POVERTY: Kenya: Nomadic communities

31 August 2010 (PLUSNEWS)
KENYA: Camel clinics bring condoms to nomads - In the remote and rural district of Samburu, northern Kenya, where paved roads are scarce and motorised transport hard to come by, reaching the mostly pastoralist and nomadic inhabitants with HIV/AIDS services requires an unusual approach. John Lokolale, 21, a Samburu Moran (warrior), said he did not know what the word condom meant until recently. "Now I know a condom because I have seen it," he told IRIN/PlusNews. "These days, when I get a girl I tell her I will use a condom because I have a stock in my house. They brought it here with a camel, and I kept many for myself." The Nomadic Communities Trust (NCT), a community-based health services organization, started using camels to reach the Samburu people with mobile clinics in 2006. "We realized we had to be innovative ... and we looked around; we are glad camels have come in handy in [delivering] not only condoms but also drugs and other reproductive health services," said Rose Kimanzi, an NCT field coordinator. The camel clinics offer family planning services, antenatal care, palliative care, HIV testing and condoms. NCT has trained 45 local people to provide information about HIV and condoms and they have so far reached more than 68,000 people. According to the 2007 Kenya AIDS Indicator Survey, Samburu district has an HIV prevalence of 6.1 percent, slightly lower than the national average of 7.4 percent. "When people come to places where we have set up camp they can receive all the services," said Kimanzi. "We have witnessed comparatively wide acceptance of condom use and family planning services." When I started working here, you couldn't mention the word condom...telling them to test for HIV was like an insult Michael Lol'ngojine, a community health worker trained by the NCT project to provide HIV counselling and testing services in Samburu, said people in the area had gradually changed their attitudes. "When I started working here [five years ago], you couldn't mention the word condom, or even tell people about family planning; telling them to test for HIV was like an insult," he told IRIN/PlusNews. "Today I am happy because they now seek services ... When they see the camels, they come along because they appreciate the need to test and they appreciate the need to use condoms," Lol'ngojine said. "Here people still believe in traditional medicines, and if you don't test them for HIV ... even those who are ailing from HIV-related diseases will just seek herbal treatment." Kimanzi noted that high levels of poverty, illiteracy and cultural practices like polygamy and early marriage have led to high levels of HIV infection among the Samburu and other nomadic illithan a dollar a day. "Poverty makes many parents marry off their daughters early, putting them at risk [of HIV]. Many of these young girls are married off to men who are already in polygamous unions, and when you mix that with illiteracy, then the situation becomes difficult." Besides these cultural practices, "Tribal conflicts amongst the Samburu and Pokot [a rival pastoralist group] have hindered the provision of health services, including HIV/AIDS services," Kimanzi said. The two communities carry out frequent cattle raids against each other. The government struggled to bring HIV/AIDS services to the people, said Dofa Abdi, Samburu District HIV/AIDS and STI (sexually transmitted infection) Coordinator. "We appreciate any efforts to offer HIV prevention services to nomadic communities here because they do not visit health facilities, nor is it easy to get to them since most government services are static."

TUBERCULOSIS: SOUTH AFRICA: TB patients not getting HIV counselling

DURBAN, 11 June 2010 (PLUSNEWS) - Too many tuberculosis patients are not receiving counselling about the link between TB and HIV, according to new research. A study by South Africa's University of the Free State (USF), involving 600 TB patients, found that about 40 percent had never received HIV counselling, and 75 percent did not understand the relationship between HIV and TB. The findings were part of a broader study into safer sex practices among TB patients, presented by USF Associate Professor Christo Heunis at the South African TB Conference in the east-coast city of Durban. South Africa's TB epidemic, one of the world's worst according to the World Health Organization (WHO), has been fuelled by a high HIV prevalence rate of 18 percent. Globally, TB is the leading killer of people living with HIV, whose weakened immune systems make them particularly susceptible to the airborne disease. In the part of Free State Province where the USF study was conducted, the HIV/TB co-infection rate was 62 percent, which is below the national average of 73 percent. The South African government made giving TB patients better access to HIV care and services a priority in its 2007 National TB Strategic Plan, but implementation has lagged behind policy. The study noted that about half the TB patients surveyed had used a condom during their last sexual encounter, and that patients who reported using condoms were more likely to have received counselling. However, female patients who understood the relationship between HIV and TB were less likely to have used a condom than their male counterparts. Heunis attributed this discrepancy to women's fear of HIV-related stigma.