child prostitutes of mtwapa

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The  Kenyan media has in the recent past been abuzz with news of the Kenyan women and a foreigner caught in the act of committing bestiality in the Kenyan Coast. This is a story that shook the nation and was trending in most social media, yet stories of child prostitutes some who are involved in pornography and drug cartels get no headliners.

The coastal town of Mtwapa has been popularized for all the wrong reasons. A growing town in the suburbs of Mombasa, Mtwapa is a favorite tourist destination which operates around the clock. The clubs and pubs in Mtwapa are host to locals and tourists alike and sex work is widespread in this busy robust tourist haven where young girls and boys linger around pubs and night clubs in the hope of getting a client. Some of these young boys and girls are living double lives as they are actively engaging in transactional sex without their parents’ knowledge.

Sexual exploitation of children continues unabated in the region where young boys and girls are exploited for commercial purposes while others intentionally and willingly engage in sex work for various reasons. Regardless of the reason child prostitution and living from the proceeds of prostitution is illegal in the country. According to the Penal Code, Cap 63 Laws of Kenya, prostitution or sex work is not prohibited by the law, but various issues surrounding sex work could be illegal, for instance living from the earnings of sex work, solicitation and indecent exposure.  Child Prostitution is not provided for under the Penal Code which was a gap in the law that has been addressed by enactment of the Sexual Offences Act (2006) and Children’s Act (2001).

Section 15 of the Children’s Act protects children against sexual exploitation and the use in prostitution, inducement or coercion to engage in any sexual activity, and exposure to obscene materials.  This provision places an obligation on everyone to refrain from doing all of the above above. The provision also lays burden on parents or guardians to protect the child from child prostitution. Section 3 of the same Act, provides that the government should take steps to ensure that a child’s rights are protected and realized.

In addition, Section 15 of the Sexual Offences Act prohibits child prostitution but is silent on themeasures to be taken on a child who is prostituting herself. However, it establishes various offences against a person who will directly or indirectly influence or cause a child to prostitute themselves. Any person who keeps a child for the sake of prostitution, or, pimps a child or takes advantage of his relationship with the child to induce him or her to have sex with another person for monetary consideration and other benefits, will be committing an offence and is liable to imprisonment  to a term not less than ten years.  A person who will also pay to have sex with a child commits an offence and is also liable to the same punishment.

Despite the legal provisions the business of the flesh involving children continues to thrive through organized networks in private houses. Middlemen and pimps who identify clients and venues continue to eke some money from negotiating deals for these children. Incidences of child prostitution will most certainly go unreported because these middlemen and pimps are often close relatives to these children. Tourists have been blamed for the escalation of child prostitution in the area, yet we forget the locals who encourage young girls to get a “Mzungu”. A girl seen walking with an elderly “Mzungu” three times the age of her father is accorded much respect and honor.

Whereas before the trade normally targeted young girls, today young boys have became prime target especially for tourists and rich locals. Beka is a 12 years old boy who combs the beach everyday together with other boys in such of white men who pay them for sex.  Sometimes he does it with fishermen at “Marina” in exchange for fish. He is a student at a local school but he doesn’t consistently attend classes. His family is aware of what he does but they have turned a blind eye as long as he continues to help support the family.

Sele on the other hand will only take clients given to him by his uncle who acts as his pimp. His uncle takes most of the proceedings which he uses for drugs and provisions. Sele does not go to school.  Twice he has been treated for Sexual Transmitted Diseases and he says his clients are men from the area though occasionally he does it with ‘wazungus’.

Young girls in the area are also involving themselves in pornography which is a booming underground business in the region. Whereas local girls will often involve themselves with sex work, girls from upcountry have gone a step further and they willingly take part in pornographic acts and live sex shows which are slowly gaining popularity in some of the clubs.

These young boys and girls are not aware of the health risks they are involved.  It is a pity that most of these children are not even aware of effective HIV and STI prevention. In the course of their “duties” they don’t always practice safe sex and will forgo the usage of condoms if the pay is more or when they have anal sex because to them anal sex does not transmit infections and is less risky as opposed to vaginal sex.

