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Ravi Thapa*, a 31-year-old with HIV, was admitted at a reputed hospital in Sunsari. One of the nurses threw medicines at him. She was scared to come near him. The doctors too were reluctant to check in on him during their daily rounds. His room was never cleaned—the staff never bothered to empty the trash. His wife complained, but the hospital administration blamed the patient for ‘bringing HIV to the hospital’. Thapa says visiting hospitals is the last thing he wants to do, even if he needs medical attention. Khagendra Khadka, president of the National Association of People Living with HIV/AIDS in Nepal (NAP+N), has been living with HIV for  26 years. Six months ago, he had a dental appointment. “I told the doctors that I have HIV. Perhaps that was my mistake because it delayed my treatment,” he says. He was then told to do a battery of tests that, he believes, was a way of chasing him away. “The treatment went smoothly at another hospital, where they didn’t know about my condition,” he adds. Khadka says this is nothing unusual. He has been in such situations numerous times since he was diagnosed. Anik Rana Magar, an LGBTIQA+ rights activist living with HIV for the past 25 years, says that nurses write ‘HIV positive’ in bright red letters above a patient’s bed. “This makes people stare out of curiosity. It completely violates a patient’s personal space,” she says adding doctors even deny taking on patients with HIV. Shivaram Giri, national coordinator of NAP+N, says the situation is as vexing if not more for those requiring surgeries. “Doctors deliberately push back the date of surgery to a month or so later even in critical situations. They want the patient to seek treatment elsewhere,” he says. Giri shares an incident that happened at the Tribhuvan University Teaching Hospital (TUTH) in Maharajgunj: A person with HIV was taken to the emergency room after an accident. Everyone there, he claims, was scared to be near the patient, causing much chaos and delaying treatment. These are only a few representative cases that show how people with HIV are treated at hospitals. According to data from National Center of AIDS and STD Control (NCASC), there are around 30,000 people currently living with HIV in Nepal. Most of them are migrant workers, drug users, sex workers, and individuals belonging to the LGBTIQA+ community. Majority of them are facing the same problem at every hospital department except at the Antiretroviral Therapy (ART) clinics, says Pinky Gurung, president of Blue Diamond Society (BDS). “Two years ago, we had to lose a friend as Bir Hospital was not willing to admit the patient,” says Gurung. Many hospitals, she adds, have told her to take HIV patients somewhere else. “When someone is in need of immediate medical attention, how do they expect us to run to another hospital?” she questions. Gurung, on several occasions, has found medical professionals openly denying to treat the infected or carry out their surgeries. This, she says, goes against the medical code of ethics passed by the Nepal Medical Council Act 1964 which states that in no circumstance can a doctor refrain from treating a patient. Dr Purnima Shakya, in-charge of ART clinic at Bir Hospital, says this is the outcome of how HIV has been perceived by our society for years. “People link HIV with having multiple sexual partners,” she says. This clouds the mindsets of even those in the medical field. They are much more comfortable working with infections more contagious than HIV. But HIV makes them uncomfortable. “It’s not an excuse but it’s true,” she says. Dr Bhola Rijal, a consultant gynecologist and former director of TUTH, verifies the claim. He says he has seen it happen all too many times. There are, he says, many misconceptions about HIV/AIDS among people in Nepal. “Only those who have worked closely with the infected have a better understanding of this issue,” he adds. Bleak situation  This reality weighs heavily on those living with HIV. As they fear being judged and mocked,  many refrain from testing for HIV, even when there are clear signs of infection, says Samata Bam, program coordinator at Cruise Aids Nepal, an organization that works with/for the infected. “Even if they do get tested, they don’t come for follow-ups. They don’t want to be seen near ART clinics because of societal stigma,” she says. Worse, many don’t seek medical aid even when they are severely ill. “They know it might cost them their lives yet they choose it over the discrimination they know they will face at hospitals,” says Bam. Binod Kumar Gupta, ART counselor from Meeting Targets and Maintaining Epidemic Control (EpiC) Nepal, says it’s already difficult for patients to accept their test result. “Many patients have discontinued their treatment because they would rather be in denial than take lifelong medication,” he says. Terrible treatment from hospital staff pushes them even further from acceptance. This has led to a number of suicides and suicide attempts among people who are unable to adjust with the new reality of being infected by HIV. Despite that, every month there are around 25 new HIV positive results out of the tested 150-200 individuals only at Sukraraj Tropical and Infectious Disease Hospital in Teku, Kathmandu. Manju Adhikari, chief of the ART clinic at the same hospital, informs that only few of the infected people are willing to get treated. In the fiscal year 2021/2022 according to the World AIDS Day 2022 factsheet, published by NCASC, there were a total of 1,365 reactive (may or may not be positive but is certainly not negative) cases out of the 97,455 tested for HIV infections, which is lower in comparison to the past years.  “Even if the statistics show the number of people with HIV is decreasing, there are a lot of cases unaccounted for,” says BDS president Gurung. “The situation was slightly better 10 years back when there was a lot of media support,” says Giri of NAP+N. “That’s not the case anymore. There’s very little reporting and awareness.” Government’s take Dr Samir Kumar Adhikari, deputy spokesperson at the Ministry of Health and Population (MoHP), says that the responsibility of working on anything HIV/AIDS related mostly falls under the jurisdiction of NCASC. And it has, he adds, has been working continuously to make our society friendlier for people living with HIV/AIDS. “Our job is to assist them,” he states. Lok Raj Pandey, senior health education officer at NCASC, says the government body has done its part to spread awareness and ensure a better environment, medically as well as socially for people living with HIV. He, however, denies the HIV infected face discrimination at hospitals. “We have not received such complaints so I can’t say with certainty if that’s what is happening,” he adds. On the other hand, activists and organizations ApEx talked to say they have relentlessly lobbied for the rights of people living with HIV/AIDS. Bam mentions that a bill to secure the rights of people with HIV/AIDS has been submitted in the past, but the government agencies have remained hostile. “There is nothing to protect the rights of people living with HIV till this date,” she adds. Khadka from NAP+N says the government also lacks space for people with HIV to lodge a complaint. “We don’t know where to go with our problems,” he says. He agrees with Bam on the fact that there aren’t any laws or policies that will back up those living with HIV when they face discrimination, not just at the hospitals but also in other sectors. Only a few days back, he says a child from Rautahat was not allowed to attend the school after they found out about his infection. “We had to change his school since there was no policy that could support our case,” he says, “even when the National Child Rights Council (NCRC) was on our side.” Although the government has done its part to provide the infected with free ART services, medications, and counseling, Khadka feels the same effort cannot be seen in terms of raising awareness about HIV/AIDS, especially among medical professionals. Dr Rijal believes that unless the government is willing to advocate about HIV/AIDS all year round, like they do on World AIDS Day, it’s highly unlikely for people living with HIV to get better healthcare in the future. *name changed

Two students have been raped in Sundarharaicha of Morang district. Police said both of them are 14 years old and eighth and ninth graders at a local school. The incident came to light after the parents started searching for the children, who had gone to the school, did not come home. DSP Deepak Shrestha of the District Police Office, Morang said that they had left home for the school on Friday. They had gone to Gaushala of Sundarharaicha to see a volleyball match after they found the school closed on that day. According to a preliminary investigation, Sachin Timinsina (20) of Sundarharaicha-2 and Pratap Tamang (23) of Sundarharaicha-6 lured the duo to a hotel and raped them. Police said that they kept the girls overnight in separate rooms on the second floor of the Hotel Inn Restaurant and Lodge at Belgachi in Sundarharaicha-7 and raped them. The parents urged police to search for the girls after they did not come home till late night. They returned home only on Saturday. DSP Shrestha said that they knew about the incident after the girls told their parents about the incident. Police arrested Timinsina and Tamang based on the complaint filed by the parents. They had filed a complaint at the Area Police Office, Belbari on Sunday. A team deployed under the command of Inspector Khagendra Dhamala nabbed them from their homes. Police have also apprehended Padam Karki (20) of Sundarharaicha-6 for helping Timinsina and Tamang. It has been learnt that police are preparing to send the girls to the Koshi Hospital in Biratnagar for the health check-up.    

Simrik Air has rescued a Spanish climber who slipped and injured his leg while climbing Mt Amadablam in Solukhumbu. Zapata López Soje Manuel was rescued from the height of 6,300 meters of Mt Amadablam. Simrik Air rescued him by using a long line rope. He was brought to the base camp soon after rescuing him from the mountain. Later, he was brought to Kathmandu by a Simrik Air helicopter for treatment. Manuel was climbing Mt. Amadablam on Sunday. The incident occurred between the second and third camps. He had gone for mountaineering from the 8k Expedition Company. Simrik Air pilot Siddharth Gurung, rescue specialist Chiring Dendup Bhote and Ang Tasi Sherpa rescued Manuel from Mt Amadablam by using a long line. They used the long line as it was difficult to land the helicopter in that place. “We succeeded in rescuing Manuel even in the bad weather condition,” Sherpa said, adding, “We faced difficulties in rescuing him due to strong winds. Despite difficulties, we continued our rescue efforts.”  

