Dada Says Archives - skiza mwanadada

Date Posted: May 10, 2021

COVID-19 Pandemic Must Not Interrupt Our HIV Treatment

ARVs-HIV-Drugs-Shortage (Image credits: Arise TV)

Stigma can lead to foolish choices. I once made a choice that destroyed my immune system. Typing this article using my left hand is not an act of bravery but a constant reminder of the stigma that I entertained almost two decades ago. Every month, the shame I felt picking up my free essential drugs (cotrimoxazole) to manage my HIV.

Due to my father’s constant questions regarding what the drugs were for, I would stock them up for the garbage heap. Though I wanted to take the pills, I did not want my family to know about my HIV status. The privacy of our single-roomed slum house could not allow me to hide my drugs for long. Yes! I would throw my unused pills away every month to protect my secret. And yet, I would still go for my refills each month to maintain the façade of being a ‘good patient.’

But my secret shortly revealed itself because I contracted toxoplasmosis, an opportunistic infection of the brain—a condition which I could have prevented by taking my medication. Opportunistic infections take advantage of weakened immune systems and are common in persons living with HIV. This led me to lose the use of the limbs on my right side, a permanent disability. Try explaining to people why a 20-year-old would suffer a stroke, and they start piecing together the puzzle.

But this is not about my struggle with self-stigma. It is about the essential life-saving drugs that have been freely accessible for People Living with HIV (PLHIV) for years but are now stocking out of many clinics across Kenya. Cotrimoxazole DS tablets, or septrin, is one such drug that prevents over 40 opportunistic infections in people living with HIV, including pneumonia, meningitis, and herpes zoster.

One of the challenges since the onset of the COVID-19 pandemic a year ago has been the availability of drugs to treat HIV. There has been a shortage of Septrin tablets for adults, septrin syrup and nevirapine for babies born to HIV positive mothers. During my quarterly visit last year, I confirmed this with the KEMRI FACES clinic, the Comprehensive Care Clinic I attend.

Kenya’s stock outs can be attributed to two reasons. First are the supply chain disruptions caused by COVID-19; resources are being directed to fighting COVID-19 while sidelining other diseases. Second is corruption in the health sector, causing foreign donors to mistrust the accountability of Kenya’s government.

Since mid-January, HIV drug donations from the US Agency for International Development (USAID) have been sitting at the port of Mombasa. The crisis escalated this year because the Kenya Revenue Authority imposed 90 million Kenya shillings in taxes to clear the Sh1.1 billion consignment. USAID did not follow HIV and tuberculosis drug donations protocols by using the American firm Chemonics as a consignee instead of KEMSA. Usually, for drug donations to qualify for an exemption, they have to be passed through KEMSA, the protocol for HIV supplies.

In March, I went for yet another drug refill. My heart sank when the pharmacist at KEMRI mentioned that there was a stockout of ARVs. I had to take just one bottle that lasted a month instead of the usual six months. It means having to go back to the clinic several times for refills, uncertainty caused by rationing of drugs – not sure whether I will get the medicine the next time I go to my clinic, and the fear of COVID exposure every visit.

I have been taking cotrimoxazole alongside my anti-retroviral drugs (ARVs) since January 2005 and getting it for free. Strict adherence has brought me to the stage where my viral load is undetectable. I still take my ARVs daily for the virus to remain undetectable, but I do not need to take cotrimoxazole. Now the drugs I used to throw away are difficult to find, even for people who can buy them. I sympathize with many others with low immunity and cannot afford to purchase cotrimoxazole.

HIV activists lobbied online to push the Ministry of Health to intervene with a tax waiver. As a result, a press release on 6th April promised to restore the multi-month dispensation of ARVs in Kenya. The shortage persists in several clinics around Kenya because USAID wants to control the distribution of the drug. They are now considering shipping the donations at the port to another country.

The release also said that the Ministry is considering other options for funding HIV treatment. Alternatives for funding HIV treatment should consider this fact: Most people living with HIV whose lives depend on these drugs are either unemployed or under-employed and cannot afford healthcare on top of their daily sustenance. They, therefore, cannot afford to buy ARVs and other medications to treat or prevent opportunistic infections. All of this in-fighting amongst agencies impacts real lives, including mine.

I am worried about reversing the gains over the years in fighting HIV/AIDS. Until 2018, sub-Saharan Africa has seen declines in both mother-to-child transmission and new HIV infections. Unfortunately, the WHO projects 534,000 Aids-related deaths in the region due to COVID-19-related treatment disruption and warns that nearly 70 countries might suffer shortages due to COVID-19 supply chain interruptions.

