Traditional Culture Impedes the Fight against HIV in Kenya

By Julie Bowen

The battle against HIV/ADS in Kenya is also a battle against entrenched traditions and taboos. In the rural villages, its existence is either denied or spoken of in whispers. To these people, AIDS is not real: this is Chira, a deadly wasting disease caused by a curse that strikes down anyone who transgresses society’s norms, which can be treated only by the village medicine men. This plays into the hands of opportunists, such as the rogue herbalists who see only profit in suffering, or the vested interests of those who persist in the stigmatisation of AIDS victims – seen not least in the rigid short-sightedness of the Catholic Bishops of Kenya, who only exacerbate the problem with their hard-line pronouncements against the use of contraceptives.

Women and poverty

Throughout Kenya, women are at a disadvantage in all things. In the communities of Nyanza Province for example, the twin social stigmas of poverty and HIV/AIDS, plus the lower status of women, polygamy and the practice widow inheritance, make women particularly at risk of HIV infection. The rate of infection in the province stands at 14.7% compared to the national average of 9%. However, rates vary enormously within the province, with the Suba district showing a rate as high as 41%. Average infection rates for women in the whole of Kenya are 6.9%, compared to men at 4.4% and children at 0.9%.

Pamela Dola is a member of the Luo community in the Lake Victoria region. When her brother-in-law died of AIDS, custom dictated that his widow was then inherited by Pamela’s husband as a second wife. Three months later, the second wife died. Shortly afterwards, Pamela’s husband was taken ill and died, leaving Pamela to single-handedly raise her three children as well as the five children of the dead wife and brother-in-law. This story contains all the ingredients that make HIV/AIDS infection a high risk in such communities, where women lack the freedom to control their own lives, and sex is of prime importance in every aspect of the culture.

By custom, a widow is unclean and has to endure a ritual cleansing immediately after the death of her husband. A widow who refuses to have sex with another man is considered cursed or at least unlucky and are usually ostracised. Similarly, many of life’s important milestones such as moving house, or even the routine stages in cultivating the land are marked by ritual sex, which also has protective powers: for example, if a parent dies, a man must have sex with his wife before leaving home or be cursed. Women are seen as property and are expected not to complain when another wife comes into the house or the husband has extramarital affairs. In such a society, where a man may have sex with several women, where HIV is rife, where even its existence is denied and every death is explained away, and where education is poor and poverty drives many women into prostitution or early marriage, we see a perfect recipe for the spread of the HIV, where the heaviest burden is carried by women.

Fighting the epidemic

The Kenyan Ministry of Health has tracked the spread of HIV since 1990 through annual sentinel surveys in antenatal clinics. The turning point came around the end of the decade, when rates of adult infection peaked at 14% and the government recognised that the burden of high mortality and ill health on both the rural and urban population was eroding family ties and social cohesion. A national emergency was declared and the newly created National Aids Control Council (NACC) led the response to the epidemic with the launch of the Total War on AIDS (TOWA) campaign. More than a decade later, the UNAIDS Global Report on the AIDS epidemic for the years 2003 to 2008 shows a decline in infection rates and risk behaviour alongside increased knowledge of HIV prevention and treatment. However, death rates and numbers of new infections remain high. NACC estimates the number of Kenyans living with the disease at more than 1.1 million; and after more than a decade of decline, infection figures are again beginning to rise. While improvements in medical science and services help to control the problem, entrenched cultural practices still act as a brake on progress.          

The herbalist

With the spread of HIV, the herbalists thrive. Nobody wants the stigma of being HIV positive, so secrecy is common. Amidst fear and suspicion, the herbalists see an untapped potential for profit, but fill it only with more sorrow for the unfortunate victim. Herbal medicine is not regulated by law and there is no code of ethics among herbalists. The Kenya Medical Research Institute has established a requirement for safety assessments to be made on all drugs including traditional herbal medicines, but there is no control mechanism to ensure they are implemented. 

People like Jesse Ng’ang’a, from Gilgil in the Rift Valley region, who kept his HIV positive status a secret from his wife, family and neighbours and was looking for a release from his daily dose of antiretroviral drugs, was easy pickings. The herbalist first interrogated him about his life and the history of his disease, and then told him that through his healing powers he had cured ninety-eight cases of AIDS and had become famous and influential. An hour long consultation followed that included prayers and invocations to the supernatural. He then explained that the fee would be KSh. 4,000 ($45), with a further KSh. 10,000 ($112) for the 60 day course of treatment. Jesse then had to sign a memorandum of understanding that bound him to make the full payment for the treatment after completion or he would forfeit the title deed to his land. He was given a concoction of herbs that made him feel drunk for several days. After this he came to his senses and went back on his antiretroviral drugs. He told his wife about his infection and she encouraged him to go to the Kikopey Diatomite Community Based Organisation, a home based self help group that was able to offer him support.

