Sanchit DANGOL

CONCEPT: A CUP OF TEA DONATION PROGRAM

sanchitdangol — Wed, 04 Aug 2010 20:17:47 +0000

Moving Towards the Brightness ..!

About YES and its Achievements: Youth Eye Service (YES) is a purely value and volunteer based charitable organization founded in 1995 with the aim of reducing avoidable blindness among the poor and disadvantaged of Nepal. Using limited resources and support from local contributors, it has been successful in helping more than 43,000 people (including 9000 school children) with eye health diseases/problems from all over Nepal, as well as more than 450 elderly cataract patients get back their eyesight through free cataract surgery camps by the end of 2009 December.

The Save-Eyes-Save-Lives?: The human eye is an incredibly important organ. We need good eyesight, not just to perform our daily activities freely and easily – things like walking, eating, but also because being able to see well is essential for our self-esteem. So, preventing people from becoming blind is directly and indirectly related to helping them achieve health, respect and a long life. Unfortunately, the eye health situation for Nepalese people is appalling. People are not taking care of their eyes because of poverty, superstition and lack access to eye health services. In our experience, there are large numbers of elderly people (especially 50 + years) who have to go without eye care services because their family members do not take care of them, and they often spend several years with avoidable blindness due to cataracts.

Thus, celebrating 15 years of service, YES is announcing our Save-Eyes-Save-Lives Campaign with the aim of running free cataract surgery camps and help hundreds of poor cataract patients restore their eyesight through free-of-cost surgery.

Cataract patients during post surgery orientation program

A cup of tea ? The cost of cataract surgery in the private clinics in Kathmandu and other major urban centers like Pokhara, Butwal and Biratnagar can run to more than NRs. 5,000.00. It takes several days to get from rural areas to the clinics and the transportation and accommodation costs are also daunting. The result is that the treatment of the eye diseases is totally out of the reach of the rural poor living in remote areas. We can provide cataract surgery for only NRs. 3,000.00 per case. A cup of tea program is in the process of developing a network of supporters (collecting donors) who will provide the cost of a cup of tea, the cup they have every day. Our campaign message is “Give us a cup of tea: we will give life back to hundreds of NEEDY eye patients.”

Help the visually impaired poor people.. You can provide us with a donation equivalent to the cost of a cup of tea of every day/week/month. People also can contribute the money equivalent to the cost of a cup of tea of every 2 days (every week) etc. We also request you to promote the one-cup-of-tea-program among your friends and acquaintances and create a chain of supporters among the like-minded people. We will compile a list of such people and report (data and photographs) regularly.

Cataract patients after surgery in 2009

A good impact of a donation: Ratna Dangol, a regular eye patient from Kathmandu, is one among YES’s contibutors. Following a successful intervention, she showed an interest to collect NRs. 75 every day personally herself for Youth Eye Service’s eye care program. We used her donation amount (Rs. 27,500) for free surgery camp held in November 2009.

One of the beneficiaries was a woman from Kirtipur. She was nearly blind from cataract that had afflicted her for 6 years. In fact, she got no proper care from her family and had to depend on others. After the free cataract operation, now she can do what she wants to do and so has her own freedom. She is now living an independent, self-confident, healthy and happy life.

Thanks to all well-wishers along with Ratna Dangol and their contribution, there is an answer for needy people who would otherwise face complete blindness.

Cataract surgery patients from Dhadagaon, Kavre during follow up

Further management and promotion plans: With this experience, the nubmer of people/couples joining the cup of tea donation network is increasing inside Nepal and abroac. In case of Nepal a person/couple normally contributes NRs. 3,600.00 annually. However, people also have joined it only with the token money according to their context or for their wedding anniversary, happy birthday, in memory of the departed souls of their parents and etc. After all, it’s the matter of servie tht the fellow human being at risk of losing their eyesight.

Please join the program- right here and right now!

ध्रुबतारा बाल बिकाश समाज (DHRUBATARA NEPAL)

sanchitdangol — Wed, 04 Aug 2010 18:02:18 +0000

नेपालमा बालबालिकाको अबस्था:

नेपाल विश्वमा आर्थिक, शैक्षिक र मानव शंशाधन बिकासको दृस्टिले पछाडि परेका मुलुकहरु मध्येमा पर्दछ। यहाँ कुल जनसंख्याको करीब ३३ प्र. मानिसहरु गरीबीको रेखा मुनि बाँचिरहेका छन् र करीब ४५ प्र. जनताहरु बेरोजगार छन् । परीणामत: नेपालले संयुक्त राष्ट्र सङ्घिय बाल अधिकार संधि (UNCRC)* प्रतिबद्द राष्ट्र भएपनि बालबालिकाहरुको जिवन, स्वास्थ्य, सुरक्षा र शिक्षा आदि सम्बन्धि आधारभुत अधिकार तथा सुबिधाको पर्याप्त ब्यबस्था गर्न सकेको छैन । देशमा ३ देखि ५ बर्ष उमेर समुहका ४१ प्र. बालबालिकाहरुको शिशु स्याहार कार्यक्रम (early childhood development) मा पहुंच नहुनु र करीब ८४ प्र. बालबालिकाहरु एबम् किशोर र किशोरीले बिद्यालय शिक्षा बिचैमा परित्याग (drop out) गर्नु परेको तथ्यांक यस्का केहि उदाहरणहरु मात्र हुन्*। साथै, गरीबी, अशिक्षा, सामाजिक आर्थिक बिषमता र पारिवारीक झैंझगडाका कारण देशभरीका करीब ५००० काठमाडौंमा मात्र ८०० सडक बालबालिकाहरु पाइन्छन्*। काठमाडौं राजधानि शहर भएकाले देशभरीका मानिसहरु स्वास्थ्य सेवा र रोजगारी आदिको खोजि गर्दै बसाइंसराइमा भैरहेको तिब्रबृद्दिले पनि समस्या झन बद्दै गएका छन्।

ध्रुबतारा संस्थाको परीचय:

