AN ONLINE APPEAL FROM A HIV POSITIVE TO MAKE THE WORLD HIV/AIDS FREE

Namaste (hello),

My cordial friend of the beautiful world,
It's me Rama maya(Dhan kumari). I am a poor woman from rural village of Neapl - Todkesal of Achham District. Headquarter of this district is Mangalsen .It covers an area of 1,680 km² and has a population of 23,1285. It’s 400 km far from Kathmandu valley (capital of Nepal). It’s one of the poor and uneducated village of Nepal. It’s a hilly reason. Here is no facility of proper school for education, drinking water and electricity, transportations, communication and other day-to-day living things. 32 years ago, I was first open my eyes as second daughter of my family in this world. My grandma and father was unhappy when I was born because they wanted son of their family .In our village peoples emphasis to the son because they think the son take care them when they will be old and continue their dynasty. That’s why there is no good take care and education even good food to their daughter. It’s great problem of Achham and all rural parts of Nepal too. I have 3 sisters and 2 brothers. I just studied up to class five because government made education free for girl up to five at that time. My father Bir Bhadur was not interested to send me to school but my kind and loving mother Man Kumari send me school .I am so interested to study more and I wanted to became a good teacher of my village to change the women life in this village because women are living dog life there. My dream could not come true because of poorness of my family and father against of my education. And my school was 3 hours far from my village. Here is not good facility of school that’s why many children in this village left their school in the middle of their study. In these village peoples don't teach their daughters because they think, daughters go to other house after marriage why we lost our money to educating them .It makes them to depend upon their family and husband. After my school days, I spent all the day in housework to help my mother. She is good lady, she is the only lady of our village, who think to educate the lady and women.17 years ago when I was just 15,My parents got married me a village boy Dan Bahadur . Child marriage systems are there in the village. I am so happy that time because I got a hansom village boy with red chick as a husband. I don’t know anything at that time about marriage; I enjoy it as like as a doll game because I was just 15 years with a child mind.

