In Kibera, one of the largest slums in Africa, it’s almost impossible to meet someone whose life has not been affected by AIDS. Take Caren. Her older sister died of AIDS three years ago, and Caren took on the responsibility of raising her four children, although she and her husband were already struggling to find the financial means to care for their own three children. Then, five years ago, Caren learned in the most difficult way possible that she herself was HIV positive.
While eight-months pregnant with her third child, Caren was tested for HIV and found negative. Happy to be able to nourish her baby naturally, she planned to breastfeed her child for at least 18 months. But this was not to be. When the baby was eight months old, Caren volunteered to be tested for HIV again, as part of a study by the Centers for Disease Control and Prevention. This time, she tested positive. She was devastated. When she told her husband about her status, he revealed to her that he, too, was HIV positive—and that he’d known it for years. “I felt very bad, especially when I saw the proof on paper that he had been seeking care from a treatment facility in Kibera.”
At the time, International Medical Corps was just launching its first community-based program to prevent mother-to-child transmission program in Kenya, and Caren enrolled, hoping she could do something to keep her child healthy. At her International Medical Corps training, Caren learned that she could no longer breastfeed Cliff Jeffa. She was also strongly encouraged to get Cliff Jeffa tested for HIV so that he could be started on a treatment regimen if he were, indeed, positive. At first Caren resisted, too anxious to learn the truth. Finally, when Cliff Jeffa was two-and-a-half-years-old, she got him tested and the results confirmed her worst fears: her son was HIV positive.
Caren joined International Medical Corps in 2004 as a peer mother. Her role was to talk to pregnant women in Kibera encouraging them to take HIV tests and to visit an antenatal clinic. She later joined the International Medical Corps support group, which brings women together so they can offer each other advice and encouragement as they grapple with the difficulties of living with HIV.
Earlier this year, Caren became pregnant with a fourth child, after her husband refused to wear a condom when they had sex. “He told me he couldn’t enjoy sex when wearing a condom,” says Caren. Her pregnancy caused her great stress and embarrassment, since in her work as a peer mother, she had specifically been discouraging HIV positive mothers from getting pregnant. Ashamed, she stopped attending the support group that had been giving her so much comfort and guidance. She became reclusive, sequestering herself in her cramped two-room house, eating just one meal a day. She began to lose weight and to look increasingly unwell.
When International Medical Corps staffers noticed that Caren had not been to the support group for a while, they paid her a visit. They found her lying in bed, sick. She had been diagnosed with TB; she was coughing constantly, and her body was aching. Because she couldn’t afford to keep herself adequately nourished, she was on the verge of discontinuing her antiretroviral treatment, since taking the medication on an empty stomach would cause nausea. Seeing her condition, International Medical Corps staff members donated enough food to last her a few days. When they returned to check on her, she told them how comforting their concern had been to her. “Last night, I was able to sleep for the first time in months, after you visited and talked with me,” she told them.
Ultimately, Caren lost her baby due to respiratory complications. She took several weeks to recuperate, but now she has returned to the support group, and they are helping her through the gradual process of healing.