All India HIV/AIDS Prevention and Awareness Workshops

From October 13 through October 21, 2009: The Fourth Phase of CHOICE—HIV/AIDS Initiative’s 2009 “All India HIV/AIDS Prevention and Awareness Workshops” for the Tibetan College Students studying in Indian colleges and Universities in South Indian States namely Karnataka and Tamil Naidu were launched on 13th October at the Institute for Small Trade Learning (ISTL), Nelamangala in Bangalore. The weeklong workshop series successfully culminated on 21st October 2009 in the Mysore city of Karnataka State.

The workshops which was initially organized at the behest and invitation of Mr. Kunchok Dhondup, Administrator of ISTL Nelamangala was held at the Institute for Small Trade Learning (ISTL), Nelamangala, Bangalore on 13th October attended by over 60 young trainees of various vocational skills at the Institute including the staff. The workshop that lasted for over 5 hours was followed with serious and hectic interactive question and answer session with the trainees.

The following day, a similar workshop was provided to the teacher trainees at the Teacher Training Institute of the Dalai Lama Institute of Higher Education, Bangalore. Over 85 TTC students and staff of the Institute attended the workshop with great attention and interest.

On October 15, 2009, a third workshop of the series was provided to the college and University students residing in Tibetan Youth Hostel in Koramangala, Bangalore. Despite the ongoing college exams, the workshop which was condensed into 3 hours was attended by over 80 students and staff. Besides the students and staff of the hostel, the workshop was also attended by Mr. Kunga Dorjee, Chief Representative for Tibetan Settlements in South India and Mr Dondup, Director of the Hostel.

On the 17th October, a workshop on HIV/AIDS Awareness and education was provided to the Tibetan College and University students of Chennai, Tamil Nadu at the A.I.C.U.F. Auditorium in the city. Despite ongoing college exams, over 70 students turn-up for the workshop and took active participation in the entire session. The response and the interest in the workshop and the issue of the HIV/AIDS disease were appreciable and many pledge to do their bit in the promotion of the awareness and to take necessary precautions on the same in their personal lives.

Later from 18th to 21st October, the CHOICE team accompanied by staff nurse Ms. Rinzin Wangmo of Tso-Jhe Khangsar Hospital of Bylakuppe visited the HIV patients and their relatives in the settlement and had friendly interactive discussions and exchanges with them. The team also did assessments and the case studies of the patients and their over-all conditions.

The next day, the Team also met with Mr. Migmar, Administrator of Tso-Jhe Khangsar Hospital and briefed him about the meetings with the HIV patients and also CHOICE’s other plans of providing care and support to over four patients in the settlement. The Team also explained the need of creating a Network or a Scrutinizing team regarding the campaigns on HIV/AIDS disease and the victims in the settlement. Mr. Migmar shared his views and experiences regarding the same and appreciated CHOICE’s proposal and promised to offer his utmost support and initiatives on the same.

Similar discussion meetings were held with Dr Tsephel and Dr Tsering Chonzom of Men-Tsee-Khang and Tso-Jhe Khangsar hospital respectively on the related issues of HIV/AIDS prevalence, patients and problems of social discrimination etc. The doctors shared their experience and knowledge about the disease and offered valuable suggestions on resolving numerous problems associated with the disease and the victims in the settlement.

Later that evening, the members met with Dr Gopinath, the Chief Medical Officer as well as the Talukdar of local Government hospital based in Bylakuppe’s First Camp and discussed about the conditions and prevalence of the disease under his knowledge and care. The hour-long discussion and interaction with Dr. Gopinath proved valuable and productive. He provided numerous informations regarding the patients and also offered his suggestions and guidance for future campaigns on HIV testing and availing of facilities provided by the Govt of India to the Tibetan HIV/AIDS victims from the regional hospitals etc.

The next day, CHOICE organized a workshop cum Interactive Discussion Meeting attended by several HIV patients and their relatives, Dr Tsephel of Tibetan Men-tsee-khang hospital, Administrator Migmar, Dr Tsering Chonzom and nurse and staff of Tsojhe Khangsar hospital. During the Meeting, everyone shared their views and offered suggestions regarding the problem and solutions on HIV/AIDS and also expressed commitments for furthering the campaign on the HIV awareness, care and support of the victims and the most important issue of removing stigma and discrimination on the HIV victims in the Tibetan communities. The discussion also delved into creating a network of people for the Campaign in the settlement.

