Reuters NewMedia - October 26, 2011
KATHMANDU, NEPAL (AlertNet) - In a residential area of Kathmandu, Nepal's
capital, neighbors are unaware of what goes on inside this
three-story building. Neighbors stare at the men, often dressed
in women's clothing and makeup, as they disappear inside.
The building is a hospice center for HIV-infected men who have
sex with men, MSM, and "meti," the term for transgender or "third
gender" people here. Blue Diamond Society, BDS, an advocacy group
for lesbian, gay, bisexual, transgender and intersex Nepalis,
runs the center to provide services for the most critical cases.
"Third gender people are often disliked by the society," says
Dibya Gurung, one of the residents at the facility. "Due to the
fear of discrimination, we often don't come out as HIV-infected."
Gurung, who is infected with HIV, comes from Tanahu, a district
about 150 kilometers west of Kathmandu.
He wears a green vest and a sarong-like cloth called a "lungi."
With pink bangles around his wrists, red beads around his neck,
his nose pierced, his ears decked with gold earrings and his
eyebrows neatly threaded, the 32-year-old looks like a woman. His
mannerisms and the way he talks are also feminine.
Although he has a man's body, Gurung says he leads a feminine
life. Because of this, he says he often has had to face social
Growing up, he says that he liked sitting with the girls in
school. But teachers disapproved, as girls and boys do not sit
next to each other in most of Nepal's schools. Because of this
lack of acceptance, Gurung dropped out of school after the fifth
Gurung says that he faced opposition at home, too. Unlike boys
his age, he preferred to do household chores and wanted to wear
his mother's and sister's clothes. Gurung's family started to
resent him, eventually forcing him to move to Pokhara, a tourist
town in central Nepal, and work as a dishwasher.
"Though I'm born as a man, I'm trying to live as a woman," a
tearful Gurung says. "It's actually a very tough job."
Born as Nandu Lal Gurung, he changed his first name when he got
older to Dibya, a unisex name that is popular mostly among women
here. In Pokhara, he says he met a man named Manoj Thapa and soon
fell in love with him.
After their relationship developed, Gurung says that Thapa told
him that Nepali society didn't respect people from the third
gender and asked him to elope in India. He lured Gurung with the
prospects of a good job and a better life in Mumbai, India's
largest city, which is notorious for human trafficking and
With a dream of getting married and meeting other transgender
people, Gurung traveled to Mumbai via the border town of Sunauli.
Upon arrival, Thapa introduced him to the "aunties" in the
brothel area for transgender people in Kamatipur, Mumbai's
infamous red-light district.
Gurung says he was happy to see people like him in the area. But
in no time, he realized that the man of his dreams had sold him
into the sex market.
"Manoj had actually duped me and sold me [to the brothel],"
Initially, Gurung worked in the hotel that the brothel owners
operated. But two months later, they forced him into sex slavery.
When he resisted, they forcefully restrained him, physically
tormented him, and allowed four or five men to rape him.
As a sex slave, Gurung says that he had to satisfy 10 to 12 men
every day. He says it was painful. He says that some of the men
who came into the brothel were handsome, and he liked some of
"However, it was like hell," he says, summarizing his experience.
And the experience only turned grimmer six years later when the
brothel owners sent him for a blood test. His test came back
positive for HIV. He says he thought the disease would kill him
Gurung says he wanted to return home and looked for opportunities
to escape. During a festival, he escaped to Nepal.
But at home, nothing had changed. He says people still didn't
like the way he walked, talked and dressed - including his
A decade ago, he decided to move to Kathmandu. Here, he met
like-minded people from BDS at Ratna Park in the center of the
city, where they usually hang out. He has lived at the facility
"I thought I would die immediately after contracting HIV," he
says. "But I'm still alive.
Now he lives and works as a caretaker at BDS. His
responsibilities include cooking for other HIV-infected residents
and also distributing condoms to other third gender people.
Still, he says he is lonely and can't be open with his family.
Gurung has been back to his hometown in Tanahu, but he didn't let
anyone know about his HIV status. He also had safe sex there with
a man who promised to marry him, an elated Gurung says.
But this turned out to be just a ploy to have sex with him. Now
he says he is alone, can't talk about his feelings to anyone and
"Most of the friends I have died of AIDS," he says. "I only wish
I had a husband [until] the day I lived."
