Kenya's slums battle AIDS

Rachel is sitting alone in the matchbox-size, sunlit library reading the last chapter of "The Scarlet Letter."

Next, she says, her pale hands shaking, she is going to go for a mystery.

In the adjacent room, a group of thin young men are working on a play for Tuesday's drama festival. A power outage has cut short the computer class down the hall, and a trickle of potential thespian volunteers are drifting in, shyly inquiring about bit parts.

The Kibera Community Self Help Program (KICOSHEP) is a youth center situated in the middle of one of Nairobi's biggest slums. It caters to youngsters who are diagnosed as HIV positive as well as those who are not infected – but who, statistically, are at risk of becoming so.

KICOSHEP is also one of the best examples in Africa of a homegrown, privately funded AIDS prevention program.

In Kenya, it's estimated that an average of 600 people die from AIDS every day. And yet, this is not the African country worst hit by the scourge. In South Africa, for one example, almost five million people, or 1 in 9 citizens, are estimated to be HIV-infected.

Seventy percent of the world's estimated 40 million people living with HIV/AIDS are in sub-Saharan Africa, according to the World Health Organization. Seventeen million Africans have already died since the epidemic began in the late 1970s – and 12 million children have been left orphaned.

A world away from this tiny Kenyan community center, some 15,000 doctors, researchers, and activists gathered this week in Barcelona, Spain, to present the latest studies about AIDS and examine ways to deal with it. Africa is a focus of concern.

New research by the US Census Bureau shows that within 10 years, the average life expectancy in 11 African countries will drop below age 40 as HIV/AIDS continues to shorten lifespans. The average life expectancy in those countries hardest hit by the disease – Botswana and Mozambique – is predicted to drop to just 27 years.

There is much talk at the Barcelona conference about accelerating research for vaccines, advances in antiretroviral drugs, and the need for financial assistance from developing countries to combat the disease in less developed ones. AIDS activists are demanding that affordable drugs be made available to developing countries.

Campaigners are disappointed that less than $3 billion has so far been pledged of the $10 billion sought by the UN global AIDS fund.

But experts say that advances in drug therapy and vaccines aren't enough. "HIV vaccines need to be developed within the context of a larger prevention effort," Dr. Lawrence Corey, of the HIV Vaccine Trials Network in the United States, told conference attendees in Barcelona.

Here in Kibera, prevention is often the only option available.

"Education is the most important tool we have for getting through this," says Fredrick Otae, the director of this KICOSHEP center (one of six spread around the Kibera slum). "We get beyond the stigma and teach the community about what is going on here – how to avoid contracting HIV and how to deal with it if one does."

UNICEF social worker Pelucy Ntambirweki lauds KICOSHEP's approach. She spent the 1980s in Uganda, working in a community-based center similar to KICOSHEP. Toward the end of her time there, her program was reaching out to 10,000 families and seriously impacting the community.

"Uganda was one of the first African countries to break the silence about AIDS and begin seriously looking at the problem," says Ms. Ntambirweki.

"We can hold endless conferences – but if we do not build capacity within communities and educate against the ignorance that brings about stigmatization – then all is for naught."

KICOSHEP workers started in the slums of Nairobi 11 years ago, bringing "after school" activities to deprived youngsters living in a world of shacks and mud who didn't even know AIDS existed.

A small bungalow was painted bright blue. A welcome sign was put up. A soccer team was organized, a library was erected, and a video room was stocked with educational films. Carpentry, sewing, computer and other classes were begun.

The idea at first, says KICOSHEP counselor Fillet Darizu, was simply to bring the kids in. "So many of our young people are idle. Just sitting around near the sewage ditches doing nothing. Here at least they can get busy. And once here we can talk about what is killing us."

Today, KICOSHEP, with funding from the Ford Foundation, ActionAid, and other private donors, is being modeled by other AIDS prevention groups in Kenya.

On top of the recreational activities, the Kibera center now provides a full range of support and educational activities for those both HIV positive and negative. There is HIV testing, free one-on-one counseling, "positive living" classes on surviving with HIV, and group therapy.

Youngsters who are infected are encouraged to speak at schools and churches and talk about the lessons they have learned – the hard way – about abstinence, condom use, and promiscuity.

"I would say we have managed over the years to really reduce the number of families who go around saying AIDS is witchcraft," says Ms.Darizu. "And that is the first front in the battle."

In an annex behind the community center, the Monday afternoon KICOSHEP support group is winding up their meeting by trying to collect money to support the three babies of a group member who passed away the week before.

One woman offers 14 Kenyan shillings (about 2 cents). But another, a thin, teenager named Benta, shakes her head. She has nothing to donate. "I can't say my life is nice. I am dying," she says. "But at least, for this hour or so, I have some comfort here."

• Material from the wire services was used in this report.