कुनैपनि देशको (खासगरि नेपाल जस्तो द्वन्द ग्रस्त देशमा) दिर्घकालिन सकारात्मक परीवर्तन र प्रगतिको लागि शिक्षा र सिप बिकाश महत्वपुर्ण आधारहरु हुन सक्छन् । तसर्थ, नेपालको प्रचलित ऐन बमोजिम गैर नाफा मुलक, गैर सरकारी, सामाजिक संस्थाको रुपमा २००४ मा जिल्ला प्रशासन कार्यालय, काठमाडौंमा दर्ता गरी ध्रुबतारा बाल बिकाश समाज सन्चालन गरेको हो। यस्को प्रमुख उद्देश्य सिमान्तकृत, जोखिममा परेका (at-risk), टुहुरा अबस्थाका बाबजुद लगनसिल र निरन्तर परीश्रमी भै समाजलाई महत्वपुर्ण योगदान पुर्याएको कारण उस्लाई उत्तर दिशामा चम्किनें “चम्किलो तारा” अर्थात “ध्रुब तारा” बनाएको सन्दर्भबाट प्रभाबित भै यस संस्थाको नाम ध्रुबतारा राखिएको हो । यस संस्थाले समाजमा मानबिय मुल्य मान्यता (पुनर्) स्थापित गर्न बालबालिकालाई बिबेकसिल, सजग, सक्षम र समाजप्रति जिम्मेवार नागरिक बनाउने लक्ष्य लिएको छ।

ध्रुबतारा संस्थाको प्रमुख उद्देश्यहरु:
१. उपलब्ध स्रोत, साधन र सुचनाको ब्यबस्थित परीचालन गरी बालबालिकाहरुलाई अधिकार र अबसरहरु सृजना गर्दै सचेत, सभ्य र समतामुलक समाजको निर्माण गर्ने।

२. बालबालिका बिरुद्ध हुने सबै प्रकारका भेदभावहरुलाई न्युनिकरण गर्ने।

३. बालबालिकाको उत्थान एवम् विकासक लागी बालबालिका सम्बन्धि अध्ययन अनुसन्धान गर्ने।

४. शिक्षा, सिपमुलक कार्यक्रमहरु मार्फत निम्न आयमा निर्भर परीवारको आर्थिक स्थितिमा सुधार ल्याउने।

५.समाज कल्याणका लागि बिभिन्न कार्याक्रमहरु सन्चालन गर्ने

२. बालबालिका बिरुद्ध हुने सबै प्रकारका भेदभावहरुलाई न्युनिकरण गर्ने।

५.समाज कल्याणका लागि बिभिन्न कार्याक्रमहरु सन्चालन गर्ने

Dhrubatara children

ध्रुबतारा संस्थाका हालसम्मका कार्यक्रमहरु:
१. बिद्यार्थि सहयोग:
यस संस्थाले स्थापनाकाल देखि सन्चालन गर्दै आएको यस कार्यक्रम अन्तर्गत काठमाडौंमा ४८ जना बालबालिकाको बिद्यालय शुल्क, बिद्यालय पोशाक, स्तेसनरी र पुस्तक पुस्तिकाका साथै बिरामी पर्दा औषधी खर्च बेहोर्ने गरेको छ । संस्थाको स्वयम्सेवकहरुले बिद्यालय वा घरमा पुगेर वा सम्बन्धित अभिभबकहरुलाई भेटेर बालबालिकाको निरन्तर निरक्षन र सुपरीबेक्षण गर्ने गरेको छ । ति बिद्यार्थि मध्ये हालै २००९ सलको प्रबेशिका परिक्षामा ४ जनाले first division/distinction नतिजा लिएर उतिर्ण गरि १० + २ कक्षा पद्दै छन् भने जन आन्दोलन २०६२।६३ का घाइटेका एक जना छोरी समेतलाई यो कार्यक्रम मार्फत सहयोग पुर्याई रहेको छ।

२.बिद्यालय सहयोग:
रोटरी क्लब अफ फ्रान्सको अनुदान प्राप्तगरी स्युचाटारका ग्रामिण भेगका २ वटा बिद्यालयहरु श्री पन्चकन्या निम्न माध्यमिक बिद्यालय (२०० बिद्यार्थि) बाउन्डरि पर्खाल र पुस्तकालय तथा अमरज्योति माध्यमिक बिद्यालयलाई (६०० बिद्यार्थि) पुस्तकालय निर्माणार्थ आर्थिक सहयोग प्रदान गरेको थियो।

३.अनौपचारिक शिक्षा सहयोग:
सन २००८ मा, यस संस्थाले स्युचाटार र नक्सालका बिद्यालय जान नपाएका ८ देखि १५ बर्षका बालबालिकाहरुलाई लक्षित गरी अनौपचारिक शिक्षा कक्षा सन्चालन गरेको थियो । उक्त कक्षामा जम्मा ४० जना बालबालिकाहरु सहभागी भएकोमा अधिकांस सडक बालबालिका र निम्न आय भएका मजदुर आमा बाबुका छोराछोरीहरु थिए। ९ महिने कक्षामा उत्तिर्ण गरेका मध्ये २० जना भन्दा बढि बालबालिकाहरुलाई नजिकका बिद्यालयहरुमा भर्ना गराई पठनपाठनमा मद्दत् पुर्याईएको थियो ।

Note: 1. Source: Save The Children Fund (SCF), Nepal; 2. Centre for Child Welfare Board (CCWB), Nepal; 3. Abbreviation: United Nation’s Child Right Convention (UNCRC)

APPEAL of Asha Jyoti Sahayog Samaj, Rupandehi

sanchitdangol — Wed, 04 Aug 2010 17:28:25 +0000

The number of people infected with HIV has increased sharply since the reporting of first case of HIV/AIDS in Nepal in 1988. HIV is now a ‘concentrated epidemic’ with a prevalence rate of over 5 percent within some vulnerable groups like injecting drug users and female sex workers. In 1995, a sero-prevalence study reports the existence of 74000 people living with HIV/AIDS (PLHA) in Nepal. Rupandehi is considered as one of the hish-risk area in terms of the HIV infecting owing to the increased number of people migrating abroad for lucrative employment, its open border with India to the South, entry and exit point of trafficking of girls and high presence of sex workers in the high ways of the district. Some people suggest that the reported number of PLHA may be like just a tip of the iceberg. There is an estimate of having 150-200 thousand PLHA.

In the context of Nepal, to be diagnosed with HIV does not only mean to live with a virus, but to face extreme social stigma and discrimination. Due to ignorance, fear of discrimination and social disgrace, our members still like to be isolated and eventually end up life without seeking health services. They lack self-esteem and self-confidence and embrace the death due to lack of needful support. In Rupandehi, out of 71 known HIV positives, 13 PLHA died in 2005 alone, many more may have died without knowing so far.

