December 1-15, 2010
ISSUE 030
A bimonthly on-line newspaper by the Media Diversity Centre, a project of African Woman and Child Feature Service
Kenyans dying of pain Terminally ill patients being driven to their graves By Duncan Mboyah When you are facing a serious illness, you need relief. This is important for people of all ages and at any point in an illness. It can be delivered along with treatments that are meant to cure. However, palliative care for children is not taken seriously in the country as many children are currently suffering from terminal ailments without pain killers. “Kenyan children with cancer and living with HIV/Aids are living and dying in horrible agony yet the Government is capable of saving them from such pain,” reveals a Human Rights Watch report. The report found that pain medicines are cheap, safe and effective but the Government had failed in availing them to the sick children.
Palliative “The Kenya government and donors must work towards providing palliative care to all irrespective of age by attending to the children as well as the elderly,” says Ms. Juliane Kippenberg, senior children rights researcher at the Human Rights Watch. She said that the Government needs to urgently change its policies that restrict access to inexpensive pain medicines, investment in palliative care services and also train its health workers adequately. This is happening despite the government being aware that many children in the country have cancer, sickle cell, tuberculosis and HIV Aids related ailments that require constant consumption of pain killing drugs. The report indicates that 150,000 children also die every year from HIV/Aids related ailments even as donors are not keen on supporting pain treatment as they allocate no funds for the pain killers. Orphanages that offer care for children living with HIV Aids also suffer from se-
Patients outside the Nyahururu Hospice located within Nyahururu District Hospital. The facility caters for cancer and HIV infected persons within Nyandarua and Laikipia County. Inset: Children being weighed before treatment at a medical facility in Ukunda. Most terminally ill patients are having challenges in accessing pain killing medication. Pictures: Reject Correspondent
vere HIV related pain leading some to die when they become resistant to Antiretroviral therapy (ART). In most cases the majority of children in Kenya are cared for at home but with little support as they are mainly given paracetamol and bruffen by their guardians who also do not have inadequate resources.
Kippenberg observed that despite the government’s efforts in establishing a few hospital palliative care units in recent years, much more needs to be done to stop sick children from suffering needlessly. Continued on page 2
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ISSUE 030, December 1-15, 2010
Unfiltered, uninhibited…just the gruesome truth
Pain killing drug shrouded in a cloud of mystery By Duncan Mboya The World Health Organisation and Kenya’s drug policy considers oral morphine an essential medicine for treating chronic pain. The drug is listed among the essential medicines in Kenya. However, the Government has erected legal and regulatory barriers to using morphine in treating severe pain. On the other hand, the Kenya narcotics law focuses on illegal uses of morphine and makes illicit possession punishable by life imprisonment and a heavy fine. Morphine is recognised for its medicinal value in the management of chronic pain. There are, however, exceptions for medical use but these too lack detailed guidelines on lawful possession by patients and health care workers making health practitioners think that morphine is a banned drug in the country. The problem is that most doctors have not appreciated that it is one of the essential medicines, hence the failure to prescribe it. As a result, oral morphine is available in just eight of the country’s approximately 250 public hospitals.
Children in the cancer ward at Kenyatta National Hospital interact with the doctors. The pain killing drug morphine, that is used to relieve pain, is not easily availed to those who need it as doctors fail to prescribe it. Picture: Reject Correspondent
The seven health facilities are Kenyatta National Hospital (KNH), Moi Teaching and Referral Hospital, Nakuru Provincial General Hospital, New Nyanza General Hospital, Kakamega Provincial General Hospital, Embu Provincial General Hospital, Nyeri Provincial Hospital and Nanyuki District Hospital. According to Ms Cathy Otieno, company pharmacist for Laborex Kenya Limited, the dispensation of morphine is poor due to bad laws that restricts its sale to pharmacists only. She says they have been storing morphine for the last three years but seemingly doctors are unaware of its importance in relieving pain to the sick. “Doctors need to be sensitised on the importance of morphine since it has an unexploited potential that is needed in the country currently,” she reiterates.
The Kenya Treatment Access Movement (KETAM) Chief Executive Officer, Mr John Kamau notes that people with terminal ailments suffering due to negligence by medical practitioners for failing to incorporate morphine in the list of the recommended drugs. “Care giving at the last stages should be put in place since not only the sick suffer but their parents and guardians too,” says Kamau. He suggests that morphine be distributed to all health facilities given that terminal ailments associated with lifestyle that have led to the increase of non-communicable diseases are on the rise. Although 250,000 people in Kenya are on antiretroviral treatment, all the morphine available in the country can treat pain in only 1,500 terminal cancer or Aids patients.
Known as the country with the highest per capita income in East African region, it is pathetic that it has the worst children health indicator. But in 2008, Uganda which is poorer than Kenya used twice as much morphine per person as Kenya. South Africa uses 18 times more and Canada 240 times more. To date, Uganda has 50 hospice providing palliative care services, including morphine, demonstrating that with political will people need not suffer pain. As the government continues to fail in addressing the issue, the incidence of cancer in Kenya is also rapidly rising, hence calling for the use of morphine and other related stronger pain killers. The government estimates that there are 80,000 cases of cancer every year in Kenya.
Terminally ill Kenyans dying before time Continued from page 1
Kenya Hospices and Palliative Care Association National Coordinator Dr Zipporah Ali says the country has 30 hospices. “This number is too small considering the fact that they do not cover people in rural areas adequately,” explained Ali. “The government has also developed 10 palliative care sites in health facilities but they lack good pain killers such as morphine that is highly recommended for people suffering from long ailments,” Ali added. She noted that people in rural areas are at risk as they do not get palliative care as opposed to those in urban areas who have access of the drugs. Ali observed that people who live with terminal ailments lives longer lives once they are prescribed better pain relieving drugs. But in Kenya, the training of medics on palliative care has not been given the seriousness it deserves. The training time allocated for palliative care is only two hours as opposed to other areas.
So far only 70 medical personnel have been trained to serve people living with terminal illnesses but unfortunately palliative care drugs are not available. Ali recommended that the Government’s clinical manual should include morphine and also be availed in all sub district hospitals. “A number of HIV/Aids positive orphans are living with their grandmothers but unfortunately they are suffering to death as their guardians fail to access palliative care in health facilities in their localities,” explained Ali. She observed that besides the children, adults also suffer as they are unable to access the best pain killers that could help in alleviating their pain. The Human Rights Watch report reveals that health workers in Kenya rarely communicate effectively with the sick children and their families about the illness. “They often fail to inform parents and the sick children who are old enough to understand their diagnosis and basic facts
regarding their treatment,” the report states. The report recommends that the Kenya government ensure that the National Cancer Control and Prevention Bill and Strategy contain strong provisions addressing pain treatment and palliative care for both adults and children. It further calls for the creation of palliative care units with expertise in children palliative in districts, provincial and national hospitals and raise awareness about the existence of these services.
Policy The report also urged health donors to ensure that all patients using donorfunded clinical services for life limiting illnesses access palliative care, either by providing it as part of the service or by strengthening hospice and public palliative care services and facilitating access to them. Despite the WHO plea for countries to establish a national policy for pain relief and palliative care, Kenya has no such
policy or strategy in place. The national health plans for 20082012 only include tuberculosis, malaria, HIV, access to clean water and sanitation as well as maternal and reproductive health. However, it has no mention of palliative care or pain treatment. Kenya’s 1994 Narcotic Drugs and Psychotropic Substance Control Act (Narcotic Drugs Act) regulates morphine and other opiod pain medicines. Illicit possession is an offence punishable by life imprisonment and a fine of up to one million Kenya shillings or $12,256. The Act, however, contains exceptions for medical use, allowing medical practitioners and pharmacists, as well as patients to handle, prescribe and possess. Hospices must obtain license to stock morphine and all health facilities must account annually for how they used the morphine they purchased. The harsh punishment in the Act is the cause of reluctance by medical practitioners to prescribe morphine to sufferers of terminal ailments.
