The Rights Based Approach, 
and the Story of Dhirendra Kumar B

The Britain-Nepal Medical Trust adopted the Rights Based Approach (RBA) for effective implementation of its Health Improvement Programme (HIP) from late 1990s.

The RBA advocates for the health rights of each and every citizen, especially those who are deprived and marginalised. The approach seeks to empower people to gain access to improved health and services and trains and plans with health service providers to ensure non-discrimination for the highest standards of care.

“The workshop has changed my life completely; I have become more aware about my rights. I am now more actively involved in social works for the betterment of my community. I owe this to the Britain Nepal Medical Trust’s ‘Right Based Approach (RBA) to Health Improvement Programme’ that made me believe in myself”

 Dhirendra Kumar B. Ka, 18 years Sidhara VDC, Morang

Dhirendra Kumar B. Ka belongs to a dalit community living in a  small village called Sidhara in Morang District of Eastern Nepal.  Dhirendra lost his sight when he was seven years old. Ever since then life had been very difficult for him. That is until he had the opportunity to participate in a workshop run under the Britain Nepal Medical Trust’s RBA programme. This workshop, for disadvantaged youths’ peer support, helped him to come out from his small hut to claim for his rights and contribute to society in a meaningful way.

He now chairs a local youth group called the ‘Dalit Janasyasthya Yuwa Club’ which meets on a monthly basis to design awareness programs on health issues such as stigma and discrimination towards people with HIV infections. He even writes scripts for street dramas and motivates his fellow youths to act and perform in the plays. The club promotes personal hygiene and cleanliness in the community. As more people start to keep their home and surrounding area cleaner, the frequency of infectious disease in the community may be expected to decrease.

Today, Dhirendra is less worried about his blindness; he is concerned rather about his community and people’s rights. He has become a change agent and he is proud that he has found a meaningful place in society.

Women talk

Village women squat on the ground. Children wait expectantly. A few men sit nearby. A young woman waits nervously to address the others. She has a flip chart of coloured pictures to illustrate her talk on sexually transmitted diseases and their prevention.

Her message is to:

Understand how HIV/AIDS is caught 
Keep to one partner 
Use condoms

The women chatter enthusiastically. The children giggle. The men banter – “There is no fun staying with one woman” But the women reply “Better to do so and love her”.

Facilitators from BNMT are pleased with the instruction and the response from the villagers.

The Tuberculosis Programme

The Britain Nepal Medical Trust has been working continuously in the area of TB prevention and care ever since its establishment in 1967. It supported the early development of the National TB centre and is working currently in 16 districts of Eastern Nepal in partnership with the National TB Centre (NTC) and the National Anti-TB Association (NATA). 

The Story of Angat Rai

“I feel like I am reborn. I was taken on a porter’s back to the TB treatment center at our local sub-health post. I was counting my last breath. The thought of my family being without support was haunting my mind.”

Angat Rai, 49
Chulachuli VDC, Illam

49 year old Angat Rai is the only wage earner in his family. He lives in a village called Chulachuli in Ilam District with his wife, son and daughter. His only property is a small pig he bought recently for Rs. 500.

A couple of years back disaster struck his family. Angat became severely ill. He was carried on a porter’s back to the local sub-health post in a critical condition. People thought he won’t even make it to the sub-health post. Here he was diagnosed positive for TB.

He received free medicines and regular supervision from a trained health worker. He took his medicines regularly . He began to improve and then the laboratory confirmed his infection had been eradicated. This system of care came about with the technical and financial aid of the Trust. 

Today, Angat is a happy man as he has recovered well. He smiles as he says “My family, neighbours, everyone thought that I would not live but I survived… I really hope everyone gets treatment like I did….. I really do…” 

The Story of Lakpa

An elderly ex-Gurka fails to collect his pension because his son Lakpa Nuri Sherpa, like 45% of the population, has TB and can no longer manage the family’s small farm that is their only source of income.

In spite of a well run Government TB programme, Lakpa doesn’t know how he can be cured.

A support worker of BNMT learned of his illness and referred him to a local health post where he was started on Directly Observed Treatment (DOTS) with free drugs.

After five months he is feeling better and can once again run the family farm. He continues to take his TB drugs at home supervised by his younger brother.

He is also helping to spread the word that treatment for TB is available and that it works!