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KENYA: HIV-positive forest evictees struggle to access ARVs

Photo: Manoocher Deghati/IRIN
Visiting public health centres to pick up ARVs can mean walking up to 50 km
MAU FOREST, 17 February 2011 (PlusNews) - Wesley Kipkoech*, 21, may be illiterate and speak only his native Ndorobo tongue, but he understands all too well that if he does not have regular access to his HIV medication, he is likely to die.

Kipkoech is one of hundreds of internally displaced people living on the edges of the Mau Forest Complex in Kenya's Rift Valley Province after the government began evicting them in 2009, in a bid to rehabilitate the forest after decades of farming, charcoal burning and other harmful activities.

An estimated 30,000 people have been affected, according to the UN Office for the Coordination of Humanitarian Affairs.

"I got infected while working at a hotel in Bomet [in the western Rift Valley]. When I discovered my status, I stopped working for fear that my employer and colleagues would find out and shun me as it is common," he told IRIN/PlusNews.

For the first year following his diagnosis, accessing treatment was easy - all he had to do was visit a nearby public health centre.

"I worked hard on my father's land in the forest, keeping livestock and growing millet for sale," he said.

When the evictions began, however, he lost his livestock and his ready-for-harvest millet crop. "I have to struggle very hard every month to raise money for the ARVs [life-prolonging antiretroviral drugs]," he said.

High price for ARVs

It costs Kipkoech KSh300 (US$3.75) to pay for transportation from his home in Tarta Camp to Oloengurone Health Centre and another $0.60 to pay for services at the government-run health facility.

''Sometimes I am lucky and get casual jobs... that way I can raise money for transport [to the nearest health centre, 50km away], but when I do not get the jobs, I have to walk''
When he cannot raise the money for transport, he has to walk 50km to and from the health centre for treatment.

"Sometimes I am lucky to get casual jobs, either grazing people's livestock or cultivating farms nearby; that way I can raise money for transport, but when I do not get the jobs, I have to walk," he said. "Most of the time I have to ask a Good Samaritan for a place to spend a night, so that I can return to the camp the following day."

Herbal option

Lucy Ngeno* and her husband, both HIV-positive and raising six children aged between one and 14, say they rely on herbal medicines when money is too tight to pay for the 40km ride from their Kapkembu Camp home to the nearest health centre.

The herbs, a concoction of boiled leaves and roots, cost about US$6.50 for a month's supply. While the cost is similar to what she would spend travelling to the hospital, Ngeno says the herbalist's medicine has other advantages. 

 "I can take the concoction on credit, and pay when I get the money," she said.

Ngeno says another major problem her family faces is the lack of sufficient food. Hunger can be a side-effect of ARV medication, and without food, taking the drugs becomes difficult.

Stigma

"It is like a taboo to talk about one's status; most HIV-positive people fear victimization," said Pastor Joseph Maritim, who had to persuade Kipkoech and Ngeno to speak to IRIN/PlusNews, and even then on condition of anonymity.

This secrecy, he says, would make it very difficult for them to access help even if it became available.


Photo: Mercedes Sayagues/PlusNews
Even if help was available, people living with HIV around the Mau Forest would rather suffer in silence than be stigmatised by their community
"I have been trying to convince those who are HIV-positive in my church to form a support group, but some of them have even left church after listening to my proposal," he added.

According to Kuresoi District medical officer Joan Chepkorir, the health ministry has been trying to eliminate stigma in the Mau Forest Complex.

"Every time we visit there, I try convincing [people] that HIV is a condition like many others, and those who were positive had a right to live just like other people, but they are too conservative," she said.

Because of stigma and the fact that the evictees came from disparate parts of the forest, it is difficult to estimate the number of HIV-positive evictees. Prevalence in Rift Valley Province is 7 percent, according to government statistics, while the national rate is 7.4 percent.

Transactional sex

"Livestock dealers buy sex for as little as KSh50 [$0.60] due to high poverty levels - they take advantage of even young, desperate female evictees," said Kapkembu Camp chairman Joel Koech.

What is more, says Koech, condoms are a rare commodity in the area. "Condoms are not available in local kiosks; it is almost a sin to sell them as it is taken as odd by local people. Besides, there is no supply by wholesalers or the government," he said.

rk/kr/mw

Theme(s): Care/Treatment - PlusNews, Food Security, Gender Issues, Health & Nutrition, HIV/AIDS (PlusNews), Migration, PWAs/ASOs - PlusNews, Prevention - PlusNews, Stigma/Human Rights/Law - PlusNews,

[This report does not necessarily reflect the views of the United Nations]

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