Tuesday, March 29, 2011

The Story of Laura....

Having lost her mother and sister to HIV, Laura almost lost the will to live, she tells us about the new challenges she faces.

Finishing my KCPE exams was the highest point in my life. I was very excited, I felt accomplished, as it had been a long struggle. Days and weeks passed, and I spent my time at home. It was really nice as I had time to relax and do a few things around the house.

Just about the same time, life did a three sixty on us and my father lost his job. It was so hard, without money, or even food. Right then I saw my dreams of ever joining secondary school fade right in front of my eyes. I wanted to join secondary school so badly. Christmas was approaching.

This situation was too hard for my family. My aunt came to our rescue by suggesting that I go and live with her. Without hesitating, I agreed. As we arrived at her house, I was surprised to see a big house with many rooms. I was taken to one of the rooms to use as my bedroom.

One night I sat on the bed staring at the clock, tears streamed down my cheeks. I couldn’t help comparing my family life and my aunt’s. I asked myself why my family was living in such poverty. There was neither food to eat nor clothes to wear. In my aunt’s house food was plenty, so much so that she would give some away so that it wouldn’t rot. This is when I realised that life would never be the same.

A month later, I returned home after the holiday. My results were already out and I was eager to know my grade. I was not happy with what I saw and felt completely shocked, but I still wanted to join secondary school. I wanted to become a journalist but my dad could not pay school fees and I felt that my bad health was going to be the downfall of my whole entire life.

My father started drinking alcohol. I could not help getting angry all the time. I mean he was drinking the money that he could save to take me to school. All my age mates are going to school while I am just at home. February is almost over and I haven’t heard anything from my father.

Nowadays I feel a lot of stress. This is because I don’t go to school. I am happy that at least I have Eneza Ujumbe. Through it I and my fellow writers can express the problems we face as young adults.

Eneza Ujumbe-Issue 3

Eneza Ujumbe-Issue 3

Thursday, December 2, 2010

Eneza Ujumbe

In the past few months, I have been privileged to meet very lovely young girls and boys who live in Mathare slums, the second largest slum in Kenya. These are young people who have refused to be defined by their illness and instead have made up their minds to carry on despite the stigma and discrimination associated with HIV/AIDS. Born with HIV/AIDS they struggle to understand why them...and each time I listen to their stories, I break down and wish I could do more to these lovely people who have let me into their lives. They are the youth support group at the Blue House clinic, an MSF run facility in the slum of Mathare.

I have been teaching them how to write and also develop a newsletter, a tool that will help them share their stories and have their voices heard across the globe. They chose the name Eneza Ujumbe, meaning spread the word, so that all who care to read and hear them may be able to create a better future for others like them not only in Kenya but in the whole world. I bring to you the first two issues of Eneza Ujumbe.

Eneza Ujumbe
Eneza Ujumbe-Issue 2.

Monday, November 15, 2010

HIV Treatment: A powerful tool for prevention

Over a decade ago, Kenya was grappling with the HIV and AIDS epidemic. In 1999, the then president Daniel Moi declared this disease a national disaster. However, with the introduction of antiretroviral therapy (ART) in 2003, tremendous achievements have been made in containing the impact of HIV.

Since then, the HIV prevalence rate in Kenya seems to have decreased and stabilized at about 7.4 percent. That notwithstanding, new HIV infections are still high. According to the Kenya National Strategic Plan 2009/10- 2012/2013, Kenya records an estimated 166,000 new HIV infections annually, translating to 455 new infections daily. This is against the backdrop of the already 1.4 million Kenyans who are living with the virus.

While HIV continues to be a crisis in Kenya, there is new hope to further decrease HIV-related death and HIV transmission. New studies show that ART dramatically reduces sexual transmission of HIV. In order to fully realize the benefit of using antiretroviral medication as HIV prevention, testing and treatment must be scaled up to reach significantly higher numbers of Kenyans affected by the virus. This scale up will require additional funds from donors and the Government of Kenya alike.