The government and donor agencies make tall promises and generate attractive projects so as to show off their role. A number of projects are designed and accomplished in the name of the PLHA so far. PLHA, especially those from the remote and rural areas, have not even got the benefit of a penny. The organizations are pocketing all the benefits while PLHA are dying at the same time.

In order to support with basic needs of PLHA and develop self-supporting systems among PLHA, Asha Jyoti Sahayog Samaj (AJSS) was formed and registered in August 2006 by People Living with HIV/AIDS in Rupandehi, a district in Western Region of Nepal. It has now 70 members from the district and has undertaken several services like nutrition, self-care and primary health care as well as the training and orientation against violence, stigma and discrimination, and care of opportunistic infections targeting the PLHA, their family members and the community members. In spite of many challenges and constraints, it has become successful to instill the hope and happiness in the PLHA and number of deaths this year is just three. We have already initiated collaborative programs with other PLHA’s organization of the district and outside.

Besides, it has been running general awareness rising and interaction activities on HIV/AIDS and STI related issues in collaboration with different like-minded and community based organizations of the district (mainly with Women Acting Together for Change which is its main supporter and inspiration). It has been recognized for its initiatives and involvements in HIV/AIDS issue by PLHA as well as and general people. Considering its services to the PLHA and vulnerable people, it has got a small projects from National Federation of Women Living with HIV/AIDS (NFWLA) and the District AIDS Coordination Committee (DACC) of Rupandehi.

Though HIV/AIDS has been a widespread phenomenon in Nepal, PLHA of Nepal from rural areas are deprived and been refrained from the urgent services. They have been abused and exploited in different places. AJSS is committed to change the distressful condition of the PLHA and their families. As we are mostly illiterate from rural areas we are almost neglected, not trusted and forgotten by the donors and projects because they have to travel from their bastions of comfort. Whereas our members are dying because of lack of nutrition, minor treatments, fear and anxiety, TB and other opportunistic diseases.

Therefore we would like to appeal with all our friends that illiterate and poor PLHA from remote and rural areas should get more attention, otherwise they will die without knowing what hit them. There is almost no services for them whereas others at the centre are getting all the services. It is always a fight between centre and periphery for services. The centre always has all sorts of services. We do not want to be slaves of centre and depend upon their left overs. We want to voice for our rights over resources. We need to put first for the reason of equity. If supported we are committed to organize PLHA in the district levels and equip them to provide necessary services in their own areas.

If you have some empathy for dying PLHA from remote and rural areas, please contact us ;
————
Asha Jyoti Sahayog Samuha (AJSS) of Rupandehi, Nepal
c/o Women Acting Together for Change (WATCH)
Golpark, Rupandehi
Post Box NO.: 27
Rupandehi, Nepal
Tel.: 977 01 543905
Fax: 977 01 543905
E-mail: ashajyotirpd@gmail.com
Email: watchrup@wlink.com.np

Asha Jyoti Sahayog Samaj (AJSS)

sanchitdangol — Wed, 04 Aug 2010 17:25:52 +0000

Introduction:

Asha Jyoti Sahayog Samaj (AJSS) is a nonprofit making, non-governmental organization established and registered at Rupandehi District Administration Office of Nepal by people living with HIV/AIDS (PLHA) of the district in accordance with the prevailing Social Welfare Act of the country in 2006. It attempts to advocate for the PLHA’s basic and the health rights and address the issues of PLHA of the district.

Objectives:

AJSS expects to achieve the following objectives;

1. To instill light of hope and positive thinking in the life of people with HIV and AIDS
2. To increase awareness and advocate against hatred, social stigma and discrimination associated with HIV/AIDS
3. To raise awareness and provide counseling services to protect people from HIV and STI transmission.

4. To strengthen the AJSS by organizing capacity building activities to its members
5. To promote economic independency among PLHA through income generating and skill based training activities
6. To organize lobbying and advocacy activities to secure the right of the PLHA and to provide care and support activities for the benefits of the PLHA

Programs:

The following programs and activities are conducted by the AJSS;
1. HIV/AIDS and STI education program
2. Primary Health Care services Program
3. Nutritional Support Program
4. HIV/AIDS Counseling
5. Capacity building program to the PLHA
6. Stigma, Discrimination and violence prevention program
7. Advocacy and interaction for the quality and needful health care services through government and non-government organizations

8. Home and Community Base Care and Support

Preface:

“Asha Jyoti Sahayog Samaj” is formed with purposes to raise dignity, self-esteem and self-confidence of PLHA against the social, economic, family, legal, psychological, physical hatred and discrimination imposed to the people living with HIV and AIDS in Rupandehi District.

Major Actions by AJSS

AJSS has undertaken the following activities until now;
- Street procession and street drama of PLHA on the occasion of AJSS’s General Assembly
- Organization of National Condom Day, World AIDS Day and International Candle Light Memorial Day
- Care and support services to PLHA
- Life Skill Training to PLHA and the care taker
- Training on Opportunistic Infections and Treatment Adherence to PLHA and the care taker
- Nutritional support to PLHA

- Scholarship support to children of PLHA
- Moral and nursing support for PLHA
- Interaction and networking against stigma and discrimination against PLHA
- Monetary support with collection from fellow PLHA in event of death of poor PLHA
- Referral and linkages for the referral to PLHA for primary health care, prophylaxis treatment, ART services
- General, school, community and workplace based awareness raising activities about HIV/AIDS and sexual diseases
- Peer group meeting and PLHA get together activities

Save Eyes-Save Lives Campaign!!

sanchitdangol — Sun, 17 Jan 2010 06:12:23 +0000

DO U BELIEVE? GIVE US THE COST OF A CUP OF TEA,WE WILL GIVE LIFE BACK TO 100S OF POOR AND NEEDY EYE PATIENTS. Youth Eye Service (YES)- an organization established in 1995 to help poor and disadvantaged people in gaining their eyesight- announces SAVE EYES-SAVE LIVES CAMPAIGN !! Please cooperate, collaborate and contribute to reduce avoidable blindness in Nepal. For your kind information, the brief introduction of the YES is as follows;

About YES

Eyesight is one of nature’s wonderful gifts. However, in Nepal, this gift is being threatened due to various factors. Lack of eye care awareness, superstitions and a lack of eye health centers in the country have been the major causes affecting people’s eyesight. Other contributing factors include poverty, illiteracy and the geographical challenges of reaching many rural areas.