The participants also lauded the amazing invaluable and compassionate medical and financial grants declared by the Department of Health, TGiE for the HIV/AIDS victim and believed that the grant would encourage victims of the HIV/AIDS to come forward and live a healthy and peaceful lives besides helping removing social stigma and discriminations etc.

The following day, the CHOICE members met with Mr Dondup (name changed) an HIV victim from Hunsur Rangyeling settlement under its care and support in Mysore’s BM Hospital and had a brief discussion and updates about his conditions and future care and maintenance etc. The members were accompanied by Staff nurse Ms. Kalsang from Hunsur Rabgyeling’s Phende Hospital during the meeting.

That evening, a final workshop of the series was provided to the Tibetan students of Mysore College and University at the Balaji Hotel in Mysore. Due to the sudden change of schedule and the ongoing exams, very few students could attend the workshop. Nonetheless the students who were presented in the workshop took great interest in the workshop and benefitted greatly from the same. They also interacted with the Resource persons on the various issues relating with the disease etc.

The resource persons conducting the workshops includes;

1)    Mr. Phuntsok Chomphel (Project Officer-cum-HIV/AIDS Trainer, CHOICE—HIV/AIDS Initiative) presented Power-Point presentation on Basics of HIV/AIDS and Sexually Transmitted Infection (STI/STD).
2)    Mr. Norbu Damdul (an HIV patient and HIV/AIDS Trainer of CHOICE) give his life testimony and his experiences of being HIV Positive status.
3)    Mr. Lobsang Yeshi (CHOICE’s Founding/Board Member and HIV/AIDS and Gender Trainer, Former TYC Vice President and an Independent Researcher) took session on HIV/AIDS Crisis in the world and China and Its implications on Tibetans in Tibet and Exile Tibetan Communities.

Workshop Formats

The workshops began with a showing of a 9 minutes-long video movie produced by CHOICE HIV/AIDS Initiatives that feature His Holiness the 14th Dalai Lama's message on HIV/AIDS crisis in Tibetan Community and Tibet, related interviews with Kalon Tripa Prof. Samdhong Rinpoche and Honourable Health Minister Mr. Chope Paljor Tsering and also a testimony of an HIV Positive Tibetan patient.  This was followed by a short powerful movie titled, 'POSITIVE' directed by famous bollywood director Mr. Faran Akhtar that depicts the life and struggle of HIV/AIDS patient and its family.

This was followed by a deliberation by Mr. Norbu Damdul, a HIV victim and HIV/AID trainer with CHOICE. Mr. Norbu spoke about his personal trial and tribulation after suffering HIV in his early age. Mr. Norbu in his deliberations honestly recalled how his life changed a few years ago when he and his wife both tested HIV positive. Mr. Norbu urged the participants to take utmost precautions in their daily lives and the importance of being faithful to their partners. He also emphasized over the importance of eliminating social stigma and discriminations against the HIV/AIDS victims in Tibetan communities for the success of fight against HIV/AIDS etc.

During the entire workshop tour, participants highly appreciated Mr. Norbu's courageous decision to interact with the Tibetan people and share his HIV positive status, experiences and challenges etc.  Mr. Norbu also visited and met with fellow Tibetan People Living with HIV/AIDS in Bylakuppe settlement and encouraged them to lead a fearless and normal healthy life challenging the social stigma and discriminations. He told the fellow patients how his life changed when he decided to face the truth and live a life not just for himself but also to help others and the community at large. He assured that “Sooner or later through campaigns and workshops such as these, Tibetan people will be educated of the reality of HIV/AIDS and embrace the HIV/AIDS victims and fight against this deadly disease jointly.”

CHOICE HIV/AIDS Initiative once again appreciate the courage and dedication of Mr. Norbu Damdul in participating in our education tour and for sharing his views, experiences and suggestions regarding future campaign on HIV/AIDS etc in Tibetan community.

Mr. Phuntsok Chomphel took the session on HIV/AIDS ranging from basic understanding of the virus to the global epidemic through Power-Point presentation, pictures and animated slides. During the interval of every session, Mr. Chomphel screened short educational advertisement on HIV/AIDS and importance of Condom use etc.
Since condom being one of the simplest, safest and most effective ways of preventing the spread of the HIV virus, around 500 high-quality condoms were distributed among the Tibetan youths as a souvenir from CHOICE. Mr. Chomphel stressed that “Just by carrying a condom or using them doesn’t mean you can be safe from the virus; one must know the 'Correct and Consistent’ way of using the condoms. This will not only prevent one from HIV infection and many other STI diseases but also from unwanted pregnancies.

