Bhutan is one of the few countries in South Asia that continues to experience a low adult (15-49 years) Human Immunodeficiency Virus (HIV) prevalence according to the Country progress report on HIV response in Bhutan 2015. Since the detection of the first case in 1993, the Joint United Nations Programme on HIV and Acquired Immune deficiency syndrome (AIDS) estimates that there are less than 1,000 people living with HIV in Bhutan.
The report states that HIV cases have been detected in 18 out of the 20 districts with more than half of the cases reported in Thimphu and Chukkha.
With knowledge about HIV mostly coming from the posters and pictures, which depicted HIV as a deadly and a killer disease, executive director of Lhak-Sam, Wangda Dorji, recalls the fear he and his wife felt in the past. “My wife and I promised that even in the future when our children get married we will not share even to our family, let alone others.”
The health ministry through the global fund project conducted a workshop in 2009 for people living with HIV, where the participants felt the need to support innocent people living in rural areas.
With various aims of reducing isolation and discrimination, to provide information, education, care, support, awareness and treatment literacy, and to built confidence and to empower people living with HIV and affected family members, Lhak-Sam was formed in 2009. It was formally registered as a Civil Society Organisation (CSO) in November 26, 2010.
Lhak-Sam has 171 members from around 18 districts, with 35 HIV positive children. With the ultimate goal of building competency and having their own registered organisation Lhak-Sam also about 90 Lesbian, Gay, Bi-sexual, Transgender (LGBT+) members.
Wangda Dorji said because people do not have in depth knowledge on HIV, people are aware of how HIV is transmitted and can be prevented but are unable to take the knowledge and practise together. “When they do not understand about HIV there are chances of them stigmatising people living with HIV and fearing HIV itself.”
One of the reasons why he came out in open he said was because if HIV is not given a face people create their own perceptions and rumors. “When we came out people knew that people with HIV are the same as everyone. They are also mothers and fathers, people of the country and the country’s children like everyone else.”
The main challenge the CSO faces is the need for collaboration and partnership with the health ministry. As the CSO works in grassroots level and the ministry in national, they are not able to coordinate and work towards prevention and reducing stigmatisation and discrimination towards people living with HIV, LGBT+, drug users or sex workers.
If the advocacy done by the CSO is accompanied by the technical experience of the health ministry such as counselling and testing, the CSO hopes to encourage at least 30 out of 100 people to test themselves.
In the near future, Lhak-sam plans to fill their 70 percent gap in programmes such as care and support, building capacity of staffs and members, study tours, and baseline studies by finding potential donors.
Global fund has classified Bhutan as being among band 4 countries, which means that Bhutan is now low middle income country with low disease burden. With the global fund, one of Lhak-Sam’s biggest funding partners slowly withdrawing, Lhak-Sam is looking into creating a sustainable and independent means for its HIV and LGBT+ programmes.
Lhak-Sam is looking into using its land in Genekha to plant commercial flowers, orchids and herbs. It also hopes to lease a land for large scale organic farming which would also generate employment for people living with HIV, LGBT+ and recovering drug addicts among others. On a larger scale it hopes to reduce the economic burden of the government.
Wangda Dorji said people have greatly changed and that stigmatisation have reduced compared to the past but that it does not mean discrimination has gone away completely. He still experiences discriminations even from educated people such as being hesitant to shake hands and sometimes fearing to be seen with him.
He said it is his duty to explain to people who do not understand about HIV and discriminates others. People ignore and are not able to sympathise with things if it’s not related to them. “People do not realize that from 548 people who are detected, there are another 600 who do not know their HIV status, and are living with HIV. ”
Lhak-Sam aims to be a premier organization in Bhutan committed to providing and promoting leadership, education and capacity building to all PLHIV and their families, empowering them to improve their quality of life, by reducing stigma and discrimination and through access to appropriate prevention, care and support services.
Eight PLHIV (4 male, 4 female) in Thimphu came together on October 08, 2009 and had a first meeting among the peers. The name Lhak-Sam (altruism) for the group was concrecreated on 14th of December 2009 by His Reverence Chazam Telku Rinpoche the 14th reincarnation of “Drupthop Thongthong Gyelpo”. The process for the registration as an public benefit, non-governmental organization began in May 2010 and officially got registered on November 26, 2010 with its registration No. CSOA/PBO-10.
“A society where all people living with HIV (PLHIV) and affected family members have opportunities for a meaningful livelihood”
To create and promote a strong support system based on solidarity, social networking and people’s participation for addressing and taking collective action towards effective response to HIV/AIDS and its impact.
Network and provide support to all PLHIV in Bhutan and the region;
Empower and build the capacity of all members to participate fully in their own treatment, care and prevention;
Reduce stigma and discrimination;
Enhance greater participation of members and other stakeholders in the AIDS response;
Establish linkages with regional and international networks of PLHIV and Increase access to resources by members through resource mobilization, grant making and management.