Merry Chrismass and Happy New Year 2015 from KARDS

KARDS is a management and local community  development consultancy skilled in promoting managerial, leadership, civic and enterpreneurial excellence.

KARDS is a management and local community development consultancy skilled in promoting managerial, leadership, civic and enterpreneurial excellence.

World AIDS DAY: AJAN’s Research on ARTs and Comprehensive Treatment

Life for people with HIV would be much easier if they had clinics within walking distance and if they spent less time in queues that stretch for hours to get their treatment.

These are two chief recommendations that emerged from the preliminary analysis of some results of regional research into access to antiretroviral treatment (ART) and related care. The research, coordinated by the African Jesuit AIDS Network (AJAN), is being conducted by Jesuits AIDS projects, by Jesuit social justice centres and by other NGOs partnering with us in several sub-Saharan African countries. Today, World AIDS Day 2014, we share findings from Kenya, Tanzania and South Africa.

AJAN joins people living with HIV in calling for ever more accessible and comprehensive treatment. This includes community-based care; better-staffed clinics; constant availability of antiretroviral drugs (ARVs) and related tests; free and available treatment of opportunistic infections; and nutritional support – gaps in these services were identified, to a greater or lesser extent, by the people who were interviewed.

AJAN lauds the steps taken to roll out treatment: overall, most of the 380 people interviewed seemed happy with the access, extent and level of care they receive. Most said they adhered constantly to their medication (86%), their health was good and they were eager to learn more about how to handle their condition: “I want to know more and get empowered.”

Some 96% said they get their ARVs for free and 79% described their access as “good”, the highest category. Over 90% expressed satisfaction with a range of components of their care, including the attitude of healthcare staff, the availability and usefulness of counselling and information about their treatment, and arrangements for clinic follow-ups and to pick up their ARVs.

Kenya, South Africa and Tanzania have worked hard to expand access to treatment. According to UNAIDS, at the end of 2013, in each of the three countries, the estimated percentage of adults living with HIV receiving ART was around 41/42%.

However many respondents underlined the excessive time and money spent to access treatment as problematic. They called for more clinics, including mobile ones in remote rural areas, and more staff to cut down on waiting times of up to 8 or 10 hours.

“At government clinics, they should first track the very sick ones, and have fast queues just to pick up medication. I go there early in the morning at 5am and finish about 2pm. More staff are needed,” said one.

Many said they could ill afford this time and in fact work was given as a reason for missing medical appointments. Another reason was transport; one-third of respondents said lack of money made clinic visits difficult: “There is the need to bring services closer to the people as sometimes transport fares may be difficult to afford.”

“Practically all the people interviewed have facility-based care, which is reportedly the case for 95% of HIV services in Africa,” said Fr Paterne Mombe SJ, AJAN Director. “We wish to build on some of our best practices, such as mobile clinics, to bring a full package of diagnosis and treatment services closer to people in need. We will also be considering innovative interventions like Point-of-Care Testing, which means that blood tests can be carried out in the community, allowing for swift diagnosis.”

The treatment of opportunistic infections also emerged as a challenge: nearly one-third of people interviewed said they were sometimes unable to buy prescribed medications because they couldn’t afford them and one-fifth because they were out of stock.

Testing was another lacuna: just over half said their CD4 count was taken regularly when they went for follow-ups, and less than one-third had their viral load measured. “All AIDS clinics should have machines for crucial tests like CD4 and viral load to avoid desperate movement by those infected in search for these tests,” said one.

The respondents proved keen to be kept updated about their health and treatment, “it is my health and responsibility as a person”, to know about treatment side-effects, about avoiding re-infection, about learning how to live longer and positively. They also called for more counselling services and said support groups were very helpful.

“I have seen people die, so whatever health concern I have, I speak out,” said one person.

The majority considered the clinic staff as allies in their personal struggle against AIDS. Around 91% said they felt open to share concerns with the staff, who they described as friendly, professional, supportive, open, trustworthy, respectful and ready to take time to listen.

“They have the knowledge and a willing heart,” said one. And another: “I feel comfortable because they make me feel like any other person and don’t judge me.”

Some made a direct link between their willingness to be open and the support they may then expect to receive: “I want to be helped and this can only happen if I share with the staff.”

This openness, in turn, arose from accepting one’s HIV-positive status. “I have made peace with my situation and condition and, as a result, I feel free to ask when I have questions.”

However, the people living with HIV clearly felt there was room for improvement among the clinic staff too: 37% felt the staff were too busy, 14% said they did not have time to do a proper check-up and 8% said either that the behaviour of staff was somehow negative or that they did not respect confidentiality.