Mr. Lobsang Yeshi (Gender and HIV/AIDS Trainer) draws the attention of the participants over the vulnerability of the Tibetans inside Tibet as well in exile communities towards the HIV/AIDS disease in his session titled, 'Summary on Global HIV/AIDS Crisis and Tibetan Community'. Based on his research on various issues including the disease in China and Tibet, he warned the participants about the major threats facing our people due to the advent of HIV/AIDS through massive Chinese immigrations into Tibet especially after the opening of the Gormo-Lhasa Railway on the summer of 2006. He emphasized Gormo as the crucial axis of prostitution, drug trafficking and smuggling in China.

Mr. Yeshi further pointed out Yunnan as the HIV/AIDS hot-spot province in China estimating almost half the HIV/AIDS patients living in Yunnan besides other affected provinces of Sichuan, Tsinghai and Gansu where numerous Tibetan areas were incorporated. In his deliberations, Mr. Yeshi further delved into various issues related with the disease. He stated, "Today according to the latest Chinese Government’s acknowledgement, there are  over 20 million Chinese in Tibet. Because of such large influx of Chinese migrants and military personnel in Tibet, umpteenth sex industry had cropped up all over Tibet. In Lhasa alone, there are more than 1,200 brothels.”

He quoted the report from the UNDP and Beijing based U.S. Embassy reports regarding the impending perils for the Tibetans. This precedence puts the Tibetan people under direct threat. He also touched upon the prevailing change in social behaviors among Tibetan communities in exile that makes the entire community vulnerable to the HIV/AIDS infection.

Network of Positive People:

For the first time in the history of Tibetan communities in exile the 'Network of Positive People' came into formalized in Bylakuppe settlement of South India. CHOICE acknowledges the sincere effort of Mr. Lobsang Yeshi (Founder/Board Member, CHOICE) and Ms. Rinzin Wangmo (Staff Nurse, Tso-Jhe hospital) for taking the first step towards meeting with down- trodden HIV patients in the settlements. They got acquainted with the suffering and challenges that HIV patients undergoes and the extend of existing social stigma and discrimination despite tremendous awareness and support campaigns spearheaded by the Dept. of Health and concerned NGOs so far.

During the official visit from CHOICE, Oct. 18 to 21, 2009 Mr. Phuntsok Chomphel (Project Officer) documented the case studies of seven varied HIV patients. After the formal meetings with Doctors, health professionals, HIV patients and their relatives, CHOICE conducted workshop, first of its kind to form the Network of Positive People. The workshop was aimed to build wider understanding between HIV patient and health professionals and also to access prevailing facilities for the PLHA and build up emotional support within the PLHAs and concerned workers.

During the workshop, Dr. Tsephel (TMAI), Dr. Tsering Chonzom and Mr. Migmar of Tso-Jhe Khangsar hospital took active participation in discussion of the problem and demonstrated their interest and commitment to provide whatever assistance possible within their jurisdiction and ability.

Though not in a broad sense, the workshop did achieved an initial step in building up a network between the PLHA and settlement hospitals with positive intention to offer best possible services to the People Living with HIV and AIDS.

Feed back:

The participants expressed great appreciation for workshop and its effectiveness and requested CHOICE to conduct more of such workshops at different level especially targeting youth. Many of the participants individually thanked Mr. Norbu Damdul with various gestures, some even providing monetary donations for his medication, food and nutrition accompanied by notes of appreciation and encouragement. Some of the participants requested Mr. Damdul to continue the noble mission.