The lack of proper services in the eye health sectors has considerably worsened the situation. People do not get proper and timely treatment, or cannot afford to travel to the capital city and pay for the treatment they need. All these factors have contributed to too many cases of preventable blindness and other preventable permanent damage to the eyes.

The Nepal Netra Jyoti Sangh (NNJS) states that 17% of the Nepalese population suffer from one kind of eye health problem or another. The NNJS further estimates that every year 42,000 people become blind in Nepal, 80% of which are reventable or curable.

To respond adequately to these pressing issues, in 1995, a group of young enthusiastic people in the eye health sector created a non-government, non-profit forum called the Youth Eye Service (YES) with the motto- Moving towards the Brightness.

Since then, YES has been very active in mobilizing and training volunteers and in providing eye health services to disadvantaged communities in dire need of proper eye care. YES is proud to be successful in gradually expanding its coverage areas and nature services with the moral and financial support of its volunteers and contributors. In its own way, YES is also contributing to the objectives of the Vision 2020 program which aims eliminate avoidable blindness by the year 2020.

Goal:

To reduce avoidable blindness among poor and disadvantaged people through prevention activities and quality eye care service in Nepal

Objectives:

To provide free quality and user-friendly eye services targeting the poor, illiterate and deprived, mainly the elderly and children
To provide mobile eye clinic service to disadvantaged communities
To raise eye health care awareness in schools and poor communities
To contribute to research programs in the field of eye health care

Activities:

On its own or in partnership with government organizations or NGOs-

YES holds regular eye camps and follow-up camps in various parts of the country.
YES organizes awareness programs on eye health for the general public.
YES holds regular eye check ups in schools and trains teachers about eye health care.
YES promotes awareness on the importance of eye donation in society.
YES conducts research-oriented activities (survey, data collection and analysis).

Major Accomplishments:

By 2009, more than 43,000 patients (including more than 9,000 school children) benefited from YES eye care services, 455 people have regained their eyesight after cataract surgery and 240 volunteers/school teachers have been trained in basic eye health care.

You can help YES by:

Financial assistance
Technical assistance
Providing equipment, medicine & books
Sponsoring various activitie
Valuable suggestions

Contact Office:
Youth Eye Service (YES)
Chalkhu Marg, Teku, Kathmandu.
(Opposite to Eastern Gate of Buddhabare Complex)
Contact Phone#: 977-01-4238079

Postal Add: GPO Box: 8050, Kathmandu

Email: youtheye@wlink.com.np, youtheye@hotmail.com

About AJSS

sanchitdangol — Sun, 17 Jan 2010 06:00:27 +0000

Kapilvastu- District:

Kapilvastu is one of the bordering districts of Nepal with India. There are 77 VDCs and 1 municipality (Toulihawa) in the district and the total population is 481,976. In spite of its importance in historical, archaeological and tourism point of view, it is one of worst districts of Nepal in terms of Human Development Index (HDI) and socio-economic development indicators and the people of the district are very poor, unemployed and marginalized. As a result, the political situation of the district has remained fragile for a long time and several armed groups are also active to be involved in looting and killings.

HIV/AIDS in Kapilvastu

HIV/AIDS has been a growing concern in the district as number of people with HIV infection is increasing every passing day. Majority of PLHA are from migrant workers and their families while few of them are female sex workers (FSW). According to a recent report, there are a total of 280 people tested HIV in the district. Altogether 108 PLHA (41 female, 39 male and 25 children) have been associated with AJSS so far. Out of them, 13 PLHA (including 5 children) has passed away due to lack of proper care and treatment as of now. AJSS has regularly met the PLHA associated with it for CHBC services and counseling as well as awareness activities. There are still 95 PLHA (including 8 children) with AJSS now. Although AJSS has become successful increasing number of PLHA taking treatment and care services to some extent, the number is not enough in comparison to the existing and ever increasing number of new PLHA in the district.

HIV/AIDS Programs in Kapilvastu

Apart from massive poverty and illiteracy, social stigma and discrimination (S & D) are main obstacles for the easy access of PLHA to health services. There are only few organizations working in the field of HIV/AIDS in the districts. There is only one government hospital. It lacks sufficient services and cannot also provide quality services. For the service like CD4 cell testing, ARV treatment, OI treatment and PMTCT, they need to go to Kathmandu (Capital city). PLHA and their family members are not aware of the fact that the basic medicines like Vitamin B complex, cotrimoxazole, iron and etc are available with the local health posts free of costs. Majority of PLHA are from the rural areas and there is very poor transportation and communication systems in the district to take the services from the district hospital. There is not even a crisis home for PLHA in the district yet.

Vulnerable Situation of the People Affected and Infected by HIV/AIDS in Kapilvastu

In addition, PLHA and their family members are not conscious about the need of nutritious food and hygienic environment. People infected and affected by HIV/AIDS are very ignorant about recent development in service availability and government’s policy concerning the HIV/AIDS and PLHA. So, the life of PLHA is in the risk.

About Asha Jyoti Sahayog Samuha, Kapilvastu:

Asha Jyoti Sahayog Samuha is the first PLHA’s nonprofit making, non-governmental organization to be established and registered in District Administration Office, Kapilvastu, Nepal by people living with HIV/AIDS (PLHA) of the district in accordance with the prevailing Social Welfare Act of the country in Nov 2006. It attempts to advocate for the PLHA’s basic and the health rights and address the issues of PLHA of the district.

Register #: 431/063/064 (District Administration Office of Kapilvastu)

Programs of Asha Jyoti

Asha Jyoti has organized several interactions and workshops with district authorities, health personnel, political and social leaders so as to increase enabling environment towards PLHA and increase access to quality health services since its inceptions. It organized delegation of its members and presented demands of PLHA to the concerned authorities twice in 2007. In addition to organizing special days and running community awareness raising events, It has been conducting monthly meetings, training on OIs, CHBC, referral meetings and counseling session to increase the number of PLHA and their family members receiving check up and treatment (TB, OIs, CD4 cell testing, ART and PMTCT etc.) by developing self-esteem, self-efficacy and treatment seeking behaviour. It has already accomplished a 7 month project on care and treatment service to PLHA with the grant support from National Association of PLHA, Nepal (NAPN). As of now, AJSS has helped 28 PLHA for TB screening (5 on treatment currently) and, 19 for CD4 cell testing (15 taking ARV) from Kathmandu. AJSS has played an important role in reforming and strengthening the District AIDS Coordination Committee (DACC) of Kapilvastu and has become successful to become one of its core members.

