Photo journey

S to ri e s fro m t h e fie ld

This bulletin is a collection of stories from the field, written by the sub-partner organizations involved in the Ungana project. The project was a capacity building initiative carried out by LVCT Health, funded by PEPFAR, through CDC. The project period was 2009 – 2014. The names used in the stories have been altered to protect the identities of the clients.

Put logos of sub-partners with names – the same as in photo book

IMPLEMENTING PARTNERS

From Informal to formal: A Message from the BHESP Director Ms. PENINAH MWANGI BHESP Director After four years of exposure to program beyond sex work, my experience has been made richer by our extended LVCT Health family involving LVCT Health staff, as well as partners. I now speak authoritatively on matters concerning sex workers. The LVCT Health capacity building project has redefined mentorship and community empowerment.

My experience with LVCT Health goes beyond the UNGANA project. It begins at a National AIDS Control Council (NACC ) meeting several years ago, where we made a brief presentation as BHESP on the challenges faced while working with female sex workers in Nairobi. We captured the attention of one lady in the room, she introduced herself to my colleague and requested for an appointment to meet us in our office.

I remember showing off my office that consisted of three chairs and one table with several files and papers all over it! Catherine Theuri, the LVCT Partner Capacity Development Manager, saw potential and took up the challenge to work with us.

Peninah, BHESP director representing sex workers in an international conference

Ms Peninah Mwangi

Although we were passionate in what we did, we did not have a defined vision or constitution (save for the model constitution from the NGO board). We did not have a working board and all our meetings were held informally in our bars. In short we had no structure, no policy and no defined direction. We just did what we felt was right.

Many years later and several grants later, I can only look at the journey that LVCT Health has taken

BHESP director on a mentorship forum with the peer educators

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Raped by security guards Agnes narrated how she was raped by two security guards one fateful night while waiting for a client to come by at one of the joints in Kayole, Nairobi. She stated that Bar Hostess Empowerment and Support Programme (BHESP) paralegals were notified of her episode that evening by her peers. The paralegals attended to her promptly. “They took me to hospital where I was given Post Exposure Prophylaxis (PEP) and later to a police station for reporting” noted Agnes.

She noted to the amazement of participants how BHESP gave her legal support including hiring a lawyer to take up her case. Through this support, the two security guards were arrested and the case is progressing well in court. “Justice is coming my way” stated Agnes amidst crowd cheers.

BHESP and I with utmost gratitude and pride. As a result of the BHESP-LVCT Health UNGANA project partnership, BHESP has been able to qualify for other grants including APHIA plus, Global Fund Round 7 and Round 10 where we applied alongside LVCT as equal partners, and qualified impressively on the capacity score. They have built our capacity to a level where we are recognized as a strong organization that is able to stand on its own feet.

mentorship programs that have greatly benefitted me as a leader and a parent. This is a peer program where all the Ungana sub-partner directors meet with the LVCT Health directors and a few managers, share experiences and seek support as peers.

From these experiences, I have learnt to delegate more, to be firmer on staff, when need arises, while at the same time communicating my reasons.

As we celebrate our graduation as UNGANA partners I am satisfied that BHESP has achieved what we set to achieve within the UNGANA Project.

By exposing ourselves to positive criticism and opportunities for growth we have grown from the one roomed office to become a national organization representing sex workers in Kenya. Through the UNGANA and global fund projects we have expanded to the Eastern (Machakos, Mwingi and Kibwezi counties) and central regions (Kiambu, Muranga and Nyeri counties) of Kenya and we now mentor a total of 36 sex worker led organizations in the same way that we have been mentored at LVCT Health.

Many of these organizations are now able to raise their own funds and have benefitted from Total War Against AIDS (TOWA) funds-, youth, women and other funds available locally and internationally thus proving the trickle down of the UNGANA capacity building model.