Acknowledgements:

CHOICE—HIV/AIDS Initiative is immensely grateful to the following people without whom the series of workshop will not be possible:
1.    Mr. Kunchok Dhondup (Administrator) I.S.T.L. Neelamangla, Bangalore for providing us local conveyance, food and lodging for three days workshop at Nelamangla and Bangalore.
2.    Mr. Nawang Dorjee (Principal, The Dalai Lama Institute for Higher Studies) for providing hall and equipments for the workshop and of course permission for the workshop at the college.
3.    Mr. Dhondup (Director, SOS Tibetan Youth Hostel, Bangalore) for providing auditorium to conduct workshop and further assistance in facilitating the success of the workshop.
4.    Mr. Karma Tenzin (President), Tibetan Students' Association, Madras for assistance and support.
5.    Mr. Migmar (Administrator) and Nurse Rinzin Wangmo (Staff Nurse), Tso-Jhe Khangsar Hospital, Bylakuppe for great assistance, support and guidance.
6.    Mr. Choesang (President), Regional Tibetan Youth Congress, Mysore for assistance in organizing the workshop.
7.    Dr. Tsephel (Tibetan Medical and Astrological Institute), Bylakuppe for valuable support and guidance.
8.    Dr. Tsering Chonzom, Tso-Jhe Khangsar Hospital, Bylakuppee for valuable support and guidance.
9.    Mr. Norbu and Ms. Pema, an HIV positive couple, for the great cooperation and encouragement (Name Changed).
10.    Mr. Dondul and Ms. Lhamo, an HIV positive couple, for the great cooperation and encouragement (Name Changed).
CHOICE extends it sincere gratitude to the Dept. of Health, CTA Dharamshala, for appreciating the importance of such workshops and continues support towards CHOICE's activities. We at CHOICE also would like to thank all the participants who attended the workshop, giving their time and energy to confront HIV/AIDS in Tibetan communities and world at large. Not the least, CHOICE also acknowledges Students for a Free Tibet INDIA (SFT) for providing us the LCD projector for the workshop at minimal rental.
In our endeavor, we will always remain indebted to the encouragement and advice of His Holiness the Dalai Lama, who believes that we as Tibetans must be open and receptive to the HIV/AIDS crisis and work jointly to fight against the crisis.

Feedback and Recommendations:

In the last several years of education and awareness campaign tours undertaken by CHOICE—HIV/AIDS Initiatives to various Tibetan settlements including schools, institutions, Monasteries, colleges, Military Units, hospitals etc, we have discovered an appalling numbers of HIV/AIDS cases and prevalence. More than 100 known cases were registered with annual death of Tibetans from AIDS numbering several scores. In one particular Tibetan settlement, doctors claimed that more than 10 young Tibetans die of full-blown AIDS each year.

This too are merely the known cases and how many die silently and how many gets infected each year seemed a tragic reality that must bother every concerned compatriots. That less than 5% of the Tibetans in exile communities had undertaken the crucial HIV test is also an awful pointer to the gravity of the whole crisis. Therefore the growing number of HIV/AIDS cases further reinforces the need for a robust joint initiative against the growing menace by the concerned offices; primarily the Department of Health, Hospitals, NGOs, individuals and the HIV/AIDS patients and of course the general public.

Major critical efforts must be made through extensive and incessant awareness workshops and training to bring about a behavioral change amongst the general public towards the disease and the victims and ensure a steady decline in the growth of infections. The most significant development following the workshop would be the willingness of the people to go for HIV testing. Many a workshops later, participants do often declare their readiness for the test.

Recommendations:

1)    Admission of the children of HIV/AIDS parents to SOS TCV schools
Through our association and exchanges with the victims, we have realized that the foremost support for the HIV/AIDS victims would be the taking care of their children through admission in SOS TCV schools. This would not only relieve a great burden from the victims but also ensure the safety of the kids from possible future infections etc. The admission into the school would also save such children from social discriminations and abuses they experiences in their local settlements. 
We believe that DOH can play a vital role in saving the future of such children by facilitating their admission in SOS TCV schools at free of cost and with slight exceptions over regular admission procedures requiring recommendation letters from Welfare Office etc which normally lead to the exposure of HIV relations thus creating scopes for discriminations. Some cases of discriminations and segregation of children of HIV affected parents were witnessed in schools and academic environments.
To quote few instances:
a) In Bylakuppe settlement, there were instances of parents withdrawing their children from a school for a simple reason that a child of an HIV positive mother (a widow) was studying in that school.
b) Norbu Damdul, an HIV positive, whose daughter studies in Upper TCV School also faced certain discrimination from the members of the community on learning about the death of her mother on account of AIDS and her father with HIV Positive status.  

