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KENYA: Rural Parents Prevent HIV Transmission to their Children

Isaiah Esipisu

NAIROBI and KIENI, Kenya, Jun 23 2010 (IPS) - When Samuel Mwangi’s one-year-old HIV-positive son died five years ago, he thought the death of his child also meant the death of his family’s legacy. “I wept. And to the bottom of my heart, I knew that that was the end of my generation,” said HIV-positive Mwangi.

HIV-positive couple Miriam Wanjiru (l) and Samuel Mwangi (r) with their two-year-old HIV-negative son.  Credit: Isaiah Esipisu/IPS

HIV-positive couple Miriam Wanjiru (l) and Samuel Mwangi (r) with their two-year-old HIV-negative son. Credit: Isaiah Esipisu/IPS

The baby’s death had been a big blow to Mwangi and his partner, Miriam Wanjiru, because their child had been on an ARV treatment program at a health centre. They had hoped he would survive.

“It had been a trying moment for us as we watched him suffer the painful ordeal of being a HIV-positive infant for his entire one-year lifetime,” Mwangi said.

Mwangi and Wanjiru are just one of hundreds of HIV-positive couples in Kieni division, at the foot of Mount Kenya some 210 kilometres east of Nairobi, who thought they could never conceive an HIV-negative child.

Despite the fact that Prevention of Mother-To-Child Transmission (PMTCT) treatment is provided free of charge in Kenya, poor attendance at antenatal clinics, especially in rural areas, keeps women from being educated about the benefits of PMTCT and from accessing treatment.

A study titled ‘A Safe Motherhood Project in Kenya: assessment of antenatal attendance, service provision and implications for PMTCT,’ reveals that half of all pregnant women in rural Kenya attend antenatal clinics only once in their pregnancy. Many have found the distance to their nearest clinic the biggest barrier to treatment. And this is typical in places like Kieni.

However, three years ago, Wanjiru and Mwangi joined the Kieni Development Initiative Self Help Group (SHG), a group that assists 106 HIV-positive residents from Kieni. Through the group, the couple learned that there was a possibility that Wanjiru could give birth to an HIV-negative child, despite the couple’s HIV status.

“The prevention of HIV transmission from mother-to-child has worked for thousands of children in Kenya and beyond. All one needs is to follow the medical expert’s instructions from the time of conception, throughout the pregnancy, to breastfeeding,” explained Professor Joseph Karanja, a consultant gynaecologist and a lecturer at the University of Nairobi.

That’s exactly what Wanjiru did with the assistance of the SHG. “We took them for counselling, and later through a program for PMTCT, which was done in collaboration with the Narumoro health centre,” said Nancy Mwithigani the development facilitator of ActionAid-Kenya, one of the NGOs that supports the SHG.

“The doctor prescribed drugs and particular food, which he said was meant to boost my immune system before conception,” Wanjiru said.

After three months, her immunity stabilised and she conceived. She immediately began attending the antenatal classes at the Narumoro health centre, situated some 12 kilometres from her home. The classes run for the entire duration of the pregnancy, and continue for another nine months after birth. Services are free of charge.

Until then, Wanjiru was like many other women in rural Kenya. She thought that PMTCT was a concept geared towards helping the elite, especially those living in urban areas.

“I usually associated it with people who have a lot of money, and not peasant farmers in the villages like me,” she said.

PMTCT guidelines were introduced in Kenya in 2005, and to date, PMTCT treatment is available free of charge in about 80 percent of antenatal clinics countrywide. But the distribution of medicines and medical services by government to many marginalised parts of the country has remained a challenge.

After aggressive public awareness campaigns by the humanitarian organisations working in the area, nearly all households in Kieni and other neighbouring villages have been educated about PMTCT. NGOs have also teamed up with government to assist with the distribution of medicines in these and other rural areas.

So when Wanjiru delivered an HIV-negative baby she and her partner were ecstatic. “This boy is the best thing that has happened to us,” Wanjiru said of her now two-year-old son, Waweru.

She sits at the doorstep of their informal dwelling peeling potatoes for dinner, occasionally watching on as her son plays ‘hide and seek’ with his father among the shrubs.

“I’m happy, that even after we tested HIV-positive more than a decade ago, God has given us a reason to smile – a child who is not infected by the HI virus,” said Wanjiru.

It also gave other couples in the SHG hope.

“Wanjiru’s delivery of an HIV-negative child was just the beginning for the group members. Twenty-two other HIV-positive couples immediately expressed similar interests and in the past two years, 13 of them have already given birth to HIV-negative children, justifying the importance and success of the PMTCT treatment,” said Mwithigani.

Jane Wandia is another HIV-positive mother in the SHG who has given birth to an HIV-negative baby.

“With free distribution of antiretroviral drugs, my husband and I feel we should go for another baby, because we feel we are strong enough to raise one more,” said Wandia. Her husband is HIV negative.

Mwithigani says that PMTCT treatment has now been made available, with the assistance of other NGOs, to other marginalised communities in North Eastern Kenya.

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