Nepal: Women who say no to drugs
Agents of social change

Nepal is one of the countries in South Asia setting priorities for scaling up health services and treatment for drug users, HIV and AIDS patients, especially for women. Since women's unequal status in society undermines their ability to access life-saving drugs and treatment, UNODC and policymakers recognize that attention to the gender dimension of treatment, especially the impact of entrenched discrimination and gender-based violence, must be addressed as well.

Roopa*, who is shy yet confident and only 23 years old, is part of a female injecting drug users' network in Nepal and is a recovering drug user. Apart from raising awareness about preventing drug use among women in Nepal, she also addresses the problem of gender-based violence and women's rights with her clients. The situation becomes even worse when a woman is HIV positive and a drug user. Roopa points out that this is almost a death sentence for many women in Nepal.

She explains that "treatment policies and programmes still tend to ignore the connection between gender-biased social roles, domestic violence, women's insecure property rights and their ability to seek treatment for HIV and drug use. Many of the female drug users that visit the drop-in centre and support group sessions, fabricate excuses to justify their absence from home because they fear abuse or abandonment." Some even hide their medication under mattresses, in food containers and holes in the ground or in walls since the men they live with discourage them from seeking treatment. Many of the women who visit the drop-in centre struggle to find money for food, for transport to clinics and for diagnostic tests. As a result, many take their medicines irregularly. Often, their male partners inject drugs and encourage them to also inject drugs and share needles. For all these reasons, female drug users form a hard-to-reach group.

Roopa's network reaches out to 7-8 women drug users every month in Kathmandu, of which 3-4 inject drugs. Noticing that their difficulties are simply not discussed in other clinics or drop-in centres in Kathmandu, Roopa advises the women on their health and their right to protect themselves from becoming infected with HIV and to not use drugs. As a service provider, she also ensures that counselling on HIV and drug use takes place in private, where women and their health-care providers can discuss the issue of gender-based abuse.

"Helping female drug users is a slow process and progress depends on all stakeholders being committed. Every female drug user who decides to start her life again and to seek treatment at the drop-in centre, every girl who musters enough courage to say no to drugs, every woman who demands her right to treatment: we feel it is worth the struggle because we are part of this movement of empowerment," shares Roopa.

Community-based social networks are pivotal, as they are a source of moral support. A woman who is denied her say regarding health, education and household matters, can, by being linked to a strong social network that promotes women's empowerment, get the kind of peer support that will assist her in making independent decisions. The impact of such women's networks goes beyond the scope of their members: by demanding rights for their members, these networks and organizations are proving to be powerful agents of social change.

UNODC provides support to the female injecting drug users' network through its projects in Nepal.

* Name changed