A Clinician’s experience in working in Korogocho, an informal settlement in Nairobi
Growing up, most of my schooling took place in a rural setting until the age of eighteen when I moved to Nairobi city for my college education. While living in the rural area I used to hear fascinating stories about life in the city, and I longed to experience that urban life. My dream came true after completing my college education. I secured a job as a Nurse Counsellor at LVCT Health.
Statistics at the time revealed that HIV/AIDS burden was high within informal settlements, which warranted the need for health services and prevention of new HIV infections. I was deployed at the Korogocho site, one of the heavily populated informal settlement in Nairobi. It is an area inhabited by a closed community and the poor living conditions increase vulnerability to diseases. Extreme poverty is one of the factors that lead the residents to engage in illegal businesses such as selling illicit brews.
Incidences of crime were also at an all-time high and many residents engaged in commercial sex work, putting them at higher risk of acquiring HIV and other sexually transmitted diseases. I recall that my experience as a health worker and an “outsider” in the slum was nerve wracking.
One day I was attacked and robbed off all my money and valuables by a group of young men in broad day light. I pleaded with them, “I am a nurse and I usually work here and offer you health services “. “That is good daktari”, they retorted, adding that they had had nothing to eat for the whole day. “Surrender everything that you have or else we will harm you.” one of the attackers said. “Welcome to Korogocho, the beautiful palace of hustlers where we also deal harshly with strangers who interfere with our women.” said another.
Since I would be dealing largely with girls and young women in the area, this spelt trouble. I narrated my ordeal to the other health service providers who had worked in the area for some time before I joined them. They encouraged me to soldier on and assured me that soon the community would realise my mission and accept me.
I started interacting with the community members and leaders on a one-on-one basis, even going to as far as far as getting media engagement on local radio – Koch FM in an effort to get the message across on how critical HIV prevention was in the area and how PrEP, a drug that prevents HIV infection would help. Gradually I slowly started making friends and getting acclimatized to the area.
Girls and young women started seeking health services at the health facility and soon brought their peers to join the HIV prevention programme. The number of girls and young women taking PrEP has since increased tremendously. This will go a long way in reduction of new HIV infections in the area.
LVCT Health implements HIV prevention programmes within the informal settlements where HIV prevalence is high. In Korogocho we implemented the Introducing PrEP into HIV Combination, or IPCP project (2015-2017), which focused on reaching young women at risk of being exposed to HIV in this area. Our Project implementers answered their questions, counselled them through the effort to adhere to a daily regime, and collected evidence that would inform others about how to deliver PrEP as part of an HIV combination prevention package in Kenya.
We are currently implementing the Determined, Resilient, Empowered, AIDS Free, Mentored, and Safe Lives (DREAMS) programme in Korogocho funded by PEPFAR through CDC Kenya, https://www.pepfar.gov/partnerships/ppp/dreams/ that focuses on the adolescent girls and young women (AGYW) aged 10-24years. DREAMS is delivered through multiple interventions, which are layered to address both risk and vulnerability that affect the adolescent girls and young women. The AGYW are offered a package of services that includes cash transfers, education subsidies and social protection.
Alfred Itunga talked to Fred Maweu in October 2017