His name is held in awe by men and women alike.  People claim that he has magical powers and anyone who is not in his
good book dies mysteriously. The residents of Mradi in Mathare No. 10 cannot bring themselves to even mention his name.
His name is mentioned in whispers by old and young, male and female.  He is “Japolo” the most famous male TBA from Mathare area 4A.

It is claimed that he has a large clientele of women who opt to seek services from him. Once you become his client you cannot change your mind and go elsewhere
more so a normal hospital or health centre. The consequence of going to these facilities, once you have sought the Japolo’s services, is instant and mysterious deaths for either the mother or
unborn child or both.

Among the Japolo’s famed services are the actions he undertakes to pregnant women for them to deliver easily. It is claimed that besides giving people porridge he
has unprotected sex with expectant mother in the guise that the cervix will open up for the baby’s easier passage. He does not ask his patients about their
HIV status and in these days of HIV this risky behavior exposes and puts very many women at risk of acquiring HIV and yet his patients follow and revere him
unconditionally.  They only whisper about his activities and none is willing to openly affirm these claims saying they are afraid of the repercussions.

As a Key Correspondent, I decided to follow up on this leads and it took me a month trying to locate where the famed Japolo operates from because people were
not cooperative. Eventually I got to Mradi in Mathare no 10. My getting there had not been easy because no one was willing to direct us to him, and the once
who gave us directions misled us several times. Others went mum on hearing us mention his name

Finally a woman carrying a child directed us after I told her I had a big problem and I needed help from Japolo.  We arrived at his place and I was led to his house by a man who appointed himself my guide.

“Why are you looking for Japolo?” he asked me.

“My husband and I have not been blessed with a child after ten years of marriage,” I answered him.

“Aaahh hiyo ni kazi ndogo kwa Japolo, yeye atakusaidia,” (That’s something small to Japolo) he assured me.

Unfortunately when we reached Japolo’s house he was not there and I was advised to wait for him; something which I was unable to do because it was getting late and I was
afraid. I promised that I would be back the next day to see Japolo.  Who is Japolo? I asked myself? Why would everyone live in fear of one man?

The next day on Tuesday 21st June, I went to see Japolo and on arrival we met women queuing outside his clinic. Some of them were expectant while
others were carrying infants. I started a conversation with one of the expectant ladies and she was full of praise for Japolo. A lady with two
children asked me for a bottle but unfortunately I was not able to assist her and she was shown a shop where she went to buy some transparent plastic paper
bags.  Japolo poured some strange brownish liquid into the bag and told her to give both her children a spooneach.  The woman I was talking to, left after being given some herbs and was told to go bath with them and return after
that.

“Ingia!”(Enter) he finally called me.

I asked my colleague who had accompanied me to wait for me outside while I went in. Inside there were four beds covered with stained blankets, on a charcoal
jiko there was a big black sufuria with a maroonish substance which looked like a piece of cloth and a sieve.  Seated on
one of the beds, was a woman carrying a baby while another woman obviously on the throes of labor was on another bed. Japolo was seated on the floor on a
small piece of torn white PVC carpet which was below a “shrine “of sorts which had pictures of various “Legio Maria” (or so I thought) leaders, a rosary and a crucifix.

Japolo was not as formidable as I had been led to believe. He is of dark complexion and small stature and was wearing a green robe. I sat next to the woman with
the baby. I was relieved because I was not alone in the room.

“Shida yako nini?” he asked me. (Note that I had been told that one need not tell Japolo their problem as he can tell your problem when he looks at you.

“Mimi na mzee wangu hatuna mtoto, tumeenda hospitali, nimekunywa dawa na pia nimeombewa but hatujafanikiwa” (my
husband and I have do not have children even after going to hospital and taking  medication and also after being prayed for
.)