One respondent confessed: “I am scared of them at times”, while others said the nurses were “rude” and “undermined us”. Many blamed the heavy workload: “The health personnel are after clearing the queue so no time for questions”, and “You always need to talk very fast so that other clients can be served”.

Overall, however, the picture that emerged is a positive one and the people interviewed called for sustainability of treatment so that they may continue to be able to live well and to support themselves and their families.

In the coming weeks, AJAN will be analysing research undertaken in other countries including Burundi, DR Congo, Madagascar, Malawi, Togo, Ivory Coast, Zambia and Zimbabwe.

Kenyans: let the He4She Campaign promote GBV awareness to all

GBV discussions
We must all support the He4She Campaign and address all aspects in our society that perpetuate gender based violence. This campaign comes in the wake of serious episodes where women were being undressed for wearing short dressses.

……We cannot have women stripped naked while the public watches without taking any action against the perpetrators. This is the height of irresponsibility on the part of the spectators. As a good citizen, what action did you take against the criminals who were violating the rights of the women? Gender equality is not just something that we will talk about, but something that we must internalise in everything we do. I unveiled the National Policy on Prevention and Response to Gender-Based Violence, and signed the ‘HeForShe’ campaign banners endorsing my commitment to champion the cause for gender parity (President Uhuru Kenyatta, 26th Nov 2014).

The attacks on women on the basis of their dressing have appalled all Kenyans of good will, were the words of Anne Waiguru the Minister for Devolution.

These heinous acts against our sisters, mothers, and children are barbaric and criminal. Beyond the outrage and horror that these attacks have rightfully provoked, we must now look inwards at ourselves and ask hard questions: what kind of society have we become? What kind of society produces men who so nonchalantly undress and humiliate their sisters or even mothers in public? Which man sexually molests a three-year-old child? Do they not have mothers, sisters, or daughters?

In traditional Africa, a shared morality was the cement of society. Nurturing and protecting our women and children is a fundamental attribute of who we are as a people. Our oral traditions and stories are full of heroic men who saved women and children from wars and ogres. Even the doyen of African literature, Chinua Achebe, noted that “it is not bravery when a man fights with a woman”.

It is to answer the cry of every woman and girl who has suffered violence for no other reason than that of being a woman or girl that we as a government ministry launched the HeForShe campaign and 16 Days of Activism against gender-based violence, as well as the National Policy on Prevention and Response to Gender-Based Violence.

The government has demonstrated its commitment to addressing the gender inequalities that persist in our society. We now have various initiatives aimed at improving the well-being of women, providing social protection, health care, education, and security, as enshrined in the Constitution and our development blue print, Vision 2030.

Through the second Medium-Term Plan 2013-2017, socio-economic programmes for women, youth, and persons with disabilities have been realised. The implementation of the Uwezo Fund, The Youth Enterprise Development Fund, and The Women’s Enterprise Fund are all aimed at deepening financial access for those who are not covered by commercial financial services.

The biggest game changer, however, is the 30 per cent preferential procurement provisions. Through this initiative, the government is putting real money and opportunities for growth in women’s hands.

UNTIL WE PARTNER WITH MENFOLK

We have realised that gender equality cannot be achieved until we partner with our menfolk. We, therefore, mark the evolving of a new dawn, where we have changed our strategies and have opened a new platform to reach out to men and boys as advocates of gender equality and in so doing, create a society where women and men, boys and girls are valued and treated equally.

n and women who call this beautiful land our home, have an agreement among ourselves, a social contract if you like, which binds us as a people to “live in peace and unity as one indivisible sovereign nation” and commits all of us to “nurturing and protecting the well-being of the individual, the family, communities, and the nation” (as the preamble of the Constitution states).

The change and possibilities we are looking for start with us.

As a female minister , I sometimes find myself harshly judged. I have to dress right, speak right, socialise right, and even smile right. I am not allowed to express my uniqueness and choice without attracting a myriad of comments. For my male colleagues, it is different; no one would even notice that they wore the same suit twice in a week.

However, we all know that it is not just about the dress or the style; it is about a social construct that promotes intolerance and oppression. Many of us are culprits, doing it both unconsciously and consciously, smothering the expression of self-identity and seeking to box others in what we consider “right”.

Let us all endeavour to make Kenya a better place for all of us. To all the men, the challenge to you is to join in, as champions for the HeForShe campaign in your daily lives as fathers, brothers, sons, boyfriends, husbands and colleagues, to promote the rights and empowerment of women and girls.