My name is Bijay and I am man of 46 years. I live with my wife and two children in Patan, an area close to Nepal’s capital Kathmandu. I used to work as an automobile mechanic, but nowadays I work full-time as a programme manager at the organisation Youth Vision Harm Reduction Services. My involvement in harm reduction was an unplanned career move. I tried to manage my heroin use alongside my automobile work, but this was difficult. So, I felt forced to aim for complete abstinence. And I ended up being a founding member of Narcotics Anonymous (NA) in 1998.
In Nepal, people who use drugs are treated as secondary citizens. They are confronted with stigma and discrimination. Because I use drugs myself, I can relate to the people with whom I work, and I am able to voice their concerns about a meaningful involvement in the matters that affect them. People who use drugs, for instance, lack adequate and affordable services. Many of my friends who use drugs are co-infected with HIV and hepatitis C. They are dying not because of drug use or HIV, but because of hepatitis C. Health workers in a governmental setting are often unwilling to treat people from key populations.
Because I use drugs myself, I can relate to the people I work with
In the period 1995-2000, the Nepalese government prescribed methadone to people using heroin, but this was stopped abruptly. Beneficiaries who were prescribed therapeutic doses suddenly had to cope without their medication. Many died of overdoses, because of the uncertainties regarding methadone and their conversion to the strong Thai heroin ‘Chiang Mail White’. As an activist and Chair of the Asian Network of People who Use Drugs (ANPUD), where I had been working since long time I advocated for the use of Opioid substitution therapy buprenorphine and Methadone. After one and a half year of pushing and lobbying the Government of Nepal, buprenorphine and methadone are now available in Nepal.
I was also actively involved in the formation of the National Harm Reduction Association (NHRA). The association works with the government and bi-lateral partners, and was engaged in the development of the harm reduction strategy of Nepal. Unfortunately, despite this presence, the voices of people who use drugs are barely heard and little has been changed in policies and laws. People who use drugs are still highly criminalised and stigmatised. An ongoing concern is the human rights violations by swindling rehabilitation organisations, of which there are 75 in Kathmandu alone. They extort families, who are forced to pay exorbitant fees to the owners of the rehabilitation centers, to prevent their relatives being imprisoned for long periods of time, only because they use drugs. This is a top advocacy priority. My aim is that people who use drugs will enjoy the same rights as other citizens, so that their quality of life improves. From ANPUD we are in the process of issuing a position statement on Compulsory centers.
What I love most is people who use drugs call me, write me and meet me. I feel needed and I am proud that they have chosen me to represent them in various forums.