Currently, only 38 to 45 percent of those in need of treatment are being reached. The coverage for children is much lower, at about 15 percent. Up to 300,000 people living with HIV (PLHIV) are still at the risk of dying, simply because of lack of access to treatment.

According to a recent article in The Lancet, a medical journal, ART reduces plasma HIV-1 concentrations to undetectable concentrations within six months on initiation. Seminal and cervicovaginal HIV-1 concentrations are also reduced to undetectable levels in most patients on ART.

The study – a prospective cohort study – conducted in Southern and East Africa included 3381 sero-discordant couples. Out of this, there was only one HIV-1 transmission event with ART use – a 92 percent reduction in transmission! The study also indicates that risky sexual behaviour reduced after ART was initiated.

This shows strong evidence that ART is both a treatment and extremely effective prevention exercise. It is probably the most effective prevention tool at our disposal now. Newer, less toxic ART makes the risk-benefit ratio to weigh in favour of treating at higher CD4, both for the individual patient as well as for population-level prevention.

Kenya can lead the way with bold new initiatives to use treatment as prevention and make Kenya a low transmission-zone for HIV. This will require increased commitments for funding and resources from government and donors alike.

Initial expansions could include ensuring rapid and universal adoption of Kenya’s new HIV treatment guidelines that provide for initiation with tenofovir-based regimens at CD4 counts of 350 as well as treatment for all TB co-infected patients. Additionally, programmatic and funding support is needed to achieve the goal of universal opt-out testing for all Kenyans 14-65 years old by 2013.

Additional potential interventions can include testing for viral load and initiating treatment for all those with HIV viral loads of over 50,000, regardless of the CD4 count. It has been established that a commitment to purchase enough tests for every PLWHIV in Kenya would quickly half the per-test cost, to less than $15(Shs1140) per test.

Of course, there continue to be major issues to address so that HIV treatment scale up can be successful. A reliable and consistent supply of ARVs is crucial as is strengthening human resources for health workers and ensuring clinicians providing ARV care are appropriately trained.

Further, increased numbers of patients on ARVs may foreseeably put pressure on the overall health system. In order to mitigate this potential roadblock, HIV treatment guidelines should consider monitoring simplification including providing a longer time between appointments for patients who are stable and doing well.

It is crucial that Kenya actively increase sustainable funding for HIV. Almost 70% of funding for HIV in Kenya is provided by external donors. Kenya must utilize donor money wisely and work with donors such as the Global Fund and PEPFAR to negotiate increased commitments for treatment as prevention programs.

However, there are also signs that government commitments are growing. This year, the government allocated 900 million to ARVs. This is almost double last year’s budget allocation to the same, there is still more that needs to be done. Kenya must also continue to pursue innovative financing measures such as looking towards the NHIF for outpatient HIV care and investigating airline taxes as ways to fund ARVs.

So far, vaccines pose a distant hope in HIV prevention. Vaginal microbicides have been ineffective, and treatment of sexually transmitted diseases does not reduce HIV transmission in most settings. Only condoms, abstinence, or delaying onset of sexual activity are effective. But with current patterns of behavior, none of these reduce risks sufficiently to halt the pandemic in sub-Saharan Africa, besides all this, increasing ARV coverage may just be one of the key solutions needing attention.

Friday, November 27, 2009

The perils of Unemployment…

By Judy Waguma

He sat there, staring blankly at me. And I felt embarrassed. He still got his job. Age for age, responsibility for responsibility - the job was the only difference between us. But it was a big difference.

In a way I really missed my desk? It was comfortable. It had been part of me for so many years. It had brought in money - just enough - to keep things going. But now it was over. Chapter closed. I was on the scrap heap. Dumped.

Did I care? For a while I cared a lot, yes, then less. To be honest, I accepted the job that day he was willing to pay my bills. I say again, it was responsibility for responsibility. How then was my baby going to eat?

But, once out in the fresh air, somehow it just didn't seem to matter any more. The world seemed full of possibilities; unexplained, undecided and only just round the corner. The country air felt fresh in my lungs, the sun beamed down and my whole body tingled with anticipation.

I had not felt so good for years. In a weird way, I accepted my fate; I was going to have a man I barely knew fend for me. He said I was pretty, worth Gold and much more, if only I accepted his offer.