Unfortunately the government has turned a blind eye even as children continue to be exploited. As a country we have failed our children by robbing them their innocence and childhood as we continue to turn a blind eye to their defilement and abuse. Kenya is a signatory of the Convention on the Rights of the Child in 1991 optional protocols on sexual exploitation and trafficking and yet the government has failed to effectively uphold it. It is high time the government acted and employ measures that will curb this growing vice otherwise the country is at risk of losing a whole generation to immorality and or HIV/AIDS.

 

When the sun stopped shinning….the story of a mother

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Despite her easy disposition Mary Adhiambo is a woman from Kenya who has been through pain and trauma. As women all over the world marked Mother’s Day (May 13 2012), Mary admires women with their little daughters as she remembers her own daughter; the daughter who was taken from her two-year-ago, due to a disease that could have been prevented.

She smiles apprehensively as she narrates her story, which she says seems like a bad nightmare that unfortunately she can’t wake up from because it is the reality.

Pneumonia is an infection of the lungs that is caused by bacteria, viruses, fungi, or parasites. It is a common and deadly disease in Kenya and across the developing world. It is estimated to be responsible for 30,000 childhood deaths in Kenya each year, while one in every 12 children suffers from it. Pneumonia is one of the major causes of childhood deaths in the world, severely affecting children below the age of two.

Pneumococcal bacteria are spread from person to person through close contact. When they attack a child they lead to difficulty in breathing, cough, fever, chills, headaches, loss of appetite and wheezing.

According to a joint report by UNICEF and WHO, Pneumonia kills more children under five than any other disease such as malaria, measles and HIV combined. The report further says that 150 million pneumonia cases occur every year in the developing world, making it a challenge in children healthcare

A few months before the birth of her daughter, Mary’s husband was diagnosed with extra-pulmonary TB and put on treatment. Together with her elder son, Mary was screened for the fatal yet curable disease and both were given a clean bill of health. Soon after this, on the 20 July 2010, Mary became a proud mother when she gave birth to her daughter.

“She was beautiful. People never believed that she was mine or that I could have such a pretty little girl,” she recalls with a sad smile.

When she was two-months-old, Mary’s daughter fell ill and was taken to a local hospital in Kibera where she was diagnosed with pneumonia. She was referred to Mbagathi District Hospital and admitted. When they get to hospital, any patient will feel relief and hope, certain they will get treatment and recover from what is ailing them. However it was not the case with Mary.

“The doctors told me they could not administer a certain treatment to give my daughter, which in this case was an injection to relieve her breathing problems, as she was too young; it is only administered to children over one year,” says Mary.

This was a big blow for Mary. She prayed her child would get better with the alternative medicine she was given. Three days after admission her child, who had been put on oxygen, started developing complications. Her stomach swelled and neither she nor the doctors could understand the reason because as she was not constipated.

Two days later, Mary watched her daughter as she took her final painful breath. Pneumonia! She never imagined that her daughter would succumb to pneumonia. Her world crashed, she forgot where she was. From a distance she could hear someone screaming and crying loudly, she lost track of time and the face of daughter haunted her for a long time afterwards.

Mary has since learned of a vaccine that could have saved the life of her daughter who would have turned two this year.

The pneumonia caccine is currently recommended for all children under five and like all vaccines it is injected into the body to stimulate the normal immune system to produce antibodies that will fight against the pneumonia bacteria. Mothers are advised to exclusively breastfeed for the first six months of a baby’s life and ensure prompt treatment of children with respiratory disease as a preventive measure against pneumonia.

According to Mr. Jack Ndegwa, KANCO’s vaccines advocacy officer, the Ministry of Public Health and Sanitation, through the Division of Vaccines and Immunization, aims to increase access to immunization services nationwide in order to reduce morbidity and mortality due to vaccine preventable diseases.