2)   Free Provision of Tibetan traditional medicine for the PLHA from TMAI

Though, the Indian Government provides Antiretroviral (ARV) treatments free of cost to PLHA and DOH too provides a remarkable financial support in all other related expenses to PLHA but one of the important assistance required for the Tibetan PLHA from DOH is the provision of free traditional Tibetan medication from Tibetan Medical and Astrological Institute (Mentse Khang). As is widely acknowledged and duly proven, our traditional indigenous medicine not only effectively reduces the adverse side effects of ARV/ART treatment but also help in regaining the immune strength. Therefore, if this provision could be made available for the PLHAs, then DOH and TMAI would be doing a great service in ensuring longer and healthier lives for the PLHA. Therefore in collaboration with TMAI head office, regional TMAI centers in all Tibetan settlements can reach-out to the PLHA and provide traditional medicine and support in every possible way.
One hopeful development regarding the same is a letter of instruction from the TMAI head Office guiding a Bylakuppe based TMAI doctor to provide free medicines to PLHA in accordance with assessment of individual PLHA cases. A similar formal declaration regarding the same provision from TMAI would be of great beneficial for PLHA and their wellbeing.

Training certified HIV Test Conductors and Counselors etc through Govt. of India Health Centers

During our meeting with Dr. S. Gopinath, the Chief Medical Officer and Talukdar (Regional) of Byllakuppe area, we were suggested that any HIV testing centers in Tibetan Hospitals or Health Care Centers must be legally approved and would be advisable to work in collaboration with WHO, NACO, or any State AIDS Control Centers or Societies in accordance with the Govt. India's provision for HIV testing and counseling.
To ensure certified training and counseling to community staff nurses, we suggest the following two options:
•    Department of Health can collaborate directly with NACO (National AIDS Control        Organization) or State AIDS Control Organization and assemble the concerned community health workers and nurses in Delhi or Dharamsala for intensive training workshop that can certify them as legally approved for HIV testing as well as counseling.
•    Or DOH can instruct their settlement hospitals to undergo intensive HIV testing training and counseling in regional State AIDS Control Centers.

3)    Providing ‘Life Saving Programs’ to PLHA

We would also like to put forward for consideration an arrangement of provisions of "Life Saving Programs" for the PLHA such as professional skills trainings like tailoring, making incense and wax candles etc. These can enhance their financial ability to sustain their living through the HIV/AIDS stages.

4)    Further financial support for the PLHA or ‘Adopt a HIV Family’

As in other communities, Tibetan People living with HIV and AIDS (PLHA) have undergone horrifying experiences and unimaginable social stigma, discrimination leading ostracism from the Tibetan public and the community.  Furthermore, most of the PLHA are in very poor financial condition needing all-round support and encouragement. Most importantly PLHA needs financial assistance to live a healthy and respectable living on top of medical treatments given their health limitation in pursuing a normal occupation etc.
If a person or family is infected with HIV/AIDS, it gradually plunged the entire family into a life of poverty. The need to maintain a proper health and lifestyle drain whatever resources available in the family. Therefore most of them need continued income or sponsors who can pay the cost involved with nutrition and supplements etc. At present, one of the greatest incentives and encouragement PLHA receives to live a healthy and comfortable lives are the valuable financial support they receive from DOH. However to fulfill further financial needs, DOH or NGOs can identify methods such as finding them sponsor or scheme such as "Adopt a HIV Family", whereby even a normal Tibetan family or a sponsor can assist a HIV positive family with minimum support of a thousand rupees a month or more.

Conclusion:

For the first time though not in a broad sense, we have strove to build a network between the PLHA and settlement hospitals with positive intention to offer best possible services to the People living with HIV/AIDS. We are planning to work more in such fields and facilitate comfortable and respectable lives for our fellow brethrens suffering HIV/AIDS.
The more we reduce the stigma and discriminations related to the disease and provide every possible support to PLHA, the more we can expect them to come forward and cooperate in the fight against HIV/AIDS that threatens the very core of our community, struggle and the nation at large. By gradually building an optimistic environment to control HIV/AIDS, people will feel free to go for HIV testing thus reducing the risk of transmission and also mobilizing and motivating the PLHA through sincere assurances that “This is not the End but a Beginning of a new way of Positive Living''.
Finally, CHOICE HIV/AIDS Initiatives offer its most sincere pledge and reaffirm our commitment to continue to work towards fulfilling our Mission statement and the goals and cooperate with all the stake-holders; most importantly Department of Health, to achieve A HIV/AIDS FREE TIBET(an) Community and a nation.

Phuntsok Chomphel
Project Officer 
CHOICE—HIV/AIDS Initiative