Eighteen years ago, my 5-month-old baby died of HIV-related complications, partly because of my not taking drugs properly. I am now HIV positive and pregnant. Life has granted me a second chance to ensure I have an HIV-free baby, and stigma no longer plays a part in my decisions. I appeal to the Kenyan Ministry of Health, Kenya Medical Supplies Agency (KEMSA) and all donor agencies involved in purchasing and distributing HIV treatment supplies. Consider the gains you have made so far, reconcile your differences, release our ARVs, and restore their distribution countrywide.

Juliet Awuor Otieno is the founder of Mwanadada CBO, a social enterprise that provides teenagers in Kenya with age-appropriate, comprehensive sex, reproductive and mental health education. She is a 2021 Aspen New Voices Fellow.

Date Posted: June 16, 2020

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Access to Child-Friendly Justice in Africa on the Day of The African Child

Day of the African Child Credits: Zach Lucero- Pixabay; Featured image: Trevor Cole- Pixabay.

Defilement, murder of three-year-old girl, by her mother’s lover in Kabisoge village in Bomet. The shooting of a 13-year-old boy by police enforcing the curfew in the prevention of COVID-19. News headlines we should never see if everyone is committed to the ideals of the Day of the African Child.

This day addresses different issues affecting children in the society, and this year’s theme is “Access to Child-Friendly Justice in Africa”. Apart from the injustices committed against children, there are also children detained in juvenile corrective facilities.

An example is the Romeo and Juliet laws which involve sex between two minors. Mostly, the older minor bears the burden of guilt. I witnessed such stories during our visit to Kamiti Juvenile boys’ facility in 2019. I remember a 16-year-old boy who had spent six months in custody for the crime of defiling a 13-year-old girl, while he swore his innocence. Such are the cases that call for child-friendly justice in Africa.

History of the Day of the African Child

Commemoration of The Day of The African Child has been each year since June 16th, 1991. It was initiated by The Organization of African Unity, honouring the children who participated in the Soweto Uprising in 1976. About 10,000 black school children marched in a column more than a half a mile long in Soweto township of South Africa protesting against their poor quality of education, leading to the shooting of hundreds during those protests.

Day of the African child is vital to Mwanadada because we highlight issues of Teenage Sexuality and encourage parents to initiate the conversations surrounding sexuality with their children at an appropriate age. Some aims of our approach are to ensure the protection of children against sexual abuse, raise awareness of the consequences to unsafe actions and that children grow up in an emotionally safe environment.

Child protection is everyone’s responsibility. Let us join hands to realize child welfare goals as parents, educators, and community, as espoused in the African Charter on the Rights and Welfare of the Child.

Date Posted: May 2, 2020

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Dignity in poverty

Transformation toward dignity

I’ve watched with horror the conditions of living that lack dignity in Mathare slums when it rains from Boniface Mwangi’s video titled Kenya is an epic horror movie. How the houses are flooded, yet the people continue living in them because of lack of alternatives. I couldn’t finish watching the video. I have seen some comments that some of the people have options of going to the village. That may be true, but picture this, going back to the village, you need money for survival.

It has brought back memories of our life in City Carton Slum. I dreaded the rainy season. Our roof used to leak at several points. My room, (the one in the documentary- Abstaining from reality) would be flooded, so I used to put all my valuables on the bed whenever it rained.

Most people, such undignified states are the only source of dignity they have. It’s dignifying to them because at least they can get work in the cities to feed themselves and their families. No matter how small the earnings are. It doesn’t rain every day. Some days, most days it’s dry. So the houses provide shelter.

When I moved from the slum in 2007, it was because I was going to university. Our mother used to wash clothes to feed us. I remember going with her to look for hostels. We looked so rugged that one hostel run by catholic nuns refused to give me accommodation even though my sponsor was willing to pay for my educational expenses fully. Maybe the nun judged by our looks and decided that we could not afford to pay the accommodation fee. She said that I was too old for them to accommodate. I was barely 24. I later found out that they were hosting even ladies who were older than me. Luckily, I got another hostel near Nairobi Hospital, where I lived for one year and later on moved to a single roomed house in Kibera- Karanja area.

I discovered that a different life was possible again. Though the space was small, it was better than the conditions in the slums. Having lived in Buru Buru Estate, in a three bed roomed house all my childhood only for life to take us to the slum was enough humiliation. If my parents never thought of going to the village then, it was to preserve their dignity. This is just to stress my point that for some people, the slum conditions are their only source of dignity. Most don’t want to go to the village to become a burden.

Thank God my parents now live a different life in the village. It took our sacrifice and strong will to convince them to move to the village. Thanks to all my siblings. Every one of us played their part. This is to encourage people who feel that their condition is permanent, that nothing lasts forever.

Do I have a solution to the suffering of people in the slum? I try my best to do the little I can; just like the hummingbird in Prof. Wangari Maathai’s famous story. It’s more like paying it forward, because someone sacrificed to change my life. I would love to do more. I am also exploring, asking myself a lot of questions, and reflecting in the process. This is why such videos are devastating to me.