“Vaccines services are provided free of charge in Kenya and therefore I urge all mothers and guardians to ensure that their children are vaccinated against the following diseases: tuberculosis, poliomyelitis, diphtheria, pertusis, tetanus, hepatitis B, Haemophilus influenza type b, measles, yellow fever and pneumococcal disease,” he said.

when the sun stopped shining: story of a mother

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Despite her easy disposition Mary Adhiambo is a woman who has been through pain and trauma. And as women all over the world marked Mother’s Day, she admires women with their little daughters and she remembers her daughter, the daughter, who was taken from her two year ago, due to a disease that could have been prevented.  She smiles apprehensively as she narrates her story which to her seems like a bad nightmare that unfortunately she can’t wake up from because it is the reality.

Pneumonia is an infection of the lungs that is caused by bacteria, viruses, fungi, or parasites. It is a common and deadly disease in Kenya and across the developing world estimated to be responsible for 30,000 childhood deaths in Kenya each year, while 1 in every 12 children suffers from it. Pneumonia is one of the major causes of childhood deaths in the world severely affecting children below the age of two. Pneumococcal bacteria are spread from person to person through close contact and when they attack a child they lead to difficulty in breathing, cough, fever, chills, headaches, loss of appetite and wheezing.

According to a joint report by UNICEF and WHO, Pneumonia kills more children under five than any other disease such as malaria, measles and HIV combined. The report further says that 150 million pneumonia cases occur every year in the developing world, making it a challenge in children healthcare

A few months before the birth of her daughter, Mary’s husband was diagnosed with extra- pulmonary TB and effectively put on treatment. Together with her elder son, Mary was screened for the fatal yet curable disease and they were given a clean bill of health. Soon after this on the 20th of July 2010, Mary became a proud mother with the birth of her daughter.

“She was beautiful people never believed that she was mine or that I could have such a pretty little girl,” she recalls with a sad smile.

When she was two months old, Mary’s daughter fell ill and she was taken to a local hospital in Kibera where she was diagnosed with Pneumonia.  She was referred to Mbagathi District Hospital where they were admitted. Any patient will get relieved, be hopeful to get treatment and recover from what is ailing them when they get to hospital. However it was not the case with Mary.

“The doctors told me that they could not administer certain treatment to give my daughter, which in this case was a certain injection to relief her breathing problems as she was too young and it was only administered to children over one year!”

This was a big blow for her and she just prayed that her child would get better with the alternative medicine which she was given.  Three days after admission her child who had been put on oxygen started developing complications. Her stomach swelled and neither she nor the doctors could understand the reason because as she was not constipating.

Two days later, Mary watched her daughter as she took her final painful breath. Pneumonia! She never imagined that her daughter would succumb to pneumonia, her world crashed, she forgot where she was and from a distant she could hear someone screaming and crying loudly, she lost track of time and the face of daughter haunted her for a long time afterwards.

Today, Mary has learnt that, there is a vaccine that could have saved the life of her daughter who would have been almost two years today.

The Pneumonia Vaccine is currently recommended for all children under five years and like all vaccines it is injected into the body to stimulate the normal immune system to produce antibodies that will fight against the pneumonia bacteria. Mothers are advised to exclusively breastfeed for the first six months of a baby’s life and ensure prompt treatment of children with respiratory disease as a preventive measure against pneumonia.

According to Mr. Jack Ndegwa KANCO Vaccines Advocacy Officer, the Ministry of Public Health & Sanitation through the Division of Vaccines and Immunization aims to increase access to immunization services nationwide in order to reduce morbidity and mortality due to vaccine preventable diseases.

“Vaccines  services are provided free of charge in Kenya and therefore I urge all mothers and guardians to ensure that their children are vaccinated against the following diseases Tuberculosis, poliomyelitis, diphtheria, pertusis, tetanus, hepatitis B, Haemophilus influenza type b, measles, yellow fever and pneumococcal disease,” he concludes.

Was TB responsible?

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“Untreated TB
represents a far greater hazard to a pregnant woman and her fetus than does
treating the disease.” {CDC (2003, 62)}

Anne Wairimu is a  mother of one and currently on treatment for MDRTB. She has been retreated for
TB on three different occasions and she confesses that she has never defaulted  in her TB treatment course.