Mentorship Experience As directors in organizations participating in the UNGANA project, we have been involved in

Ms Peninah Mwangi

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The 2012 BHESP annual sex workers meeting in Nairobi

Team Scores to Promote Good Healthby AFORD The global soccer community has a responsibility in the fight against HIV and AIDS. Every young person is entitled to actualize his/her full potential. It is their right. Sport can offer young people a place to develop skills and knowledge that translate to life off the field - how to assert themselves, use their voice, make decisions, know HIV status. In other words, their “wins” ON the field, are “wins” OFF the field also.

Action for Research and Development (AFORD) lead this effort, using the power and popularity of the game, to teach girls and boys aged 15-24 years about HIV and AIDS awareness while passing on critical life skills.

In March 2013, AFORD hosted football for Health dubbed ‘F4H’, an exciting day of football, during the event, HIV testing and counseling – HTC, were carried out as well as distribution of sex health education booklets (sex buzz booklet) and peerto-peer discussions, demonstrations on condom use and condom disposal and grassroots soccer activities. A total of 16 teams both boys and girls from Eastlands’ part of Nairobi converged at Mathare Youth Soccer Association, (MYSA)

A player in action during a F4H event

field and participated in this unique 7-a-side street football tournament. The top two teams from each group played in the final and crowned F4H champions.

As more young people are afforded opportunities to play, and build these life muscles, a collective impact is realized - a generation of youth will have increased power to change their lives.

AFORD a youth focused Organization collaborates with partners across sectors to improve access and quality of health programming for youth. From 2014-2018, AFORD will continue to focus on using sport as an innovative and impactful strategy to build leadership and empower adolescent and young people.

Team building: players participating in training session

All activities serve the AFORD’s overarching goal to help 1 million youth by 2018 to: yy Address unplanned pregnancies yy Access sexual and reproductive health and rights yy Achieve economic empowerment

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A Marathon For Blood

The WHO recommends that 1% of a country population need to adopt blood donation practices hence the national need is about 400,000 units. This has not been realized in Kenya because of the cost implications of obtaining one pint of safe blood.

Bloodlink Foundation (BLF) embarked on a campaign in 2013 to raise $50,000 funds for mobile blood donation unit, a custom made bus with blood donation beds. This effort was geared towards reducing the cost of obtaining one pint of blood during blood drives and enhance availability of blood in the blood banks within the country.

Erica Gachoka with First Lady Mrs. Margaret Kenyatta

BLF identified Erica Gachoka, a 16 year old student at St Andrews School, Turi, a beneficiary of the BLF blood donation services as the face behind this funds drive.

The efforts got the attention of the First Lady of Kenya, Her Excellency Mrs. Margaret Kenyatta. Erica received support and encouragement from the First Lady.

Other donors also came on board, such as the Nation

The Bloodlink Foundation Director receiving a cheque from the Nation Media CEO as the First Lady looks on.

Bloodlife Saved My Life

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My name is Cosmas, aged 27.

I have had a heart problem since 2003. In 2009 I was told that I should go for heart surgery. I was admitted on 10th May at Kenyatta National Hospital for one month due to lack of blood.

underwent the operation. I am now fine and can go on with my life. Currently I am the chairman of a youth group called Vision Youth Power. I plead with fellow youths to please donate blood and save lives as mine was saved.

Thanks to Blood Life Initiative Kenya, who came to my aid and gave me blood, I

by BLIK Cosmas: My life was saved

media group. Thye gave support in cash and kind.

Miss Gachoka and the Executive Director of Bloodlink Foundation, Mr. Joseph Wangendo participated in the Bank of America Chicago Marathon on October 13th.

They both completed the marathon. This raised enough money to purchase one mobile blood unit. The First Lady of the Republic of Kenya, Her Excellency Margaret Kenyatta launched the Mobile Blood Donation Unit and Valentine’s Day Blood Drive on February 14. U.S. Ambassador to Kenya Robert F. Godec was present at the event along with other government officials, including the Governor of Nairobi, Dr. Evans Kidero.

This was the result of an initiative by Bloodlink Foundation.

