Dialling down

Not the usual scenery you would expect when in Mombasa town as I head to Mwanahawa Chai’s homestead. Mud houses thatched with makuti and an occasional permanent building could be seen with a hint of cow dung in the air.

I reach Ms. Chai’s homestead in Utange  village in the Shanzu area of Mombasa . It’s a school day and I can see children of school going age doing their household chores. With a smile Chai greets me. It’s very difficult to know the difficulties she faces until she speaks to me.

‘I am HIV positive and I have 7 children. My 6^th child is living with HIV. He was born with the virus.  I think I transmitted the virus to him when I was pregnant with him.’ Chai says. “During this pregnancy I never attended pre natal clinic.”

Chai’s last child is almost a year old and he is HIV negative. Chai says she attended the pre natal clinic, during her last pregnancy.  “The health experts advised me preventive measures to take, so that I could not transmit the virus to my baby.”

Dr. Christine Katingima from the International Centre for Reproductive Health (ICRH) speaks of the dangers of being pregnant when one is HIV positive.

‘The HIV virus targets the immune system. Getting pregnant reduces immunity. She becomes vulnerable to opportunistic diseases. If she does not attend pre natal clinic she risks transmitting the virus to her baby. It’s better for a HIV positive woman to carry out family planning.’

Chai says she used to be susceptible to contracting many diseases which made her very weak. Community Light Program is a community based organization in Shanzu that deals with people living with HIV and AIDS. Edward Ponda is the program’s co-founder and a community health worker.

‘When Mwanahawa sought help from our organization she was pregnant. Her biggest challenge was carrying out family planning,’ Ponda recalls.

Chai used injections that caused her harmful side effects. She received assistance at the Community Light Program where she delivered her baby and underwent a tubal ligation. “An effective family planning method.’ Ponda observes.

According to mademan.com tubal ligation involves cutting the tubes between the ovaries and the uterus.

‘Family planning entails planning on how many children one will have and how to space them. It does not target the woman only but also the man of the family, says Dr. Katingima.

She adds that the practice helps a woman ‘breath’ after a pregnancy. She says that getting pregnant often adversely affects the mother.

‘Children well spaced are healthier. Always consider the future when deciding on the number of children so that you can comfortably cater for their needs, adds Dr. Katingima.

Chai says using injections as a method affected her health. She says she experienced nausea, dizziness and discharge during sex. She adds that she embraced tubal ligation as a method of family planning.

Tubal ligation reduces the chances of getting pregnant as compared to other methods and it is safe. This method is irreversible. However there is a myth that claims this method keeps a woman cold hence the partner does not get satisfaction during sex. ‘There is no scientific evidence to this, says Dr. Katingima.

Family planning is an issue that elicits emotions and many religious communities are divided when it comes to this matter. Pastor Zachariah Mwagandi of the Community of Christ church sheds light on this matter.

‘According to the Bible God gave us power to multiply and fill the earth. This means one has authority to decide how many children to have. It is not wrong to carry out family planning.’ Mwagandi concludes.

USING FAMILY PLANNING TO ACHIEVE MDGs

Margret Karisa Kombe’s house spells poverty. The bed has no mattress. It is raining. The roof is leaking. She takes a container where water will collect to prevent the house from flooding. The house is dark and the weather makes it worse since light cannot penetrate the creaky window. It is 3pm.She takes a lamp and lights it.

Margret,who lives in Kisauni area of Mombasa county has to hustle to make ends meet since she cannot get a decent job. She reached standard 5 in her primary education. She recalls that she used to be a bright girl but her neighbours bewitched her. She could not concentrate in class. Her parents then advised her to drop out of school. She now does domestic chores for a living, mainly washing people’s clothes. She gets sh.130 a day. This is not enough to raise her children. Margret cannot afford to work every day since she has to attend medical checkups on particular days of the week. She complains that sometimes her children sleep hungry. They even go to school on an empty stomach.

“I have 5 children, 3 are dead. I am HIV+. I never spaced my children. I always got pregnant even the last child I had, did not even start walking .I have no knowledge on family planning. I do not intend to take any pills to prevent pregnancy because I have no man in my life. I lost him to a woman who sells illicit brew for a living.”

Victoria Kapune is the co-ordinator of Reproductive Health Services in the ministry of health in sub counties Mvita, Nyali and Kisauni. These areas are in Mombasa County. She says that family planning is having of desired number of children at a particular time a couple prefers. Kapune says that family planning improves the mother’s health.

“It helps to rebuild her body since she requires a lot of nutrients during pregnancy. It also gives time for her to take care of her child. Spacing helps a mother regain energy. It is advisable for a mother to gap her children by a minimum of two years. In case the mother is HIV+ she should consult with the doctor before getting pregnant. She should have a high CD4 count and high immunity for to carry a baby. The doctor will also advise on how to prevent the baby from becoming HIV+,” adds Kapune.

Family Planning has been mentioned to help in achieving The Millennium Development Goals (MDGs) MDGs are eight international development goals that were officially established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millennium Declaration. All 189 United Nations member states and at least 23 international organizations have agreed to achieve these goals by the year 2015. The goals are: Eradicating extreme poverty and hunger, achieving universal primary education, promoting gender equality and empowering women ,reducing child mortality rates, improving maternal health, combating HIV and AIDS, malaria, and other diseases, ensuring environmental sustainability, and developing a global partnership for development.

Sammy Tanui, Senior Population Officer from the National Council of Population and Development, Coast Province says that Kenya’s population stands at 40 million. He adds that it keeps growing by 1 million annually and by 2030 this country will record a population of 75 million people. Tanui is quick to say that family planning helps to improve maternal health and health of the baby which is one of the MDGs.