Hers is a very sad  story on what Tuberculosis can do to a mother.  Like other people who have had Tuberculosis,
hers started with a persistent cough which resisted local remedies thus  prompting her to go to hospital where she was diagnosed with Tuberculosis.  She diligently finished her first treatment
course but she had a relapse a couple of months later. She was put on  retreatment and after she was through with the second treatment course she
thought she had left her worst nightmare behind her, only for her to continue  coughing and having severe chest pains. A third screening showed she was still
Tuberculosis smear positive and once more she had to start anti TB medication.

At around this time she  also discovered that she was pregnant. She however continued with the TB treatment
not knowing what effect the drugs have on her unborn child.

The risk of not  treating Tuberculosis in an expectant woman, are much greater to her and her
unborn child than treating the disease.  Women with untreated TB risk giving birth to
premature babies or children with lower birth weight who may also be born with
TB.

In December 2010, shortly  after finishing her second trimester, Anne delivered a baby before her term  ended to a child who was underweight and sickly. At this time Anne was still  taking her TB medication and she was told her child had severe pneumonia and  was put on treatment. However, her baby’s health did not improve even after two  months of pneumonia treatment.  A certain  doctor told them that the child had heart problems and referred them to a heart
specialist.

Meanwhile the baby had  not yet received his BCG shot as the doctor had advised against it by virtue of
the fact that he had pneumonia, but a nurse at Machakos District Hospital  seeing that the child had not been immunized two months after delivery went
ahead and gave the baby the BCG shot. When Anne complained against it the Nurse  dismissed her telling her that she knew her work.

Days after this, the  baby refused to breastfeed and was not moving. He looked tired and weak and
would vomit when breastfed. That night the baby was not responding to the  mother’s touch and the nurses tried to give him oxygen but he died shortly
thereafter.

This was a painful loss  to Anne which she accepted as part of life. A month later in March, Ann
completed her TB treatment course but she continued having the TB symptoms and  after further tests she was diagnosed as having MDRTB. She started MDRTB
treatment in June of this year and is currently taking her medication.

According to Dr.  Sitienei head of the Division of Leprosy, Tuberculosis and Lung Diseases in
Kenya, pregnant women should be treated as soon as TB is detected as this will
reduce the chances of her passing TB to her unborn child or herself getting sicker.
But he notes that the best option would be to advocate for family planning for
women who have been diagnosed with Tuberculosis.

Is it possible the  medicines Anne was taking played a role in the loss of her baby? When the baby
was born  he was not tested for TB but  was diagnosed with severe pneumonia from observation, would he have lived if a
TB test could have been done on him to rule out his having been born with TB?  These and many more questions will continue to weigh greatly in Anne’s mind and
the answers will always remain a puzzle to her.

Ogutu’s story

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Godluck Ogutu is no ordinary father; he is a father of four and a casual labourer who despite the fact that he is
co-infected with both HIV and TB, shoulders the burden and responsibility of solely taking care of his children after their mother who was also living with
HIV left him to continue with the responsibility of raising and taking care of the children.

On a visit at the Kitengela Health Centre, I was surprised to see a man coming out of the consulting room carrying an
infant child in his arms, a huge envelope and two young children clutching protectively at his shirt. At first, I thought my eyes were playing tricks on
me but it was true, before me was a man who had brought his child to the clinic for ante-natal care. I double checked on my camera to see if I had captured it
right and it was all there.  I stopped what I was recording and sought Nurse Grace for more information concerning the
man with the three children and that is when I was introduced to Ogutu who told me his story afterwards.

Ogutu and his wife like all couples have had their ups and downs and once when this happened, they separated for close
to a year after which they resolved their difficulties and came back together. After a while though the wife realised she was pregnant and she enrolled at the
health centre for ANC. At the centre she was offered the whole package which included HIV screening, apparently she tested sero-positive and she hid it from
her husband. She refused to be enrolled to the PMTCT program and carried on as usual with her life.