The heavy satchel on my unfit shoulders seemed light as a feather. I felt like I was in the movie, ‘Lady in red’, how else could I explain it. Last night I was eating in a dumpster, I was unemployed for heavens sake.

Today I was listening to songs from hidden birds in the hedgerow crowded by the country air, lifting me up, leading me on.

Just a small country lane - but for me it held the promise of new and better futures. Each stride pushed memories of bitter setbacks into the past and brought with it the promise of a few pennies in earnings.

"So what is it my rose bud, will you take my offer?" I froze, scared, but there in his hands was a bundle of very new notes, enticing me, making me salivate.

For one minute there, I appreciated having a job, and missed my old workstation. That very moment, I wanted to shout to everyone who has a paying job to be grateful, I felt like I was selling my soul to the devil.

He was my rich Uncle, my father’s brother, giving me an offer, to be his mistress.

His voice was low with a musical lilt, a trace of Ireland or Wales.

Completely embarrassed, I felt like a youngster caught pilfering. His look was quizzical, inquiring. But his demeanor was certain, like he knew he was torturing me.

And I looked on….thinking….wanting, was it worth it??

Thursday, June 18, 2009

I lost my baby to Violence.....

By Judy Waguma

She lays exhausted on her hospital bed;oblivious of her surrounding-ward 17, at the provincial Hospital, Kisumu. She is alone in this big room.

Shortly the tea lady has arrives. Chai Chai, kuja Chukua chai! (Tea Tea Tea) but she just lays there. The tea lady moves on to the next ward. A Good Samaritan sympathizes with this girl and rushes to get her the tea.

She takes a deep breath, not interested in the tea either.“It was Thursday morning,” she says, almost like a whisper. I was at the displaced camp in Naivasha.

“A bus had just come to take us home, and I was overjoyed as I knew I was going to join my family again”.

Susan Akinyi says that she collected the little household goods she salvaged during the post election violence and was ready to go.

In her joy, the 17 year old stood holding her protruding belly, softly she whispered to her unborn baby, with a broad smile on her face, ‘home at last’

She says that the journey back to Kisumu began early.

In the bus, she sat staring out of the window, Susan could be heard humming a song, her joy profound, and even the rough road seemed like nothing.

All over sudden, her face hardens. She keeps quiet, closes her eyes and with renewed strength she continues to say, “I felt a sharp pain in my stomach, then another, then another”

She says that she panicked, and did not know what to do, since this was her first pregnancy.

“I tried so hard to hold it, I couldn’t, it was becoming unbearable, and then I started to scream, that made me feel a little better, at least it would get my mind off the pain,” she says.

In the bus, she says, a lady came to her rescue. The lady took her to the back seat and put her to lie on her back.

Her water broke, all she could feel was wetness. Unaware of what to do, she diligently relied on this lady to help her.

“The lady, told me that she had been through this before and could help me, she asked me no to worry or be scared”

To her amazement, the lady wore black rubber shoes, pressed on her buttocks, and prodded her to push.

I pushed, and pushed, and pushed, until we could see the baby’s head, she says.

Meanwhile the bus was moving, probably to get her to the nearest hospital as soon as possible.

With abated breath, Susan says that she was drained. “I was so tired, I could not push anymore, but we were lucky as I was rushed to Pap Onditi hospital”

However as they got to the hospital, the doctors there could not help the young girl; they did not have equipments to deal with her state and therefore referred her to the Provincial Hospital.

The baby could not move, and from the pain, she passed out.

At the provincial hospital, Dr Paul Mitei says that Susan had had an obstructed labour, the fetus was dead.

“She had also gotten infections, and therefore we had to remove the baby through cesarean section,” says Dr Mitei.

A week later, says Mitei, Susan developed more complications; she had severe pain in her stomach.

We had to take her back to theatre since she had sepsis, says Mitei. Sepsis is a medical condition characterized by a whole-body inflammatory state caused by infection.

Sepsis is broadly defined as the presence of various pus-forming and other pathogenic organisms, or their toxins, in the blood or tissues, says Mitei.