Dan Bahadur is a nice guy .His family is also poor family with some land. He is only son of his family .His is only one brother of is 6 sisters. They all got married before our marriage .His father was died when he was only 5 years .His mother was also died after 6 months of our marriage .He help me in my every work .Our days was running happily. It's poor village, we just eat 4 to 6 months what we grow in our field. After 1 years of marriage, I gave birth a son as our 1st baby; we became so happy .Dan Bhadur was dancing with joy at that time. Our happiness was not stay too long. After 1 year of our child birth our field was caught by flood, we became landless .We didn’t have anything to eat, there were not any work in the village, then my husband decided to go to the neighbor country India in search of work. Most of the male people of this village go to the neighbor country India for searching works .He went to neighbor country for work .He sometime send money from there. After 8 months, he was gone to India I gave a cute baby daughter as my second child .My days were running to keeping them and I worked in the village to feed them. He came back from India after 5 years.1 years of his back to village I became pregnant at that time a NGO blood checking (HIV testing) camp came to our village. They took blood of many villagers to kathmandu for HIV test. They back to the village after one-month .In their reports 15 peoples are dented HIV positive out of 100, my husband and me as well. They found HIV virus in our blood. The blood camper told us its so dangerous disease and there is no treatment of it. There is a drug but it’s so costly, its need near 950 dollars (40,000 Nrs.) per months for taking the drug (at that time drug was not freely distributed). If you have money u can take drug if not, its only way is wait your death. When I heard it, I was just sock and became wordless, my lips were became dry and my husband was not accepting it. But its was true .All my happiness was gone that time. We did not afford the drug because it need huge amount of money that we don’t have. This disease is transform through my husband having sex with him .He is infected from HIV when he was gone to work in India. Lack of sex and HIV/AIDS education, he had unsafe sex with sex worker and got infected and infected me too .Its not only my story, its the story of many poor peoples of the village. Most of the uneducated and poor male people of our village go to the neighbor country in search of work. Long time staying there, they unsafe sex with sex worker and infected many sexually transmitted disease (STD) and HIV/AIDS too and came to home and transform HIV and Sexually Transmitted Disease (STD) to their innocent and uneducated wife and innocent children too .Its great problem of Achhan .HIV transmission rate is increase day by day here .No one is heartily interested in HIV prevention and HIV education in Achham. Government has started many programs in this field but not effective to control and prevent it. They all are urban and suburban areas oriented but not village oriented. Recent studies and surveys show that 325 peoples infected by HIV/AIDS in our village but it’s not facts. Facts is more then it .Its just official data. About 60,000 peoples of total populations (26500000) of Nepal are infected by HIV/AIDS .I gave a dead baby after I was infected. When people know me and my husband is HIV positive, the villager and my relatives too stared to hate to our family and stop all of the relation. They kick out us from the village, then my husband and me were decided to suicide but we didn't do it because of our children .We went to Kathmandu. At first we did not get any job or work in Kathmandu, we didn’t have enough of money to stay in hotel .We sleep in temple passage many nights and take food one time in a day because lack of money. After 6 days my husband got a job in as Garment Factory as a watchman then we sleep in that factory. After one month I got job as a labor .We didn't tell anyone about our disease and us because we were afraid of people hate ness. After one month of my job, We rent a room of a old house in Dmaitol near Hanumandhik as chip rate at 7 dollar (Nrs. 500). We are leaving dog life with our 2 children lack of money .We didn't send them school too because we could not afford it. In staying in kathmandu, I heard a INGO who re-habitat and teach about HIV/AIDS.I join there and take many class about it. It’s shown me positive aspect of life. They told me HIV aids can't fully cure but there is a drug which can help to slow the decreasing rate of our immune system and help us to live more life as a healthy people .Its is freely distrusted in government hospital .We can live many years as other not infected peoples live .It make me so happy .Me and my husband start antiretroviral drug from there. Their teaching and programmed give me a vibrant energy .Its break many myth of HIV/AIDS which I have .Its add happiness in my life which I was lost it many years ago .At that time I thought why these type of program not held in our rural village like Achham and I told myself I will start it in my village. I meet a European volunteer Caroline their .She took interest in my life story and promise me to help. Two days later she called me in their room and told me you must learn English language 1st. I accepted it and start learning English language with her at every night in her room. It makes me so happy because I am so interested in learning and growing from my childhood. It was not fulfill because of my poorness and my family too (expect