I am stronger on my own....
‘I was diagnosed some few months ago and found to be HIV positive, I had no sign of being HIV positive but I was shocked to know that “kumbe” I’m infected.’ Karen (not her real name) says when asked her story.
Being a mother of two, she didn’t expect such a big blow to hit her like that. “I have never disclosed my status to even my children and other sexual partners because I really fear what these people might do” she adds.
Karen was diagnosed after she fell ill and went to Burnt Forest dispensary to receive care. She thought her illness was due to the extreme cold in the area. She thought she had developed flu or maybe she had malaria. Her aim was to go to the dispensary and back to make lunch for her children before they came back from school. She was tested and found to be HIV positive. Her reaction surprised many, including the health care givers at the hospital. She wailed uncontrollably cursing at the top of her voice. Two clinical officers attempted to counsel her but she strongly refused. She went home distraught with tears flowing down her cheeks. She was in denial and became hostile towards everyone. Even her children were scared of her. “No one could follow me up because I gave out the wrong information about myself on that day,” says Karen. She fell seriously ill and was taken to Burnt Forest hospital where she was treated, started on ARVs and discharged.
It was during this time that she met Grace, a Community Health Worker (CHW) who she sought help from after being too weak to work. She needed food which Grace helped with once in a while. Being still in denial, she hid her Burnt Forest card and went for retesting at Ampath centre where she tested positive again and was counselled by the nurses. She was referred to Burnt Forest where she continued using her older card.
Karen is now stronger and can provide for her family through casual jobs. Her husband who Karen suspects to have given her the disease but who keeps denying, works as a watchman but does not support the family.
Karen therefore vowed to live positively as others have done and to encourage people to visit VCT Centres for testing. Karen thanked NIA Kenya and Red Cross for rescuing her and letting her know the right steps to take through Grace. She promised herself that she won’t proceed on spreading the virus and instead encourage people to go for testing so as to know their status.
Where culture hinders disclosure and openness;
Born in 1956, Kipketer Arap Sang looks stronger today. He ushers us into his compound and helps us settle. Arap Sang is married to a cheerful mother of four. Sang had problems with his wife in 1999 and as culture stipulates, she had to be taken back her home to learn some manners. Upon her absence, Arap Sang became a “free” man and freely began hunting for fresh and energetic blood, hopping from one lady to another. He was not aware of any existence of diseases such as HIV/AIDS.
When his wife came back, he relegated his infidel ways and settled down to continue building his family with his wife and kids. His wife delivered their lastborn later on and as before, Arap Sang continued to drink. This, he attributed to probably be the major reason as to why he never got to know about the disease earlier. He fell ill and later progressed to being in a bed-ridden state. He was then taken to Eldoret Town Hospital after being forced due to the development of other complications such as swollen feet.
He was later in 2007 referred to Moi Teaching and Referral Hospital where he was admitted for two months. He was diagnosed and found to be HIV positive but his friends hid this from him, telling him his illness was due to his heavy drinking. He was discharged after two months and went home but fell ill again after a short while. He visited the nearest dispensary (Burnt Forest) where anti-malarial drugs were administered to him. His status was however not disclosed to him.
His immunity had greatly diminished. He fell ill again and was bed-ridden for a long time. He almost lost his ability to walk and could not move out of the house on his own. His family was in a state of abject poverty and they could not provide for his meals at times. This further exacerbated the situation making him completely dependable on others. “nilikuwa karibu niende kabisa! (I almost died), even my friends and neighbours always thought I would definitely die only for me to resurface well and stronger.” He was admitted to Burnt Forest hospital where he was tested and found positive.
Sang was summoned by the doctor, counselled and started on ART but wasn’t alarmed; he knew his previous actions had caught up with him. He however decided not to disclose his status to his family or friends for fear of being stigmatised. Therefore, he used to hide the ARV drugs and appointment cards from his wife. She however learnt from some of his friends about his status and confronted him. She even thought of killing her husband and herself.
Sang’s wife was convinced to visit a VCT Centre for testing. She tested negative and both were counselled to adhere to use of condoms during sexual intercourse. This discordant couple is served by a Community Health Worker who regularly visits to check on them and supply them with condoms.
From sex work to a business lady.........my own story
One of the program beneficiaries is a 28 year old lady called Ann (not her real name) in Burnt forest Town, Eldoret. In 2008, she got married to a loving and caring husband together with whom she was blessed with 2 children; a 3 year old daughter and a 2 year old son. Her husband started drinking local brew that led to an abusive relationship. She suffered through years of abuse and domestic violence that forced her to separate from her husband in the year 2010.
She was then left with her two children in pursuit of a comfortable life in spite of her being hopeless and defenceless since her husband used to be the sole bread winner for the family. Misery and predicaments befell the family making it challenging to settle bills and fees for her children’s education which caused her to seek advice and help from friends and peers.
Being in a semi urban set up, and far from family members, she was approached by sex workers who introduced her to an “easy to get” business. Her friends complemented her looks saying “You’ve got what is needed for the job, let’s go for it and you’ll earn a lot of money.” This and the desire to meet her children’s needs lured her into the business despite having been against it for a while. She chose to enter the business due to the difficult circumstances that surrounded her.
In early 2011, she became fully involved in the business in order to support her family. She attributes the nature of the work with challenges and hardship; she was forced to exchange sex for security offered by security officers at night, furthermore she encountered humiliation from rude and abusive clients due to low bargaining power since she was “new” in the business, paid as little as Ksh. 50 per client. She was coached to be a specialist by fellow sex workers and for 2 years that saw her able to foot bills and educate her children. Despite her practice, Ann points out that she faced a lot of obstacles while looking for alternative sources of income that would allow her abandon this life of struggle.