ISSUE 030, December 1-15, 2010
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Unfiltered, uninhibited…just the gruesome truth
HIV Aids
Confidentiality remains a right in testing By KEN NDAMBU When Ben Nzusya fell sick on the night of February 30, 2008, he complained of severe headache, stomach pains, general body weakness, chest pains and endless coughing. He had just arrived from Mombasa where he worked in one of the beach hotels. After he was given a sick off, he travelled to his Kitui rural home but the illness persisted. Nzusya was taken to Kitui General Hospital where he was compelled to undergo HIV testing first. He was diagnosed with Tuberculosis (TB). He also tested HIV positive. His wife was also infected and suffered similar ailments. The couple underwent the same process and was put on anti-retroviral drugs. Nzusya gave up his job at the Coast. Once his health improved with the antiretroviral therapy, he underwent training and is now an HIV/AIDs awareness creation educator in his village with support from the Kitui Catholic Diocese.
Stigma A few years ago it was very hard to find anyone coming out openly about their HIV status. But when the pandemic was declared a national disaster things changed. While an individual is entitled to have his or her status kept confidential, many of the people living with Aids have had their rights violated. According to Dr Ignatius Kibe of Kenya Agriculture and Health Improvement Initiative (KAHII), an indigenous NGO which advocates for HIV/Aids patients, rights and confidentiality must be respected. Kibe says a HIV/Aids test must be done with informed consent of the person or a guardian for the minors or those with disability. “HIV testing has to be voluntary as forced testing further stigmatizes and discriminates the patient further,” says Kibe. He adds: “Even though -premarital testing helps couples to make an informed decision it must be voluntary.” The right to privacy is violated when one is subjected to a HIV test without informed consent. People living with HIV/ Aids (PLWHA) suffer total stigma and are often victims of human rights violations needing good care and support. Things get
worse for them if their rights are violated. Outlining ways of addressing human rights violations and discrimination, Kibe stresses the need to voluntarily counsel anyone before he/she agrees to be tested. There is need to maintain strict codes of conduct for confidentiality by all persons handling the patients information including medical practitioners and employers.
Human rights The HIV/Aids Act 2006 provides full protection of human rights and civil liberties to persons suspected or infected by compulsory testing. The Act guarantees the right to privacy, outlawing all forms discrimination and ensuring provision of health care and services. But a doctor at Kitui General Hospital who requested anonymity says results of HIV tests should be treated as confidential and can only be released to the tested person. “Medical practitioners are, however, put on a vicious cycle because the patient is brought to the hospital by relatives and friends and when eventually put on ARV drugs, there is no secrecy as the relatives assume that he is HIV/ Aids positive,” explains the doctor.
Protection In the case of children, the result is given to a parent or legal guardian but there could be exceptions where a person is unconscious and unable to give consent to be tested. In this case the medical practitioner makes a decision on behalf of the family. However, the doctor says a person who offers to donate blood shall be deemed to have consented to the HIV test as the blood should be disease free before it is transferred to patients. “This is where the patients’ rights seem to be violated,” he said. If the rights of people living with Aids are protected, it becomes easier for them to receive voluntary counselling and testing. “It also makes it easier for them to get the information and medical treatment that they need to lead healthy lives,” says the doctor.
Zaituni (standing centre), a Muslim woman living with HIV talks to patients at a health centre in Eastleigh. The culture of silence is making many Muslim faithful fail to seek medical help for HIV related illnesses on time. Picture: Edwin Kiprotich
Culture of silence makes it difficult to manage infections By EDWIN KIPROTICH Zaitun faced a lot of challenges when she was tested positive in 1996. She began living a life of withdrawal and self pity. Her husband had worked at Isiolo as a police officer, while she worked in Nairobi as a nurse but their home was in Malindi. Being Muslims, Zaitun hardly got to know of the cause of her husband’s death since a post-mortem was not performed. Islamic culture dictates that the dead be buried within 24 hours, and with this there is little time to discuss the cause of death. Zaitun learned of her condition when she fell ill and was hospitalised. When her co-wife passed away in 2002, the sad reality that she was next hit her. Her failing physical and health condition became subject of stigmatization among friends and colleagues. She says most of her colleagues who tested positive died as a result of psychological trauma. However, Zaitun’s brief brush with death in 2005 became her turning point. After getting a new lease of life, she came out publicly and
declared her status. Using herself as an example, she has encouraged many to come out and be tested. However, it has been challenging dealing with refugee communities in Eastleigh where she lives.
Challenges Convincing married couples, especially the male partners to come out and be tested has not easy. Some who tested positive have not be willing to enrol for the antiretroviral therapy or may not take the drugs especially during the month of Ramadhan. Among Muslims, sex is a taboo topic even for married couples. In the wake of HIV/Aids pandemic, this culture has made them vulnerable. Those already living with the condition are scared to come out and declare it publicly since they are most likely to be stigmatised by the community. The polygamous family system, where a man is at liberty to marry up to four wives further worsens the condition since an infected spouse may not reveal her/his status to the partner.
Among Muslims, sex is a taboo topic even for married couples. In the wake of HIV/Aids pandemic, this culture has made them vulnerable.
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Unfiltered, uninhibited…just the gruesome truth
HIV Aids
ISSUE 030, December 1-15, 2010
Free flowing money on highway increases risks of HIV By NZINGA MUASYA Thika highway is a multi million project. It is consuming a lot of money in terms of construction. However, it is also releasing a lot of money that is being paid to workers and others involved in subsidiary services. The 50.4 km project is set to consume KSh26 billion upon completion. However, this kind of money is increasing hyper sexuality and careless unprotected sexual escapades. The partakers of this loose money are the suppliers, engineers, supervisors, road surveyors, drivers, day labourers, plumbers, bitumen and concrete mixers and hundreds of food hawkers supplying food and refreshments to these workers. Commercial sex workers, including men who have sex with men have flocked this strip to lay claim to this stake. Centres likely to be affected include Muthaiga, Kasarani, Juja, Githurai, Ruiru and Thika. Here hyper sexuality and high levels of prostitution have been necessitated by the flow of money. Other nearby towns like Kiambu, Githunguri, Gatundu and Kilimambogo are also affected.
The Thika Road superhighway is a multi-million project that has generated a lot of money among casual workers and other related businesses. Picture: Reject Correspondent and Nzinga Muasya.