my loving mother). After 6 months learning with her she admitted me in a language school of Bagbajar. I start learning English language and computer course too. It add new dimension in my life. I left the work of labor and fully involved in learning and growing and HIV Volunteer works. I took part in many seminars and programs on HIV/AIDS.I learn more about it and meet many people who are infected of this disease. It makes me courageous. I dream and promise to me from myself “I will make my beautiful village and rest of the world HIV/AIDS free”. I can’t fulfill it only myself, I need your love, supports and helps too. Now it’s not only my dream, it’s our dream. Caroline helps me in many things. She is really a good-hearted woman. I am so thankful to her. She admitted my children in a boarding school in kathmandu. After 6 years staying in kathamndu my husband seriously infected by AIDS, he shown different HIV symptoms and AIDS symptoms, after one year of it, he died, early symptoms of HIV shown on him many years ago when he back from the work of neighbor country .At that time I don't know any thing of this disease .Now I know his fever, diarrhea of that time was early symptoms of HIV . My husband death makes me so sad and I promise him I will wipe out of this disease from my village and rest of the world too. I decided to back my village and work there for their HIV positive people to make their life easier. With Caroline company, love, and suggestions make me courageous and bold. I have confidence to fight against of anything that is against of my dream and goal. I know that peoples hate and not make any relation to the HIV positive peoples because they don't know the truth of this disease. They only know myth of these disease .I decided to remove the ignorance by giving HIV/aids education to them and anyone will not leave their village like us from people misbehave and hateness of people. After 7 years staying in kathmandu I get back to my beautiful village with great dream and confidence to wipe out this disease from my village and any women of my village will not face any problem like me. I left my 2 children in Kathmandu for study. Caroline also helps me to hostel them. I saw the HIV positive peoples life is going bad to worse. I talk with them. When they talk with me tear were running continues in their eyes. It makes me so sad and gives me energy to fight against this disease. And I start struggling to remove people ignorance about this disease and disease too from my village .I am facing many problem and challenge in my village .I saw here are different kind of NGOs and INGOs working in then field but they are not effective because they all are in capital. They some time comes to the village and organized HIV testing camps, HIV education and other programs. They check their blood and find out the HIV positive people and told them,"You are HIV positive" and back to the capital .The HIV positive people who are known in the village are hated by the villager. They don't get any work in the village because the village people don't give them any work .Its create more problems to there life. They leave their village or they are psychology broke and get suicide. Many HIV positive got suicide in these days, these rates is increasing day-by-day .Its makes me so unhappy. I thought this problem can be solved my awareing peoples about this disease I mean HIV/AIDS education to both HIV positive and non-HIV peoples. The INGOs and NGOs fail in their goal because they are urban and suburban area oriented but not village oriented. They some times go to the village. They don’t know about that actual problem of HIV positive people in the village and they are unknown about the effect of their program in the village and life of HIV positive of the village .By knowing this, I decided to do something from myself to the helpless, poor, uneducated HIV positive people to uplift there life and lifestyle. I start interact with them and help to solve their problem. Then I design program to them and start in the village. It is helpful to them. Many HIV positive peoples are taking part in my program. In 4 month program, I saw that, its adding new dimension to their life, make them psychology strong and face their sociological and day to day problem with courage .I gave them antiretroviral drugs which is freely distributed in Government hospital but they don’t know anything about that. These drugs help them to live more life after HIV infection. My program adds more colors in their life. It makes me so glad. But at that time I faced a financial problem. Then I Back to Kathmandu to do something on it. When I came in Kathmandu I heard a bad news about Caroline, she was died in car accident when I was in Achham. It made me orphan and very sad. I met many people for help to my program but no one took interest in it. Then an idea came to my mind, why don’t share my dream and goal to “YOU”, then I used a modern powerful tool Internet to share my biography, problem and program with great hope. I hope you will love, support, help, guide and comment to me, we can make our beautiful world HIV/aids free. My future goal are: to open HIV testing center in the rural parts of the country, open HIV information center in different parts of the country, properly distribute Antiretroviral Drug all over the country and open a vocational training center for HIV positive to re-habitat and to create job opportunities. I know ”YOU” are with me. Your small helps and supports can add more life in HIV positive and cute smile in their children face. What you think????

