HIV prevention in the cultural context of Nepal
Condom day celebration
Von Bharat Rijal / Schweizerisches Rotes Kreuz SRK
Have you ever celebrated ‘National Condom Day’? Won the condom-blow competition? Visit Nepal during the main festival season and participate in this yearly fun event organised nationwide by the Nepal Red Cross Society. A whole day is dedicated to the condom, breaking the taboos of HIV. And this happens already since more than 14 years.
In the traditional Hindu society of Nepal people are not open to talk about sex, sexuality and reproductive health issues. Only behind closed doors women would talk to each other about their contraceptives and reproductive rights. Information about sex is mainly passed on among peers, prone to transmitting wrong information and fostering superstition. Even though reproductive health is included in the school curriculum of health and physical science, embarrassed teachers skim over those subjects or only superficially deal with them.
Condoms were introduced and promoted in Nepal since 1978 as one of the family planning devices. Even though they are available in health clinics, pharmaceutical outlets and retail shops, the public awareness and use of condom is still low. In a study conducted by the Swiss Red Cross’ supported ‘Community Eye Care and Health Project’ of the Nepal Red Cross Society (NRCS) only 29% of the respondents stated to have used a condom when last time having sex. (Annual Report 2008)The main reason is the difficulty of wives to negotiate on condoms in the male dominated society like Nepal. Another important barrier is the misconception that condoms are to be used only for extramarital relationships. Thus purchasing and marketing of condoms has not been an easy task in most areas of Nepal.
The origin of Condom Day
In 1993, during the tenure of the ‘Reproductive Health Project’, the NRCS staff working in Udaipur district decided to hold an exclusive event on the condom, in order to disseminate information of contraceptives in 5 districts. When organized for the first time, people were shocked about the open discussion and display of condoms. However, despite all personal hesitation and shyness, the local people showed a huge interest to know more. Inspired by its success and in the light of the growing HIV epidemic in Nepal, NRCS decided to launch this event nation-wide. Since 1995, every first Saturday after the Hindu festival Dashain, the time when family members and migrants from within Nepal and abroad return to their homes for the holidays, is set as the National Condom Day. This special event, originally targeting male and female community members for family planning purposes, is meanwhile focusing on the importance of condoms in prevention of HIV and AIDS. Thus the day is particularly designed to reach migrants, youth and risk groups but also the general public.
Games and fun
Nowadays the celebrations not only involve the Nepal Red Cross, but all stakeholders in the area of health and HIV prevention participate. National Condom Day is used as a kick-off to many more events and campaigns throughout the month. The Ministry of Health, Non-Government-Organizations, school children, positive people, sex workers and other groups organize different activities allowing people to learn more about HIV and AIDS, stigma, positive living, and reproductive health issues in a playful way. Processions and rallies with people dressed like condoms and carrying placards, puppet shows, street theatre, films around the theme of HIV and AIDS, concerts, dances, fairs, posters and pamphlets, games and competitions with packets of condoms as prizes, are attractive awareness raising instruments.
Red Cross volunteers wearing special tags, caps and T-Shirts displaying the years particular theme, are ready to answer questions during the events and at special information stalls. The stalls at the border to India are open for the whole month targeting the returning migrants from India before reaching their home villages.
Breaking barriers and taboos
An estimated 2,500,000 people are directly reached every year through this
unique event and many more through media transmission. Whereas in the past parents
would forbid their children to be part of the celebrations, the participation
of young girls has increased every year. (Statistics of the National Centre
for AIDS and STDs Control, December 2008) Dealing with the sensitive issue of
condoms so openly has helped to break barriers even within generations. Due
to the enhanced awareness and publicity, also accessibility of condoms has improved.
A grocery shop keeper in Jumla reported that in the past he would insist that
the customers who asked for condoms disclose their marital status. “I refused
to sell condoms to unmarried persons. Now I have completely changed my attitude.
I am aware now that condoms protect lives from the deadly disease of HIV&AIDS,
so I do not care any more whether my customers are married or not. I just want
to save their lives.”
The increased condom promotion and awareness has also influenced the policy level. Only in 2002 the National Guidelines for Family Planning Service stated that adolescents, irrespective of their marital status, are granted access to family planning services and free condoms. (Adolescent Youth and Reproductive Health in Nepal, Status, Issues, Policies and Programmes, January 2003) Over the years of observing Condom Day, discussing sex, sexuality and HIV and AIDS openly in Nepal’s society has become much less a taboo.
*Bharat Rijal is the Senior Field Coordinator of the Swiss Red Cross in Nepal. Contact: firstname.lastname@example.org
Facts on HIV and AIDS in Nepal
According to the data of the National Centre for AIDS and STD control, by December 2008 12’933 cases of HIV were reported, among which 2’151 persons are living with AIDS. 187 cases of HIV and 48 cases of AIDS were newly registered in December. The second highest case detection rate is among housewives, giving evidence that HIV has spread far beyond the traditional risk groups of injecting drug users and clients of sex workers, and manifests itself in the general population. Given the hidden nature of the problem, the actual size of the infected population is likely to be considerably larger. It is estimated that 72,000 of people of Nepal living with HIV and AIDS.