Rising prevalence At the end of the project which is scheduled to last more that two years HIV/Aids prevalence is expected to rise by between two to three per cent in the said areas. This rise could be catastrophic noting that the disease is shifting from major towns to rural areas. Dr Ignatius Kibe of Kenya Agriculture and Health Improvement Initiative (KAHII), a non govern-
“HIV/Aids follows the steps of big money, more commonly where it is loose and fluid.” — Dr Ignatius Kibe
mental organisation that has been collecting data and conducting training workshops on HIV/Aids in urban centres says that the downpour of money along the highway is the main contributing factor. “HIV/Aids follows the steps of big money, more commonly where it is loose and fluid,” explains Kibe. He notes that between university way and Blue Post Hotel in Thika, a huge chunk of this money is flowing like rain which is paid constantly to casual workers. A survey done by National Aids Control Council in conjunction with Ken-
ya Demographic Health Survey shows that HIV/Aids is on the increase in Central Kenya where it was 3.7 percent in 2008-2009 and now stands at 4.7 percent. “The most vulnerable groups are construction workers because they have a lot of money to spend and are easily lured into irresponsible sex,” notes Kibe. The pandemic is also likely to hit hard at institutions of higher learning along the highway, and especially the adventurous youths. “Many students who are known to venContinued on page 5
Goats donated to empower those living with Aids By JOSEPH MUKUBWA It was joy and celebrations as over 200 HIV/ Aids victims recently when they received goats as Christmas gifts. People living with HIV/Aids from Kieni West and East districts received each a dairy goat from a Catholic Church organisation known as St Joseph HIV/Aids Self Help Group. The goats will serve them with milk which is expected to improve their health. They are expected to rear the goats which they will give back once the animals have given birth. They will return the orig-
inal goat to the self help group which will in turn give them to other survivors. The goats were bought in Thika with funds from mobile phone provider Safaricom which together with a German NGO gave KSh865,000. “The goats are not for eating during this Christmas season but are aimed to keep the promise of the victims so that they can know that they are important members of the society,” said Mr Haron Kamau, project coordinator. Those who benefited are from AmContinued on page 5
Kieni East and West districts HIV/Aids victims received dairy goats from St Joseph HIV/Aids Self Help Group. They are expected to rear the goats and give back once they reproduce. Picture: Joseph Mukubwa
ISSUE 030, December 1-15, 2010
highway increases risks of HIV Continued from page 4
ture out in search of pocket money are having a field day,” claims the doctor. Githurai, Ruiru, Juja and Thika towns where most of these institutions are situated are teeming with drunken youth who exchange sex for money. Kibe says single mothers living along the highway will be tempted to have boyfriends from the construction sites. “Nightclubs have sprung up in Juja, Ruiru, Githurai and Thika where several students carouse and make merry throughout the night, only to stagger back to their hostels in the morning,” he explains. “All colleges and universities along the highway should alert their populations of the consequences of the millions of shillings that will be spent in their vicinity,” reiterates Kibe. He advices: “College administrators should caution staff and students to take care and not register hikes in HIV/Aids due to the financial downpour brought about by the construction of the road.” When women travel from upcountry to do menial businesses or even trade in sex they carry back home the virus, thus this project will increase HIV prevalence in rural areas peripheral to urban centres. The effect is likely to be felt in the nearby Kiambu, Murang’a and Machakos counties. The phenomenon should also be anticipated in other places where similar road works going on. He notes that donors sponsoring construction of the super highway had suggested that at least five percent of the funds be directed towards the prevention of HIV/Aids along the highway.
Awareness campaigns “A casual look indicates no such funds have been utilised into the prevention and control of the disease, otherwise information should have been evident from billboards, posters, banners leaflets and construction trucks. Workshops would have been held within the communities along the highway to sensitise them on possible rise of the scourge,” explains Kibe. Such measures are key and authorities should ensure they are put in place to reverse the trend. Kibe calls on faith based and civil society organisations to preach and educate the masses on the consequences of fluid money flowing along the highway.
Continued from page 4
boni, Ewaso Nyiro, Endarasha and Samaki. Over 400 others will be given soon since there are over 600 victims in both Kieni East and West districts. The goats produce over two litres of milk per day and mostly give birth to triplets. “I am happy to have found a new source of protein,” said Peter Macharia from Endarasha. From Samaki area, Ms Mary Nyaguthi, 52, has been using almost KSh100 per day to buy milk. “The money will now be saved and used for other purposes,” she says. The goats were presented to the individuals and several groups by Mr Caritas Nicholas Wambugu, an official in charge of micro-finance project from the Catholic Church. The St Joseph HIV/Aids Self Help Group gives comprehensive care centre to seven HIV/Aids groups and provides basic needs such as food to the infected and affected families. They have 50 social workers who have been helping. The group also helps orphans in the area.
Unfiltered, uninhibited…just the gruesome truth
HIV Aids
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Multiple effects of male circumcision and counselling
Nyanza PC Mr Francis Mutie (right), the provincial director of Public Health and Sanitation, Dr Jackson Kioko (clasping his hands) and Riaga Ogallo (left), chairman Luo Council of Elders during the launch of HIV counselling in Kisumu. The Government is currently sensitising Nyanza communities on the benefits of Voluntary Medical Male Circumcision for HIV prevention. Picture: Odhiambo Odhiambo
By Odhiambo Odhiambo At only 24, John already had a series of girlfriends that he had lost count. He had not thought of being in a monogamous relationship. However, for man who “used to have many girls” taking an HIV test before being circumcised made him realise the folly of being in multiple relationships. John learned during pre-circumcision counselling that he was engaging in high-risk behaviour and if he wanted to remain HIV negative, he would have to change his behaviour. According to a small qualitative study conducted in Kisumu, being offered HIV counselling and testing, just before male circumcision has encouraged many men to change their behaviour to avoid HIV infection.
Research study The research is one of the studies being carried out to address concerns that being circumcised might lead to riskier behaviour. Twenty-five of the 30 men interviewed reported either no change in sexual behaviour after circumcision or behaviour change by using condom or having fewer sexual partners. The study was conducted by Mr Thomas Riess of the University of Illinois in Chicago together with a team from the same university and another from the University of Nairobi. It was sponsored by the United States National Institutes of Health and Centre for Disease Control and Prevention. According to a Male Circumcision Newsletter, the circumcisions had been performed between 1986 and 2008 on 30 sexually active men aged between 18 and 34 years from Kisumu District. Men who had recently been circumcised gave accounts of their sexual behaviour before and after circumcision. Those who had gone for the ‘cut’ in their youth — before clinical trials confirmed that the procedure could help protect men from acquiring HIV infection during penetrative sex. Nine men reported to adopting one or more protective behaviours. Five of them said that they had reduced the number of sexual partners and six said they had increased use of condoms. Some attributed these changes to the risk-reduction counselling or HIV testing and counselling services they
had received along with the procedure. An 18-year-old man said he learned how to use the condom during pre-circumcision counselling and started using them after he was circumcised. Another 18-year-old decided to become monogamous after receiving pre-circumcision counselling. “I realised I was messing up and I could lose my life so that is why I decided to change my ways,” he said. Seventeen men reported no change in their sexual behaviour. For some, this meant engaging in some level of risky behaviour. One man said he did not use condoms before or after being circumcised noting that he considered circumcision an alternative to condom use. Several others, however, reported that they already practiced safe sex and did not think that being circumcised was a reason to stop doing so. “I’m still cautious, just like I used to be even when I was not circumcised,” said another. Only one of the five men who engaged in riskier sexual behaviour after circumcision reported less frequent condom use. He explained that he had taken a temporary break to experience unprotected sex with his wife (while continuing to use condoms consistently with other partners) and had since resumed condom use with his wife.
Targets Four men said they had more sex partners since becoming circumcised but reported no changes in condom use. Almost all the men interviewed expressed an understanding that male circumcision offers partial protection from HIV infection and that circumcised men should continue to practice safe sex. Provincial Director of Public Health and Sanitation Dr Jackson Kioko said so far 151,000 men had been cut since September 2008 when the Voluntary Medical Male Circumcision (VMMC) programme was launched in the region. “We are targeting at least 100,000 men every year between now and 2014 in a bid to surpass our projections,” he said. The national programme, targeting the entire country, aims to circumcise about 1.1 million men by end of 2013. Kioko told Kenyans that male circumcision did not protect one from acquiring HIV and it only reduced chances of infection.
