People on the move

Jeevan Karki and Kesh B Malla

DEC 12, TKP - International labour migration from Nepal has a longstanding history, and it has become a growing phenomenon in recent years. Migration to the Gulf is a relatively new trend which commenced about two decades ago. The exodus to India, however, goes back a long way. The movement to India where a large population of Nepali migrant workers resides is undocumented due to the open border between the two countries. Migration to foreign countries is growing faster than before whatever could be the cause — political instability, conflict, natural disasters, unemployment or poverty. About 80-90 percent of the households in the Far Western Development Region have at least one male member residing outside the country, mostly in India, as a migrant worker.

The labour migration, which has also played a key role in improving Nepal’s human development index (HDI), is an increasingly important livelihood strategy of the country. Despite the fact that the remittance sent home by Nepali labour migrants has improved the living standards of their families and contributed to the national economy (about 20 percent of GDP), HIV/AIDS has become a key and crucial issue.

According to studies, high rates of HIV are found among migrant workers. In Nepal, over 70,000 adults (15-49 years of age) are estimated to be living with the HIV virus. Labour migrants make up about 40 percent of the total known HIV infections followed by clients of sex workers and injecting drug users. Nepali migrant workers, especially in the Far Western Development Region, returned from India have a high prevalence of HIV/AIDS and sexually transmitted infections. Since the disease has spread to various places of Nepal through returnees from cities in India, particularly Bombay (now Mumbai), the disease is also called “Bombaiya rog” in some districts. The disease has already impacted the hundreds of migrant workers and their families. Therefore, labour migration that is being considered a boon to the national economy and poverty reduction could turn into a bane in terms of its long-term economic implications for the country.

As most of the migrant workers are illiterate and unaware of HIV/AIDS, the disease is spreading fast through this group. Many migrant men workers visit brothels during their stay abroad, and having multiple sex partners and lack of condom use puts them at risk of contracting sexually transmitted diseases and HIV. A large proportion of migrant men workers who purchase sex are also married. They carry HIV back to their homes and transmit it to their innocent wives in the village. In west Nepal, HIV and AIDS, mostly spread through migration, has already become a big challenge to the development of the region.

There are multiple consequences when a migrant worker gets infected with HIV and AIDS. First, there is a very high probability that he will infect his wife. The rising figure of HIV-infected housewives in far west Nepal justifies this notion. The infected migrant worker’s family faces a financial crisis as he is sent back with little compensation or no consideration as soon as he is found to be HIV positive. On the other hand, expenditure on treatment increases significantly. People living with HIV and AIDS (PLHA) are being discriminated against and stigmatised severely in society. Not only him, his wife and children are also treated in the same way.

The consequences of AIDS spreading among the migrants will be much bigger than imagined, much higher than the income being made. Therefore, it is high time that a strong initiative is launched to prevent HIV and AIDS among migrant workers. Effective migrant-focused intervention is necessary with a special emphasis on the Far Western Region. Labour migrants should have access to information, education and communication materials regularly and easily.

In high out-migration districts, a mechanism may be developed at the village development committees (VDCs) to give information on HIV and AIDS before the jobseekers leave home and after their return. The district development committee, the VDCs and I/NGOs can collaborate in this endeavour. Programmes must go beyond targeting migrant men at their places of origin within Nepal. Therefore, the government of Nepal and I/NGOs should partner with like-minded organisations working with Nepali migrants abroad such as in the cities of India. Men and women need to be made aware of HIV and AIDS, and women need to be further empowered.

Thanks are due to a number of I/NGOs and government bodies that have been actively and consciously involved in raising awareness in the communities, providing treatment to PLHAs and helping the affected families. Nevertheless, they should extend their target geographical area to serve a larger population. And a long-term commitment is required from the I/NGO sector. Since labour migration is required to boost economic activities, a practical and strong strategy must be prepared to generate awareness among these workers. The country should also care for the migrant workers, not only their remittance!