There will be more than half a million AIDS orphans by the turn of the century and almost one million by 2005.
It is very difficult trying to imagine what these figures represent in terms of human suffering and of social and economic consequences. In the course of my research for this issue, I talked to people who have lived with the disease at first hand and are devastated by it and with others who are grappling with efforts to respond to the pandemic. I read books and reports on the subject. Trying to absorb the enormity of the problem, I came to realise one thing: that we are dealing with a national disaster of extraordinary proportions and that our response to it is totally inadequate and often inappropriate.
AIDS is not a disaster in the way the August 7th bomb blast was a disaster: people are not falling down dead around us, buildings are not collapsing and the injured are not running all over, covered in blood. Perhaps, for that reason it is hard for us to imagine the enormity of the HIV/AIDS pandemic. Is it also the reason for the total inadequacy of our response?
As far as the Government response is concerned, it is true that it has set up structures for research and reporting; however, it has totally failed to diminish the spread of the disease. One of the major causes of the prevalence of AIDS in Kenya is poverty: as long is poverty is on the rise, there can be little reduction in the number of people infected. The Government has shown no commitment to reducing the gap between the rich and the poor; on the contrary, it is still pursuing practices which increase that gap. It must therefore bear a large portion of the blame for the situation with respect to HIV/AIDS.
What about the response of the Kenyan society? The response of the society as a whole leaves much to be desired: many people would rather not think about the problem; their reaction is like that of the Kenya Broadcasting Corporation on August 7th: business as usual. Also, there is still far too much prejudice against the people affected and a lot of discrimination, some subtle, some cruel. There are cases of HIV-positive persons being dismissed from jobs, even if they are still healthy. .Medical personnel, with some laudable exceptions, are on the whole insufficiently trained to cope with patients sensitively.
On the positive side, we can say that nongovernmental organisations have tried: at the latest count there are some 500 organisations which are involved in responding to the pandemic in one way or another. The Kenya AIDS NGOs Consortium (KANCO) is doing an admirable job in trying to co-ordinate the work of these various bodies. But, as the members of KANCO will be the first to admit, the work of the NGOs is but a drop in the bucket compared to what should be done, especially in the rural areas.
Religious organisations are also trying very hard to cope with the multitudes of their adherents who are suffering and dying. But there is still a lack of openness about the pandemic among them as well as a lack of realism. They will pull out of co-operative ventures because of disagreement about methods (sex education, use of condoms) thus diminishing the impact of interventions. Some still see the epidemic as a punishment from God.
The groups that are the most effective, that is the youth to youth programmes of peer counselling, on the whole lack sufficient support from the public and from donors. Their methods should become much more widely known and they should receive greater support. (See the article on the youth programmes in this issue.)
The HIV/AIDS pandemic is a disaster without precedent in Kenya. It ought to be declared a national emergency and all of us should be in the front line of the battle. The enemies are ignorance, apathy, greed, struggle for power. To win the fight against the pandemic we need to set our priorities straight: our personal priorities and our societal priorities.
There is a lot of talk about behaviour change. But if we think we will have won the battle once we can get all sexually active people in Kenya to use condoms, we will have missed the boat completely. Yes, there is need of behaviour change for the sexually active who are most at risk of being infected or of passing on the infection. But the rest of us need a behaviour change just as much.
Perhaps for this to happen we need to start listening: to the young who are full of enthusiasm and have learned how to share; to the poor and the marginalised who may know more than we do about solidarity and compassion. But especially we need to listen to those who have looked death in the face and have gained the courage to face life with a new purpose. There are many examples of such people among the HIV-positive and we should learn from them that death can be a teacher about life. In the face of death, we can gain a better perspective on life, we have a great chance to learn about those things in life which really matter: love, solidarity, compassion.
Too many AIDS victims are still dying a lonely and miserable death because they are afraid of meeting with condemnation from their relatives and friends. We can add to the number of those dying by our apathy or we can decide to change our attitude and to do everything in our power to diminish the impact of this national disaster. The AIDS pandemic gives us this opportunity. The choice is ours.
ABOUT OUR CONTRIBUTORS
Mrs. Anne Marie Kinara is a Librarian and Information Consultant with LISS (Library & Information Support Services). Mrs. Kinara came to Kenya from the Netherlands in 1966. She is married to a Kenyan and has two grown-up children. She has worked in various positions in libraries and documentation centres in the Kenya Government. From 1983 to 1996 she was the Head Librarian of the United States International University-Africa. She has published a book and several articles on the flow of information and knowledge from the national level to the rural areas and vice versa. Her hobbies are reading, listening to music and visiting African art galleries and exhibitions.
Rosemarie Muganda-Onyando is an anthropologist by training. She is the Outreach and Research Co-ordinator at the Institute for Econonomic Affairs.
Dr. Halima Abdullah Mwenesi is a Senior Research Scientist working for the World Health
Organization (WHO) on secondment from Kenya Medical Research Institute. She has a PhD
in Social Sciences from the University of London, School of Hygiene and Tropical Medicine.
She has undertaken research in the area of tropical diseases, gender and health issues, drug
abuse and communication for health. She is a member of local and international medical
Maureen Ong'ombe is the Communication Officer of the Kenya AIDS NGOs Consortium. She holds a B.A. in English Language and Literature and an M.A. in Communications. She has been involved as a trainer and resource person in health communication and in curriculum and project development.
Anne Owiti is the Director of the Kibera Community Self Help Programme, and is deeply involved with their HIV/AIDS services, such as peer counselling and income generating programmes. Her background is in Primary Health Care management and Theology (special emphasis on community evangelism).
G. Wakuraya Wanjohi is a librarian by profession and a consultant with LISS (Library and Information Support Services). After many years with the UN in Nairobi, she now combines consultancies with working for Wajibu. She is the chief editor of the journal.