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Unfiltered, uninhibited…just the gruesome truth
HIV Aids
ISSUE 030, December 1-15, 2010
Women living with HIV demand sexual and reproductive rights By ERICK OTIENO From a casual glance, 23-year-old Diana Ivyonne is like any ordinary young woman nurturing life’s dream. However, when she begins to narrate her encounter with five men, five years ago, and what the future holds, tears roll down her cheeks. “Being raped is a bad experience that one cannot easily forget…growing up knowing that it’s difficult to enjoy your sexual and reproduction health rights is even much more traumatising for a young woman like me,” says Ivyonne.
Mishandled Ivyonne who contracted HIV during the ordeal is not only bitter with her assailants but also health care providers who she rushed to for help. She was shocked with the way in which they handled her case. “They only gave me antibiotics and discharged me. If I were given prophylaxis, I would not be living with HIV/Aids. They didn’t even care to admit me for close observation,” she says. Although Ivyonne has learnt to live positively with her status, she fears that she may not live to have a child because of rampant abuse of the sexual and reproductive rights of women living with HIV. Ivyonne’s worry is confirmed by the experience of Maureen Mirenga in the hands of healthcare providers. When Mirenga conceived her last child in 2004, she did not hesitate to go for antenatal clinic but the treatment she got from health care providers there still rings in her mind. “I was counselled and tested for HIV but when the results came out positive they threw my status on my face,” she says.
Today, Mirenga and her child are both HIV positive child. She says the situation could have been prevented had the healthcare providers respected her sexual and reproductive health rights as a woman. Ivyonne and Mirenga are Ms Lilian Mworeko, regional coordinator International Community for Women living with HIV and AIDS in East Africa (ICW), addresses the press at the end of the conference where young among hundreds of young men living with HIV/Aids complained of being mistreated by health care givers. women living with HIV/ Picture: Erick Otieno. Aids in Kenya who have been abused and denied their sexual and reproductive health the women access to safer sex and pre“Those who say they have been denied rights as a result of their status. vention of mother to child transmission PMTCT services could be talking about Similar stories rent the air at a gather- services. the past when there was still stigma and ing in Nairobi of young women living with “Women living with HIV who are attitude among healthcare providers but HIV/Aids who have come out to demand looking for family planning services are this has changed with the training,” he their rights to sexual and reproductive denied available options other than con- says. health. doms and tubal ligation,” says Mworeko. Cherutich also notes there are no limiKenya has in place a prevention of tations for people living with HIV with mother to child transmission (PMTCT) regards to family planning methods. He During the conference organized by programme, which helps women give says a woman living with HIV and AIDS the International Community for Women birth to babies who are HIV free. How- can only be denied one or more available Living with HIV and AIDS in East Africa ever, many women living with HIV who family planning options like the coil in a (ICW), the young women narrated how choose to have a child complain of harsh situation of sickness. they experience violence and sexual abuse judgment, stigma and harassment from every day. the community and healthcare providers. “The only challenge we have is female The women who came from across the But health authorities have dismissed country lamented lack of appropriate in- claims that women living with HIV/Aids condoms which are limited in stock but formation as well as health care and sup- are being denied access to sexual and re- with the support of the United Nations Population Fund (UNFPA) we expect to port which has increased their vulnerabil- productive health care. ity to HIV and violations of their sexual Deputy Director and head of HIV pre- secure sufficient quantity within a year or and reproductive rights. vention at the National AIDS/STD Con- two,” explains Cherutich. Section 45 1(a) of the new Constitution According to the regional coordina- trol Programme (NASCOP), Dr Peter tor of ICW in Eastern Africa, Ms Lilian Cherutich says healthcare providers have spells out that every person has the right to Mworeko, discrimination in health care been trained to provide services from a the highest attainable standard of health, which includes the right to healthcare servservices has denied many women who human rights perspective. have been raped access to appropriate He says more than 20,000 healthcare ices, including reproductive healthcare. There is, however, apprehension among treatment, care and support, like post ex- providers have been trained to counsel posure prophylaxis for prevention of HIV and test HIV infected mothers in a bid to many women like Ivyonne and Mirenga infection after rape. ensure successful implementation of the that implementation of the clause will not be effective. The healthcare system has also denied PMTCT programme rolled out in 2003.
Discrimination
Support
Youth engage in sexuality dialogue By Odhiambo Odhiambo About 150 youths in Migori District have received training on reproductive health rights and promotion of dialogue on sexuality at the family unit. The 11 day workshop sponsored by the United Nations Population Fund (UNFPA) through the Ministry of Youth Affairs and Sports saw the young participants receive tips on correct condom use to reduce the spreads of HIV
and Aids in the region. The youth were also taken through the anatomy and physiology of the male and female reproductive systems to enable them “know who they are”. Director of Youth Development Mr Julius Kubai and his assistant Mrs Josephine Mwangi underscored the importance of engaging the youth in a free and candid chat on their sexuality. “Most Kenyan parents fear discussing openly matters regarding sexuality
with their children and that is why we felt it is important to build their capacity for a healthy living,” said Mwangi. The programme is only taking place in four districts in the country including Bahari, Naivasha, Nairobi West and Migori. Mwangi said teenage pregnancy was on the rise, leading to the high rate of school dropouts because many young girls did not have anybody to turn to for “informed advice on their
sexuality”. “This group we have trained will go back to the villages to educate others on the information learnt here,” added Mr Alex Otieno, the Migori District Youth Officer. The participants were asked to educate their parents and grandparents on the need to discard outdated cultural practices such as female genital mutilation and widow inheritance that retarded socio-economic development.
ISSUE 030, December 1-15, 2010
A pillar of hope in Maragua By RYAN MATHENGE After ailing for many months, Mrs Joan Nyambura Mwangi went to a government hospital where she was tested for HIV. It turned out she was positive. That was in 2000. It is 10 years since Mwangi knew of her status. She has lived with the HIV virus after being infected by her husband. However, Mwangi decided that she would make the best of the situation. She decided not to live in secrecy and came out about her status, being the first person in Murang’a County to go public.
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Unfiltered, uninhibited…just the gruesome truth
HIV Aids
Village ravaged by scourge gets help from church
Rejection Mwangi did not know that she had almost jumped out of the frying pan into the fire. After coming out publicly on her status, she was at first rejected by her family before they later came to accept her. Other than her family, even the community in which she lived initially rejected Mwangi. They would later retract and accept her. The stigma went down and others have since joined her in the fight against Aids. Mwangi is now employed by Vida, a Spanish NGO and is attached at the Maragua District Hospital where she is charged with advising and counselling those who have tested positive and negative. “Those who test positive must be given hope and encouraged while those who have tested negative are advised on how to remain negative,” explains Mwangi. A year after declaring her status, Mwangi founded a group called ‘Friends of Joan’ in Mjini area, Murang’a town. Together they have been calling on the people of Murang’a to come out publicly and declare their status. The group has also received funds from National Aids Control Council and other well wishers in support of their work. Speaking to The Reject, the mother of three says she came to accept her condition in an effort to bring up her children who were left young after her husband’s death.
Support groups According to a former Maragua medical officer of health Dr Lyndon Marani, Mwangi has been instrumental in encouraging many people to know their status. “Joan is a pillar of hope as she has helped change the lives of many people who by now could have perished,” explains Marani. Maragua District Hospital VCT wing has a client base of 7,800 who are treated and given advice on how to cope with life despite being positive. “After one tests positive, they are grouped according to locality. In Maragua there are 40 support groups which meet every month,” explains Mwangi, who has been identified as a role model by giving encouragement to people who come out seeking assistance at the VCTs. “I have seen more people come out in the open for testing and despite public talk they turn out negative,” explains Mwangi. In December last year, several women who had been tested and found to be positive were assisted and delivered healthy babies after they followed instructions given by medics. Mwangi has never missed in marking Worlds Aids Day celebrations since year 2000 where she gives hope to persons infected with HIV/Aids.
