino job gave her good money. At work, she met a Nepali man from a well-to-do family and they got married. But her in-laws did not accept her, and soon she discovered that her husband could not hold down a job as he was a drug addict. In fact, he even asked Rita to try brown sugar and she eventually did.

Soon, Rita was giving him money to buy drugs and ultimately she lost her job at the casino. She always told her parents in Kalimpong that she was well and very happy with her married life. But in reality, Rita had no bank balance and her husband soon abandoned her.

However, Rita did not give up hope. She joined the Richmond Fellowship Centre (RFC), which is affiliated to the Richmond Fellowship International and has a network of community health service providers in Southeast Asia and the Pacific. RFC is the only rehabilitation centre for women drug users in Kathmandu. Today, at the age of 27, she has given up drugs and is also helping her husband recover from the addiction.

Bhawana, 37, is also at RFC. Her husband, a tourist guide in Kathmandu's popular Thamel area, was a drug user and convinced Bhawana to start on brown sugar. Her addiction played havoc with her family life; she could not take care of her three children and had to borrow money to send them to school. After undergoing treatment at RFC, Bhawana went looking for her husband. She returned in two days: she had found his body in a morgue. Recently, Bhawana discovered that she is HIV+.

Rita and Bhawana are among the few drug users who have found some direction in life after joining RFC. Supported by the UNDP, RFC aims to address the issue of vulnerability of women drug users to HIV/AIDS. At present there are close to 20 women in the centre. Some stay full time, while others come in the morning and leave in the evening.

According to Pooja Niroule, the Richmond Fellowship Programme Coordinator, a major problem they face is what to do with the women after rehab. "We have been working for a short while now, but we have seen that once they leave the centre they are still vulnerable," adding, that the relapse rate is very high.

One of the ways RFC helps drug users to nurture feelings of self-worth and develop a sense of well-being is by engaging them in income generation activities. The current group of women at the centre have been working on manufacturing fancy candles and seem to enjoy the work they are doing.

The National Centre for AIDS and STD Control (NCASC) recently announced that Nepal had 4,861 cases of HIV/AIDS as of March 2005. Experts, however, believe that there are some 65,000 people suffering from HIV/AIDS in the country. And one of the most vulnerable groups in Nepal is drug users. Around 40 per cent of the drug users in Nepal are HIV+. NCASC research says, 68 per cent of the Injecting Drug Users (IDUs) tested positive for HIV in Kathmandu itself. Staff at the RFC says that when they started (in 2000), they were aware of 20-25 sites in Kathmandu where women were injecting drugs. Five years later, 10 more sites have been discovered.

Women in these places live in pathetic conditions, often without access to clean water and sanitation. Many live on the streets or in slum areas. Most have early births, and are not married.

Says Ivana Lohar, UNDP's Project Coordinator for the HIV/AIDS-Harm Reduction Programme for IDUs, "The drug problem began in Nepal may be in the 1960s, when marijuana was used as a source of pleasure and entertainment. But by the '80s, many Nepalis were hooked to injecting drugs."

Niroule says most women are introduced to drugs by their partners. Take the case of Nanda, 30, who was a secondary schoolteacher, married and with three children. Out of sheer curiosity, she tried brown sugar offered by her husband. Soon, Nanda was a user and became irregular at work. For 13 years, Nanda continued like this, and very often her eldest child had to take care of the younger siblings. Today, both Nanda and her husband are in the centre, trying to bring their lives back on track.

Niroule says the drug problem among Nepali youth remains largely invisible. Many are hooked for years before they go for rehab. Sapna and Sonu, both 25 now, started using drugs while still in school. Due to their addiction, they dropped out of school by the time they were 15.

Lohar says their big concern is the women's vulnerability to HIV/AIDS. "They are not aware about their reproductive rights or educated about sex. Their vulnerability is aggravated due to their addiction. It is, thus, a hidden - and more dangerous - problem."

While the number of IDUs may not be as large as in some other countries, the stigma of being a woman IDU in Kathmandu Valley is extreme. This makes the women IDUs even more invisible.

"Women drug users always existed but were discriminated against, which prevented them from coming out in the open. The first thing they tell us in our outreach programmes is that they do not want to be identified even by the centre. The problem of women drug users came to light only after more and more got infected with HIV," says Niroule.