12/20

One patient today had been removed from her home in Kibera. She has recently been diagnosed as HIV-positive, and had finally decided to tell her partner. He had been drinking for the past few days, became very hot-tempered, and kicked her out of the house. She is scared to go back, and was mad at us for convincing her to tell him.

This was not an uncommon situation today, as we had 3 other patients with similar stories. The healthcare professionals were too busy diagnosing and treating a whole slew of patients to attend to these 4 broken families, so I decided to take these patients on my own. I first asked the mothers to send their kids to friends' homes so they don't have to be exposed to the discussion I planned on having. I then went to the local grocery chain (Nakumat) and got juice and crackers for the families. I think food is something that unites and resolves differences, and I wanted to establish a sense of trust with the family by showing that I am willing to dedicate my resources to them.

After comforting the women and engaging them with infants in the clinic, I went with Peter to meet the husbands. 2 were mildly intoxicated, and were particularly challenging to deal with. I offered my apple juice, which they drank thinking it was beer. I first just told them I am in Kenya to meet with people, and had a particular interest in their lives. I did not mention the familial situation to not alienate them before making any progress. After chatting for about two hours, they sobered up almost completely. I asked them to come with me and took them to Ushirika.

Behind closed doors, I had an honest discussion. We had been laughing like old friends for a bit of time, so they listened to my thoughts and were very open to discourse. I did not address their drinking behavior directly, but talked about what I have seen alcohol do to families. After they were interested in my stories, I addressed alcohol objectively by providing them with statistics and ill health impacts.

I then shifted my attention to HIV. Unsurprisingly, HIV and alcohol are closely linked in Kibera. Parituclarly during the holidays, revelry leads to unsavory amounts of intoxication and unprotected intercourse. With an already high prevalence of HIV in the slum population, it becomes clear how the disease spreads like wildfire. As I explained a variation of this to the families, the men were not happy. Tribal culture, which I have described in previous posts to be very prominent in modern Kenyan society, came to the forefront of these men's minds and they told me that I was wrong. HIV is not a virus, they claimed, and is instead a method used by god to punished unfaithful women. We went around in circles, and I had to explain my stance in different ways after paying for dinner, but everyone was satisfied well into the night. I was not able to convince the men to go to rehab, or "devil's play" as they liked to call it, but they agreed to be tested and keep their family together in their time of greatest need.