Archive for April 1st, 2011

Kenya – April 2011

Friday, April 1st, 2011

We arrived in Mombasa in the evening to a wall of moist heat. Very different from Addis Ababa and Kampala. Earlier, I warned Herb and Adela that it would be hot but the humidity was still a surprise for them.

Mkindani Clinic Team

Mkindani Clinic Team

We spent Friday with our prevention programs coordinator, Mary – first making our political calls to the health department and the Mayor. We then made a quick pit stop at Nakumaat (a “Rite-Aid” type store) for a cold ice cream — it was hot! And, continued our visit to our two Mombasa clinics, Mtongwe and Mkindani. We spent much time talking with the staff at both clinics asking them for input on marketing to new clients and kept an ear out for challenges and suggestions. We all really enjoyed that.

At Mkindani, all the staff and volunteers were in red AHF Test and Treat t-shirts which was a warm welcome. In the doctor’s office, pinned on the wall behind his desk was a black and white photocopy of an extremely ill, thin man with a photo next to it of a healthy, happy man. Same guy, 6 months after anti-retroviral treatment initiation. Very powerful. And the doctor, having no other marketing materials,  just typed it up with the header – Treatment Works! and photocopied it. Every patient that comes into his office sees it — they can’t miss it. I loved it.

We found out some startling things during the meetings — one being a shortage of condoms which has led to a spread of ‘condom sharing’ — people are washing and reusing condoms. This is so frustrating for me to hear because condoms are so cheap (3 cents) and available by the billions.  A major problem is the condoms sit in warehouses and don’t get distributed – we’ve found that the reusing of condoms is only one of many improper ways condoms are used in these countries due to shortage of safe sex materials including lube.

The bulk of HIV/AIDS cases in Kenya are in the rural areas and condoms just don’t get to them. An issue we will take on with the Ministry of Health. Parliament says there is ‘no shortage’. I guess they are not talking to the guys who have a line of washed condoms drying in the sun.

We heard a lot about some of the real issues of why people are not accessing treatment or defaulting from treatment – mainly witchcraft. Witchdoctors tell people they will cure them and advise them to stop their ARV drugs. We know what the outcome of that is .. it’s not good.  This came up a lot so far during our trip. In Ethiopia, it is ‘the holy water’ that is promoted to cure AIDS.  Here in Kenya it is potions and spells and people’s belief in being bewitched.

Mombasa Marketplace

Mombasa Marketplace

We are strategizing on how to best deal with these witchdoctors.   It will be challenging but with a good strategy, we may be able to affect change.

We visited the largest marketplace in Mombasa, which was very griddy – much more than Owino marketplace in Kampala.  A little dicey.  I have to admit that I felt a bit unsafe landing in the middle of it, knowing I had to protect Adela and Herb form any harm  — until the marketplace chairman arrived to show us around. If you have the chairman with you, no one will touch you.

We toured a ‘building’ for rent for a possible new clinic but the structure was in such a terrible state — it should really just be torn down! I watched Herb’s face as he could not believe what he was seeing. Quite strong smells in the marketplace, too. My flipflops were the wrong shoes to wear.

Mombasa and the AHF Kenya program is struggling with the constraints of national policies that need to be changed but our team is a dedicated group and we will help them grow and excel.

Mombasa is a rough town but with beautiful beaches and crystal clear water. The tide was out and on Sunday Adela and I walked the water far past the anchored boats. We fought off aggressive vendors following us but still enjoyed the warm water.

We leave Kenya with a long advocacy agenda and much work to do. On to Zambia….

Herb meeting my pal, Dr. Chidagaya, Medical Officer of Health, Mombasa

Mombasa is "a corruption free zone"

Mary - heads up our testing and prevention efforts. Love those earrings!

Our lab at Mkindani clinic

Our Mtongwe clinic staff.

Our billboard of the Mombasa mayor who we paid a courtesy call to - and he signed on to our DC Declaration for the International AIDS Conference 2012.

Our Mkindani clinic staff

Meeting with the marketplace chairman and owner of a very 'rustic' space we are considering for clinic.

Bats! Bats!

Mombasa Marketplace

Mombasa Marketplace

Mkindani Clinic Team

Mkindani Clinic Team