Susan’s condition had now worsened and Mitei says that they had to take her for surgery to remove the pus. In the process they also discovered that the upper part of her Uterus had been destroyed and so it had to be removed.

She was in danger of getting Fistula, but we have been able to save her. The doctors at the hospital had to maintain her for 14 days where she was under drugs and she was being monitored on her condition every day, says Dr Mitei.

The saddest part however is that Susan will never conceive again, she only has her lower uterus left.
But she is not moved by that.

“I knew that I would not come back after the second surgery, but I am alive. I don’t care that I cannot deliver anymore, because I never want to go through that pain ever again,” she says.

Monday, June 8, 2009


By Judy Waguma

Sineno has a round, smooth face. Her complexion is chocolate and her smile infectious.
The jolly girl greets us candidly as we enter the rescue center. She is lively, and speaks fluent Kiswahili.

The young girl looks in perfect condition and happy, oblivious of all the troubles she went through. Sineno is not just any other child. She has been robbed of her innocence. She was raped and now lives with the agony of seeing her perpetrator every single day.

Sineno, 11, comes from Taveta district, where she lives with her single mother and three siblings. At the age of nine, a man she knew only as a neighbor, attacked her and defiled her in a nearby thicket on her way home from school.

The little girl finds it hard to talk about the experience. Her face has changed. The former bubbly child has been transformed into a pouting and not-so-friendly person. She is fidgeting with her clothes as tears well in her eyes. The memory is unbearable.

“He grabbed me, pulled me into the thicket and defiled me,” she recalls. The 50-year-old man, after finishing his dastardly act, left her unconscious in the thicket, not caring whether she was still alive or not. The only thing Sineno says she remembers is that the man threatened to kill her and her family if she told anyone about what had happened.

But she couldn’t care less; she was in too much pain. When she gained consciousness she stood up and walked slowly home. Her mother was livid with rage. Her first step was to report the matter to police, and the man was arrested. She then rushed her daughter to Coast General Hospital, but the medical staff could not handle her case. Her genitals were badly damaged. “Coast General Hospital referred me to Nairobi Women’s Hospital, where I was admitted for a week,” the little girl recalls.

Sineno has now recovered, but she constantly gets rashes and pain in her genitals. She does not know what the problem could be, but she has to be taken to hospital each time the rashes occur. She says her attacker’s case is pending in court. He was released on bond, but still goes to court for hearings. “However, he has threatened that if we do not withdraw the case, the whole family will perish, and that’s why I was brought to the rescue center,” she adds.

Joseph Okwino, the home’s director, says the girl has made tremendous progress. When she was brought to the center, where she has been living since, she could not stand seeing men. “The young girl would set out for school, but would not reach there, say that someone had threatened her on the way,” he points out.

“She would come back with so many excuses, until we figured out what the problem was and put her through a counseling session.”

Sineno is not alone; there are other defiled young girls at the centre. Nine-year-old
Rachael was left to take care of her siblings as the mother went to fend for them as a sex worker, says Okwino.
That night, Rachael says, a neighbor came calling in the pretext that he was looking for her mother. It is at this point that he attacked her. She is till in pain as she struggles to forget the day. She, too, contracted a sexually transmitted disease and has to seek medical attention every so often.
The centre is home to 14 other girls, each with a different problem. Initially, says Okwino, the place was meant for physically abused girls. But today, it receives all manner of cases, ranging from sexual abuse to domestic issues. It also houses teenage mothers.

But Okwino says the center is a temporary shelter, as the girls stay for some time as they get medical attention or counseling before rejoining their families. It is also home to girls whom, the administration, feels are at risk in their own homes. An example is Sineno who is still being threatened by her attacker. Action Aid brings in the children, gives them support by taking them to hospital, he explains. They are provided with food and medicine as well.

He explains that in the area, defilement is rampant. “We also girls who have been defiled by their fathers, strangers and other people known to them. “At the moment, we have a girl who was defiled by her father and she conceived,” Okwino adds.

“We took her in, and now she has gone back to school, we take care of her.”