Children whose parents have died from Aids playing at the St Luke’s Centre for Hope in Ulungu. The facility is housing more than 300 orphans. Inset: Grandmothers who have been left with the burden of caring for Aids orphans. Pictures: Ken Ndambu
By Ken Ndambu Naomi Muasya’s memory of the death of her daughter four years ago is still fresh and vivid in her mind. So does that of her son and daughter-in-law still haunt her as she bears the burden of caring for the orphans left behind. Muasya’s daughter Peninah Nzanzai was married with eight children. When her husband succumbed to HIV/Aids related illness, she was chased away from the matrimonial home together with the children. She had nowhere to go except back to her parents home. Here she found her brother and his wife were also suffering from the same disease. Nzanzai as well as her brother and his wife died in a span of three years. Their mother was left behind with 12 orphans to care for.
Burden Muasya’s age mates Emma Wambua and Emily Nyamai of Ulungu Village, Kisasi Location, Kitui District count between six and 12 orphans they are struggling to bring up after their parents died from the HIV/Aids scourge. These are just but some of the families. A visit to Ulungu Village reveals the dilemma its residents are facing as the scourge has taken away all the young people leaving behind a huge number of orphans with elderly guardians. For Muasya the death of her children left her in a difficult situation. “Taking care of the orphans has been difficult as many times we sleep hungry. Sometimes, the children abandon school to do casual work in the nearby farms so we can get something to eat,” she says. Muasya adds: “Sometimes my family
would look like a social misfit in the village as the culture has it that if one dies from HIV/Aids related illness, the stigma not only haunts the family but the entire village.” However, despite the difficulties the orphans have fared well. One of them has graduated from Jomo Kenyatta University of Agriculture but is yet to get employment. The children have been receiving help from St Luke’s Centre for Hope, Ulungu, a facility of the Anglican Church of Kenya (ACK) where more than 300 orphans have found hope, relieving the burden experienced by the guardians. The Centre Coordinator, Reverend Benjamin Mutia says a baseline carried out in 1998 showed that HIV/Aids impact in the area was great with at least every household having been affected or infected. Poverty, poor health and low level of education was high and is said to be a contributing factor to the rise in HIV/ Aids infections.
Rehabilitation The plight of the needy orphans touched the Christian Reformed World Relief Committee which offered to build a rehabilitation and vocational centre for orphans in the village. Since the centre came up, hundreds of orphans have found a place to call home. “Orphans and vulnerable children who finish Standard Eight and fail to get a place in secondary school get vocational training at the centre at
minimal cost.” The Red Cross has drilled a borehole at the centre from which clean water is supplied to the residents within a five kilometre square radius. From the borehole, 500 households can now get clean water and at the same time use the water for minor irrigations in their backyards. Says Mutia: “Part of the proceeds from the water sales assist the orphans to meet their basic needs like clothes and education.”
Giving back “As an initiative for the orphans, they are given a goat and a chicken to care for in their homes. The first offspring is given back to the centre for distribution to other children,” explains Mutia. Also the guardians are given capacity building on guardian to orphan relationship which stresses that communication is important for the wellbeing of the orphans. “When there is a lapse in such communication, it is the orphan who suffers and this even applies to parent to child communication,” says Mutia. The Church has six other centres in Mutomo, Ikutha, Yatta, Matinyani and Kanyangi to refurbish the lives of the less fortunate children.
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Unfiltered, uninhibited…just the gruesome truth
HIV Aids
ISSUE 030, December 1-15, 2010
Moraa is down but not out with positive status By BEN OROKO Five years ago, Ms Milkah Moraa, from the sprawling Daraja Mbili slums in the Kisii Municipality could have joined the list of people committing suicide after discovering that they are HIV positive. However, Moraa gave a second thought to her status and decided that contracting HIV was not the end of one’s life. “Discovering that one is HIV positive can be shocking and traumatising not only to the infected but to the affected members of the society,” says Moraa. She adds: “It is important that one takes courage and faces the reality that HIV/ Aids is real and that way they will be able to live with it positively.” Moraa, a mother of five, realised she was infected about six years ago, after separating with her husband who is a mechanic in Kisii town.
Bold steps She suspects she could have contracted the virus in 2005 after reports emerged that the wife to her former man friend (now deceased) had died from the disease. “When I received the news, I was shocked and this forced me to immediately abandon the man out of stress and trauma. Unfortunately he died from the disease two months after we separated,” says Moraa. She adds: “This caused me more stress and I decided to go for testing to know my status.” Moraa first went to Daraja Medical Centre for the test but the proprietor of the clinic, Mrs Winfridah Abuya, referred
her to Kisii District Hospital and accompanied for the tests. “The first tests revealed I was HIV positive. I could not immediately accept the results until I went through a second test which revealed the same,” explains Moraa. She reiterates: “Doctors immediately put me on tuberculosis treatment for eight months as I was too weak to be put on antiretroviral drugs.”
Awareness Her situation changed her view about the disease. She has been trained in homebased care and community health after she went public about her status in 2008. Since then she has been going round to chiefs’ public barazas (meetings), churches and other social gatherings creating awareness not only about the negative impact of the scourge but also the dangers of living in silence or denial. She has used such a force to educate the public on the need to visit Voluntary Counselling Testing (VCT) centres near them to know their HIV status. “I am setting the record straight and those from my Gusii community living in the retrogressive belief that people dying from the disease are bewitched should accept that HIV/Aids is real,” reiterates Moraa. She warns men from the community against hiding behind witchcraft yet still inheriting women whose husbands have died from Aids. She says the outdated culture was threatening the lives of many families as unsuspecting women in the region continue bearing the brunt of the scourge due to their husbands’ secretive
inheritance of women who have been infected with HIV. “It is interesting to attend the funeral of a person who has died from HIV/Aids in Kisii because during the speeches you will hardly hear the speakers mention that the deceased died from the Aids,” says Moraa. She adds: “Instead you will hear even priests and pastors presiding over the burial ceremonies deviating from the reality to mislead the public on the cause of death.” The culture of not speaking the truth about the cause of death is worrying and Gusii community is sitting on a time bomb.
Hope Despite knowing her status Moraa gave birth to a daughter who is now two and half years old. She is encouraging mothers who are HIV positive not to despair about giving birth and that with care it is possible for them to give birth to HIV negative children. Moraa’s daughter is negative, healthy without any health-related complications. I attended ante-natal clinics as required during which I was advised to deliver in the health facility to avoid transferring the virus to my baby,” she explains. Before she gave birth, midwives at the health facility gave her Nevirapine (NVP) tablet and her new-born baby was also given NVP syrup within the recommended 75 hours to avert the transmission of the virus from the mother to the child. “My last born daughter went through three consecutive HIV tests which revealed she was HIV negative before the doctors closed her file and declared her HIV negative,” says Moraa.
