Kisii makes the greatest progress........

When Mrs Asanath Musandu took part in the premier First Lady Half Marathon of 2014 in Nairobi , she had not imagined that touching the finishing line of that race would change her life for ever… and dramatically.

Upon finishing the Marathon alongside the First Lady Margaret Kenyatta, Mrs. Musandu, then only 27, confidently walked into the Kenya Red Cross Tent for an “innocent” HIV testing  to establish her status, a process that was being publicized openly  and which is one of the key focus points for Beyond Zero.

But the news awaiting her at the Red Cross tent was not only surprising, shocking, unbelievable and shattering but became the turning point in both her life, that of her husband and her unborn first baby. She was HIV positive!

She was immediately referred to a Health Centre in Ngong town where she underwent further confirmatory tests and  where she started her  long journey  as a person living positively with HIV.

After counseling to enable her exit the initial shock and grief, she was advised to return to the Health centre accompanied by her Husband, George Onyango, who tested negative for the HIV virus.

Mrs. Musandu was immediately put on a combination of therapies to both prevent her unborn baby from being infected with the virus and also reduce her viral load.

Surprisingly to her, the husband remained strong, supportive and encouraging. He did not abandon her in the hour of need as most would do in the circumstances.

Their child was finally born, put on Nevirapine syrup for babies from HIV positive mothers, breastfed for six months and subjected to the mandatory three tests upon which the child has finally graduated as HIV Negative.

The couple is still together, their baby boy is now three years, and upon the advice of the doctor, Mrs. Musandu is now pregnant with their second child.

“ My husband has been the biggest encouragement and support. We have brought up the child  together and now he is three years old and HIV negative. I am proud to live positively” ,  says Mrs Musandu when we caught up with her at the Nduru Health  Centre in Mugirango South of Kisii County.

The family relocated from Nairobi   to Tabaka region of Kisii County in 2015 where Mrs Musandu is a small-scale farmer  and a  volunteer peer educator on HIV/ AIDs especially during Beyond Zero Moblie clinic outreaches.

Husna Atieno , 32, talks of her journey living positively with HIV virus but in a stable marriage with an equally  HIV negative husband Mr. Kennedy Onyango.

Atieno discovered her status during the launch of the Beyond Zero Mobile Clinic at Kisii Stadium in November 2014  when  she  voluntarily presented herself for testing.

Like her counterpart Mrs Musandu ,  Atieno was also pregnant with her second child when the shocking news hit her like a thunderbolt. Her life immediately took a new twist and meaning.

After initial counseling, she was referred to Nduru Health Centre for further guidance, testing and Post Testing  Services (PTS). When she presented her husband for testing, Mr Onyango tested Negative for HIV.

Their second born has also graduated as HIV negative  child after the mandatory three tests.

The two discordant couples are now members of the Nduru Discordant group that brings together 26 such families whose main purpose is to share experiences, challenges   and support while participating in peer education and mentorship in their community.

But Kennedy Waro, 38, adds a new plot to the HIV journey among couples. He was initially a matatu driver in both Nairobi and then Kisii.

But what started as a joke in a matatu termini between him and his colleagues in Kisii after the launch of the Beyond Zero Clinic in the County, would turn his life upside down when he tested  HIV positive.

The matatu men were talking in jest at the busy matatu termini  in Kisii, provoking each other to go for testing now that the First Lady had launched the mobile clinic in  the area and the services were readily available.

This is when Mr Waro took up the challenge only to test positive for the HIV virus! His career as a matatu operator came to a crushing halt and remained confused of what to do when he was barely out of his early 30s!

 Mr Waro is now among  a special group of Volunteer peer  educators  in Gucha sub-county participating  in  health talks during the  Beyond Zero Mobile clinic outreaches , seminars, church functions and schools.

His main role include mobilization of people to present themselves for testing and participating in health talks on the need to stop stigmatization of HIV positive people, need for  full disclosure, nutrition and how to exit shock and grief upon confirmation of  being positive.