‘It helps to avoid straining of resources in case of overpopulation. Overpopulation leads to pollution of the environment and rural- urban migration. This leads to congestion, rise in crime levels and vices like prostitution which might lead to spread of HIV and AIDS in urban areas. Depletion of natural resources which brings about economic development is experienced. This will lead to high poverty levels in the nation,’ adds Tanui.


 The UK has population of approximately 60  million people. It covers 242,514km^{2 .}Kenya has 40 million people and covers 582,000 km².This translates that England has a larger population than Kenya,yet England is smaller. Despite England being a smaller country and having a higher population development has been experienced.

Administrative Division	Area Size (sq km)	Population density 2003 (people per sq km)
England	130,281	383
Northern Ireland	13,576	125
Scotland	77,925	65
Wales	20,732	142
United Kingdom	242,514	246

Source: http://resources.woodlands-junior.kent.sch.uk

Administrative Division	Population (mid 2004)	Population (mid 2005)	Population (mid 2006)	Population (mid 2007)
England	50,093,800	50,431,700	50,762,900	51.1 million
Northern Ireland	1,710,300	1,724,400	1,741,600	1.8 million
Scotland	5,078,400	5,094,800	5,116,900	5.1 million
Wales	2,952,500	2,958,600	2,965,900	3.0 million
United Kingdom	59,834.900	60,209.500	60,587,600	60,975,000

Source: Office for National Statistics; National Assembly for Wales; General Register Office for Scotland; Northern Ireland Statistics and Research Agency and http://resources.woodlands-junior.kent.sch.uk

‘The MDGs are a good idea but I think African countries has been brainwashed to think they have high populations. I do not think those countries have a high number of people. A good example is England with a population of 60 million yet they are a developed nation. The problem is not the number of people but the exploitation and utilization of resources,’ concludes David Kebenei a development consultant based in Mombasa.

Robbed

The referee blows the whistle. It’s a goal. Fans of the football team that has just scored are busy cheering while the other fans are busy sulking. I can see a few fans of the opposing team tear up with fear of their team losing.

It’s not the usual football match you would expect. The match is at the Chuma football grounds in Shimo la Tewa Maximum security Prison in Mombasa. The match is between sex offenders and paralegals. The sex offenders play for the Badilika team representing the prison, and Mabrouk representing the paralegals. The match ends 6-5 with Badilika winning the match.

Betty Sharon is the co-ordinator of Pwani GBV [Gender Based Violence] network, an organization which deals with raising awareness on gender based violence. Sharon says, “The world marks 16 days of activism against gender based violence from November 25^th to December 10^th. We chose Shimo la Tewa prison because we run a program with them that involves sex offenders.”

The network rehabilitates the sex offenders and also provides counseling to help the offenders evaluate their actions. Some offenders defiled their own children.

The GBV network chose football  as a way to bring together both groups; the convicted offenders and the paralegals who were involved in their indictment. The network believes that this would be able to foster understanding and good relations between the two.

Michael Tole the chairman of the Badilika team explains, ‘We started this group to educate our fellow prison mates on human rights. And raise awareness on gender based violence. I was found guilty for sexual assault. I still insist on my innocence. I am serving a 15 year jail term.’

Sergeant Kessy Rashid co-ordinates the GBV clubs in the prison and agrees with Sharon.  Rashid says the Badilika team has done an excellent job in raising awareness on gender based violence. All members of the team were found guilty of carrying out sexual offences. Rashid is quick to add that he has seen a positive change in the offenders now with high levels of discipline. Rashid says that he wishes a football match could be organized where the ladies would play against the gentlemen.

Lou Derrick, is the chairman of the International Centre for Reproductive Health (ICRH), Mombasa. ICRH works closely with women and children who have undergone sexual abuse.  ‘We work hand in hand with the Coast Provincial General Hospital in Mombasa. We are ready to work with men but reports say they do not seek help in case of sexual defilement because of stigma and denial.’

Women and children are most vulnerable to cases of gender based violence.  Monica Aluoch lives in the sprawling slums of Mombasa. It was not immediately evident, when I spoke to her, of the magnitude of the ordeal she had undergone.

‘‘I am HIV positive and I am a reformed sex worker. When I was 16 I got married but I am now a widow with 4 kids to raise. I do odd jobs like helping people brew chang’aa, and yes I know it is illegal,” Aluoch says.

When Aluoch’s husband died she turned to commercial sex work to feed her children. She could not get a decent job. “Getting a job is not easy.” She says. Aluoch used to sleep with 4 men in one day and each would offer her on average, 200 Kenya shillings.

 ‘Some used to beat me up after an encounter. Other men would call their friends to rape me after I got drunk.’ Aluoch recalls.

Aluoch was molested at the age of 9 by her cousin. ‘My cousin used to touch me inappropriately. I reported the incidence to my brothers. They reported the issue to my uncle, a doctor.” Her uncle ignored the whole incident noting that the perpetrators were also his relatives.

Challenges arise when solving gender based violence in cases where the perpetrator is a relative.

In the cases ICRH receive in Mombasa, 74% of the survivors know who defiled them. Most of the survivors are children who account for 80% of those who have been violated. Elizabeth Aroka is a lawyer with ICRH in Mombasa who specializes in representing survivors of sexual assault. She explains her experiences.

“Most of the time children report these cases after these acts have been happening for a long time. Sometimes the children are threatened and given as little as ten shillings so that they do not report the incidences,’’ concludes Elizabeth Aroka.