Comparison cost per litre of blood donation

COST EFFECTIVENESS OF THE MOBILE BLOOD UNIT IN KSHS The use of the mobile blood unit has reduced the cost of blood donation considerably as shown in the graph below.

The mobile blood unit has been used consistently since it was launched, yielding the results shown below.

The mobile blood unit has yeilded more blood donations

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Meet mama condom

By BHESP

letting go those who insist in unprotected sex”.

Sharon, a sex worker and a mother of one, resides in the sprawling slums of Kiamaiko in Nairobi. The first time she heard about sex work, she was only 14 years old. She had wondered why anyone in their right senses would choose to be a sex worker. “who is supposed to pay who?’ she always wondered. She would argue that both parties enjoyed the pleasure and if there was any reward involved, then it would be an equal share. She never imagined that fate would tailor her future to be in the same business she so loathed.

After sometime, Sharon was taken for more trainings as a condom advocate as well as a peer educator.

She was empowered with knowledge, skills and confidence to reach out to her peers with HIV information and supplying of Condoms.

She was introduced to sex work by a friend at the tender age of 16 years after she lost her mother who was a single parent. According to her, sex work was the only choice to take care of her younger siblings who solely depended on her for basic needs and school fees. “I was inexperienced and seldom knew how to negotiate with my sexual clients who took advantage of my tender age and naivety”.

Sharon now ensures that condoms are always available to her peers at any time.

“I have made it my business to ensure the sex workers have the right information about HIV and they have their condoms with them. My peers and friends now refer to me as “mama condoms” and always call me whenever they do not have enough condoms”.

In a day, she could sleep with more than four clients at an average of Kshs. 200 per client. “Most clients demanded for sex without a condom and I agreed since it paid more than protected sex and I did not have any reason why I should decline”.

One chilly night as she was waiting for clients in the streets of Kiamaiko, a lady approached her and introduced herself as a Bar Hostess Empowerment and Support Programme (BHESP) staff. She was mobilizing for an outreach that was to take place the following day targeting sex workers. She told her all about the organization and invited her for the outreach. “I was afraid since she was a stranger but together with some friends we decided to attend”.

“Attending the BHESP outreach was a turning point in my life and it became an eye opener. We were educated on the importance of correctly and consistent uses of condoms. It gave me a different view of my health. The outreach workers took me through methods and ways of confidently negotiating for safer sex with our clients and

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Sharon (right) and BHESP team members on a condom distribution exercise

Sharon demonstrating how to use a condom

I love you, let’s have sex

FMP facilitators with their target children display their graduation certificates

by BPEO Chris and Mary both 12 years of age, had been dating for a month and Mary believed that she was falling in love with Chris. He wrote her letters, and he told her how beautiful she was. She was happy that all of her friends liked him. One night they went out, and he told her that he loved her. She felt everything was so wonderful and perfect.

Chris who had had sexual intercourse experience before convinced Mary that they should go ahead and have sex. He explained to her that it was a way to show your love for someone. Mary at the time was not sure if she was ready for the intercourse but knew she loved Chris very much, however, Mary strongly believed on sex after marriage.

Chris pressured her to make a decision telling her that lack of sex amounted to lack of love between them. “I am not sure I will be with someone who does not have feelings for me as I do for him” He reiterated. Mary got scared that they would have a break up soon. She did not want to lose him, but was also scared of having sex.

While in this state, she approached one of the BPEO Healthy Choices facilitator for advice. Mary

Graduation ceremony for an FMP class at Kikuyu

enrolled for the next classes of Healthy Choices for a better future (HC) and managed to acquire skills on abstinence and ways to delay her sexual debut.

Mary managed to engage the skills she had learnt in the sessions and managed to convince Chris that there were other safer ways of showing love apart from having sexual intercourse. Chris was also later enrolled for healthy choices classes and is now a behavior change model in his community.