“Bwana yako hana shida, shida iko na wewe, uko na uchawi katikati yako yenye  inakufanya usizae; (you are the one with
the problem your husband has no problem
) he told me and started to chant in Luo or so I thought as I was only able to pick out the words ‘haleluyia’  ‘Joseph’ and” Maria’

He asked me to remove my clothes so he could show me where the witchcraft was but I said I could not. He then asked me to lift my sweater which I did and he
applied some white cream from a small bottle and rubbed it on my stomach.   Without warning he twice bit me on my stomach. I pulled back but he had already
bitten me.

“Shida yako ni ndogo sana unipe elfu mbili, nitakupatia dawa utakunywa for 30 days na mtoto utapata” Japolo

I left promising to go back with the money as soon as I could.  We quickly ran back to the vehicle where I wiped my stomach with alcohol prep pads which I normally
carry with me for first aid.  My skin was  not broken so I relaxed.

There are several health facilities in Mathare which offer antenatal services yet women prefer Japolo’s services.  There is
a public health facility in Mathare where it is said that the health personnel are unfriendly, could this be one of the reasons why women opt for Japolo? The
health facility is cheaper as compared to Japolo therefore money is not the issue? Why are women opting to go to Japolo? Why are people afraid of him? Do
we need to sensitize the women about the risks involved when they opt for   the TBA’s services?  Do we sensitize women  and educate them on the advantages on seeking proper health care? What next?

We were impressed by the state of the Mathare North Health Centre which as far as Public Health facility are, was well equipped, had enough skilled health
attendants and a day time ambulance for emergencies. The Dispensary is relatively clean and contrary to what had been said by our sources, we got a
fairly friendly reception.  The Centre provides health care services to thousands of Kenyans and it receives between   120 – 150 mothers for antenatal clinic every month but less than that deliver
at the health centre. So where do the rest go?

The District Reproductive Health Coordinator who had just been posted to the District was not in a position to answer this as she had not yet settled in her
new office but she referred us to a service provider who on condition of anonymity said that ignorance and insecurity in the area were the main factors
that made women go to Japolo. She reiterated that they sensitize the women on advantages of accessing skilled health care when they join ante-natal care.

A new mother however gave the reason for not accessing the health facility as to the fear of knowing their HIV status and the hostile attitude of the
attendants.

“Ukienda hospitali watakwambia na kukuuliza hali yako na Japolo haulizi na hajali na hao nurses ni wakali na wanaweza hata kukujibu vibaya” (‘At the hospital they ask you about your status and the nurses have a
bad attitude and can talk to you badly, but Japolo doesn’t bother’
)

It is evident that there are expectant mothers especially in the slum areas who still consider visiting Traditional Birth Attendants for their delivery, other
than health centers.  The government has scaled up efforts in providing accessible and affordable healthcare to its citizens but still the culture of TBAs continues. A few years back the Government tried
to incorporate The TBAs into the system as healthcare providers and after an unsuccessful attempt to, train and equip them, they were discredited after they
failed to reduce the country’s mortality rate and were cited as contributors to the increase in mortality rate due to their crude practices. According to Dr.
Nakato Jumba from the reproductive health department, Ministry of Public Health and Sanitation, TBAs are contributed to the stalemate in the reduction of
maternal mortality.

Women are recommended to attend at least four antenatal visits as it is important in the management of maternal complications as well as for providing essential
services such as tetanus immunizations, iron supplements nutrition education.   Besides expectant mothers need to be counseled and empowered with relevant information on the importance of having a
HIV test and being handled by skilled health workers as they attend antenatal clinics where if found to be sero-positive they shall be enrolled in Prevention
of Mother to Child Transmission programs .

Women may not be aware of the deficiencies in TBAs skills and the potential risk to themselves and their unborn babies. Because most of these TBAs do not consider
their lack of training an issue which is more dangerous as they not only endanger their lives but also put at risk the live s of the mother and her baby
especially where one of them is infected with HIV .

“As much TBAs do assist sometimes there is need to deploy retired midwives to cover the gap in the shortage of human resources as they are well versed in handling
emergency situations which could lead to untimely deaths,” Dr. Jumba concludes.