“It is important that one takes courage and faces the reality that HIV/Aids is real.” — Milkah Moraa Besides using ARVs, Moraa has always observed the nutrition advice that she should not take beef and instead opt for traditional vegetables, fish, chicken and blended porridge of soya beans, cassava, ground nuts and wheat flour. Moraa says she has tremendously regained her health. She is busy in her income generating activity selling chips at Daraja Mbili open air market. She also engages in small-scale poultry farming which earns her income to support herself and children with basic needs. Moraa got initial capital for her business from Daraja United Women and Youths Empowerment (DAUWOYE), a local nongovernmental organisation (NGO) dealing with HIV/Aids activities and programmes in the Kisii region. “The capital I got from DAUWOYE has empowered me economically. I use the income to support my children who are staying with their paternal grandmother in Gucha District. The money has also assisted me to pay part of the school fees for my first born son who sat for his Kenya Certificate of Secondary Education (KCSE) national examinations this year,” reiterates Moraa.
Nyeri holds a fun day for orphans By Joseph Mukubwa It was joy and dance as over 300 orphaned children from the larger Nyeri District came together to celebrate and interact. The children who were left behind by parents who died mostly of HIV/Aids congregated recently at Ministry of Public Work grounds where they shared a meal. They were also given presents which included clothes and shoes. The children sang and recited poems in the fun day, the first ever to be organized jointly by the Mukaro Orphans and Vulnerable Children (Movoc), Kenya Network of Women with HIV/Aids (Kenwa) and the St John’s Ambulance. The chair person of Movoc, Ms Immaculate Wairagu said the aim of the fun
day was for the children to feel that they are also important members of the society. The children aged between nine months and 19 years came from Kieni, Mukurwe-ini, Othaya and Tetu districts. Movoc has been engaged in tracing orphans out of school in the district and counselling them on the benefits of education. It also carries out regular home visits to orphans and vulnerable children, sensitizing community and care givers on the need of educating orphans to be responsible citizens. The organisation also sources for food which it gives to the orphans. “Today marks a day when children without parents come together as a family and interact with the volunteers and well wishers,” explained Wairagu. She said that they have been able to trace a children’s home at Mweiga town at a cost
Mukaro Orphans and Vulnerable Children (Movoc) chairlady Immaculate Wairagu speaking to the orphans at Nyeri town recently during the Fun Day. Picture: Joseph Mukubwa
of KSh30 million which has an orphanage as well as primary and secondary schools with a capacity of 1,500 children but have no funds. She appealed to well wishers and donors to support them so they are able to achieve their dream. Wairagu said: “If we
can get a home, the orphans who stay at separate homes can be accommodated together where they can stay peacefully without stigma and discrimination.” Regular counselling and other material help would be available more regularly when they acquire a home.
ISSUE 030, December 1-15, 2010
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Unfiltered, uninhibited…just the gruesome truth
No end in sight to blinding disease Narok remains trachoma endemic despite massive campaigns By KIPKOECH KOSONEI Mr Kimong’o Sankei, 72, stands forlorn, supporting himself with a traditional stick. From far you might think he is peering ahead at the horizon surveying his herd of cattle at the Naroosura plains, Narok South District. Only when you get close to him do you realise that his eyes are completely damaged and that he can no longer see. Further down in the Loita plains, Ann Naserian, five, gropes helplessly trying to discern the identities of the other children playing nearby. Naserian and Sankei are among 6,000 people in the larger Narok who have gone totally or partially blind due to complications of trachoma. Six million people in the Rift Valley belt are at risk of going blind due to trachoma infection. Globally, some 84 million people have active trachoma (the infectious stage) in about 56 countries. A further 7.6 million have trachomatous trichiasis (eye lashes scrapping the eye), the potentially blinding stage of the disease.
Slowed development An ancient disease which is extinct in the developed world, trachoma remains the leading cause of avoidable blindness in developing countries, Kenya included. It is, therefore, a top priority under the disease control component of the global initiative for the elimination of avoidable blindness, Vision 2020, dubbed ‘The right to sight’. The coordinator for Africa programme at the Operation Eyesight Universal (OEU), Mr Todd Simpson, says if unchecked trachoma can hold back development in more ways than eyesight. “To fully appreciate the effects of trachoma, it must be seen as hampering health, education, development. This calls for concerted efforts in checking its spread,” says Simpson who is in charge of OEU operations in Zambia, Rwanda and Uganda.
Poor sanitation Trachoma is caused by a bacterium known as chlamydia trachomitis. Repeated trachoma infection in childhood causes scarring of the conjectiva (membrane lining the inner side of the eye lids) and distorts the eye lids. This makes eyelashes turn inwards and rub on the eye ball inflicting painful, blinding injuries. The risk factors usually associated with increased occurrence of trachoma include dirty faces in children, water scarcity, poor environmental sanitation which promotes breeding of flies, lifestyle and culture among others. In patriarchal communities like the Maasai, women are responsible for most of the household work. They are, therefore, at a disproportionately higher risk of contracting the disease than men. While recent surveys show trachoma has been on the decline in Kenya and the
A woman in Narok prepares to load water on a donkey. The area is known to have a high rate of trachoma infections. Inset: Children whose eyes have been affected by trachoma. Pictures: Kipkoech Kosonei
rest of the developing world in the past 25 years, Narok is one of the seven districts which have remained trachoma endemic despite massive health campaigns. Others are Kajiado, Samburu, West Pokot, Turkana, Laikipia and Nyambene. The pastoralist Maasai are known worldwide for their legendary love for cattle. They are known to live closely with their animals. “The cow dung and spilt milk make their environment conducive for breeding flies,” says Mr John Sironka, ‘The Campaign Against Trachoma’ coordinator in Narok North District. Cultural beliefs on flies and riches among pastoralists are another factor which makes the campaign against trachoma difficult. It is widely believed here that the more flies one attracts, the more
wealth he has. “Besides the cultural issues, the trachoma problem in Narok is further compounded by frequent prolonged droughts which make water a scarce commodity,” explains Dr Michael Gichangi, head of the division of Ophthalmology (eye services) at the Ministry of Public Health and Sanitation. According to a 2009 baseline survey on attitudes and practices relating to facial cleanliness and improvement of environmental hygiene carried in 88 sample manyattas (households) in the larger Narok, a majority of children do not wash their faces and those who do share their towels which spreads the disease even further. Sironka says in order to check the spread of the disease, measures aimed at
Cultural beliefs on flies and riches among pastoralists are another factor which makes the campaign against trachoma difficult. It is widely believed here that the more flies one attracts, the more wealth he has.
eliminating factors that encourage proliferation of flies have been put in place. About 200 have been completed with 65 being already operational in the worst-hit divisions of Loita, Mara and Osupuko. “There is an ongoing trachoma awareness campaign which will culminate in mass treatment in Narok North district at the end of July,” he says. A similar campaign ended last month in Narok South District. A medic at the Narok North District Hospital, Dr Mukiri Mukuria, says they have done 25 successful surgeries in Loita division. He laments the indifference from trachoma patients is one of the biggest stumbling blocks to treatment.
Bore holes “In Talek area which borders the Maasai Mara Game Reserve, we have not done more than 10 operations since we started the campaigns more than 10 years ago,” reveals Mukuria. However, sustainable health promotions in arid and semi arid lands must go with provision of water, medicine and face washing campaigns. Drilling of bore holes should be an integral part of the campaign. About 38 bore holes have been drilled throughout the expansive district.
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ISSUE 030, December 1-15, 2010
Unfiltered, uninhibited…just the gruesome truth
Government urged to boost maternal health care By Faith Muiruri
Even as maternal deaths continue to take a high toll on women, budgetary allocations remain glaringly low to realise any notable impact. When Lucas Oloo opted to assist his wife deliver at home, he did not know that this gesture would turn out to be a nightmare that would forever haunt him. First he watched in horror as their bundle of joy died soon after he was born. Then his wife succumbed to complications arising from the botched delivery.
