In Nairobi, saving children’s lives in difficult conditions is a team effort

Volunteers and faith communities join to push HIV testing and treatment for children

NAIROBI, Kenya — It looks like any other meeting in the yard of a church health center — people sitting in plastic lawn chairs, sheltering from the midday sun under the shade of an umbrella tree. But this group gathered in Korogocho is doing nothing short of saving children’s lives and laying the groundwork to one day achieve an AIDS-free generation.

Korogocho reflects one of Nairobi’s greatest challenges. As many as 60 percent of the population of Kenya’s largest city live in “informal settlements.” Collectively, those who call slums like Korogocho home live squeezed together on about 5 percent of the city’s total land mass. Tin shacks bake under the equatorial sun. Scavenging in trash piles often means the difference between a full belly and an empty one.

The men, women and young people gathered in the yard on the edge of Korogocho help to stop the spread of HIV among children. The AIDSFree Project, funded by USAID through PEPFAR, has mobilized community health volunteers, religious leaders and youth leaders to work as a team of “Pediatric Champions.” These Pediatric Champions strengthen access to, and demand for, pediatric HIV care and treatment services in Nairobi.

It takes a network of community health workers, youth and religious leaders to reach places where children are at risk. The people who make up this team represent the determination of these crowded, informal communities not to buckle to HIV despite the numerous challenges their communities face. AIDSFree’s impact can be felt with every interaction these volunteers have with community members, providing HIV prevention messages and urging HIV testing, treatment and adherence to life-sustaining medication.

These Pediatric Champions meet at a faith-based health facility known as Redeemed Gospel Health Center once a month to talk about their successes and struggles, and to think through the problems they encounter.

One woman stands up to describe a family resisting life-saving treatment because their neighbors are shunning them for being HIV positive. Another talks about finding a mother and her newborn on her neighborhood rounds — the baby too sick and weak to nurse. Her immediate referral to a health center for testing and treatment led to a positive HIV test result and the baby was initiated on antiretroviral therapy that likely saved his life.

“I have young girls coming to me asking me what to do [to stay healthy],” one Swahili-speaking pastor said. “I want them to be safe.”

Another pastor who introduced herself as Layla earned affirmation for her work with commercial sex workers in her neighborhood, encouraging them to stay protected and seek treatment, which keeps them healthier and helps to reduce risk for other families and children in the community.

“Community health workers are the backbone of this effort,” says Nkatha Njeru, AIDSFree Program Manager with IMA World Health. They are members of the community who have formal training in community health interventions. But they are not alone.

One of the young men, a youth leader under the umbrella tree rose from his seat to talk about his recent experience speaking with peers in his mosque. “Because, as youth, we got the chance to speak in mosque, and we promoted testing for HIV, the effect was immediate,” the young man said. “Everyone wanted to get tested right then.”

In areas like Korogocho, the religious leaders now gathered under this tree are as critical as CHWs to IMA’s work. As many as 8 in 10 people on the African continent practice some form of religion. Recognizing their potential to influence behavior change and social norms, AIDSFree trained Christian and Muslim leaders to become Pediatric Champions. These Champions work through their congregations to increase community knowledge about pediatric HIV care and treatment services, building demand and access.

In addition, the AIDSFree Project recently launched khutbah and sermon guides to provide religious leaders in Nairobi’s slums with messaging rooted in sacred texts, explaining why pediatric HIV testing and treatment are a critical, and even a faithful, act. Both the National Council of Churches of Kenya and the Supreme Council of Kenya Muslims have praised these religious guides. AIDSFree encouraged religious leaders to use them in their congregations beginning in September 2016.

Religious leaders have been tremendously effective at connecting people in need to services. For example, in December 2016 religious leaders were credited with making 199 referrals for HIV testing and services, more than youth leaders and community health workers combined.

Part of the reason for their impact is that faith leaders see far more people in a given time than community health workers or other volunteers working door-to-door might. But Njeru thinks it’s something more: “They have standing in the community, and people trust them.”

Late in the meeting, the group stands to conclude. The sun still burns on the red clay and the acrid smell of burning trash still wafts on the air. But these volunteers — Muslim, Christian, men, women — remain united and determined to create an AIDS-free generation.