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The Power of Information

by DISCOK I am in a discordant relationship but I do not like using a condom…”

Lack of information is a major challenge that can lead to discordant couples making wrong decisions that can influence their relationship and life in a negative way as was seen in the case of Ben who is HIV positive and Mary who is HIV negative and have been in a discordant relationship for the past 4 years.

During one of the therapy sessions with a counselor, Ben shared that Mary preferred him not to use condoms. Ben shared that he opted not to use condoms but preferred using the withdrawal method. Ben believed at the time that if he used the withdrawal method, he would not be in a position to infect Mary.

Ben and Mary had a desire to have children and decided they would go to a clinic and get information on how this could be achieved especially in discordant relationships.

EBAN-K session Mukuru DISCOK Field office

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Before they both got a chance to visit a clinic, Mary found out that she was pregnant and shared the good news with Ben. To Mary’s surprise, Ben was not happy and asked Mary to get an abortion as he believed that the child they would have was already HIV infected. Unfortunately Mary got an abortion and she later got tested and found out she was HIV negative and this traumatized her and in turn affected their relationship negatively.

Ben and Mary agreed to go for therapy where they met a counselor, and she provided them with psychological counseling and gave them the correct information on how HIV is spread and the importance of the use of condoms. Mary and Ben were grateful and realized the harm they had done to each other over lack of information. Through the help of the counselor Mary and Ben have joined a support group and once more have the desire to have children in the near future.

EBAN-K session Mukuru DISCOK Field office

In the Driver’s Seat: Truck Driver Vows to Protect Family from HIV AIDS

by HCHRC Paul (not his real name), a 45 year old long distance truck driver with a polygamous family knew the importance of testing for HIV AIDS, though he had never considered it a priority. After all, his family looked healthy.

It was a visit to Highway Community Health Resource Center that became the turning point in his life.

The counselors encouraged him to take the test owing to the nature of his work and the fact that he had three wives – two of whom he had been compelled by circumstances to inherit after their husbands had passed away.

The HCHRC service provision center along the Northern highway corridor at Mlolongo in Nairobi

His third wife had been married to his cousin. After his death, his kinsmen had urged him to inherit her in accordance to Luo customs. Paul had obliged – not bothering to find out what the course of his cousin’s death.

A rumor that he had succumbed to AIDS related illness prompted him to take the test. He feared that he would test HIV positive but to his surprise, he was HIV negative. His two wives turned negative, the third one positive. The result made him vow to more responsible in his sexual behavior. He also promised to undergo Voluntary Medical Male Circumcision (VMMC) and use a condom with his third wife whenever they had sexual intercourse.

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A Toothache Transformed Our Lives – Community Health Worker

by CDM James, (not his real name), had brought his child to one of the dental clinics supported by CDM for tooth extraction in 2010. As he was waiting for the daughters turn to see the dentist, a nurse was giving health talk to the waiting clients on the benefits of HIV testing and counseling.

The nurse enumerated the benefits of testing for HIV and encouraged him to take the test even though he was not the patient . After some resistance, James finally agreed to take the test and was directed to the counselor.

To his surprise, he tested HIV positive, and that was a turning point in his life; ‘I felt like the world was torn apart and I did not know what to do next. How would I break the news to my wife?’ recounted James.

James’ family was tested for HIV and he and his wife were enrolled to care. Their two children were tested and found to be HIV negative and are healthy and schooling.

Today James is a peer counselor and a community health worker. He has become a champion of community mobilization for HTC services and has been exemplary in following up patients that give up on treatment and brings them back.

“My family and I remain indebted to the initiative by the nurse to encourage me take the test.” He says.

Living Positively

by IDF

Case 2

Case1 Luke lost his job in Nairobi after testing HIV positive in 1998. His wife also tested positive.

They were put on antiretroviral drugs at Homabay District Hospital.

When Joshua Odago and his wife discovered that they were a discordant couple, their marriage almost broke up.

Despite their status, they are blessed with four children who are HIV negative.

The couple practices safe sex and is active in encouraging others to take bold steps to know their HIV status in order to help them plan their future lives. They also emphasize on the importance of ARV drugs adherence to those who are already on medication.