Loss
“I watched my baby die immediately after birth. My wife developed complications shortly after the delivery and died five days later at the Kenyatta National Hospital,” he recalls in a crippling personal account during the launch of White Ribbon Alliance, an advocacy platform for Maternal and Newborn Health in Kenya at the Kibera grounds in Nairobi. He says that his wife was HIV positive and the only traditional birth attendant he knew refused to attend to her citing her status. “I did not have a penny in my pocket and hence could not rush her to the nearby medical facility. I had no option but to follow the instructions given to me by the birth attendant,” says Oloo, a cart puller in Korogocho. But that only complicated matters for him. He lost the baby and the mother went into a coma soon after. He had to rush her to the nearby Vision Medical Clinic. Her condition deteriorated and they were referred to Kenyatta National Hospital where she died moments after admission. “Up to date, I have never known what went wrong. All I know is that my wife would still be here with us if she had access to quality health care,” he affirms.
Responsibility After her death, life at home became unbearable and he was forced to take their children to live with his mother as he could not manage to raise them on his own. Oloo is not the only one who lost a loved one to child birth. Florence Wanza recalls the pain of losing her mother at childbirth. The pain has refused to fade away. Her mother’s death forced her to drop out of school to tend to her three siblings. “My mother was a single parent and when she passed away I was in Standard Seven at Hunyumu Primary School in Korogocho,” says Wanza. Being the first born in a family of four, she had to take up her mother’s roles and look for odd jobs to keep the family going. “I was forced to drop out of school because I could not balance between tending for the family while at the same time going to school,” says Wanza. She adds: “At one point we were ejected from the house because we could not raise the KSh400 monthly rent in Korogocho.” Today Wanza works as a volunteer at Aphia II Centre in Korogocho where they sensitise the community on the benefits of attending both prenatal and antenatal care. She says that if the Government could invest in maternal health care, the number
From top: Mama Ida Odinga, who is the Patron of the white Ribbon Alliance addresses residents of Nairobi during the official launch of the project where she called on Government to allocate more funds to maternal health care. Pictures: Faith Muiruri
“I watched my baby die immediately after birth. My wife developed complications shortly after the delivery and died five days later at the Kenyatta National Hospital.” — Lucas Oloo who lost wife and baby. of women dying at childbirth would considerably go down. Through the organisation, they have been able to identify needy cases and link them to cheaper health facilities. However, Wanza says that the organization has been constrained by limited resources. She calls on other well wishers to join in saving the lives of both the mother and the child and make safe motherhood a priority. Oloo and Wanza’s predicament speaks for millions of Kenyans grappling with the reality of losing their loved ones due to pregnancy related complications. The Kenya demographic survey 20082009 reveals that about 56 percent of women are giving birth at home without the skilled care that could save their lives. In some regions less than 20 percent of women give birth in a health facility. The survey further indicates that only
25 percent of hospitals have all the medicines required to manage serious complications. An estimated 7,700 women die in Kenya each year from pregnancy related complications. This translates to 21 women dying everyday or one woman every hour from preventable causes. Speaking during the official launch of White Ribbon Alliance (WRA), Mrs Ida Odinga who is the patron of the White Ribbon Alliance in Kenya called on the Government to increase the funds allocated to maternal health to help ensure that mothers do not die while giving birth. Ida said: “The death of a woman and especially that of a mother has far reaching implications on the health of the family, survival of children and the social or economic development of the family and community at large.”
Funding Dr Nancy Kidula who is the chairperson of the Alliance says maternal mortality could be reduced if it was accorded the necessary attention. She says that the country continues to lag behind in reducing maternal deaths in accordance with the Millennium Development Goals (MDGs) which requires countries to increase access to good quality care during pregnancy, childbirth and the postpartum period. Dr Kidula said: “The situation has been compounded by limited resources with the current budgetary allocation for maternal and newborn health standing at less than 6.4 percent as a quarter of this goes to HIV/AIDS.” She laments: “This is far way below the 15 percent allocation that African government’s committed to in Abuja declaration of 2001.” Angela Nguku who is the founder and national coordinator of the Alliance says that there is need to make health systems effective if we are to make progress. Speaking at the same event, a representative from the Department of Interna-
“I watched my mother who was a single parent die when giving birth. I was forced to drop out of school because I could not balance between tending for the family while at the same time going to school.” — Florence Wanza, a school drop out tional Development (DFID) UK, Mr Tony Daly challenged the Government to commit more funds on maternal health and improve infrastructural facilities to help bring down the maternal mortality ratio. Founded in 2009, the White Ribbon Alliance for Safe Motherhood is a coalition of organisations and individuals bound together by a common goal to help ensure that safe pregnancy and child birth is an attainable priority for all mothers and their newborns. With members in 11 countries, the White Ribbon Alliance advocates for changes to ensure that every woman has access to quality health care before, during and after child birth.
ISSUE 030, December 1-15, 2010
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Unfiltered, uninhibited…just the gruesome truth
Farmers ditch coffee for miraa By JOSEPH MUKUBWA
After poor returns of the coffee crop, some farmers have decided to look for alternative crops which have good returns. Several farmers in Kieni West District have started growing miraa (khat) which has made better proceeds in a short while compared to other crops. One such farmer is 49-year-old John Mambo from Njeng’u Village, Mweiga location, who says he used to get KSh3,000 per year from coffee but now gets the same amount within three days from miraa.
Profit “Don’t think miraa can only grow in Meru, even here it can do better. My 360 trees bring between KSh5,000 to KSh10,000 per week. Why then should I invest in obsolete crops?” poses Mambo. He adds: “These trees have helped me to educate my two children up to college level.” Mambo is one of the farmers who have abandoned growing coffee and uses part of his small piece of land to grow miraa trees. He says miraa is becoming more profitable than even dairy farming. “Miraa is not labour intensive. Once it matures after planting which, normally takes three years, then you start plucking and selling. No chemicals needed or pruning. It is al-
John Mambo, a former coffee farmer who has since shifted to miraa growing which he finds profitable. Inset: Young men chewing miraa in Mambo’s farm. Pictures: Joseph Mukubwa.
most two decades since I started growing the miraa,” he explains. Mambo refutes claims that miraa makes some men impotent saying he has been chewing the plant for over two decades. With his wife Damaris, they host youth from as far as Sangare, over 10 kilometres away to chew the stimulant. “I have been coming here for over five
Chances for higher learning enhanced for teachers By KARIUKI MWANGI Teachers will now start enjoying a 15 percent discount on tuition fee whenever they want to advance their careers. This offer comes from memorandum of understanding signed between the Kenya National Union of Teachers (KNUT) Embu branch and Embu College Campus. All the teachers under the KNUT branch who wants to further their education at the college will get a 15 percent discount. The agreement will also extend to the teachers’ spouses and children who get higher education through the college.
Agreement Both parties in the agreement can terminate the agreement anytime but will have to write to the other partners 90 days prior to the termination. All the disputes arising from the agreement will be settled through arbitration. According to the KNUT secretary Embu branch, Mr John Gitari, the agreement will ensure that teachers will be able to get advanced education together with their spouses at an affordable fee. “The agreement is a great opportunity for Embu teachers and their children to go through higher education,” said Gitari. He argued that there are so many development activities that the teachers unions in Kenya can achieve other than fighting for the salary increments.
