For Shanti Tamang Lama, getting people living with HIV the care that they need is an intensely personal journey.

A survivor of sexual trafficking, Tamang discovered after her escape that she had contracted HIV. Antiretroviral therapy was a necessity. But then the Nepali earthquake of April 2015, followed later that year by a border blockade of the country, made these live-saving medicines hard to come by.

At that time, Direct Relief responded by providing a supply of the antiretroviral drugs for a number of Nepalis living with HIV. Tamang was one of them.

A broader problem

Inspired by the aid she’d received – and determined to get vital care to others with HIV – she began bringing antiretroviral drugs to communities that were impacted by the earthquake or having difficulty getting the medicines. “When I was very sick and when I was very alone, there was no one to support me,” she explained. She didn’t want that to be the case for others.

During the time she spent in these communities, she became aware of how widespread the problems connected to having HIV were, particularly for women. Some were unable to get the care they needed. Some developed cervical cancer, as women with HIV are statistically more likely to do. Some were shunned by their community, or experienced discrimination and stigma. Some needed a way to support themselves and their families.

Tamang decided to tackle it all. She created the Shanti Foundation, which screens and provides education, counseling, and treatment, for women with HIV, cervical cancer, and uterine prolapse. When they encounter a woman who is diagnosed with one of these conditions, they coordinate her care, which often means bringing her to Kathmandu to receive sophisticated medical treatment.

Education and community outreach efforts are designed to reduce stigma and reintegrate vulnerable women into their communities. The Shanti Foundation even teaches handicrafts, including jewelry making and knitting, so that clients can support themselves and their children.

In the past, Direct Relief has provided a total of $117,000 to the Shanti Foundation through two grants.

But even as Tamang cleared hurdle after hurdle for the clients in her care, she discovered one more: Women who needed treatment in Kathmandu often had no place to stay.

A new home

HIV is on the decline in Nepal, thanks to government, community, and NGO efforts to treat and prevent the disease. But as Tamang explained in Nepali – her daughter, Kranti, translates for her – there is only limited space in the Kathmandu’s shelters for those who need to seek care there.

Many women, Tamang said, are already at a late stage of their disease by the time they come to Kathmandu. Many have been abandoned by their families and have limited means. In some cases, people lost housing when their HIV status became known. “They do not even get the dignified death that they need,” she said.

The Shanti Foundation’s newest project will change that. It’s a 2.5-story building that can house five people at a time, many of them living there for months, or even a year, as they undergo treatment in Nepal’s capital city. Counseling and medical assistance will be available in the building, and there’s a meeting hall to do training, therapies, and exercise. Staff members will feed clients at the shelter a nutritious diet – an absolute necessity when undergoing therapy for HIV, Tamang said.

The shelter, which the foundation is currently in the process of purchasing, will be funded by a Direct Relief grant of $250,000.

In the shelter, people “won’t be kicked out because of health status,” Tamang said. “They’ll get a safe environment that they can call home.”

While the first clients at the shelter will be women experiencing HIV, Tamang also plans to include survivors of sex trafficking, whom the Shanti Foundation rescues as part of its work and reintegrates into their communities.

A dream come true

Tamang also has plans to help the shelter stay afloat. The land on which it stands will be used to grow potatoes, cauliflowers, mushrooms, and other crops that can both be used in the shelter and sold at local markets. She plans to teach handicrafts to the women living in the house to fund the shelter and, eventually, to provide them with a livelihood when they return home.

And Tamang’s work won’t end when her clients’ treatment does. She takes a holistic approach to their future.

When the women who stay in the shelter are ready to go home, she plans to help reintegrate them into their lives: assessing their homes, nearby health services, and access to medication; making sure that they’ll have a sustainable income and education for their children; and making sure they’ll be safe. She also plans to follow up with them every month to make sure they’ve taken their medication and help with any challenges they’re encountering.

“The shelter was a dream of the Shanti Foundation and its people. And now we’re going to have our shelter, so it’s like a dream come true for all of us,” Tamang said.