TwoHelp Kenya

Kisumu

The neglect of Kisumu seems slightly more than recent. In the world of public health, it holds significance for being the primary entry point for HIV - slim’s disease as it is called - into Kenya. HIV blossomed in Kenya, and Kisumu withered from an opulent port on the shores of Lake Victoria into a town most famous for its appearance in research articles about disease.

The Sunset Hotel reflects that change, both in comfort and interior design. Once comfortable mattresses are now saggy hard spring boxes and the threadbare towels are sunset orange in color, matching the hotel’s exterior and dating the relief map of Africa in the lobby, where Angola is still Portuguese, Western Sahara does not exist, Ethiopia and Eritrea are united, and Namibia is little more than a provincial name.

The view of Lake Victoria from the Sunset Hotel is beautiful in the early morning, but fades to the sweltering heat of midday. Small fishing dhows sit still on the motionless water - today the wind has forsaken them. The second largest lake in the world and the source of the White Nile, Victoria is a fragile ecosystem, invaded by Brazilian Water Hyacinth, Nile Perch, and no small amount of raw sewage dumping into its waters, mostly from Kenya.

Introduced to help control mosquitoes, the Nile Perch (which grows to 250 kg) has reduced the number of species of Cichlids in the lake from over 300 to just 8. Shore areas where the Cichlids may have sought refuge are the site of a battle between Water Hyacinth, choking all of the oxygen out of the lake and entangling ferries and fishing boats, and humans, who have introduced a species of Weevil to the ecosystem, certain that it will only consume the plant. But what happens when the Hyacinth is gone? Two-Hundred and fifty kilo Nile Perch don’t eat mosquitoes and I’ll wager that hungry Weevils will find another source of food when the Hyacinth is gone.

The human ecosystem is also in disarray. The Central Kolwa District of Kisumu has good news - the HIV prevalence in the District is down to 25% from 38%. A remote branch of the Kisumu branch of the Kenyan Red Cross is struggling to build acceptance of HIV testing in the area, work being carried out by 58 Home-Based Care workers. Without compensation, they relentlessly visit hundreds of HIV positive people in Central Kolwa, bathing them, changing their sheets, changing their wound dressings, medicating them, and referring them to hospitals for further health care. The Red Cross Branch runs an IGA (Income Generating Activity) based around a poultry farm. Eggs are sold to locals for 5 KSh each (about $0.08) and they resell them for 7 KSh each, for a profit of about $0.03 each. If they are lucky and sell 30 in a day, they will profit $0.90. Other IGAs have recently failed. Floods destroyed a horticulture project and an ill-conceived project to create tailors failed because nobody was available to train locals to use sewing machine.

A small boy walked passed me in Central Kolwa. I waved to him and he approached Kirsten and me. His school uniform was in tatters, with the shirt unbuttoned and his pants were unzipped and he was wearing no underwear. He stared at his feet, which were in tattered shoes. He looked remarkably sad and whispered one word: sweets. Kirsten and I tried to engage him by asking his name and shaking his hand. His uncle, the director of the Central Kolwa Red Cross Home Based Care program, approached us. He told us that the boy had just found out, 5 minutes earlier, that his grandmother had just died from AIDS. He was alone. His mother and father were both dead from AIDS and his grandmother - his caregiver - was now gone, too. This 8 year old boy had nothing but an empty house to go home to. I searched my pockets for sweets, but had none. Kirsten gave him a toy car, which he slid into his pocket as he hung his head and shuffled off into the distance.

Central Kolwa is a catastrophe. The HIV prevalence has only dropped due to deaths and the lack of willingness of the population to be tested. For one young orphan, he is lucky that his uncle is willing to provide him with food and care. For thousands of others, unable to secure food, unable to afford a school uniform, and thus, unable to attend school, the future is not as bright.

I take $5.50 for granted on a regular basis. Whether it is a Venti sugar-bomb from Starbucks or a cup of fruit and yogurt at school, I’m more likely to put the $0.02 in change in the change cup by the register than to take it home. One meal at McDonalds is the cost of putting a child in primary school in some poor areas of Kenya. One bicycle means that 20 more people receive home-based care and potentially, anti-retroviral drugs in Central Kolwa. One more Red Cross volunteer means that at least 20 more people suffering late-stage AIDS can receive hospice care. Time, transportation, and money are everything here. It makes the thought of Starbucks slightly less sweet.