Organization Contact Address:

Ms. Kamala Sunar (Cell #9847135277)

Shiv Mandir Tole, Hatbazar

Toulihawa Municipality, Ward No. 2, Kapilvastu District, Nepal

Telephone #: 977-076-561079

Email: ashajyotikpl@gmail.com

Dhrubatara-Nepal

sanchitdangol — Sat, 15 Aug 2009 08:02:25 +0000

Background:

Nepal is among the poorest and least developed countries in the world with more than one third of its population living below the poverty line. In spite of the huge potentiality for the use of its human and natural resources, Nepal has not yet been able to capitalize them effectively for various reasons and thus, is lagging far behind in its socio-economic development.

As a result of massive poverty, political instability and a couple of other reasons, majority of Nepalese children are living in a pathetic life situation and are deprived of their rights including the right to life, right to protection, and right to education and capacity building. Though Nepal is obliged to ensure child right in reference to UNCRC (United Nations Convention on the Right of the Child, 1989) as being state party for, there is still a long way to go to fulfill its commitment for child protection and promotion in the country. Realizing the situation, Dhrubatara Nepal came into existence to be a part of the national effort on child right.

Introduction:

Dhrubatara Children Development Society (Dhrubatara Nepal) is a non-profit and non-governmental social organization established and registered at District Administrative Office, Kathmandu in 2004 by some youth enthusiastic to volunteer for human cause. The main objective of the organization is to provide moral and financial support to disadvantaged children and orphans for their education and overall development. The organization is named after a poor (lonely), but a wise child, Dhruba, who was placed in the north sky as a bright star, Dhruba-tara (polar star), by his country men recognizing his persistent hardworking (struggle) and generous contribution to the society in spite of the fact that his parents had abandoned during his childhood, as per a Hindu mythology. Being inspired by the story, the organization aims to make every child a wise, intelligent and energetic as well as socially responsible citizen like Dhruba so as to establish human values in the society of Nepal. The organization believes that the childhood is the foundation of an efficient and productive citizen of future but it is only possible if we provide them child friendly learning and growing opportunity/environment.

Specific Objectives:

To work for equal and civilize society for the rights and opportunity of children through the maximum mobilization of available resource, mean and information
To provide scholarship, stationary and implement non-formal education program for the most vulnerable children to increase their educational status
To decrease the all kind of social stigma, discrimination and harassment against children
To implement diverse health program to improve the health situation
To implement special program for the physically challenged children to orient them into socialization process
To carry out different kinds of survey, research and investigation for the welfare and development of children
To carry out skill development program to improve the economic situation of the poor and disadvantaged families

Current Activities:

Education Support:

Dhrubatara Nepal has been providing school sponsorship support to 50 vulnerable children from different parts of Nepal since its beginning. Under the support, it pays school fees and bears the cost of uniform, stationary and books of the children. Besides, its volunteers make visit to the homes and schools of children for their supervision and monitoring. Out of the total, 3 completed School Leaving Certificate (SLC) Exam in the year 2009. Under the program, it feels privileged to support a daughter of a victim (Bishnu Lal Maharjan) of historical people’s movement 2006.

Dipesh Pant is from Syuchatar, Kathmandu. His father was died while he was studying in class V in 2004 AD. His mother was unemployed so Dhrubatara-Nepal provided him a school sponsorship support. He has got distinction marks (87%) in the SLC exam this year (2009)

Nabin KC (Right) got the first division marks (73%) in the SLC exam this year. Like Dipesh, Nabin is also one of those supported by Dhrubatara-Nepal for education. Both of them are happy with their results and express their commitment to support poor children of their society in the future.

School Support:

With the grant support from Rotary Club of France, Dhrubatara Nepal helped 2 public schools of rural areas of Kathmandu. It helped Shree Panchkanya Higher Secondary School of Syuchatar-8 for the construction of its boundary wall and library while Amarjyoti Higher Secondary School of Syuchatar -5 for the establishment of its library. In Panchakanya, there are about 200 students and above 600 students in Amarjyoti.

New library

Non Formal Education:

In 2008, Dhrubatara-Nepal ran 2 non-formal classes for 9 months targeting out-of-school children of Syuchatar and Naxal, Kathmandu. Altogether 40 children of 8 to 15 year’s age group were benefited from these classes. The children were from street and out-of-school children and after graduation, 50% of them is reported to join formal school in a nearby area.

Non-Formal Education of Naxal, Kathmandu

Niva Manadhar (Left) and Benjila Maharjan (Right) are from Kirtipur. Niva’s mother died 7 years ago and father a year ago. With 3 sisters and a younger brother, she is living with her second mother. Benjila is living with her old grand parent and mother. She is the lonely child to look after her family because she was just a 7 day's baby when her father passed away. Dhrubatara Nepal is supporting for their education. Now both of them are studying in grade 9 at Hilltown Int’l Higher English Secondary School, Kirtipur.

PROFESSIONAL REALIZATION AMONG FEMALE SEX WORKERS

sanchitdangol — Wed, 29 Jul 2009 22:15:33 +0000

A Case Study of Street Based Sex Workers of Kathmandu

I have come to post the summery, conclusion and recommendation of my dissertation, Professional REALIZATION AMONG FEMALE SEX WORKERS: A CASE STUDY OF STREET BASED SEX WORKER OF KATHMANDU”, that I submitted to Tribhuvan University for the Partial Fulfillment of the Requirement for the Master Degree of Arts Degree in April, 2003. Though we have passed almost 6 years since then, as a community development worker, I see no positive change in the situation of the women at-most-risk. So I think the document is still relevant and hope that concerned agencies and people can find important issue related with the sex workers from it.

1. Summary

The urban centers are emerging as the hub of the sex trade, where women are installed into a machinery process to mould them to fit in the sex racket. One very recent study states “… there are about 6,000 sex worker in Pokhara” (THT, 2003). Several studies previously have proved the existence of sex workers in the Kathmandu valley. The sex workers are purely human beings, but made to absorb the profession by deteriorating socio-economic condition of the country and, no doubt, some sects of human beings themselves are fueling the situation to aflame. But they are extremely conditioned to work as non-human beings. This study, thus, is keenly focused on the street based sex workers (SBSWs) of the Kathmandu.