“There are other important things that this union can do for development other than fighting for salary increments,” said Gitari. He explained: “Embu KNUT branch can set an example of how unions should also invest even in other private sectors such as insurance companies which can enhance development.” He argued that even though the region has never been allocated a public university, teachers can take advantage of such opportunities to improve the education status in the region. According to Embu College principal, Mr Justin Njaunene the agreement is a wake up call for area residents to educate their children and a boost to education standards which in turn will expand development. Education secretary, Professor George Godia who witnessed signing of the agreement hailed the private sector for their role in providing access to quality and affordable education adding that the initiative will promote continued learning in Embu. “The Ministry of Education is strategising on improving the ICT sector so as to reach the constituency schools as a package and ensure the necessary capacities are built under the economic stimulus package,” explained Godia. He added: “Education is one of the major pillars in the realisation of vision 2030.”
years. Instead of engaging in evil matters or taking beer in the local bars, I spend time relaxing here chewing miraa. It is more enjoyable and cheaper than taking beer. I don’t find any difference between this one and the miraa that comes from Meru,” says Samuel Kahoro, a casual labourer who is a daily customer. The farmer also sells the plant in Nyeri town, about 20 kilometres away. During this dry season, the farmer took advantage of the Njeng’u–Nyaribo water project to irrigate the trees which
also brought in a lot of income since the long spell of sunshine did not affect it. However, there have been challenges with some youth coming in during the night, camping on top of the trees to chew the miraa to evade paying. The farmer is now planning to expand his work by planting more trees in order to venture into national markets. He encourages other farmers to plant more trees adding that the miraa plant is medicinal. Many farmers who have been sensitised are also creating awareness and encouraging other villagers to plant the crop.
Water projects brings hope to Isiolo By HUSSEIN DIDO A Danish Company in conjunction with the Kenya Red Cross has commissioned an innovative and modern water technology with a remote monitoring system to sustain water supply in Isiolo. The Grundfos lifelink head of the social responsibility department, Ms Irene Mortensen who presided over the inauguration of KambiyaJuu Water Project said the company will inject KSh30 million towards water projects in the Isiolo County. Mortensen said: KambiyaJuu is a pilot project of nine others that are expected to start in Garba-Tulla among other divisions in Isiolo County.” She added: “Grundfos, a leading pump manufacturer with 85 companies all over the world will help communities in the region to access the commodity to create sustainable human development and provide families with an opportunity to give children a good and healthy life.” The company was investing in the right technology throughout the world by bringing about innovative payment system. As one draws water from the boreholes, they do not paying in cash but instead use the Mpesa system. One needs to obtain a card and get a key in order to draw water from the borehole which is remotely monitored. The borehole ensures adequate supply of
water for area residents throughout the year. Grundfos staff will contribute money from across the world to pay for lifelink systems in Kenya to meet costs of the advanced system to ensure the needy families access the commodities uninterrupted. Grundfos operates in Germany, Hungary, China, Mexico, Demark and Dubai among other countries. Isiolo Branch Kenya Red Cross chairman, Mr Tache Bonsa, hailed the Danish company for availing water to the community through modern technology.
Sustainability He said over 70 percent of bed cases in health facilities are attributed to waterborne and related disease. Bonsa reiterated: “There was high need to complement Government effort in realisation of the dream by providing clean and safe water to the needy.” The Kenya Red Cross Society was partnering with Grundfos to alleviate human suffering through provision of access to clean water for needy families in the region. Kenya Red Cross Society through its water and sanitation department has strived to contribute to the realisation of the Millennium Development Goals to ensure sustainable access to safe drinking water and basic sanitation by 2015.
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ISSUE 030, December 1-15, 2010
Unfiltered, uninhibited…just the gruesome truth
Youth group combats unemployment By HENRY OWINO
A group of youth known as Mizuka Reform is changing the status of young people at Lang’ata District by having them engage in income generating activities. Mizuka Youth Reform Group was started by friends who were age mates. They lived at Kibera’s Makina estate and would collect garbage from houses in the slum at a fee. The group grew big as many youth came to join the occupation. Chairman of the group, Mr. Anthony Wambua says they thought of other income generating activities apart from garbage collection. Tree nursery became the next project. According to Wambua they had to register members to enable them get the actual number of people. It turned out to be 50. The income reduced due to their big number but they now had few houses from which to do garbage collections. Says Wambua: “We had to diversify because the group had people gifted with diverse knowledge in different types of projects that would profit us and even attract donor support.”
Versatile The current list of projects that they have proposed is long but today they are engaged in solar bottled water disinfection, rabbit rearing, guinea pig keeping, poultry farming, garden in a sack kale farming, selling tap water, bathroom shower services and garbage collection. They also run Mizuka Football Club. Assistant secretary of Mizuka Youth Reform Group, Mr. Steve Okode says they moved to the roadside just opposite the District Commissioner’s offices (DC) commonly known as Corner Mbaya because they had no land from which they could put all the proposed projects into practice. “The number of projects members have proposed that are on the waiting list are more than what is on the ground currently,” explained Okode. The area Chief allowed the group to put up the few projects they had in mind as they did not need a big piece of land. The group has since grown and their fate hangs in the balance as the land from which they operate belongs to City Council of Nairobi. “We are here with good projects to earn a living and put food on the table but City Council Askaris can come and demolish everything because the land belongs to them,” says Okode. The members are cooperative and this has made work easier. Secretary General Mr Michael Jumba says: “The solar bottled water disinfectant is the latest initiative the group has put in place to treat raw water from the other several projects in list waiting to be implemented.”
www.mediadiversityafrica.org
From top: Members of the Mizuka Youth Reform Group busy in their water project. One of the members displays the solar bottled water and another member at the rabbit project. They fear that lack of land to carry out their activities will send some of them back into a life a crime. Pictures: Henry Owino
Solar bottled water is a treatment that only requires clean water in clean plastic bottles, which is heated by sun rays for about six hours. However, it also depends on the radiation strength.
Challenges The group’s treasurer Mr. Ahmed Yusuf, says limited finance has been their main challenge. Currently, the group relies on earnings from the sale of water and sukumawiki (kale), garbage collection and provision of bathroom services to the area residents. “We do not rely so much on donor money but we need them for support to realise our goals,” explains Yusuf. He adds: “The group sells a 20 litre jerri can of water at KSh3 which is fair for the residents.” The group also provides cold water shower services at KSh10 for both male and female customers. Travellers, long distance drivers and local residents use this service. According to Yusuf, the Ministry of Agriculture awarded the group a KSh150, 000 grant after they wrote a winning proposal. Yusuf says they have put up shelter for
the layers and plan to purchase chicks soon. Currently the group has the local poultry breeds which they are phasing out for the pedigree and in particular layers. The football club has been very successful and Mizuka Football Club are champions of Ramadhan Tournament 2010 that ended early in September. Currently it is among the teams still left in Inter-Routes Football Tournament taking place in Bahati, Kabete, Huruma and Lang’ata grounds. Rugendo says out of 32 teams of InterRoutes Football Tournament, 28 teams have been eliminated but Mizuka FC is thriving to take the winner’s trophy home. The group advises young people to use the skills and knowledge acquired in school to start income generating projects.
Executive Director: Rosemary Okello-Orlale Programme Coordinator: Wilson Ugangu Editor: Jane Godia Sub-Editors: Florence Sipalla and Mercy Mumo Designer: Noel Lumbama Contributors: Duncan Mboya, Ken Ndambu, Joseph Mukubwa, Ryan Mathenge, Erick Otieno, Edwin Kiprotich, Nzinga Muasya, Odhiambo Odhiambo, Kipkoech Kosonei, Kariuki Mwangi, Henry Owino, Faith Muiruri and Ben Oroko.
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