Reduce Suffering in Kenya Via Health Care Services

“Yei, I got it, I got it!!” sighed Halima* with joy at receiving a 3 years contraception protection method of family planning (FP), and having called Fatuma*- CHAT’s partner and a Family Planning Community Own Resource Person (FPCORP) to report on the good news.

“My husband has finally accepted and I have visited Eremeti dispensary for my implant” Said Halima with uncontrollable tears of joy.

Halima’s husband, Muhusin*, is a Madrisa teacher (one who teaches on Muslim doctrine), but with Fatuma’s household health education that includes a strong referral system, Muhusin had become an ‘enlightened’ man and allowed his wife to visit the Eremeti health facility to access family planning services.

This Muslim community has very rigid religious belief.  Women in this particular setting have very little or no say - their husbands making most of the decisions on their behalf.

It has been a challenging journey requiring enormous amounts sensitization sessions & patience breaking into these strong religious communities - but CHAT in collaboration with members of the community and the Kenya Government - ministry of health (MOH)  identified Fatuma, a wife to the Mullah ( senior religious leader in a Mosque) to facilitate the gentle penetration to these relatively deeply religious communities.

CHAT’s support to  Fatuma’s important work, has been well received - echoed by the Kenyan government, the MOH , where Muslim women’s accessibility to fp services have increased tremendously from approximately 5%  in 2014, to approximately 25% by October 2017.

Before Muslim women would not even walk to the health facility to seek for any health-related services without their husband’s consent -  let alone seek FP services - which is still a controversial issue within the Muslim faith.

However, Fatuma by using CHAT’s innovative a door to door mobilization method of sensitization using a back packing strategy, most of these stringent cultural and religious barriers are slowly fading, paving a way for women to freely walk to the health facilities and seek for health care services – and most with a major focus on seeking for  FP services!

This was pointed out during a field visit by CHAT’s Project officer to facilities around Isiolo Town - by the GoK Medical Officer who commented that - “This county is very much impressed by the work done by Fatuma, the FPCORP that you are supporting - her mobilizing, counseling and referring within this very stigmatized group (Muslim women) about FP services” said Dr. Kiluva, the Medical Superintended Officer.  “Were it not for the effort of Fatuma, the hospital would be reporting very poorly in these family planning/ Reproductive health key indicators,” he added.

“Fatuma’s contribution is highly felt in both Maternal Child Health and FP departments, where she is referring an average of 30 - 45 FP clients for long term contraception methods, and 15- 20  for short term contraception methods,  on a monthly bases respectfully,”  noted Miss Halake –  Isiolo County Gok MoH Nursing Officer  & Reproductive Health Coordinator.

In the quarter under review, thanks to your donations- that contributed to helping CHAT reach 19,141 individuals with family planning/ ecological awareness information out of which 6,638 clients were able to access different FP contraception methods of their choice & 1,228 patients treated for different conditions.

“Woman has always been the chief sufferer under this merciless machinery of the statutory law. Humbly she has borne the weight of man-made laws, surrendering to their tyranny even her right over her own body.... Against the State, against religion, against the silence of the medical profession, against the whole machinery of dead institutions of the past, the woman of today arises.... If she must break the law to establish her right to voluntary motherhood, then the law shall be broken. ~Margaret Sanger, "Shall We Break This Law?" in The Birth Control Review, February 1917  [Referring to the Comstock Act. —tε¡·g]

At the foot of Mt Kenya, Gatwiri,* is a 14 year old girl living in a Nanyuki town slum called Likii, since 2012

“I came to work for my aunt as a maid, earning a meager salary of Kes 1000/- a month (USD $ 10). It was rigorous and back-breaking work.

When my aunt approached me to accompany her to Nanyuki, I naively imagined that life would be rosy; but was soon puzzled as to why my ‘dear auntie’ began treating me the way she did after I complained to her about the enormous workload. My aunt, annoyed, then beat me unconscious, locking me in a room for two days without food/water.

I managed to run away to a friend who ‘worked’ in Nanyuki’s 'red light’ street.

Another chapter opened - I am now a prostitute!” Gatwiri smiled to an astonished CHAT nurse.

Gatwiri’s friend introduced her to a new life of “money without sweat”’ as she put it - a life where she makes money effortlessly, sometimes as much, or even more than what she was earning per month - in just one night!

“What with the big spending foreign soldiers and our own army soldiers, who number in thousands - and not forgetting that Nanyuki is a popular tourist destination - all good for ‘businesses! And provides me with a much needed refuge away from that cruel harridan of an aunt!”

“I have perfected the art of prostitution. Sex work’ is my permanent source of income - affording my own rent in the neighboring Majengo slum.

I was a timid innocent girl, but currently I am now a hardened night lady who not only will sell sex, but also indulge in drug abuse - and I have also terminated several pregnancies,” Gatwiri comments.

“This way of life brings with it challenges such as being used without payment for my services by ‘macho men’ - being raped and dumped, often mostly late at night; being assaulted, or arrested for loitering by security personnel whose main motive is often to extort money from me, or give them free sex – sometimes in gangs!  Nonetheless, there seems to be no turning back as much as I want to. I don’t have another way of making money – and anyway, I feel like society would not accept me back to allow me to lead a normal life,” she says.

“I can attest that Gatwiri detests being what she is today. She never dreamed she would end up like this – selling sex;  but she does manage to feed, clothe herself and pay for her one shack ” CHAT's mobiliser, Rosie, confirms.

“I learnt about CHAT services from a friend” says Gatwiri, “Out of curiosity, I visited Rosie, when she counseled me about the different FP options I realized a sense of freedom!

Rosie discussed risk factors associated with my lifestyle – STIs and HIV/AIDS. I thank God that I had not contracted HIV /AIDS (as far as I know) which my peers and I in this business regard so casually - that AIDS is “just another accident” but is actually serious concern causing fear and dread,” Gatwiri laments.

And hey, this might surprise you but I am getting married and will invite CHAT team for my wedding - I feel I am  here today because  they opened my eyes so much -I really appreciate the knowledge and sensitivity they shared with me,” Gatwiri smiles as she leaves the clinic.

CHAT reached 15,938 individuals with fp/ecological awareness information, of which a total of 1,609 patients were treated for different conditions; 7,448 women chose different FP contraception methods in 10 counties where CHAT operates in the last three(3) months.

Did you know Kenya has the highest unskilled abortion rate (46%) worldwide.