I went to Kibera today. Home to anywhere between 750,000 to 1 million people, Kibera is the largest slums in Africa and one of the largest in the world. I have seen photographs and heard stories from colleagues, but still found myself a bit surprised at the level of poverty. I grew up just across the Mexican border, near the town of Tijuana, and thought it would be similar. But the sheer size of Kibera is stunning. You can see tin-roofed shacks as far as the eye can see. You see occasional latrines and water spigots here and there, but other than that, there is no sanitation infrastructure. I learned the term “flying toilet” today, which is essentially human waste in a plastic bag. They are everywhere.
It struck me that there were kids in school uniforms and men dressed in suits or nice slacks and shirts amongst the filth. There are all kinds of businesses – restaurants, pharmacies, vegetable stands and mobile phone shops. These are all housed in flimsy structures, most with tin roofs that have rusted.
I tried to be as respectful as possible when taking photographs. I did not want to be a “tourist”, but someone who instead was documenting the lives of people struggling to make a living and take care of their families. I was met with a few glares, but mostly people were happy to have me take their photograph. I always asked in advance.
Tuberculosis and HIV/AIDS are big problems throughout the slums, and often people are co-infected. International Medical Corps has a lab on site to test people for TB and HIV as well as offering them treatment for TB and counseling for both. We will be opening a clinic very soon that will allow us to offer HIV/AIDS treatment as well.
I met one woman who is what we call co-infected. Melanie has both HIV and TB. We had been treating her for her recurrent TB when our “VCT”, voluntary counseling and testing staff, Anthony, tested her for HIV. She was positive. Melanie credits Anthony and International Medical Corps for getting her through that difficult diagnosis. Because of the counseling she received she did not feel ashamed of her status. And the education we provided has helped her live a healthy life. Her biggest challenge is food. She owns and operates a hair salon, but still finds it difficult to afford food. Most often she has one meal a day – in the evening. She takes her medication in the morning. Both TB and HIV/AIDS drugs are very hard on the system and food is essential. Melanie has stayed on her drugs, but many people lapse simply because they do not have enough to eat. The current drought that is affecting all of East Africa right now has not made it any easier.
Marie invited me into her home – one small room with a couch, chair and coffee table. There was a curtain blocking off the rest of the room, which likely was kitchen and bedroom depending on the needs at that time. A curtain acted as the front door. Two of her young children were with her when I visited, one shy and the other a total ham. Marie was sick for 6 months before she was properly diagnosed with TB. The district hospital referred her to International Medical Corps for her treatment. Anthony has been with her every step of the way and she is now one month away from completing the six-month treatment. She was very sick, but is now starting to feel better and hopes to go back to her job as a factory worker as soon as she is strong enough.
After talking with Melanie and Marie, then walking through Kibera, I felt conflicted. Overwhelmed with the poverty, but hopeful that with support from International Medical Corps and people like Anthony, those who are most in need can get at least some of the help they need. And most importantly, be treated with dignity despite the undignified surroundings.
There is a beautiful golf course right next to the slum. A cruel irony that is very hard to accept. Secretary of State Hillary Clinton is going to be in Kibera tomorrow. I hope she sees that same irony. Even so, I am encouraged that such a high-level and well-respected U.S. Cabinet member is going to walk through the muck and meet people like Melanie and Marie.
When I got back to the office I was whisked away to catch a flight to Kisumu, a lovely town on the edge of Lake Victoria. I will head out to Migori tomorrow morning to see our home based counseling and testing program that has been so successful in Suba we are expanding it to Migori. I am looking forward to meeting the staff and hearing more stories of how International Medical Corps is making a difference in people’s lives. Quite simply, that is what it is all about. We may not be able to change the world, but we can bring real healing – medical and emotional – to many people. Of that I am very proud.