Besides being a HIV/ Aids awareness platform, the Beyond Zero campaign and the Mobile clinic programme have triggered several other critical initiatives  that make health services accessible at the doorsteps of thousands of hard-to-reach residents of the densely populated  Kisii County that boasts of 1.3 million people.

Through partnerships with other key stakeholders including the the County and National Governments, the Red Cross, Afya Plus Kamili, Chagua Maisha, Care Kenya, the Kisii Teaching and Referral Hospital, the Kenya Episcopal Conference, the International Medical Corps  and the Enabling Sustainable Health Equity (ESHE), the mobile clinic has , for the last three years made over 200 outreaches across the 9 sub-counties of Kisii.

During these outreaches, the mobile clinic has touched the lives of thousands of residents and improved the lives of Kisii people in critical areas of basic health including cancer  (breast, cervical and prostate) testing, HIV /Aids testing and counseling , diabetes, hypertension,  ulcers, neuritis (complications of nerves) Malaria and eye conditions among others.

During that period, 54,125 clients have been tested and counseled for HIV where about 50 of them turned positive and referred to nearest health facilities to start specialized care. In total the County has over 34014 people living with Aids.

During the last three years, HIV prevalence rate has steadily dropped from a high 8.9 per cent in 2014 to the  current 4.7 per cent. Further drop is expected if the current advocacy , awareness ,testing and counseling  are sustained according to Dr. Kimutai Cheruiyot , the County Chief Pharmacist who  talked on behalf of the County Director for Health.

Due to escalated health education services and prenatal testing, Kisii has also made the greatest progress in the elimination of mother-to-child transmission of HIV according to the County Chief Nurse Ms. Ruth Mogaka, all courtesy of the Beyond Zero intensive drive that focus on maternal  and child health.

But the war if far from over because 73 per cent of HIV positive pregnant women in Kisii do not deliver in health facilities. And Only 41 per cent of the pregnant women in the County attend the recommended four antenatal visits.

 Besides advocacy and the strong partnerships, the  reduced mother-to-child HIV transmission and the dropping prevalence rates can also be attributed to  accelerated testing, counseling and treatment under the new health guidelines  that demand clients be treated  as soon as they are diagnosed positive without the previous long referrals.

“The new guidelines are focused on the prevention of further opportunistic infections and spread of the virus”, says Dr. Ambrose Nabwana the Medical Superintendent  and MOH for South Mugirango.

Although all the stakeholders are celebrating the achievements made so far in the area of health access in Kisii, ESHE  programme has been pivotal in the overall improvement of maternal health.

The programme conducts research on rural women who are in their productive age (15-49), promotes the prevention of unplanned pregnancies among women and conducts  talks to facilitate  informed choices and bringing the  gap in the provision of health services.

 The programme  embeds itself in  the Mobile Clinic programme besides operating several Comprehensive Care Centres (CCCs) across the county.

“The mobile clinic is very relevant. Its services bridge the gaps where there are no facilities by the Government. It also triggers people to come out for testing services including the vaccination of children who previously defaulted on critical immunization”, says Ms Pricillah Moraa, the ESHE  programme County Co-orqdinator.

We caught up with her at Moremani Catholic Church Where the mobile clinic was conducting one of its outreach services.

“Moonlighting” is another key aspect that is attributed to the success towards the reduced prevalence rates in Kisii County.

The partners have started a unique program where they pitch over-night HIV testing camps in special areas associated with sex commercial workers and same sex relationships, who would ordinarily present themselves for testing during the day.

These critical and popular moonlighting sessions have already taken place in Gucha, Kisii  and  Mugunga towns which are known to have the highest numbers of commercial sex workers. These towns also happen to be on the main highways.

Despite these milestones, cancer is also becoming one of the key disease burdens in Kisii.

Beyond Zero campaign is a platform designed to provide high level leadership in reducing maternal, child and new born deaths and ending new HIV infections using the mobile clinic as the baseline instrument of engagement

The initiative is premised on the principle of catalyzing actions at the grassroots and accessing the hard to reach populations with vital health services and medical care while complementing existing health infrastructure.