It’s a summery of my "AUTOBIOGRAPHY “. I will write details in future for that I need your love, suggestions, helps and comments and guideline. You can suggest and comment me by email, which is given on right hand sidebar in CONTACT ME section . I will write my autobiography in monthly basis for you………….only you. I hope you will love it. It’s not only my biography, I m the representative of all rural HIV positive of Nepal.

At last,I would thanks to Mr. Hari Thapa for their technical support to write and update this blog.I am very geartful to him.

Lets make the world HIV/AIDS free …………………..together ……………From now........

Your's ,

Ram Maya (Dhan Kumari)

Todkesal, Acham, NEPAL

Email: mail2rammaya@gmail.com

WHAT IS HIV/AIDS?

HIV (Human Immunodeficiency Virus) is a virus that causes AIDS (Acquired Immunodeficiency Syndrome), a health condition in which a person is affected by a series of diseases because of poor immunity. HIV by itself is not an illness and does not instantly lead to AIDS. There is no way of knowing whether just looking at them infects someone. An HIV-infected person can lead a healthy life for several years before developing AIDS. However, during this period, he or she can pass the virus to others.AIDS is a health condition where the body’s immune system is gradually destroyed following an HIV infection. Over a period of time, the immune system weakens and the body loses its natural ability to fight against diseases. Eventually the infected person may lose weight and become ill with diseases like persistent severe diarrhea, fever, skin diseases, pneumonia, TB or tumors. At this stage, he or she has now developed AIDS

Origin of HIV

AIDS was first reported June 5, 1981, when the U.S. Centers for Disease Control and Prevention recorded a cluster of Pneumocystis carinii pneumonia (now still classified as PCP but known to be caused by Pneumocystis jirovecii) in five homosexual men in Los Angeles.
Three of the earliest known instances of HIV infection are:
A plasma sample taken in 1959 from an adult male living in Kinshasa, today part of the Democratic Republic of the Congo.
HIV found in tissue samples from "Robert R.", a 15 year old African-American teenager who died in St. Louis in 1969.
HIV found in tissue samples from Arvid Noe, a Norwegian sailor who died around 1976.
Two species of HIV infect humans: HIV-1 and HIV-2. HIV-1 is more virulent and more easily transmitted. HIV-1 is the source of the majority of HIV infections throughout the world, while HIV-2 is not as easily transmitted and is largely confined to West Africa.Both HIV-1 and HIV-2 are of primate origin. The origin of HIV-1 is the Central Common Chimpanzee (Pan troglodytes troglodytes) found in southern Cameroon.It is established that HIV-2 originated from the Sooty Mangabey (Cercocebus atys), an Old World monkey of Guinea Bissau, Gabon, and Cameroon.
Most experts believe that HIV probably transferred to humans as a result of direct contact with primates, for instance during hunting or butchery.A more controversial theory known as the OPV AIDS hypothesis suggests that the AIDS epidemic was inadvertently started in the late 1950s in the Belgian Congo by Hilary Koprowski's research into a polio vaccine. According to scientific consensus, this scenario is not supported by the available evidence.
A 2007 study published in the Proceedings of the National Academy of Sciences by Michael Worobey and Dr. Arthur Pitchenik claimed that, based on the results of genetic analysis, HIV probably moved from Africa to Haiti and then entered the United States around 1969.

Transmission

Since the beginning of the pandemic, three main transmission routes for HIV have been identified:

Sexual route. The majority of HIV infections are acquired through unprotected sexual relations. Sexual transmission can occur when infected sexual secretions of one partner come into contact with the genital, oral, or rectal mucous membranes of another.

Blood or blood product route. This transmission route can account for infections in intravenous drug users, hemophiliacs and recipients of blood transfusions (though most transfusions are checked for HIV in the developed world) and blood products. It is also of concern for persons receiving medical care in regions where there is prevalent substandard hygiene in the use of injection equipment, such as the reuse of needles in Third World countries. HIV can also be spread through the sharing of needles. Health care workers such as nurses, laboratory workers, and doctors, have also been infected, although this occurs more rarely. People who give and receive tattoos, piercings, and scarification procedures can also be at risk of infection.

Mother-to-child transmission (MTCT). The transmission of the virus from the mother to the child can occur in utero during the last weeks of pregnancy and at childbirth. In the absence of treatment, the transmission rate between the mother and child is 25%.However, where drug treatment and Cesarian section are available, this can be reduced to 1%.Breast feeding also presents a risk of infection for the baby.

