People with HIV need drugs but without food
they still die, writes
Mwangi Esleborn
Photos Alex Caballero
Walk
through Nairobi South B estate in the industrial area and you come across
vendors selling a variety of foods for as little as five Kenyan shillings.
Name it and they probably have it, from roasted pig’s trotters to sweet
potatoes. In the outskirts lie Mukuru kwa Njenga and Kaiyaba slums.
Here doors stay ajar because people fear closing them and not being able to
open them again once getting out of bed becomes a daunting task.
It is deathly quiet in and outside the mud-thatched houses. People walk around
like ghosts. Some cannot remember when or what they had for their last meal.
Rose Muthoni is a home-based care volunteer for people living with HIV and
Aids. Her clothes are tattered but clean. She walked me around the village
showing me people bed-ridden for lack of food.
“This place is like hell on earth,” she explains, adding most
HIV positive people came here to die, away from the rest of humanity.
In a half collapsed hovel, the latest casualty of Aids was found two days
after she died, her face half eaten by rats. Her neighbours called her ‘sweetie’
but in the mortuary, her body is labelled ‘unknown’.
“She came here eight months ago carrying a yellow polythene bag,”
says a neighbour, Dorcas, not keen to give her second name. Dorcas wrapped
up her neighbour’s body in a blanket as they waited for transport to
the city mortuary.
“I last saw her four days ago when I came to check on her; I used to
bring her what little food I could,” she adds.
Sweetie was a silent neighbour, like the rest. They come to Mukuru and surrounding
slums to quietly live out their remaining days as obscurely as possible.
It is their sanctuary.
Sweetie had been HIV positive, and had gone on to develop full-blown Aids.
She took the antiretrovirals she was prescribed but she had no proper diet.
Rose explains that people with HIV have nowhere to go and this place, this
slum, is all they have to call home.
She suggests we visit another sick woman. By the door of a rusted tin shack,
flowers are blooming. If only they were edible.
The person I set eyes on is a woman in a child’s body. She was diagnosed
with HIV six years ago. Her one year old daughter died of complications resulting
from the virus. She is grateful for the ARVs supplied by the National ARV
Programme but goes hungry for up to four days at a time.
When we visit, her body is shaking hard after falling off her bed, beads of
sweat rolling down her temple.
Sensing visitors, she screams for food with her hands scratching the earthen
floor. We give her a loaf of bread and milk in a mug. What happened next will
forever be etched in my mind. She chewed the bread greedily slurping the milk
all over her face, not knowing what to do first: take a bite of the bread
or drink the milk.
Then she starts shouting for more, hitting Rose with the aluminium mug.
For a moment, I think she is going to choke. Her body reacts to her eating
and she has a convulsion, almost to the point of vomiting.
“No one, not even you, brings her food?” I enquire. “This
is wrong, so wrong,” a colleague interjects shaking his head in disbelief.
“Where is the money to buy the food? I don’t even have food for
myself and have not eaten well for two days,” responds Rose.
The woman eats the whole loaf and pleads for more, which we give her. As we
leave she shouts at us to stay. We promise to come back with more food.
We enter the next home. Here those who can walk go to Mukuru kwa Njenga to
look for food. A child is asleep on the dusty ground, too weak to walk down
the row of houses. A third woman’s door is ajar. Inside she groans as
pangs of pain gnaw at her chest. Down with pneumonia, she has not been out
of her bed for a week.
She swapped roles with her 10 year old son who fends for her since her condition
deteriorated. Her house is cluttered with the food the son brings home from
the garbage dump.
“He normally brings ugali [corn meal] and fruits from wherever he can
for me to eat,” she whispers with the little energy she has left. She
is too hungry to talk.
Her last meal was close to two days ago and most of her medication is taken
with water and that’s it.
“I’m going to die any time soon and leave my son an orphan,”
she laments. “Maybe that is better for him for he will not suffer while
scavenging for edibles for me any more.”
Her son has stopped attending school to take care of his ailing mother after
city council askaris (policemen or guards) rounded up his siblings and took
them to orphanages.
“Though I miss them, I think they are better off there than here. Without
my son I would be long dead by now,” she adds.
We give her bread and milk before we leave, but she is in so much pain she
doesn’t notice the items; her hunger is secondary.
The
National ARV Programme was meant to improve the quality of life for people
with HIV thereby increasing survival by about 10 years and reducing HIV-related
hospital admissions by 60 percent. The programme was used to start a new approach
for regional and district treatments, to act as entry points for up to 23,000
Aids patients potentially eligible for ARV treatment each year nationally.
People with HIV may have community health workers, home nursing care and voluntary
counselling within reach. But food is not. Dr Meshack Odero, of Kenyatta National
Hospital, agrees. “We provide ARVs to boost immunity and it needs to
work alongside a proper nutritious diet,” he says.
“We educate people living with HIV and their families about how to live
positively. We also arrange spiritual or pastoral care, mobilize material
support and train home-based care-givers,” says a National Aids Council
officer.
“We give them their medication and visit them whenever possible, but
that is not enough. Yes, we have ARVs but no food, no water,” she complains.
Meanwhile, as the National Aids Council discusses food provisions with the
World Food Programme, more are dying of hunger than the virus.
The National Aids/STD, TB and leprosy control programme aims to make food
supplements available to HIV and Aids patients nationally. Once this happens
it will complement the efforts of the Kenya Network of Women with Aids (KENWA),
the NGO distributing food alongside the medications.
“We have drop off points at Mathare, Soweto and Kiandutu and even in
our offices at Pangani where the food is prepared and given to patients,”
says a field co-ordinator at KENWA who did not want to be named. We provide
two meals a day for the patients to be able to take their ARVs. Without the
food there is no point in giving them the drugs.”
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