During this time Ogutu became sick and he went to hospital where he was screened and found to be living with the virus.
He was effectively put on ART because his CD4 count was quite low. Shortly after his wife delivered a baby boy and though her condition had deteriorated
drastically she adamantly refused to be put on ART and left for her village. Ogutu who had been attending support group therapy sessions decided to take
charge for the sake of his newborn son. The boy had been put on ART but because his mother had left with him and considering the attitude his wife had towards
medicine, Ogutu travelled to the village to take his son. He came back with the boy and left his wife at the village.

Currently Ogutu has been struggling to balance his days which consist of going to work and taking care of his
children, attending TB clinic for DOTS because he tested TB smear positive and occasionally taking his child for the regular and recommended clinic.

Ogutu says the love he has for his children is what motivated him to do what he did and what he is doing. He has been
attending regular health talks at the Kitengela Health Centre and knows the importance of adherence. Despite the fact that he is a potential risk to these
children by virtue of his Tuberculosis infection, Ogutu refuses to delegate their care to relatives believing that they will not get the necessary care and
attention that they deserve. Besides he says that his eldest children are attending school in Kitengela and they might miss out on school if they have to
go to the village.His children have not been screened for TB.

 

Unfortunately in Kenya we lack an organized system of social welfare programs and child protection systems despite the obvious need. Ogutu’s is just one of many experiences that is happening especially in these days of HIV and AIDS.  There is need for the government to address this need and respond to families living with HIV through
the provision of temporary social welfare programs to enable people like Ogutu finish their treatment without being a potential risk to their children.  With child protection systems, policies and services  will be set up that will support the prevention and response to potentially related health risks

IN this case children can temporarily be taken to foster care and guardianship or charitable children’s institution for the duration of the parent’s treatment course,
especially if the parent is suffering from a potentially infectious disease like Tuberculosis. Under the Children’s Act 2001 children have a right to be
protected and not exposed in a manner likely to cause unnecessary suffering or injury to the child’s health or seriously affect his or her well being.  Under this

KEVIN’S STORY

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KEVIN’S STORY

Kevin is no ordinary child, he has had to go through a lot of pain in his thirteen years and probably he will continue to suffer if the necessary interventions are not carried out as soon as possible. He was born with the HIV virus and has been battling with unending Pneumonia infections ever since he was four months old.  In 2001, Kevin was diagnosed with tuberculosis which was treated however in 2010, the Tuberculosis recurred. In between this period he also had several pneumonia infections. The first time he was put on anti TB treatment, Kevin started developing complications which have seriously affected his young life. He lost his eyesight from unexplained reasons.

At first he could see blurred images and he was always complaining of a headache but eventually his eyesight completely failed him. His sense of hearing too was not spared, Kevin was affected and currently he can only hear partially in on his ears and you have to really shout for him to slightly hear you.

He has always been complaining of chest pains and headaches and whenever this happens, the doctors always diagnose him with pneumonia with the most recent case being in August of 2011.

Kevin’s father abandoned them when his son’s condition got worse leaving his mother to take care of him and she has left no stone unturned in her quest to find a more helpful and lasting solution. She enrolled him in a school in Meru where he was learning Braille but the school was very far considering her son needs constant care. She is now in the process of transferring him to a school in Nairobi that has a special unit for special children.

“Kevin has been attending regular clinics at Kenyatta to find out why his head is growing bigger.  And I was told that his head has filled up with water,” his mother points out.

Kevin has hydrocephalus (swelling of the brain as a result of cerebral spinal fluid building up in the central nervous system which causes the fontanel to bulge and the head to become larger than expected). Could this be a direct result of the drug interactions?

Like in adults, TB in children is becoming a major infection in children who are living with HIV and can result in childhood deaths even in children who are not infected with the HIV virus. Sadly in Kenya the diagnostic systems are still not up to standards and many children end up misdiagnosed at the first screening. When taken to hospitals with TB symptoms, children get treated for other chest infections such as pneumonia, asthma and bronchitis, something that fuels the delay in treatments.

