It has been more than a month since the controversial electoral results that were announced in Kenya created so much violence. Although there are underlying issues as to why the situation is as it is, things tend to take different turns everyday.
As mediation continues headed by former UN secretary general, Kofi Annan, there is a new crisis coming out as a result of this conflict and that is the increase in the number of HIV infections.
Almost two thirds (63%) of all people living with HIV globally live in sub-Saharan Africa — an estimated 24.7 million in 2006. Some 2.8 million adults and children became infected with HIV in 2006, more than in all other regions of the world combined. As if the situation is not grave enough, the 2.1 million AIDS-related deaths in sub-Saharan African represent 72% of global AIDS deaths.
Across this region, women bear a disproportionate part of the AIDS burden: not only are they more likely than men to be infected with HIV, but in most countries they are also more likely to be the ones caring for people living with HIV. Provision of antiretroviral therapy has expanded dramatically in sub-Saharan Africa: more than one million people were receiving antiretroviral treatment by June 2006, a tenfold increase since December 2003, this is according to UNAIDS.
Treatment scale-up efforts have been especially strong of late in some countries, including Botswana, Kenya, Malawi, Namibia, Rwanda, South Africa, Uganda and Zambia. However, the sheer scale of need in this region means that a little less than one quarter (23%) of the estimated 4.6 million people in need of antiretroviral therapy in this region are receiving it.
These efforts are about to go to waste especially in Kenya, if the current crisis is not dealt with fast. Already many women in camps and those fleeing violence prone areas have experienced sexual violence with most of them being gang raped. According to Dr. Sam Thenya of the Nairobi Women's Hospital, 187 women and 23 men have been seen at the hospital since the crisis started. "The gains that have been made are going down the drain as rape is used as a tool of intimidation," Dr. Thenya said. "This also means that the spread of HIV is high since most of the people raped don't get to hospital in time for treatment."
The number of displaced people within the country is increasing with current figures reading 300,000. With displacement comes vulnerability, which has made many women susceptible to sexual violation in the camps. By virtue of displacement HIV positive women who have babies have ended up having to breastfeed their children because there is no formula milk or clean water. The other issue is that many women have had to give sex in return for food stuffs at the camps.
So while Kenya is still grappling with sorting out the political impasse, the gains that were made over the years in reversing the effects of HIV/AIDs are going to unravel.
Although anti-retrovirals were available in district hospitals, getting access to these facilities for the displaced is becoming difficult. Those who were getting these drugs had cards that identified them to get the drugs free but some of them having left their homes with nothing else but the clothes on their backs, its difficult to trace them or have them access treatment.
Speaking recently the British Ambassador to Kenya, Mr. Edward Clay stated that security needs to be improved in the camps to protect women and children. With eighty percent of those raped having been gang raped by 2 or 11 people it is difficult to prosecute or trace the culprits. One can only imagine who among these cuprits is HIV positive.
Rape survivors are encouraged to get to health clinics as soon as possible so they can receive post-exposure prophylaxis, or PEP, to prevent possible infection by HIV. According to Florence Gachanja of UNFPA, "Women need to come early for the treatment because after 72 hours the drugs may not be useful anymore. So they need to get to the facilities where these are given, or within the crisis centres within the camps, so that they can get the treatment before 72 hours are over."
In the meantime, the Ministry of Health warns HIV patients against rationing their ARV's, saying that it is better to stop taking drugs altogether than to try stretching out supplies by reducing their daily consumption.
Such behavior allows the virus to build up an immunity against the treatment. People who have already run out of medicine should record the date of their last dose and inform accordingly the next health official they meet.
As protests continue throughout Kenya, all is not lost as different organizations step up to reach the displaced and offer treatement. Doctors with Borders (MSF) has been responding to the additional needs created by the violence of recent weeks. In Nairobi, where MSF has provided HIV/AIDS and tuberculosis (TB) care in the slums for over ten years, medical teams have set up extra clinics and first aid posts in order to assist people wounded during the protests.
However, a considerable number of patients who are on HIV/AIDS and TB treatment with MSF have missed scheduled appointments. Interruptions in treatment can bring long-term consequences in their life-saving treatment.
And the violence and ongoing insecurity has prevented some regular patients from attending MSF's clinics in both Kibera and Mathare. Between December 31 and January 14, for example, 290 patients missed their appointments at MSF's health facilities in Kibera and in Mbagathi hospital.
If HIV/AIDS and TB patients do not regularly take their medicines, their health will deteriorate and there is a risk of resistance developing. If TB patients do not take their medicines there is also an increased risk of infection for those around them.
MSF has set up a free phone hotline for both MSF patients and patients followed in other health structures which are currently closed, so that they can get their treatment. As of January 21, MSF patients throughout Kenya who have not been able to attend their appointments, and may have been displaced by the insecurity, will be able to call for guidance on how to get their medicines and advice on their closest health center.
Let's hope that this issue is soon resolved and we can get back on track.