In November 2012, Ann was reached through an outreach program, a program targeting Most at Risk Populations (MARPS) implemented by NIA-K, a Global fund round 10 supported organization located in Burnt Forest. Through training and education, she was introduced to alternative means of generating income apart from sex work. “Besides the challenge of sudden behaviour change, being involved as a volunteer with NIA-K benefited me greatly. In addition to reaching out to my peers, my own life has also changed because of the knowledge I acquired which helped me to change my risky behaviours” she says. Given that she had no business at hand, the transport and lunch allowance of Ksh. 500 awarded to her at the end of the meeting, motivated her to enrol into the program.
Later in the GF program she joined a salon course as a result of an idea conceived from the training that she had underwent. This enabled her to singlehandedly save some money to start up her own business. Her resilience and determination made it possible for her to open up a salon in Burnt forest town in early 2013 to supplement basic family needs. This business has considerably enabled her to grow to be a self-reliant lady; successfully raising her children and enabling them get education. She’s being followed up by program peer educator, Makena, for positive behaviour change.
HIV positive Sex worker
In Jua Kali Centre along Kenya-Uganda road approximately 20kms from Eldoret town, we met 30 year old Everlyne. Everlyne was raised by a single mother in a polygamous family of eight children following the death of her father in 1996 when she was just 13 years old. A drastic change of circumstances followed since he was the sole bread winner for the family.
Everlyne was forced to drop out of school and left her mother to stay with her grandmother in Sotik Town in pursuit of a better life, given that she was the second born in the family. She managed to get short term casual jobs around Sotik Town that gave her a ‘taste of money’ which was completely different compared to the old rural home life.
Everlyne says, “At first I just wanted to help at home, earn some money and save enough to help my mum and siblings. But I later realized I could buy whatever I wanted which felt good for a change”
At the mere age of 16, she was introduced into sex work after mingling with modestly rich men from the community. Her first encounter was with a client who purportedly wanted to be helped with domestic chores only to find out later that he was after sexual favours. She was given cash and that intrigued her to come again for another “service”.
This single act led to addiction and psychosocial torment in her life after she realised that she had become a captive of sexual exploitation. With the taste of money, she relocated to Kapsoit Town Centre to immerse herself fully into the business. She unfortunately got pregnant with her first born when only 18 years old. As she was not married, she took her first born son to stay with her mother back in the village while continued with the “business”. This apparently appealed to her since she could afford to save some money as well as send some back to her family for her child’s upkeep barely having time for her son’s upbringing.
A year passed and she became pregnant with her second born but she opted for an abortion citing that she was not prepared for the responsibility.
Three years later she moved to burnt forest having heard that it’s a hot spot for sex workers who need high scale pay from truck drivers. She however states that she was greeted with challenges and predicaments that made her barely able to survive the business. She started feeling ill in 2010 which she later thought to be unusual after being put on different medications. She was prompted to seek intervention at a higher level that led her to AMPATH centre in Burnt Forest where she tested positive. With tears rolling from her eyes, Everlyne narrates that unprecedented psychosocial trauma and torment befell her when she started to develop opportunistic infections like chronic diarrhoea since she had rejected medication following denial and stigma that came from friends and relatives. She was bed ridden without support and a shoulder to lean on throughout the whole ordeal.
She was later approached by a NIA-K Community Health Worker during outreach community meetings, a program funded by Global Fund Round 10, who led her again to AMPATH centre where she was restarted on ARVs. Thereafter, she experienced a tremendous improvement in her health, phasing out all the signs and symptoms of HIV.
Later in 2012, she moved to Jua Kali Centre, along the Kenya - Uganda Highway, that greatly harbours sex workers who equally target truck drivers. She was reached out to again during outreach exercise by NIA-K. Everlyne points out that she still faced the risk of re-infection since she was still obliged to embark on the activity due to lack of alternative source of income.
The NIA-K, through funds from Global Fund Round 10 organized training on income generating activities and positive behaviour change which prompted her to establish a self-sustaining business. Through the training, Everlyne has managed to put up a firewood and charcoal store business in Jua Kali to sustain her living as opposed to sex work. The business has enabled her to educate her 14 year old son now a class 8 candidate. Her business has grown leading to a second branch at Baharini centre in Eldoret. In winding up her narration, Everlyne highly appreciates NIA-K program for allowing her to face life with positivity regardless of her state as a PLHIV. She has been trained as a peer educator for sex workers in Jua Kali within the program.
A CHW led the team to one of her PMTCT client who is HIV positive. Mary, a mother of 3 children aged 12years, 10years and 7 months respectively knew her HIV status when she first went for her 1st Ante-Natal Care visit during her most recent pregnancy.
As we sit down to talk with her, she scans her surrounding to make sure no one is listening. The CHW informs us that there still exists some level of stigmatisation in the community. Mary tells us that her health begun deteriorating in 2012 just before she noticed she was pregnant. She was taken to hospital and was treated without testing.
She later realised that she was pregnant and visited the hospital for antenatal care. It was during this time that she was tested and confirmed to be infected. Her CD 4 count by then was 247 and she was put on medication immediately. The mother was so stressed and it was very difficult for her to accept her status and further disclose it to her husband.
After some time through health education and counselling by the CHWs, she was able to disclose her status to her partner who also tested positive and is also on medication. The mother continued with her visits to Emusanda Health Facility as well as receives regular visits from the CHW giving her health education.
She eventually delivered at the health facility and was advised to exclusively breastfeed for 6 months which she did with constant support from James the CHW and her husband. The baby is currently 7 months, very active, healthy and HIV negative. This has made the mother so happy and promised to bring up the child as advised by the CHWs and the health care providers. The mother was also advised to join a support group and the CHW was tasked with that responsibility.