Juls’ reflections.

Jennifer Schlecht (center, kneeling in a white shirt) had worked across Africa in humanitarian aid for issues affecting women. (Courtesy of New York Daily News)

Date Posted: December 4, 2019

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Jennifer Schlecht’s Death Calls for Addressing Domestic Violence as a Global Problem

Jennifer Schlecht, left, daughter Abnysh, center, and Yonathan Tedla, right, (Courtesy of NY Daily News)

Jennifer Schlecht, left, daughter Abnysh, centre, and Yonathan Tedla, right, (Courtesy of NY Daily News)

Featured image: Jennifer Schlecht had worked across Africa in humanitarian aid for issues affecting women. (Courtesy of New York Daily News)

I knew her colleague at Family Planning 2020 and still remember her colleague’s post vividly on Facebook. The NY Daily News story announced her murder, a week before the ICPD25- Nairobi Summit where she was to speak. Jennifer Schlecht was the Senior Advisor, Emergency Preparedness and Response for Family Planning 2020.

I remember the livid feeling I had as I read on. That a woman who was such a strong supporter of women and girls in crisis, ending up as a casualty of domestic violence, spoke volumes on the need to reexamine ourselves as a community. Jennifer Schlecht and her five-year-old daughter Abaynesh died in domestic violence on November 6th, 2019.

The speeches by her colleagues and the family planning community during her memorial held in Nairobi’s Serena Hotel left an impression of a woman who was devoted advocate of reproductive health to women and girls in crisis, a helpful colleague and a loving mother.

The head of UNFPA, Dr Natalia Kanem, also paid her tribute at the memorial. She said that Jennifer’s death is a mirror of what other women go through in silence. They died in the hands of a husband and a father. Yet Jennifer was such a devoted activist on women’s issues, how about the woman in crisis, who lives in the slum and doesn’t know where to seek help?

A few Kenyan youths stood up to give their tributes. Of course, in such situations, some people innocently quote scripture to fill their speeches with meaning. One paraphrase I remember well was “If we live, we are the Lord’s, and if we die we are the Lord’s.” I sat there deep in thought. Could the patriarchy excused by ignorant religious undertones be the cause of so many cases of domestic violence? Sometimes silence is golden in such situations.

I cringed through some of the tributes and was relieved when Beth Schlachter, executive director, FP2020 went to the podium to adjourn the tribute session.

Jennifer’s case shows that domestic violence does not know social class or country. It is a universal problem that we have to address. Yonathan Tedla, the husband who killed his wife and daughter before taking his life, according to the NY Daily News article, reportedly threatened to kill Jennifer when the issue of divorce came up.

Being a good mother, Jennifer Schlecht stayed in the marriage, not wanting to separate the child from her father. Many women make this choice, and sometimes they leave abusive marriages when it’s too late.

As we observe 16 days of Activism against Gender-Based Violence, let’s remember that no relationship is worth losing your life. Seek help. Share your struggles with friends. Gather the courage to walk away while you are still alive.

Date Posted: November 5, 2019

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HPV Vaccination a Licence to Sexually Violate Minors?

HPV vaccine Credits: pink.pharmaintelligence.informa.com/

By Juliet Awuor.

October 30th, Dorothy Kweyu wrote a commentary on the Daily Nation against the push for mass Human Papilloma Virus (HPV) vaccination of young girls. She argued that the vaccine would be a license to violate girls sexually.

Though there are valid concerns in some of her assertions, for instance, parental protection of children against sex pests, her views on the correlation of HPV vaccine and sexual violation of minors are unrelated. We are with her in advocating for parental holistic involvement in their children’s lives. Ideally, parents should be the source of sexuality education for their children.

According to ICO/IARC Information Centre on HPV and Cancer, cervical cancer ranks as the second most frequent cancer among women in Kenya. It is the most prevalent cancer among women between 15 and 44 years of age. This vaccine will serve as protection against a preventable reproductive disease, that has been a menace in Kenya. HPV is sexually transmitted.

Even before the conversation on the introduction of the HPV vaccine to the young girls, cases of defilement were ongoing. As a country, we should come out of this culture of burying our heads in the proverbial sand of morality and overlook the facts.

Paedophilia mostly is by trusted people, For example, their trusted relatives or religious leaders. A few months ago, media reports revealed how even some places of worship are not safe for children when it comes to the issue of defilement. Looking at another case, we saw the massive number of teenage pregnancies among primary school girls last year. These and similar situations did not require a licence to defile the minors. The two issues, defilement of children and HPV vaccine are not related.