Determined resistance by such individuals and organisations to the pressure by society on the HIV-positive to be ashamed and secretive about their status can help turn the tide of the epidemic. HIV/AIDS has profoundly challenged Kenyan society, putting a burden on its healthcare system. Only by the breaking down of some of society’s barriers, its prejudices and traditions, will the war against HIV eventually be won.

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Building Roads to Equality: the Gradual Political Journey of Kenyan Women

By Julie Bowen

In recent years there has been a determined push to put more women into strategic positions in Kenyan politics. Much of the pressure has come from the various women’s organisations in the country – in particular the Women’s Leadership Academy and the Women’s Empowerment Link, which is managed by the United Nations Development Programme (UNDP) – under the auspices of Amkeni Wakenya, a civil society that works to encourage communities to be involved in the democratic process, and in particular to promote policies that are favourable to women. In 2010 the new Constitution was signed, promoting gender equality and seeking to encourage the inclusion of women in political leadership and decision making. The ‘two-thirds rule’ that requires a maximum of 66% of either gender in elected political bodies forced all the political parties to recruit an average of 23% more women. Although a significant gender divide remains, the future of gender equality in Kenyan politics looked set to change.

In the run-up to the March 2013 election, as a result of the Amkeni Wakenya initiative, more than 350 women from all areas of rural Kenya had been trained in leadership skills as a preparation for becoming candidates at county and national level. 70 of these women were able to enter the contest with a real prospect of victory. This was to be an election of real significance in Kenya – both as the first general election since the violent aftermath of the 2007-2008 election, and the first to be held under the new constitution. As such, hope ran high. The result, with women winning nearly 20% of the seats in the National Assembly and the new Senate, compared to only 10% in the old Assembly, vindicated all the effort put into realising the dream of a more equal political landscape in Kenya where women have a real power to influence policy.

During the election, various local civil society organisations worked with UN Women and the Angie Brooks Centre to coordinate 500 trained election observers, which made over 1,200 reports from around the country about complaints, threats to the electorate, property damage and violence, which were resolved efficiently. The election was judged to be a success, although there is still a way to go before the process is considered as representing the ideal of a fair and peaceful democratic process.

A Different Approach 

The political spheres in many countries have encouraged an increase in the number of female politicians and leaders for a number of reasons. While it is not wise to over-generalise about character and gender, women are generally known for being non-confrontational, motherly and hard working. In the cut-throat world of national and international politics and business, this caring side often equates to a more soothing and measured counterbalance to male ruthlessness. According to Debra Burrell, females are thought to be generally better than men at seeking and implementing compromises, which translates into a desire to build for the long term rather than aiming for the short term relish of a single moment of victory. While any man or woman can pick up a book and learn about the theory and application of politics and business, their actions are usually influenced by their gender. Collaboration, democracy, persuasion and attentiveness are all attributes commonly brought to the table by female leaders. Women have therefore come to have a crucial position in politics and business in Europe and the United States.

Getting Started 

The greatest battle faced by women is to get their foot in the door. According to Nicholas Anyuor, many parties have found it challenging to respect the Constitution with regard to gender representation because of the lack of any decisive strategy to implement change. Without proper intellectual and logistical infrastructure, engendering real change will always be a challenge. For example, the UK elected its first female Prime Minister in 1979, and she continued to hold that position until 1990. A ruthless politician whose success apparently stemmed from a combination of her fierce intellect and caring femininity, Margaret Thatcher was virtually alone female in a male political world. Even now there are only 146 female members of parliament in the UK compared to 504 men. Between the three main parties there is considerable inequality. In the coalition government the leading Conservative Party has 19% women, the Liberal-Democrats 14%; only Labour, the main opposition party, has a healthy 51% female representation. If the UK, which has been striving towards gender equality in politics for more than thirty years, has still failed to achieve equal representation, it is no surprise that Kenyan politics, which began to address the issue only three years ago, has not yet achieved equality; but there has been remarkable progress.

In 2012 the Supreme Court judged that the ‘two-thirds rule’ would not be achievable in 2013. The Court ruled that this would be implemented progressively during the three years up to August 2015. Chief Justice Willy Mutunga spoke against the majority ruling: ‘Parliament by its silence cannot deprive women of this country the right to equal representation. In the event that Parliament fails to implement that principle, any of the elected houses will be unconstitutional.’ Equal representation may be a long way off, but the situation overall is one of hope and good intentions. The fledgling constitution has managed to increase the number of women in politics despite inequalities in the system and the resistance that females in Kenya continue to face.

Worldwide Scrutiny

Other countries such as the UK, US, and Australia have already done much of the groundwork in showing the world that women can become competent politicians and business leaders, which should make the struggle for Kenya’s women easier. Religion, tradition and superstition continue to be used to dissuade women from entering the political race (for example, a reporter for Aljazeera News claims that voters are warned that they will go to hell if they vote for a woman); but the internet and globalised media have opened up the situation in Kenya to worldwide scrutiny and the results are beginning to show. As a new generation of women reaches their intellectual maturity, the country has never been in a stronger position to make the transition to gender equality. The finish line may be a long way off, but if campaigners and politicians keep working to pave the way the chances of reaching it are high.