NEWS: Nepal, TB & the Sex Trade

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Jyothi Kanics---Global Survival Network (
Wed, 11 Nov 1998 13:37:07 -0800 (PST)
South Asia Correspondent Daniel Lak reports

             Medical experts are warning of the threat of a tuberculosis
             epidemic in Nepal as the sex trade in South Asia helps fuel
             the spread of diseases.

             The poverty and cramped living conditions of much of rural
             Nepal means a disease that the developed world thought had
             been conquered is, in fact, thriving.

                                 Tens of thousands of Nepalis
                                 die from TB every year - despite
                                 countrywide efforts to spread
                                 awareness and treatment.

                                 Three-year-old Bishnu Maya
                                 caught tuberculosis from her

                                 She says: "We thought she
                                 was going to die when she first
                                 got sick. She had this horrible
                                 swelling on the side of her neck
                                 and she was coughing a lot.
             Now she'll be alright - she's going to be cured."

             Now Bishnu and other TB patients make the daily half-hour
             walk to a clinic where they get treatment.

                           The little girl is given a daily cocktail of
                           drugs to bring the disease under control.

                           TB becomes resistant to treatment if all
                           the medicine is not taken so a local
                           health worker watches to make sure that
             Bishnu competes the whole course.

             Potential disaster

             It is safe to say that Nepal has declared war on tuberculosis,
             and the battle is well under way.

             But Dr Ian Smith of the World Health Organisation says there
             is still the potential for disaster:

             "Over half the people in Nepal have been infected with TB -
             in other words they have the potential to go on and develop
             the active disease.

                                 "We estimate that over 100,000
                                 people in the country, at this
                                 moment, have TB. Half of them
                                 have infectious TB -
                                 transmitting the disease on to
                                 other people. So the potential
                                 for a huge epidemic of TB

                                 About 90% of Nepal's people
                                 live in remote rural areas and
                                 villages. But the cities are
                                 where the TB problem has
                                 become most acute.

             Many of those who live in the countryside will some day
             move away to find work in Kathmandu - or even in India - and
             that migration has added a chilling new factor to the already
             disturbing epidemic of tuberculosis.

             Sex slaves carry disease

             For years women from Nepal have been kidnapped or lured
             away to become prostitutes in Bombay's infamous red light

             Many come back infected with HIV which makes it almost
             certain they will get tuberculosis and pass it on.

             Abserra is two - she has TB and is HIV-positive.

                                 Her mother died from Aids a
                                 few months ago - still mourned
                                 by the other women who lived
                                 and worked with her in a shelter
                                 in Kathmandu.

                                 Aids and HIV infection are
                                 common here - largely due to
                                 the years these women spent as
                                 sex slaves in Bombay.

                                 They live at the shelter because
                                 they are not welcome in their
                                 villages. But their deteriorating
                                 health is already part of an
             HIV-fuelled wave of new TB infections in Nepal.

             "We were at the brothel one night and the police raided and
             took me away. They sent me back to Nepal. I started having
             chest pains when I was in India but in Nepal I was coughing
             up blood - I was really sick," one told me.

             Nepal's only hope comes with keeping their children healthy -
             and that means keeping them separate from infectious TB
             sufferers. It is essential across Nepali society as a whole for
             the health of an entire generation.

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