Pokhara Regional International Airport is set to celebrate its formal opening with the start of the year 2023. On Jan 1, an international flight is set to make its first touchdown on the airport’s runway. Binish Munakarmi, chief of the airport project, says aside from a few technical and logistical bumps that need smoothing, they are ready to launch the airport by the set deadline. The airport has been a long time coming. Its genesis goes back to the early 1970s when the government acquired land for the project. But the actual work would not start until 2016 due to decades-long political, bureaucratic and financial hurdles. Pokhara, the city of lakes, is one of the most visited tourist destinations of Nepal. It is the gateway to the Annapurna mountain region that draws tens of thousands of foreign trekkers every year.  So, naturally, opening an international airport in the city is only a matter of common sense. More tourists equals more revenue, but there is a catch. The $300m Pokhara airport project was built with a $209m soft loan from China’s Export-Import Bank (Exim). As per agreement, 25 percent of this loan is interest free and the remaining lending is pegged at an interest rate of 2 percent, which is higher than that of other multinational financial institutions. Besides Exim, Asian Development Bank and OPEC Fund for International Development have also supported the airport project in the forms of loans and grants. Understandably, there is the excitement that Pokhara is finally opening its own international airport, but there is also the anxiety of financial sustainability. Nepal will have to start paying back Exim from March 2023. To date, there is no clarity as to how the loan will be repaid. The main sources of income are landing charge and rentals. But the expected revenue will be insufficient to repay the loan. Anup Raj Joshi, the airport spokesperson, says they plan to raise flight numbers—both international and domestic—and include night flights to generate revenue. Officials expect to earn Rs 250m from domestic flights alone. But this is just a projection and it remains to be translated into reality. And even if the airport did make the projected turnover, it will be only enough to cover the maintenance and operation costs. There will be other additional expenses as well. Sabin Phuyal, senior accounts officer of the airport, says the Civil Aviation Authority of Nepal (CAAN) would cover those expenses. So far, Himalaya Airlines of China and Jazeera Airways of Kuwait are the only international carriers that have agreed to launch flights to and from Pokhara. No other international airlines have signed formal agreements to connect their flights with Pokhara Regional International Airport. Jagannath Niraula, CAAN spokesperson, says they are hopeful more international airlines will sign agreements once the airport is up and running. He believes that Pokhara airport is more viable than two other international airports of Nepal. Kathmandu’s Tribhuvan International Airport is the oldest and the busiest airport in Nepal. The second, Bhairahawa’s Gautam Buddha International Airport, which launched its international flight services in May, is struggling to attract both flights and passengers. There is a clear lack of inter-agency coordination and communication on how to increase the number of flights in the new airport. The city’s tourism potential is the key to the success of the airport but throughout the airport development project, the local tourism council has largely stood on the margins. Pom Narayan Shrestha, chairman of Pokhara Tourism Council, says they have more recently participated in interactions with CAAN, Nepal Tourism Board (NTB) and other concerned bodies in regards to the launch ceremony of the airport. If the airport and CAAN officials are willing, he says they are ready to make contributions from their side. Krishna Acharya, a local tour operator, says they have not received any call for support from concerned authorities. Annapurna Conservation Area attracts a great number of foreign trekkers every year. Pokhara is the main starting point for travelers visiting the area, but the Annapurna Conservation Area Project (ACAP), which looks after the overall aspects of this protected area, does not know what is going on with the airport. Raj Kumar Gurung, who heads the Pokhara office of ACAP, says they are rarely invited to the meetings concerning the airport development. Kashi Raj Bhandari, director of NTB Gandaki Province Office, admits they could not promote the airport from the tourism development aspect as well as they would have liked. Still, he is optimistic about more international airlines connecting their flights to Pokhara in the near future.  In order to promote international flights and bring in more tourists, he says NTB Gandaki Province Office and CAAN are already in talks with almost a dozen international airlines. Not everyone shares Bhandari’s optimism of Pokhara international airport becoming a success, at least not in the short term. It is going to be a long haul journey to success.