25th January, 2008
Thousands of people living with HIV and TB are still unable to access treatment in Kibera slum in Nairobi, Kenya, following post-election violence in the country.
Patients are staying away from AMREF’s health centre in the Laina Saba area of the slum for fear of being attacked. And health workers who go out into the community to visit patients in their homes have been unable to do so because of the tension in the slum.
AMREF’s country director for Kenya, Mette Kjaer, explained: “We’ve lost 60 per cent of patients who were on anti-retroviral (ARV) treatment and another 30 per cent of those on TB therapy.” Patients had to leave treatment behind as they fled for their lives, and are now unable to reach the health centre to replace it. AMREF’s Deputy Director General Florence Muli-Musiime explained that the situation “is similar to people being under house arrest. We don’t know where our patients are. We had a very good tracking system using our contacts in the community, but this has now broken down”.
Abigail Lukhwaro, a research assistant at AMREF’s health centre in Kibera, said that out of the 30 patients she usually works with, only five are coming to the centre. “Most of them live more than 30 minutes away and are just too afraid to attempt the journey here.”
She added that the situation is also causing problems for those who are able to get the drugs. “Patients don’t have access to the nutritious food that they need for the drugs to be effective. They are anxious and not sleeping well and are having stomach problems. All of these factors are reducing the effectiveness of the medication. One patient who visited the clinic told us she had only eaten porridge for the last three weeks. She lost a lot of weight and was unable to take the drugs as they were making her ill. AMREF has now given her nutritional supplements and she has started taking her medicine again, but there are so many people who we are unable to reach.”
AMREF’s volunteer health workers are desperate to get out into the community to continue their work but many have been threatened by vigilante groups. “Nobody trusts anyone,” says Sakwa Mwangala, AMREF’s Project Manager in Kibera. “The tensions are so high. In the clinic we have to operate on a strict number system so that we are not seen to be favouring any particular ethnic group.”
In order to address this grave situation, AMREF is ensuring that the current sensitivities are taken into account when deploying community workers, and is sending people to their own communities, where they can be trusted and are secure. AMREF’s mobile clinics are also being managed in a way that ensures that all communities are served.
AMREF is also planning to equip community-run clinics in Kibera with ARVs so that people who are unable to access the health centre in Laini Saba can go to clinics closer to them. To notify people where these drugs are, AMREF will make use of the local media and community volunteers. And for the safety of health workers in the community, AMREF has agreed with local community leaders that all health workers will be provided with clearly labelled AMREF jackets and cards identifying them as official health workers.
For more information please contact Louise Orton in London on +44 (0)207 269 5526 or +44 (0)7939 141 764 (email l.orton@amrefuk.org) or Bob Kioko on +254 (0)20 699 3111 or +254 (0)735 546440 (email bobk@amrefhq.org).