With his history of tuberculosis, Kevin’s constant pneumonia infections should be taken seriously considering the facts that he is always complaining of chest pains and that he has had a recurrence TB infection twice. This however is a long shot!

“Sometimes it is so hard for Kevin he cannot sleep well because of the pain especially at night,” says the mother.

If only more funds could be invested in pediatric diagnosis and treatment programs, children like Kevin would not have to suffer or undergo the pain that he is facing every other single day of his life. Failure to do this will result in more TB deaths in children, something that can be avoided because Tuberculosis is curable.

TB – the myths that surround it

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Over a century later after Tuberculosis has been in existence, it is still enshrouded in myths and misconceptions especially in the rural areas of Kenya. This has led to TB patient to delay in seeking treatment while others misdiagnose themselves putting them at a higher risk of developing the deadly strain of Tuberculosis that is multi drug resistant TB or MDRTB.

During a field trip to Wote in Makueni, the thing which came out strongly to me is that despite the successes achieved in TB advocacy in the area, communities still need to be sensitized on TB awareness its primary cause and mode of transmission.

In this area it is interesting to note that people are still not fully aware of TB’s mode of transmission.  For most of the residents in the area, TB is caused by witchcraft and cold. It is not uncommon to find mud and grass thatched huts with no windows or any opening besides the door. This measure which is meant to keep the cold wind away from the family has and can be very dangerous in the long run because it fuels rather than control the spread of TB.

Inside the hurts it is naturally dark that you cannot see your hand when you close the door even during the day. Besides this the huts are stuffy probably due to the fact that there isn’t a fresh flow of clean air. This environment is conducive for many disease causing agents and if not addressed or measures taken up to enlighten, educate the people then TB cases will not stop in the area and cases of re-infection will also increase.

Witchcraft is also believed to be a cause of Tuberculosis in the area. Most residents will therefore go to witchdoctors to break the evil spell and heal them. It is not uncommon to find TB patients taking local herbs and remedies alongside the conventional anti- TB regimen for psychological effects.

KANCO through local groups like the Wote Youth group have been conducting TB awareness campaigns and has been supporting them to advocate for TB and do TB related activities such as patient support, defaulter tracing, and community sensitization.

One of the people who has directly been receiving assistance from this group which does TB advocacy at the community level is Mutheu*.  At first when you look at her you could easily mistake her for a young girl in her teens, however, she is a mother of four and her story is as sad like all the other stories.

She was just an ordinary homemaker who took care of her family in their family home. Her TB first manifested as a cough which she dully ignored despite advice from her peers to get treatment. She thought maybe it was a result of the hard chores such as carrying firewood and water on a hilly terrain that was causing her to chest pains and the cough. However with time, the symptoms did not go away and so she went to the next best remedy that she could think of, and that was local herbal remedies from the local herbalist or witchdoctor because to her and her husband, she had been bewitched or looked at with an evil eye.

This too did not bear any results because she continued coughing, finally though she was taken to hospital where she was examined and diagnosed with Tuberculosis. After completion of her treatment, her husband blocked all the windows in their house because to him his wife had become infected with Tuberculosis as a result of the cold wind and the only way to stop this from recurring was to block up all the windows.

Shortly after Mutheu became sick again and this time she was tested for her HIV status and she was found to be HIV positive. She lost weight was bedridden; she could not walk on her own and had to be supported. Unfortunately for her the Tuberculosis recurred and she had to again take TB medicine which she did and finished successfully.

Currently she is well and living positively having finished her anti Tb drugs and has been set up a small kiosk by her husband where she sells basic foodstuffs. She is yet to fully recover but the windows in her house are still blocked.

Is this an area of intervention? Mutheu and her husband are not the only ones who have this belief in the area. Looking at most houses in the vicinity the first thing you will notice if you are observant is the fact that the houses do not have windows and if they do have then they have been blocked and cannot be opened.

This is very dangerous considering the known and documented facts about Tuberculosis transmission.  It is known that the TB germs nourish in dark stuffy areas, so what should be done to sensitize these people to change their perception? Are the TB advocacy programs not effective as such?

 

 

 

 

 

 

 

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