Tuesday, January 29, 2008

From Nepal to India: Trafficking and the HIV/AIDS Crisis

From the American Chronicle:

Nepal is certainly an important country globally for urgent HIV/AIDS interventions? UNAIDS predicted two years back that Russia and India were going to be the two largest centers for the future AIDS epidemics, though both countries are able to expertly handle any kind of pandemic when push comes to shove. In fact India's projected rate of 50 million next to South Africa's 56 million, is now hugely diminished re-totaling to only 21 million, but still a large figure nonetheless. China too has nearly 27 million known HIV infections. Both countries are capable of intensive AIDS patient care and produce their own anti-retroviral treatment based total health care packages.

Where would that leave Nepal, which is the only country that India shares an open border with? Has anyone thought about it seriously? The alarming fact appearing to both Indian and Nepali media these days is that a large number of Nepalese girls and women are trafficked to India and known to be engaging in the commercial sex trade in Indian brothels substantiating a decade old ILO estimate. There are only a handful of NGOs that work in this sector among the 6,500 registered at the national level.

Just imagine this likely scenario. A quarter of Nepal's female commercial sex workers numbering around 100,000 of a total 200,000 were infected with HIV or had full blown AIDS (a 2005 estimate that is quoted in You and AIDS, UNDP web portal), came back and got married into Nepalese communities, gave birth to Nepalese children, and infected their Nepalese spouses.

According to the UN website, "a major challenge therefore is to control HIV in the country is the trafficking of Nepali girls and women into commercial sex work in India, and their return to practice in Nepal. About 50 percent of Nepal's FSWs previously worked in Mumbai, India and some 100,000 Nepali women continue to engage in the practice there. The National Network against Girls' Trafficking, an Indian coalition of approximately 40 NGOs initially established to tackle the problem of girl trafficking, has also begun to address the issue of HIV/AIDS".

But many of the remaining have got married to Indians in Indian cities and stayed back. What kind of crises would Nepal and India jointly face in the future? Certainly, on of the most staggering geo-strategic cross-border security and human development challenges facing any two countries in the world requiring 'quick brew' interventions, availability of an international pool of knowledge bank experts, vast quantity of ART drugs, hospitals and hospices, 'stand-by' financial resources and workable intervention strategies comparable to a hidden, springing math formula.

It would be a major diversion from the two countries' development budgets and a loss of human lives as more people died of AIDS related illnesses. Are we capable of handling such a scenario in Nepal? The answer again is NO!"

The author of this stark and alarming article is Surya B. Prasai, a Nepali national who has written extensively on issues of the environment, HIV/AIDS, the United Nations, and migration, often with inclusion of Nepal's issues. The scenarios and figures Mr. Prasai discusses, however, are not only concerns he has. The Journal of the American Medical Association produced a report in August 2007 entitled "HIV Prevalence and Predictors of Infection in Sex-Trafficked Nepalese Girls and Women," which produced the following results among 287 repatriated Nepalese victims:
  • 38% tested positive for HIV,
  • Girls who were trafficked prior to the age of 15 were at increased risk for HIV with over 60% of this group testing positive for infection,
  • Girls who were trafficked prior to the age of 15 were also at greater risk of being detained in multiple brothels with longer periods at each one,
  • Additional factors associated with HIV positivity included being trafficked to Mumbai and longer duration of forced prostitution
In a New York Times article, written at the time of the release of the report, Dr. Jay G. Silverman, professor of human development at Harvard's School of Public Health as well as the lead author of the AMA report had this to say:

Girls from China's Yunnan Province sold to Southeast Asian brothels, Iraqi girls from refugee camps in Syria and Jordan, and Afghan girls driven into Iran or Pakistan all appear to be victims of the same pattern, he said, and are presumably contributing to the H.I.V. outbreaks in southern China, Afghanistan and elsewhere.

"Most authorities fighting human trafficking don't see it as having anything to do with H.I.V.," Dr. Silverman said. "It is just not being documented."

Brothel owners pay twice as much for young girls, Dr. Silverman said, and charge more for sex with them, sometimes presenting them as virgins, because men think young girls have fewer diseases or believe the myth - common in some countries - that sex with a virgin cures AIDS.

"It's absolutely heartbreaking, "Dr. Silverman said. "Some of them are just shells - and shells of very young human beings. It's every father of a daughter's worst nightmare."

"About half of those tested had been lured to India by promises of jobs as maids or in restaurants. Some were invited on family visits or pilgrimages and then sold - sometimes by relatives. Some were falsely promised marriage. Some were simply drugged and kidnapped, often by older women offering a up of tea or a soft drink in a public market or train station," Dr. Silverman said.


  1. I like your thoughts, friend. I spent four months in Calcutta, India working with an NGO that helps women out of the sex trade. We spent time with the women and watched them bloom into their new lives of freedom...it was quite a scary thing to walk into...but there is hope. so much hope.

  2. Thank you for your comment. What kind of work were you doing in Calcutta? Are you still involved in similar work? I spent last year working with human trafficking NGOs in the Philippines. It was an amazingly difficult, powerful and eye opening experience for me. And despite the grand scope of the issue, the impact that some of these NGOs are able to have on a local and even national or international level is incredible. Im very interested in hearing more about your experience.

  3. My search ended to this page as I am working on the issue..I am from India and have worked with many organizations,but in rape Crises Cell.right now I am working under an exchange programme and placed in Nepal and learning about trafficking. This article of yours helped me a lot..to learn about the issue...but you know NGO's have limitations, either they don't have much scope to do things or they don't want to go beyond...they start with too much passion and enthusiasm but it dies with the time..I just hate it. when I was in Delhi it was to painful to see those 2 years old girls being raped or sold.Many of those girls were homeless and hopeless. Even me, being just a worker at a local NGO could not do even if I wanted to and I always felt bad about it and still feel so.