By Rens Saat, Programme Officer @ Simavi
West of mainland Kenya, in the waters of Lake Victoria, we can find a destination that tourist books would describe as the idyllic archipelago of the Mafangano island(s). What appears as a tropical paradise to the eye, soon reveals itself as a place with one of Africa’s most worrying health conditions for its younger population. Demographics speak for themselves, as in the time frame of 2014-2016, 33% of young people within the age category 19-24 were confirmed to be HIV positive. More recently in 2017, the number was estimated at 43%, indicating a rise in HIV infections by 10% among youth in just one year.
Young girls are easily persuaded into unsafe sex
The problem is rather complex and partially attributed to the attitude and behavior of the fisherman who are the main providers of food and income to the island. The fishermen have expressed that they are exposed to greater risks in their working conditions on the water, thus see no reason in adopting a cautious approach regarding their health once they land on the shores of the island. After a tough day at work they wish to enjoy the hard-earned cash which makes them resort in excessive behavior, often sparked by heavy alcohol consumption and drug abuse.
With money flowing on the shores of the island, many impoverished young women are attracted by the men, who are offered food or financial compensation in exchange for their ‘company’. Consequently, high sexual activity is present along the shores of the island. This activity includes young girls who are drawn in to an early sexual debut. Exemplified by a statistic it is not uncommon for girls to become sexually active from nine years old. Due to the lack of proper education, young girls are generally not aware of the risks in which they engage, and are easily persuaded into unsafe sex with the adult fishermen (at times also ignorant about the consequences of their actions), which causes high numbers of infections as well as unprecedented numbers of unintended (teen) pregnancies.
Get Up and Speak Out
This alarming health situation has not gone unnoticed and has since 2016 been targeted by the GUSO program, a development aid initiative funded by the Dutch ministry of Foreign Affairs, in which young people in developing countries are stimulated to Get Up and Speak Out their sexual- and reproductive health rights (SRHR). Implementation of the program on the island is entrusted to Simavi, which aims to bring positive change in communities by working with local NGO’s. Simavi supports local partners so that they are able to provide affordable, suitable and sustainable health services, such as comprehensive sexuality education or condom provision and STI testing.
Meanwhile it encourages to empower communities to demand quality services and practice healthy behaviour, e.g. build morale not to engage in unsafe sexual activity or not to force women in to sex. On top of that capacity of local partners is strengthened, to support them in creating an enabling environment in which the relevant stakeholders, such as health clinics and providers of medical supplies, work together and are accountable.
Fighting the alarming health situation
With the support of Simavi, local Kenyan NGO ADS Nyanza is able to address and fight the alarming health situation. Through the use of paralegals (counselors trained in basic law & ADR- alternative dispute resolution) as well as with the support of youth advocates, the complex health status is dealt with comprehensively. These admirable volunteers offer awareness trainings and preach about safe sex in public places including beaches, where the people generally gather together and are exposed to such risks.
The paralegals also have a weekly hour of broadcasting time on the island’s radio, to create awareness among the community. Here they speak on legal issues, or sexual reproductive health rights (SRHR) and answer questions from listeners that come in through a SMS platform. Additionally, paralegals have at times referred criminal offense cases to lawyers, as they have met multiple instances of sexual and gender based violence (SGBV) or cases of defilement.
Decreasing number of new infections
Due to the efforts of the paralegals trained by ADS Nyanza with support of the GUSO program since 2016, positive trends can be found due to the fact that inhabitants of the island now have access to education and information provision regarding their (sexual) health. Further, teenage pregnancies have plummeted and the average age for sexual debut is statistically going up. Additionally condom dispensary machines – which used to be emptied only once per month – now take on average three days before requiring full replenishment.
According to heath facilities on the island, a direct effect has been that the number of new infections have started to decrease. Also due to the efforts of the paralegals, (foreign) migrants are now entitled to equal treatment with Kenyan inhabitants. They now have access to the medical services they were previously denied, and those who do not speak English or Swahili are offered the possibility of having translators. Paralegals have also managed to bring to justice several perpetrators who have committed sexual and gender based violence (SGBV) or cases of defilement.
However positive results are achieved, circumstances in which ADS’ volunteers and paralegals are operating remains challenging. Stock-outs of condom and medicine provision at times plague the island. On top of that, the situation is being complicated by difficulties staffing their health facilities with skilled workers. With the location being remote, compensation is low and the pressure is high. Further, the issue of stigma for living with HIV still remains a big problem. In order to tackle the matter, discussions in health facilities are being organized which aim to normalize the disease, mainly by educating participants and debunking myths that exist around infected citizens.
Awareness on safeguarding sexual health
Both the figures and agonizing stories remind us of the important work in which Simavi is involved. Through proactive information dissemination as well as active service provision offered by our partner in the field, we can reach out to communities in which people’s awareness is raised on how to safeguard their sexual health. While the whole community is targeted by these actions, it is especially young girls who are benefiting. As the demographic who are most vulnerable to engaging in harmful sexual behavior, young girls can are now better equipped to protect themselves against the threat of HIV that is surrounding them.
Find out more about our SRHR programs.