Bandhs, or general strikes, have become such recurrent events in Nepal that even as people complain about them, they are resigned to them.  During a bandh, markets and offices are closed and public transportation is halted, bringing life to a standstill.  Anyone venturing out in a vehicle during a bandh would risk broken windows, punctured tires, or even having their vehicle set on fire at the hands of bandh enforcers.

Because bandhs generally last only for a day or two, Nepalis usually take them in stride, but in April 2012, Nepal’s Far Western Region underwent a bandh that lasted for 32 days.  For the more than 5,000 people living with HIV in the region, this was a life-threatening situation—particularly as nearly half of them are dependent on anti-retroviral therapy (ART).

ART is a complex treatment involving multiple medications that need to be taken at the same time every day over the long term.  With local transportation halted, people in remote areas had no access to government-run ART centers.

That’s where the USAID-funded Saath-Saath Project stepped in.

The Saath-Saath Project, which has been providing support to people living with HIV through community and home-based care (CHBC) providers (PDF), was aware that these individuals would soon run out of their regular supply of medicine due to the prolonged bandh.

USAID's community and home-based care team travels to visit people living with HIV at their homes in the Far Western Region of Nepal. Photo: USAID

So the Saath-Saath Project, its local NGO partner Asha Kiran Pratisthan, CHBC team members, and Seti Zonal Hospital joined hands on an innovative solution: they would distribute supplies using a method similar to a relay race.

They started by mapping the location of all HIV-positive individuals needing ART.  Then they began delivering medicines to these individuals, carrying banners that read “Delivering Essential ARV Medicine to People Living with HIV.”  The CHBC team members traveled by bicycle, motorcycle, and even on foot—some travelling more than 35 kilometers through difficult terrain—to deliver the needed medicine.

“I was stopped a couple of times by bandh enforcers, but after seeing the medicine inside my bag, they even apologized and let me go,” said Chhabilal Khadka, one of the CHBC team members and an HIV patient himself.  “In the end, the relief I could see on the clients’ faces gave me a sense of pride and fulfillment at having saved lives.”

Workers trained through USAID's Community and Home-Based Care Program provide care and support services and replenish essential medicines for individuals with HIV in the Far Western Region of Nepal. Photo: USAID

“My medicine had run out.  I was sharing another HIV patient’s supply and when that started running out, we began to panic,” said an HIV patient in the Kailali district, who declined to provide his name due to privacy concerns.  “But the CHBC team came to my aid in the nick of time.  I am forever thankful to these dedicated people for going through such risk and trouble to ensure the well-being of people like us.”


USAID’s efforts to reduce HIV in Nepal began in 1993 and have since contributed extensively to the Government of Nepal’s national HIV response.  Today, Nepal is emerging as one of the few countries that have made remarkable progress in meeting the United Nations Millennium Development Goals, including combating HIV/AIDS.