This study is based on field survey, the data and information of which are taken from the SBSWs with a semi-structured questionnaire for the insider’s viewpoint. The study has adopted the purposive sampling and 20% of the total population of 150 SBSWs, who have already identified themselves as street based sex workers. This came out to be 30 women who were spotted in the field and residents where they were interviewed. The data collected from them were also verified with the data from observation and key informants for the outsiders’ viewpoint. The collected data and information are analyzed by using percentage and tables.

Under the conceptual framework, it was analyzed that sexually active women are guided to the sex profession by pushing and pulling factors of the society. It is an easy way for them to earn money, but there are several constraints too, which always makes them reflect on their profession. But the factors leading to them to the profession are so strong that the constraints are felt to be loosened. The professional realization might thus proceed since, they can hardly return back from their profession. This study attempts to explore, analyze and describe the very matter of; professional realization amongst the street based sex workers of the Kathmandu Valley. Specifically the objects are.

q To analyze the background and the present social and economic status of the SBSWs

q To assess the knowledge and attitudes of the SBSWs towards STI, HIV and AIDS and contraceptive and condom use.

q To highlight the types of clients, and SBSW’s sexual behaviour with the clients.

q To explore the reasons and period for SBSWs entering the sex profession, the problems they faced in the profession and their realizations towards the profession

……………….. are the places, which were previously in the media coverage as centers for SBSWs. These places are junctions for people from different field to pass through and come around for various purposes: marketing, refreshing, waiting for appointments and so forth. A large number of people are also seen to come with the purpose of quenching the thirst of sexual desire too. Those who have a view to see these matters can see bargaining activity in different points. This proves that several centers are becoming favourable places for sex workers to solicit the clients with the sexual thirst across the valley and the majority of them using the lodges for sexual intercourse, though they have to pay higher amounts from what they earn.

The SBSWs are from different part of the country, as 83.33% respondents are from the outside the valley. Of the total population, 63.33% is illiterate and the heads of 50% of the respondents’ households are illiterate. Thus, the educational background of the respondents is not good and significant numbers of family heads are either illiterate or just have primary level education or only a few of them have a secondary level of education. The respondents are distributed across different caste or ethnic and religious groups.

Ninety three percent of the respondents have been married, but only 60% were found still married. Some of them were still with their husbands, but they do not have harmonious relationships with their husband due to the economic situation of the family and the drinking and pressing habits of their husbands among others. Thirty percent are divorced or separated and 3.33% are widowed. The marriage age of 46.67% of the respondents falls below the age of 16 years, 75% of them had got married before the age of 20 years. Ten percent of them were pitiably even below the age of 11 when they had had first sexual contact. Including those still unmarried, the average age of the respondents’ first sex contact falls at the ages of 16 to 17 years, the age when they had still not crossed the stage of adolescence. The picture becomes disgraceful when the respondents attribute it to the forceful rape. Direct rape cases were found among 6.67% of the respondents while the other 10% had first sexual contacts with relatives.

The family occupation of respondents varies, like agriculture (33.33%), wage labour (23.33%), service, store keeping (10%), and others (23.33%). Most of the respondents’ (56.67%) family occupation was not satisfactory, as being agriculture and wage labour while those employed in a foreign country have been separated for more than 4 years. Due to various reasons, most of the respondents have children relying on them; or in case of some respondents, they were providing support to families in the countryside. Respondents seemed to have harmonious relationships of the very good category with the family and husband. Most of the respondents reported bad and okay relationships and quite a small percent of the respondents had relationships of the good category with the husband and family. Some respondents had escaped from their houses many years ago due to discontent in the families, while some of them (6.67%) had remarried after having long term quarrels with the first husband. Thirty Three percent reported to have entered their profession after marriage, while 30% after their divorce. Though the respondents showed various reasons for entering this profession, the main reason for entering the profession is for fulfilling the family requirement, as there is no second alternative for livelihood. Only 3.33% percent reported that her sexual contact was initiated with the client.

There were many different situations and stories that the respondents stated had compelled them to follow this profession. It did not happen over night or in a day and without any reason. It is because they generate income so easily, what someone expects in this profession. After coming to the profession, they had faced several hurdles. They have to remain or be mobile in the market place where they can find someone who recognizes them and be shameful if it becomes known about their profession. Sixty three percent of respondents were mobile and the remaining 36.67 % were confined to one place. They had no appropriate place for the sexual intercourse other than lodge (86.67%), where they had to pay more than Rs.200 out of the amount gained from selling their flesh rudely to clients (rude in the sense that out of the total 105 responses on the client’s behaviour, 45% negative behaviours were recorded from the respondents.). They reported that only in some cases the SBSWs had a chance to walk to the clients’ room. Three fourths of the respondents were recorded to be abused by the clients in the last six months, despite being aware of these possibilites. The abuses ranged from the looting of money, clothes and jewelry, forcing them to submit to whatever position the clients wanted, gang sex, mutilation and not giving money as agreed. Frequent police raids had to be faced in the street as well as in the lodges, making the situation further problematic.

As for the sexual activity, 50% of the respondents reported that they did not use to care about the sexual desire of the client. Majority of respondents replied that they just came to the profession for money and for that ……………….

The risk of STI was always there and recently HIV infection has also created a pressing situation amongst the sex workers, since unsafe sex with an HIV-infected patient is one of the modes of its transmission from one person to another. As most of the respondents were illiterate as aforementioned, awareness among them is a difficult job; it involves a long time, even in the case of the educated, to disseminate the knowledge of STI and HIV/AIDS properly. The majority of respondents (96.67%), however, have knowledge of STI and HIV/AIDS and the treatment of STI (100%) was also recorded satisfactorily due to the endeavors of the organization working in the respective field. It is possible the non-symptomatic STI remained unseen and unknown to the respondents. They have now started to go for check-ups, even though they do not have such suspicions. But the contraceptive use (40%) and consistent condom use (66.67%) was not satisfactorily found among the respondents. This indicates that the prevailence of STI and HIV/AIDS was higher among them. All of the respondents reported that clients do not like to use condom due to reduction in pleasure. But some respondents reported clients coming with condoms in their pockets these days.

Information/knowledge about the modes of transmission was found in the majority of the numbers. Ninety Three percent knew of unsafe sex with the person with HIV, 83.33% of HIV infected blood, 93.33 % of injection used by HIV positive and 73% of HIV positive mother to child. However, 86.67% of the respondents knew the use of condom as the prevention of HIV/AIDS. Half of the respondents replied that avoiding multi-sex partners and still 10% replied using other family planning methods, as methods of prevention of HIV/AIDS. Still, 3.33% remained unaware of modes of transmission and the methods of preventing it.