HIV-2 is transmitted much less frequently by the MTCT and sexual route than HIV-1.
HIV has been found at low concentrations in the saliva, tears and urine of infected individuals, but there are no recorded cases of infection by these secretions and the potential risk of transmission is negligible.The use of physical barriers such as the latex condom is widely advocated to reduce the sexual transmission of HIV. Spermicide, when used alone or with vaginal contraceptives like a diaphragm, actually increases the male to female transmission rate due to inflammation of the vagina; it should not be considered a barrier to infection. Trials, in which uncircumcised men were randomly assigned to be medically circumcised in sterile conditions and given counseling and other men were not circumcised, have been conducted in South Africa,Kenya and Uganda showing reductions in HIV transmission for heterosexual sex of 60%, 53%, and 48% respectively. As a result, a panel of experts convened by WHO and the UNAIDS Secretariat has "recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men.Research is clarifying whether there is a historical relationship between rates of male circumcisionand rates of HIV in differing social and cultural contexts. Critics point out that any correlation between circumcision and HIV is likely to come from cultural factors (which govern not only whether someone is circumcised, but also their sexual practices and beliefs).South African medical experts are concerned that the repeated use of unsterilized blades in the ritual (not medical) circumcision of adolescent boys may be spreading HIV.

Is kissing can cause HIV?

Kissing someone on the cheek, also known as social kissing, does not pose any risk of HIV transmission.Deep or open mouthed kissing is considered a very low risk activity for transmission of HIV. This is because HIV is present in saliva but only in very minute quantities, insufficient to lead to HIV infection alone.There has only been one documented instance of HIV infection as a result of kissing out of all the millions of cases recorded. This was as a result of infected blood getting into the mouth of the other person during open mouthed kissing, and in this instance both partners had seriously bleeding gums.

HIV test

Many HIV-positive people are unaware that they are infected with the virus.For example, less than 1% of the sexually active urban population in Africa have been tested and this proportion is even lower in rural populations. Furthermore, only 0.5% of pregnant women attending urban health facilities are counselled, tested or receive their test results.Again, this proportion is even lower in rural health facilities. Since donors may therefore be unaware of their infection, donor blood and blood products used in medicine and medical research are routinely screened for HIV.
HIV-1 testing consists of initial screening with an enzyme-linked immunosorbent assay(ELISA) to detect antibodies to HIV-1. Specimens with a nonreactive result from the initial ELISA are considered HIV-negative unless new exposure to an infected partner or partner of unknown HIV status has occurred. Specimens with a reactive ELISA result are retested in duplicate.If the result of either duplicate test is reactive, the specimen is reported as repeatedly reactive and undergoes confirmatory testing with a more specific supplemental test (e.g., Western blot or, less commonly, an immunofluorescence assay (IFA)). Only specimens that are repeatedly reactive by ELISA and positive by IFA or reactive by Western blot are considered HIV-positive and indicative of HIV infection. Specimens that are repeatedly ELISA-reactive occasionally provide an indeterminate Western blot result, which may be either an incomplete antibody response to HIV in an infected person, or nonspecific reactions in an uninfected person.Although IFA can be used to confirm infection in these ambiguous cases, this assay is not widely used. Generally, a second specimen should be collected more than a month later and retested for persons with indeterminate Western blot results. Although much less commonly available, nucleic acid testing (e.g., viral RNA or proviral DNA amplification method) can also help diagnosis in certain situations.In addition, a few tested specimens might provide inconclusive results because of a low quantity specimen. In these situations, a second specimen is collected and tested for HIV infection.

WHO Disease Staging System for HIV Infection and Disease

WHO Disease Staging System for HIV Infection and Disease was first produced in 1990 by the World Health Organisation and updated in September 2005. It is an approach for use in resource limited settings and is widely used in Africa and Asia and has been a useful research tool in studies of progression to symptomatic HIV disease. Most of these conditions are opportunistic infections that can be easily treated in healthy people. The staging system is different for adults and adolescents and children.

Stage I: HIV disease is asymptomatic and not categorized as AIDS.
Stage II: include minor mucocutaneous manifestations and recurrent upper respiratory tract infections.
Stage III: includes unexplained chronic diarrhea for longer than a month, severe bacterial infections and pulmonary tuberculosis.
Stage IV: includes toxoplasmosis of the brain, candidiasis of the esophagus, trachea, bronchi or lungs and Kaposi's sarcoma; these diseases are used as indicators of AIDS.