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They did not understand what their condition what resulted into a conflict that almost tore the family apart. Thanks to IDF intervention – they have now come to terms with their health condition and are practicing safe sex.

The couple has two children who are HIV negative and are playing a lead role in encouraging community members to go HIV testing and overcome stigma.

Strength of a Woman: Determination Earns Sex Worker White Collar Job

by WPC

Modern WPC Road-Side Wellness Centre Mtito-Andei – Makueni County

During construction of WPC Mtito-andei Wellness Centre, WPC, as a strategic decision, mobilized sex-workers in the town to be involved in the construction through fetching water for a small wage. The passion and energy shown by the sexworkers in fetching water for construction as an alternate way of earning livelihood was in line with WPC goal of working with sex-workers.

With clear understanding that involvement causes commitment, immediately after the completion of WPC Wellness Centre –Mtito-andei, a competitive interview for the position of the Centres’ Receptionst was conducted.

WPC Centre Athi-river – Machakos County

Out of the eight sex-workers who presented themselves for the interview, Maureen, pictured above, was selected. On 1st April 2011, she was granted her first one year contract with WPC as Site Receptionst.

Maureen’s engagement boosted utilization of the site by fellow sex-workers and their clients and built a lot of confidence from all sex-workers that the facility was friendly to them and manned by one of their own. This is a reputation that the site has mantained to date.

Maureen at work

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Families Matter program: Training on Parenting Improves Mother – Child Relationship

by ZAF Margaret from Kayole estate in Nairobi, is now a happy parent after attending the Families Matter Program training. She admitted that she had not been a good parent to her children. She thought that providing the basic needs was good enough.

Her daughter who is twelve years old was performing poorly but as a mother, she never bothered finding out the cause of the problem. Instead she kept on heaping blame on the girl. Their relationship deteriorated – forcing the girl to stay at her aunt’s place during school holidays.

Facilitation of a discussion at a mobile VCT

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It was only after attending the Family Matter Program that the mother saw the need to bring her child closer in order to reconnect with her. She said that the session which she liked most was “EFFECTIVE PARENTING” which covers the importance of being close to your children, effective communication and laying a good foundation for your children in order to help them achieve their goals.

She now sees the need to have a close relationship with her children and give them correct and consistent information at the right time.

Youth Outreach in Makueni

Looks can be deceiving

by DISCOK Stigma is still a major challenge that faces many couples who are in a discordant relationship as was portrayed in Millicent and Tom’s story.

Millicent and Tom began their relationship with a lot of challenges and rejection from Tom’s family because they had an assumption that Millicent was HIV positive because of her small petite body. This came about as Tom presented Millicent as his future wife to his family.

As time passed Tom’s family continued to reject Millicent and did not want to accept her to the family.

Unfortunately Tom suddenly fell sick and he became worse. Millicent then told Tom that they should go visit a VCT so that they could know there status.

After paying a visit to the VCT, Tom was surprised to find out that he was HIV positive and his wife was HIV negative. It dawned on him how unfair his family had been towards Millicent, yet they did not know the truth about their status.

DISCOK Peer Educators training at Shauri Moyo

With time, Tom’s health started deteriorating as his family put pressure on him to leave his wife yet they did not know the truth of the matter.

All this while Millicent had contemplated leaving Tom because of the negative treatment she was receiving from Tom’s family but after taking considerations she opted to stay with Tom as she loved him despite the treatment from the family.

With time Tom could not take the negative treatment his wife was receiving from his family and confronted his family members and told them his status and his wife’s. The family felt very embarrassed and both of them decided to move out of the home they were living with Tom’s family. Millicent and Tom thereafter joined a discordant support group where they received support and empowerment from other discordant couples. Tom’s health has become better and with support from health practitioners they have been able to get HIV free children and have a loving fulfilling relationship.

Food distribution at DISCOK office

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M INIS TRY O F HE A LTH

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