FEATURED STORY

Kenya's fishing communities

International Medical Corps responds to the high HIV prevalence

by Amabel Karoub

Hellen Amollo Ogutu lives at Ngóre beach in Kenya. Her husband died 15 years ago, leaving her with no means of supporting their four children. In desperation, Hellen began to engage in a common business in the Kenyan beach communities – she became a jabila – meaning she exchanged fish for sex.

On Ngóre beach, being a jabila is not a shameful occupation and Hellen did not feel the full weight of what she was doing. Hellen said she became a jabila without understanding the risks of having unprotected sex with multiple partners. Hellen recently discovered that she has HIV.

Hellen’s story is not unusual. People in the fishing industry in Kenya are known as a “bridge population,” or a population with higher risk of contracting HIV. Recent research in Kenyan fishing communities showed that the prevalence of HIV among fisherman is 26-30%, more than six times the country’s overall HIV prevalence of 6%, which was reported in the 2012 Kenya AIDS Indicator Survey.

In 2010, International Medical Corps began a five-year program in Kenyan communities at high risk of infection to raise awareness about HIV prevention. One key component of the program is the peer-led intervention, during which fishing community members teach each other about how they can change their behavior to prevent HIV infection.

The peer intervention program shares critical information on HIV and other sexually transmitted infections (STIs), drug and substance use, gender and masculinity issues and the importance of condoms among others. By educating peer mentors who will then spread the knowledge to the rest of the community, International Medical Corps encourages self-reliance in these populations.

After finding out she had HIV, Hellen stopped her activities as a jabila and started her own business. She credits International Medical Corps with helping her make this huge step forward in her life. Hellen now has protected sexual relations with only one man, a man that she loves.

“I even left the habit of sex daily and got one man I love with whom I now live with and trust and use a condom with him,” Hellen said.

International Medical Corps’ work in Kenya has not only benefitted the jabilas, but also their male counterparts – the jaboyas, or men who bring the women fish in exchange for sex. One man who benefitted was 37-year-old Kennedy Onyango.

Kennedy is a fisherman living in Kenya’s Muhuru Bay. Though Kennedy is married with four children, in the past, he gave fish to women in exchange for a small sum of money and sex.

“After fishing, I give the fish to my girlfriends at the lake who go and sell the fish at the market and bring me some small money,” Kennedy said. “I only give fish to my girlfriends who in turn pay me and give me sex.”

Kennedy would spend the money he made on alcohol and on more sex.

“That is what we do because we know that even if we squander all the money we will get more money the next day,” he said. Kennedy lived like this until International Medical Corps’ intervention taught him how to live more responsibly. Volunteers tested Kennedy for HIV, and discovered he was positive. They advised him to stop having reckless sex, and to start using condoms.

Today, Kennedy has reunited with his family, who he abandoned while acting as a jaboya. He is taking the information on healthy living he learned from International Medical Corps and passing it on to his children.

Like Hellen and many other members of the Kenyan fishing communities, Kennedy now feels empowered to seek alternative sources of income outside of the jaboya-jabila system.

Though they have both changed their lives for the better, Hellen and Kennedy both realize the work of International Medical Corps is far from done in their areas.

“We need continuous education so that we do not go back to our past practices which put us at risk,” Hellen said. “We have some more people who have started following us, and that is why we need more teachers to continue walking with us.”

FROM RELIEF TO SELF-RELIANCE

For 30 years, International Medical Corps has worked to relieve the suffering of those impacted by war, natural disaster and disease by delivering vital health care services that focus on training, helping devastated populations return to self-reliance.

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