Kenya

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In Kenya, Handicap International works in the following areas:

• disability
• health and prevention of diseases
• income generating activities

CONTEXT
Kenya has a population of 29 million. Life expectancy at birth is 52 and the country is one of the 10 African countries to be the most affected by the AIDS virus (13% of the population). Kenya is still registering an average of 700 AIDS-related deaths a day. Kenya also has a refugee population of 180,000, mainly from the Sudan and Somalia. Most of these refugees are concentrated in the north-east of the country, where there are many economically insecure people and little in the way of appropriate public services, particularly in terms of access to health care.

BACKGROUND
1992: launch of an emergency food aid programme in Garissa following the famine and civil war in Somalia.

1992-1996: development stage, focusing on improving surgical treatment at Garissa hospital for refugees and people suffering from tuberculosis, and on support to the primary health care system in the neighbouring communities.

1994: following inter-ethnic troubles, a relief programme was set up in the districts of Trans N’Zoia, Mount Elgon and Bungoma.

1996-1999: by providing support to existing organisations (e.g.  dispensaries, village health committees), the project aimed to improve access to primary health care and ensure a better quality of prevention activity (mother and child protection, water quality, AIDS).

2000-2002: global action for AIDS control in the Trans N’Zoia district, including both preventive and curative aspects, and with the Somali populations in Garissa.

2002-2003: activities in the field of disability began in Nairobi with particular focus on the coordination of existing disability-related activity. Over the last two years we have also developed assistance activities in institutional fundraising and logistical support for the programmes in the region.

STRATEGY
Since 2001, our programme has considerably increased its activity in the field of AIDS control, in line with what has become a national priority. We work both at a provincial level, with the communities, care centres and associations, and at a national level, with the coordinating bodies. It has also been decided to take the multi-cultural dimension of the country into consideration in the work carried out in the two provinces where the association has been active since 1992, the districts of Trans N'Zoia and Garissa.
 
In 2003, activities in the disability field concentrated on improving the networking of the different Kenyan operators and building the capacities of a local association for families with disabled children. The thematic of AIDS/disability was developed and funding is being sought to implement a project in this area.  

ACTIVITIES

District of Trans N’Zoia: AIDS control

• Technical assistance to the Kitale Counselling and Voluntary Screening Centre
• Installation of a combined counselling and voluntary screening centre and a documentation and recreation centre aimed at a young public (Chanuka centre)
• Training of staff from the hospital and dispensaries to improve the care-management of people living with the AIDS virus and the disease
• Extension of the project for providing access to essential medicine via the creation of 13 new community-run pharmacies
• Training of community relay staff to facilitate home care for people living with AIDS
• Technical and financial support for implementing income-generating activities for affected and infected people
• Implementation of prevention campaigns in the district’s secondary schools, technical support to the teaching staff and pupils, peer prevention and publication of an interschool magazine
• Prevention activities within the different communities
• Support to associations of people living with AIDS in their various prevention and care-management activities.

Beneficiaries

• about 6,000 people receiving individual counselling at the Counselling and Voluntary Screening Centre and attending the youth centre
• 40,000 HIV positive people
• the district’s population with access to the community pharmacies
• about 6,000 secondary school pupils
• 75 community relay staff trained to provide home care
• 70 families helped with their income-generating activities
• women’s groups working in community action.

Partners: Ministries of Health and Education, National AIDS and STI Control Programme (Nascop), Kenya AIDS NGOs Consortium (Kanco), Medical Missionaries of Mary, Tipha-K (association of people living with AIDS in Kitale), Jiendeleze Group.

District of Garissa

• Management of the referral centre for Somali refugees hospitalised in Garissa hospital
• Raising of Muslim religious leaders’ awareness on AIDS prevention, and support to public and associative structures to improve the care-management of people living with AIDS
• Technical and material support for the setting up of a counselling and voluntary screening centre within the district’s hospital
• Implementation of prevention activities in Garissa’s primary and secondary schools
• A broader programme for another district whose population is essentially made up of nomadic Somali herders is ready to be launched once funding has been obtained.

Beneficiaries

• 700 Somali refugees hospitalised each year
• about 4,000 secondary school pupils
• 25,000 people with access to AIDS prevention campaigns.

Partners: associations and religious leaders working in the field of AIDS control (Simaho – Sisters Maternity Home; Supreme Council of Kenya Muslims – Supkem), Opaha (associations of people living with AIDS in Garissa), United Nations High Commission for Refugees, Ministries of Health and Education.

Nairobi

• Technical and organisational support to the Kenyan association Nairobi Family Support Services (NFSS) to improve the care-management of children with disabilities in the Kibera shantytown.
• Implementation of activities for coordinating stakeholders in the disability field at national level (launching of a directory, training of a coordination committee)
• Carrying out of a study on the accessibility of AIDS screening, counselling and prevention services for people with disabilities. 

Beneficiaries: Nairobi Family Support Services – a local association involved in support work for children with disabilities.
Partners: NFSS, Union of the Disabled People of Kenya (UDPK), Ministry of Health and Ministry of Social Affairs.

RESOURCES
Nairobi: 1 field programme director, 1 assistant, 1 administrator, 1 liaison officer responsible for institutional fundraising, 1 Disability project manager, logistics team.

Kitale base (Trans N’Zoia): 1 project manager, 1 administrator, 1 doctor/technical assistant, 1 technical assistant on the Micro-credit project, 4 section managers (prevention in schools, screening and care, community information, micro-credit), community workers, logistics team.

Garissa base: 1 project manager, 1 prevention group leader, 1 manager for the refugee reception centre, 1 administrator, logistics team.

CONTACTS
E-mail: hikenya@handicap-international.or.ke