Third gender people and MSM living with HIV say they face a
double stigma in Nepali society. BDS is one organization that
strives to educate and treat sexual and gender minorities when it
comes to HIV, as well as sensitize the community to reduce
ridicule and abuse. The government is implementing various plans
to address HIV here and is working on issuing citizenship cards
to third gender Nepalis to ensure their rights to access various
BDS is currently working with more than 300 HIV-infected MSMs
across the country, says Malika Lama, BDS care and support
program manager at the Kathmandu office.
About 6.2 percent of all HIV infections in Nepal occur in men who
have sex with men, according to 2009 statistics from the National
Center for AIDS and STD Control, NCASC, established under the
Ministry of Health and Population in 1995. Of 140,691 Nepalis who
identified as men who have sex with men in 2009, the HIV
prevalence was 3.8 percent. But the report acknowledged
limitations in these figures because data has been collected only
in Kathmandu, with the prevalence for the entire country
estimated from these figures.
In Nepal, third gender people don't have equal rights with other
people, according to a BDS study. The society also doesn't openly
embrace them, citing religious and cultural reasons. Their
families isolate them, and society discriminates against them on
various fronts, such as education, employment and inheritance of
Many end up in the sex trade either by force or by choice in
order to make a living, which often leads to them contracting HIV
and, therefore, the double stigma. In the sex trade, they are
vulnerable to sexual violence, rape and mistreatment by customers
and even the police.
Om Prakash Khanal, local police inspector, says there have been
some cases of police abuse, but that most reports are blown out
Like Gurung, Mohini Sardar, 26, from Morang, a district in
eastern Nepal, is also an MSM. Born as Gopal Sardar, he prefers
to be called Mohini, a female name, and bears feminine traits.
Sardar also has HIV, which he contracted two years ago.
The only child born to a family with moderate income, he moved
out when his family started disliking his behavior. He says that
living on his own, it was easier to be himself �- to look at
himself in the mirror, comb his hair, apply makeup and have other
male friends over.
He lived in a rented room in the industrial town of Biratnagar in
southeastern Nepal, which is close to the Indian border. There,
Sardar worked as a third gender entertainer, dancing during
weddings and other functions.
"But financial woes are a part of life since I didn't have a good
job," he says.
One day he ended up in New Delhi, India's capital, with the dance
troupe. There, Sardar says he had sexual intercourse with several
men - at first for pleasure, but then to make some extra money.
"When there were so many men, I didn't have time to ask them to
use a condom," Sardar says. "That's how I contracted HIV."
But then Sardar found out about BDS and stopped having sex for
money. Now Sardar works at the Biratnagar branch of BDS. He
spreads awareness about HIV and also distributes condoms to other
people like himself. During his leisure time, he still works as
an entertainer for extra cash.
Like Gurung and Sardar, Kala Rai, 37, from Sunsari, a district in
eastern Nepal, also has HIV. Though his name is Chakra Rai, he
says he likes being called Kala or Kshitija, female names.
Rai says he came to Kathmandu to escape life in a poor family. He
initially got a job as a dishwasher, but he quit after his
employer didn't pay him. When he couldn't find any other work in
Kathmandu, he says he got into the sex business.
But Rai says it wasn't as easy as he had thought it would be. He
says that customers used to run away after having sex without
paying him. One time, a group of men took him to the outskirts of
the city and had sex with him, but then they robbed and beat him
instead of paying him.
When he went to the police, he says they put him in jail and also
raped him. He says he has been in police custody multiple times,
once for 17 days.
Khanal says that there have been some cases of police abuse, but
that most cases are exaggerated.
Rai says joining the sex business has also affected his health.
He initially suffered from sexually transmitted diseases such as
syphilis and gonorrhea, and he eventually contracted HIV.
"I sold my body to survive," Rai says. "I'm now living with the
Rai has since left the sex business and now works for BDS,
helping other HIV-infected transgender people and also advocating
for gender rights.
BDS was established in 2001 in order to protect and advocate for
the rights of sexual and gender minorities. BDS, with support
from Sidaction, a French nongovernmental organization, has been
running a care and support program for people who have come
forward as MSM.
The organization has 50 network offices in 30 districts that
teach sexual and gender minorities about safe sex through the use
of condoms and lubricants. The workers educate them about HIV
tests and make them aware of their rights. So far, some 400,000
sexual and gender minority have been in contact with the
Gurung says that BDS has become a forum for people like him to
come and share their problems. He says that listening to stories
from people all over the country makes him forget his ordeal in
the Mumbai brothel.