The pregnancy of the respondents was also reported. Out of the 30 respondents, 23.33% have got pregnant from sexual intercourse with the clients. Most of them had aborted the foetus. One respondent was found pregnant during the interview, it was one of the people who reported that her client was only using condom sometimes or not consistently. Her husband was reported to be employed in foreign country but she was thinking of giving birth to the baby for it had already been seven months.

The attitude of the ordinary people was not reported as favoring to them. Over half reported that they were hated in the society, while some reported that they did not care. Only a few respondents (6.67%) reported a feeling of having love from their neighbors. Only 53.33% had a good feeling about the profession, yet 30% feels bad and 16.67% just okay. The level of satisfaction in the profession varies: 53.33% reported they were satisfied but 43.33% were not satisfied. Similarly 33.33% of the respondents wanted to continue this sex profession. Contrarily, 36.67% wanted to leave, 20% had not decided at the time and 10% reported they could leave at any time.

Coming to the point of the idea of the respondents on liberating and organizing the sex trade, 83.33% of the respondents were in favour of it, while 16.67% were not found convinced with the idea and they fairly opposed the idea. Those favouring the idea replied that the organizing and liberating of the profession would not allow them to live in fear, ordinary people would not hate them, police would not arrest them unnecessarily. Those opposing the idea suspected that there would be an increment in the number of sex workers resulting in deterioration in the set socio-cultural and traditional values of the society.

2. Conclusion

On the basis of the finding of the study, one can derive the conclusion as given below:

Women from different caste, ethnic and religious background and come from different parts of the country are attracted by the lucrative business of sex work of Kathmandu and other urban affluent areas of the country for various reasons. The socio-economic, socio-politic and socio-biology in general and massive poverty, abject illiteracy, soaring unemployment situation in particular are behind the thriving situation of the sex trade in Nepal.

The sex business historically came into existence with the emergence of family and marriage systems in the social development process. But it was traditionally confined to the high caste, elites and landlords who used to exploit women belonging to the lower socio-economic strata, but now it has touched the general public that came with the globalization, urbanization and economic development systems triggering widespread expansion of the sex trade in the society. The concentration of economic activities in the urban centers have left other rural areas marginalized in every respect thus paving way to people migrating from their villages to the urban areas including Kathmandu which have been turned into the hubs of sex trade. The massive flow of women into sex work is because of unemployment and thus finding no other alternatives for providing even two square meals to the family, especially for their dearest own, viz. children. In the context of Nepal, the majority of the sex workers have two options at their disposal: either to commit suicide or to get involved in sex business. But they are also aware of the social stigma attached to it.

Sex workers are usually blamed for the social insecurities, other misbehaviors and conditioned to set into the corner as the “fallen” ones in societies. But the data in fact reveals that, despite social stigma and discrimination against them they are serving the clients from different walks of life in the current society. If HMG or any actor in the urban areas abruptly stops the kind of the business they are carrying out, its repercussion in the society would be unimaginable. In view of the aggressive behavior of male stock of people who are in satisfying their momentary sexual desires might be further aggressive which may have impact upon the normal women who may be walking in the streets regardless of time and places. The data favors a saying that there is a possibility that we would witness more incidents of rapes and other sexual harassments in urban centers. Even people who are supposed to be giving protection to the ordinary people are indulging themselves into having contacts with women. They are powerful people and are the ones who have immense desires and they might opt for a different option, which may turn into rape and harassment cases.

The awareness of STI, HIV and AIDS is in the rise among sex workers. It is noteworthy that consistent and correct condom use is probably the only way for preventing HIV and STI transmission. Despite the awareness programmes in this area, they have still not consistently practiced safer methods and thus still are in the high risk for transmission of STI and HIV. Solidarity and empowerment activities among themselves might create amicable situation for them to refrain from the abuse and hatred associated with the profession and at the same time to adopt the sex methods thereby reducing the risk of STI and HIV infection cases in the societies resulting from sexual contacts with multiple partners.

The term “prostitution” (Besyabriti in Nepali) has been generally used for the sexual activity opted for money and other benefits and “prostitute” (Besya in Nepali) as an identity, for a life long period, to the women involved in the sex business. But people, in recent times, have started to replace the term “prostitute” with “sex worker” (Yaunkarmi in Nepali) from the professional viewpoint. The possibility of interpretation of sex worker as an occupation rather than identity is in the card with the likelihood that they will no more remain as a prostitute or sex worker once they give up the profession. The sex workers have started to take their activities as their profession and also realize the social conditioning that has impacts upon them. The emerging professional realization, in changed social context, among the street based sex workers, is undoubtedly unprecedented and in effect they might enter into the mainstream of the society and put their potentialities in the social development.

Since a large chunk of women has already joined this profession and others are in the process of entering into it, there seem no other options than to recognize them and their profession. It is high time that the practice and behaviours of the state machineries including the police administration, court and other actors should abide by Nepal’s current constitution and agendas of international conventions associated with the sex workers’ rights. The sex workers should be treated as human beings as well as a segment of the sovereign people of the country. By the same token, they also should have a right to the concept of the fruit of the law-governed society. Had the socio-economic development of the country had in a right track, the number of women fixed in the trade would have reduced and the pouring of the women into the trade would have automatically diverted to a different direction in their favor. Recognizing the sex trade as the profession is a new phenomenon and a challenging one for a country like Nepal and appears non-conventional too, but may be one and the only way to change the prevailing unsympathetic situation in the society.

3. Recommendation

Sex workers

q As sex workers are increasingly found to have absorbed sex work as their profession, they will be expected to strictly consider all the things that are relating to their profession, including the things which hampering to people other than themselves. After all they are the part of the society, and thus they must always be taking the well-being of society into account as well.

q As they are being made aware of STI, HIV and AIDS, it is also expected that they will practice safer sex and take precautions since the spreading of STI, HIV and AIDS will also threaten their profession.

q The issue of girl child and women trafficking has soared in the country for several decades; most of them were related to the sex trade in the cities of neighbouring countries. Such cases have however not yet been found in case of the sex trade in Kathmandu and other urbans of the country. Sex workers must not attract or lure the other naive women and girl children to the sex profession. This can restructure the social set up with dire consequence of breaking the norms and values of society as well as normal human rights situation of the country.

q Sex workers are conditioned to remain on the sideline from the mainstream of the society. Sex workers and other people are the two sides of the coin even though they are its first victims. If once they endeavor to walk alongside the mainstream of the society, how long other people will be successful in putting them further to that condition.