The reason for the recommendation of the HPV vaccine for young girls who are not yet sexually active is that there is no possibility of prior exposure to the HPV virus.

Evidence shows that countries that introduce the HPV vaccine at a young age (11-13 years) have a low cervical cancer prevalence. According to the Centers for Disease Control and Prevention (CDC), infections with HPV types that cause most HPV cancers and genital warts have dropped 86 per cent among teenage girls,

Parents should no doubt, take an active role in educating and protecting their children against sexual predators. However, one of the two cannot replace another in a discussion.

Date Posted: September 17, 2019

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Is HIV Ignorance Self Imposed?

Image source: Guardian.ng

I recently read a story about a lady who tested HIV positive and failed to tell her lover. I could just imagine the mixed feelings that readers had, first when the manly man played with her emotions and wasted her time. He even ended up marrying another lady. This story revealed the amount of HIV ignorance that everyone.

At the end of the story, this lady, who chose to be anonymous, for obvious reasons, was the villain. She didn’t disclose to a family man, who she instead chose to have a child with. Though I don’t agree with her reasoning – she wanted to have a child because she was HIV positive, single and in her 30’s – for now, I will express my thoughts on the comments left by the readers.

Some readers said that she was punishing an innocent wife and children. We may never know the back story, about who she got HIV from. It might have been from partner number two. Might even have been from her numerous one night stands during her depressive time, when she was trying to get over the fact that her lover got married and never told her. How about the possibility of getting HIV from the mysterious family man? She was to blame here. Why was she punishing an innocent married woman?

HIV is complex. You may decide to be loud about it and scare those who want to keep it under wraps. Those who choose to stay silent about it may just want to live a normal life, away from the glare of the public. The lady in question wanted to live a normal life, that’s why she opted to have a baby. One is not obliged to reveal their HIV status to everyone- apart from their intimate partners.

I know this is an ethical dilemma faced equally by HIV positive individuals and those who are negative. Let me throw some breadcrumbs for thought here: Ever heard of U=U (Undetectable=Untransmittable)? I might address that in a subsequent post.

Date Posted: March 22, 2019

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The Protest for Angela that brought light in darkness

“The beasts who did this to Angela must pay!” I once organized a riot. Those who know me will tell you that the statement is an oxymoron. I normally like to stay out of trouble. Once in a while, I explode out of hiding, and this was one of the instances.

Angela was a hardworking single mother of two. She used to sell vegetables in Buruburu estate. Angela was our family friend, every night, she would pass by our house before proceeding to her house. Every time, she would come bearing one gift or another. Sukuma wiki (kales) from her leftover stock, milk, maize flour. Come to think of it, she brought me milk severally when I had little David. Sigh!

Our mud house was strategically positioned next to Nairobi River Primary School. It was the first point of arrival from the darkness that was the path from the primary school to the swimming pool. We lived in City Carton slum. People were not afraid of the darkness. Would you rather your children went to bed on empty stomachs because of your fear of an imaginary danger that lurked in the night?

Angelina was not one to be put back by fear of anything, let alone the dark. She was light herself. I still hear her soft laughter followed by ‘bwana yesu asifiwe.’ (Read with a Kamba accent) Yes, she carried her Bible everywhere. Even this day, she had her bible in her vegetable bag. She was light! Light does not fear darkness, does it?

We were used not only to her gifts. We were used to a time of fellowship together. She would make sure she stopped by to say a prayer before proceeding to her home. Her daughter had just finished high school. Her son was in primary school. He was in class six or seven (13-14 year old).

We waited for Angela to pass by, unfortunately, she never showed up. My mom and her daughter started looking for her after two days. They went to her place of business to ask if anyone knew where Angela might have gone. She went missing on a Friday.

Three days later, my mom was called to go identify her mutilated body. She had been raped, her face mutilated and her body dumped next to the swimming pool compound at Nairobi River Primary. She met her death a mere 5 minutes from our house. She was most likely gang raped. ‘Why do terrible things happen to good people?’ I asked myself such questions over and over. My mom said the thieves took her bible too.

Then anger developed! You know the lump that is lodged in your throat? I had to do something about this anger. I wrote a petition demanding for floodlights to be installed near Nairobi River. I then went door to door mobilizing signatures from women in the slum.

After collecting signatures, I went to the chief’s office. The plan was to march to Buruburu police station. The chief managed the situation. He assured me that they would conduct investigations. That the murderers would be brought to book.

We went to Kangundo to burry Angela. Her family did not want to follow up on justice. So, out of respect for their wishes, we let the matter rest.

Two weeks later, I saw floodlights installed next to our house. Whenever I go to City carton slum and see the bright shining floodlight, I remember the time when Adopt a light was all over Nairobi, yet Angela was killed in darkness. Angela’s life might have been cut short, but her light still shines brightly.

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