"Though discriminated by family and society, we have a place to
call home here," Gurung says. "It feels we have gained a lot in
BDS aims to spread awareness, find employment for MSMs and meti,
enhance their capacity and advocate for their rights, according
to its 2009 annual report.
"After BDS came to existence, who voices for us, we haven't had
to face such violence," Rai says.
The BDS hospice facility in Kathmandu treats people with the most
critical cases of HIV. Personnel there are currently treating
nine transgender people, while eight have died during the past
year. Others have come to the facility but have been able return
home after treatment and advice from the doctors there.
Still, BDS personnel say there are many challenges to providing
Although many come for treatment for HIV, most don't disclose
their sexuality for the dread of being a social outcast, says
Shila Chaudhary, program coordinator of the BDS HIV and AIDS
prevention office in Dang, a district in Nepal's Mid-Western
region. She attributes their hesitancy to a lack of awareness and
education in society. The officers must persuade them to disclose
their sexual identity so they can receive the treatment they
Lama says that the lack of social recognition of third gender
people presents an added challenge. They still aren't seen as
credible employees, face discrimination, and often are confused
as male or female at health facilities, she says, citing some of
"They face problems in every sector," Lama says.
Coming out openly as an HIV-infected MSM or meti would only add
fuel to the problems, so many remain silent, she says.
"When you say third gender and, on top of that, HIV-infected, the
struggle is paramount," Lama says.
Lama says it was difficult to rent a facility for the hospice in
Kathmandu because of the double stigma attached to HIV and third
gender people. Before, they were forced to leave another property
they had been renting in a different residential area of
Kathmandu because the landlord found out that they were treating
transgender people. So they are now operating without disclosing
their identity, Lama says.
Lama says that the government hasn't helped, and the funding they
receive from foreign donors doesn't allow them to maintain a
satisfactory lifestyle for the patients.
In Kathmandu, services such as antiretroviral treatment, ART, for
people living with HIV are most available at the Sukraraj
Tropical and Infectious Disease Hospital. But the hospital is
usually busy with patients with other infectious and waterborne
diseases, Lama says. So patients have to go to other hospitals
like Bit Hospital and Tribhuvan University Teaching Hospital for
ART and for any surgeries they may need.
"Even to get [medical] treatment, you have to struggle a lot,"
Chaudhary says that because it's awkward for MSMs to go to
hospitals in their villages, it also takes time to obtain the
The government is currently implementing the National HIV/AIDS
Strategy 2006-2011 and the National Action Plan 2008-2011. It has
created advocacy programs across the country and offers free ART
to Nepalis who are HIV-positive.
Nepal's government classifies male sex workers and their
customers, female sex workers and labor migrants as high-risk
groups in its National HIV/AIDS Strategy. But Sanjay Dahal,
public health officer at NCASC, says there isn't a separate
policy or programs for MSM.
"Nepal government's treatment toward all HIV-infected is the
same," Dahal says.
According to the NCASC report, it is difficult to reach MSM with
HIV and AIDS programs because many MSM lead heterosexual
lifestyles, thanks to social factors and cultural pressure, such
as the push to conform to traditional male roles and the stigma
Still, NCASC carries out regular studies of the behaviors, habits
and lifestyles of the most vulnerable populations, including MSM,
to improve services.
Meanwhile, the Supreme Court has ordered the government to
recognize sexual minorities and issue them citizenship cards to
reduce stigma. They have the right to choose a third gender
option, so they aren't limited to checking the "male" or "female"
But Sardar says that the decision hasn't been implemented, and
they haven't been issued citizenship cards accordingly.
"We're also a citizen of this country," Sardar says.
"Discrimination based on sexual orientation means we're being
deprived of our basic rights. Our rights should also be
Manisha Dhakal, president of the Sexual and Gender Minority
Association, an umbrella federation for organizations nationwide
working for rights for sexual and gender minorities, also agrees
that the court's order hasn't been enforced yet. She says
government officials tell people that it's not possible to get a
citizenship card with a third gender option.
Hari Prasad Mainali, undersecretary for the Ministry of Home
Affairs, says the government is preparing laws to enforce the
Supreme Court order to grant citizenship to Nepalis of the third
Until this happens, transgender people and MSM say they will
continue to press for rights and are optimistic they will achieve
them one day.
"Though we have gone through the pain [and struggles], we hope
the future generation will not," Gurung says optimistically.
Source: Content partner // Global Press Institute