KENYA: HIV/AIDS patients fight for healthcare

When Gladys Wainaina [not her real name], pregnant with her second child, returned home from a routine visit to her doctor in 1999 she found her husband had left home. Knowing her doctor and husband were friends, she returned to the surgery to ask if the doctor knew her husband's whereabouts. "He's left for good, don't you know what's wrong with you?" he said.

Shortly after her first visit to the clinic, the doctor had telephoned the woman's husband to tell him she had tested HIV-positive. He had not informed Gladys of her HIV status.

Gladys's is just one of the many cases Asunta Wagura, Executive Director of the Kenya Network of Women with AIDS (KENWA), has dealt with since the organisation's inception in 1993. Wagura told PlusNews that she had often had to help HIV-positive women overcome resistance from health workers to be treated for health problems, both related and unrelated to HIV/AIDS.

HIV-positive women have to be very stubborn when seeking health care, Wagura said. "They have often been turned away, or given ineffective medicines just so the doctors can get them out of the clinic quickly."

Sometimes women will go back to the doctor several times and still not get the treatment they are after, she said. "Eventually some just give up and die."

Several months after learning she was HIV-positive, when Gladys arrived at a local hospital after suffering a miscarriage, hospital staff were reluctant to treat her. Both her in-laws and her own family refused to help her, and so she turned to KENWA for assistance.

KENWA, a non-governmental organisation working with HIV-positive women in the Kenyan capital, Nairobi, was able to provide her with some medical aid and counselling, and she is now living at home with her first child and has felt able to be open about her HIV-positive status.

The Kenyan government in September published guidelines for Voluntary Counselling and Testing Centres to safeguard the confidentiality of those taking HIV/AIDS tests. Counsellors have argued that such safeguards are vital because a lack of confidentiality has led to the refusal by many individuals to take an HIV/AIDS test, and also to an increase in domestic violence.

KENWA currently provides home-based healthcare, counselling and support services to some 2,140 HIV-positive women, most of whom manage to exist on less than US $1 per day in Nairobi's impoverished slum areas. Some 400 of these women are seriously ill, many suffering from tuberculosis (TB) and pneumonia, and are too weak to leave their beds, Wagura said.

While TB medication is provided free of charge by the Kenyan government, patients living in the slum areas must pay 1,000 Kenya Shillings (about US $15) per fortnight for a nurse to administer the daily treatment - often forcing the women and their families to choose between essential healthcare, primary schooling for their children, and sometimes even food and water, Wagura said.

Antiretroviral drugs used to combat HIV/AIDS are totally beyond the reach of almost all KENWA's members. "Most cannot even afford simple medicines like paracetamol or aspirin. None of them receive treatment with ARVs," Wagura said.

Only 2,000 of the estimated 2.2 million HIV-positive Kenyans are currently able to afford treatment with ARVs, according to health officials. Despite the Kenyan parliament in June passing the Industrial Property Bill to allow low-cost importation of ARVs, the government does not have enough money to buy the drugs, Deputy Director of the National AIDS Control Council (NACC), Dr Patrick Oregi, said in September.

Providing ARVs to patients in public hospitals would mean spending one fifth of the Kenyan health ministry's Ksh 15 billion (US $195 million) budget on the therapy - and force spending on many other services to be frozen, Health Minister Sam Ongeri stated in September.

The East African Standard reported on 20 November that patients with HIV/AIDS had, at times, occupied 60 percent of beds at the Kenyatta National Hospital, Nairobi's largest hospital. "Patients suffering from HIV/AIDS further take long to vacate their beds and wards. This has led to an enormous increase in the cost of utilities and other variable costs," the newspaper quoted the hospital's chief public relations officer, Naftali Mungai, as saying.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated in 1999 there were some 730,000 HIV/AIDS orphans in Kenya, and that the number was set to rise, as Kenya had the fifth largest number of people living with HIV/AIDS in the world.

KENWA provides assistance to 309 children orphaned by HIV/AIDS. It is also preparing to assist the children of its 400 critically ill members when they become orphaned by helping them stay in school, protecting their rights and raising funds to help provide them with food and shelter.

Kenyan government statistics suggest the number of people dying each day from AIDS has increased from 500 to 700 over the last five years, with some 250,000 thought to be living with AIDS.

While Kenyan government campaigns are widely viewed as having been successful in raising awareness of the HIV/AIDS epidemic, they have had much less success in changing attitudes to the disease, according to Wagura. "The new National Aids Control Council has drawn up a good strategy on HIV/AIDS, but done little to implement it," she said.

Despite the government's decision to import 300 million condoms to help prevent the spread of the disease, a September poll commissioned by the Media Institute, a Nairobi-based non-governmental organisation, found that 54 percent of Kenyans believed condoms were not an effective measure to prevent HIV/AIDS transmission. The study found, however, that over 90 percent of respondents were aware of the HIV/AIDS epidemic.

The promotion of condom use has met with strong opposition from the Catholic Church and Muslim groups, who believe the use of condoms promotes promiscuity and does not prevent HIV infection. They say people should change their sexual behaviour and practise abstinence in order to avoid HIV infection.

According to Wagura, KENWA has managed to achieve significant impact on behaviour by using people living with HIV/AIDS in their education and awareness-raising campaigns. "When people are confronted by an HIV-positive person, or someone who has developed AIDs, they really take notice," she said.

Wagura said that, although she had seen a big improvement in attitudes towards HIV/AIDS in Kenya since she was diagnosed as HIV-positive in 1988, there was still much work to be done. "Stigma and denial are still there," she added.

Theme (s): Care/Treatment - PlusNews,

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