Development organizations and workers

q The study found that the recent endeavors of the development organizations are encouraging and this has brought momentum on the issues of STI, HIV/AIDS and sex work. But the majority of these organizations confine their work merely to health related issues, proving that they are not really concentrated on the crux of the issue and engaged in the transformation of society.

q The sex workers are the by-product of the socio-economic phenomenon and process. As such organizations are considered to be one of the vehicles of the development in society, they should be attentive to confirm and address the root causes of the problem and act accordingly.

q The development organizations should be involved in many levels, from the grassroots level to national level advocacy workshops in favour of the sex worker’s rights issue, against girl’s trafficking, against sexual abuse and other issues relating to the sex workers.

Government body and political party

q The increasing number of sex workers in the valley and across the country has primarily resulted from abject poverty, massive illiteracy, shortage of the implementation of human resource development programs for rural people, unemployment and market oriented programs and policies. The government and political bodies must formulate the programs and policies which emphasize poverty alleviation, free education, imparting vocational and community-based skill oriented trainings and education, creating employment opportunities in local and national levels. The implementation part of these programs and policies should be accountable towards the target people. If socio-economic development process takes its own course, women opted for the sex business automatically direct towards their favourable profession and no other people should have to forcefully stick them to follow any direction.

q The sex profession is an age-old issue, and it has now become fixed in the society as a part of the employment sector for those who are poor and less educated. Thus legalization and provision for organized sex trade in the law must be done to help helping to those who have already entered the sex profession. This will be helpful to them to take it as a profession. When the sex workers begin to realize sex work as their profession, they will certainly give concern to their career and profession. This will no doubt help in controlling over the alarmingly spread of STI, HIV and AIDS across the world.

q The literature review reveals that blame should be placed on the politicians, police, army and other ruling bodies for giving rise to the sex trade through their involvement in the activities like the girl trafficking, catering of women in wars in Nepal and being clients across the world. The ruling bodies and their mechanisms, which are considered to be leading the society and nation, need to perform consistent behavior toward all walks of life including women.

q The government should formulate, revise and practice rules and regulations to address the issues like the girl trafficking, sexual abuse and management of the sex trade, and mechanise to implement them effectively.

Map of Nepal

sanchitdangol — Sun, 19 Jul 2009 16:50:04 +0000

Naturally Nepal

sanchitdangol — Sat, 18 Jul 2009 19:07:23 +0000

Swayambhu

Geography

Nepal is a landlocked country of the South Asia, 400 km long and 200 km wide. It is situated between two giant countries- China in the north and India in the South -covering a total area of 147,181 sq km. Geographically, it is divided into 3 regions- Mountain, Hilly and Terai (Plains) with respectively 15%, 68% and 17% area of land from the North to the South. Kathmandu is the capital city of Nepal. I live in Kirtipur, a historically and culturally important town of Kathmandu.

Landscape of Nepal

Population

The total population of Nepal is 29.52 million- (Men 49.05% and Women 50.05%) in 2008 and its national (population) growth rate is 2.095% (2008). Nepal is a homeland of many castes and ethnic communities with different culture, religion and language background like Brahmin, Chhetri, Newar, Tharu, Magar, Tamang, Rai and Sherpa etc. There is a harmonious existence among Nepalese with an innate culture of “Unity in Diversity”. Its major language and religion are respectively Nepali and Hinduism. I belong to Newar – the indigenous community of Kathmandu having its own culture, language and dialectics. Kathmanu is known as the city of ancient temples, Durbar squares (Royal Palaces) and feast and festivals.

Economics

Nepal is among the poorest and least developed countries in the world with more than half of its population living below the poverty line. Agriculture is the mainstay of the economy, providing a livelihood for three fourths of the population and accounting for 38% of GDP. Its per capita GDP (Gross Domestic Product) is US $1000 and the GDP- growth rate is 3.2% in year 2007. Nepal’s currency is Nepalese Rupees (NRs.) and US $ 1 is currently equivalent to around NRs.75.00. Agriculture, tourism and hydropower are potential source for Nepal’s economic development. As Nepal is a mountainous country, the development of irrigation, transportation and communication infrastructure and systems has become its major challenges. Nepal is a federal democratic republic country. The king’s rule was abolished in mid-June 2008. There are president as the chief of state and prime minister as the head of government.

Natural Resources

Since Nepal is rich in natural resources we call it “Naturally Nepal“. There are some animals and birds that are found only in Nepal such as the Spinny Babbler. Nepal is also host to a large number of Rhododendron species. Wildlife of Nepal includes its flora and fauna and their natural habitats. One can find many endangered animals in Nepal- like Tigers, Leopards, Rhinoceros, Marbled Cat, Red Panda, and Tibetan Fox. There are a large number of rivers of which the Himalaya is the source. The experts say that Nepal has a capacity of generating hydropower of more than 80 thousand Megawatts.

Tourism

Nepal has been one of the well known destinations for world’s tourists and travelers for a long time. In tourism’s point of view, Pokhara (city of lakes), Kathmandu (culturally rich city) and Lumbini (birth place of Lord Buddha) are some of the important sites. Nepal is also famous for the snowy Himalayan range of the North side, trekking routes, national parks, rafting and paragliding. One can find eight of the world’s ten highest peaks in Nepal.

Bouddha

Literacy, Health and others

In Nepal, about 48.6% people from the age 15 and over can read and write according to the national census, 2001. Likewise, life expectancy at birth is 60.94 years in 2008. There is an increasing number of private nursing homes and medical institutes equipped with modern technology in the urban centers alongside the public hospitals. Though the health status of the population in Nepal is still poor in general, significant improvement in maternal and child health is attributed to the expansion of public health services towards the rural communities. However, Nepal lacks the system of effective mobilization of medical professionals/experts and use of technologies is not sufficient to address the real need of people. The lack of potable water and sanitation, adulterated food supplies and paucity in medical facilities are major contributing factors resulting in the poor state of health. The major infectious diseases found in Nepal are bacterial diarrhea, hepatitis A, typhoid fever, Japanese encephalitis and malaria.