Outreach program in Kenya aims to reduce AIDS' impact, prevalence

August 15, 2012


The HIV/AIDS epidemic has had a more drastic impact on sub-Saharan Africa than on any other region of the world, with more than 22 million currently infected with the disease and more than 14 million children losing at least one parent to HIV/AIDS. The region's population is about 800 million.

An outreach program called Upendo Village in Naivasha, Kenya, is providing support — including health care, nutrition, education and microeconomic loan programs — for people with AIDS and others impacted by the disease.

Sr. Francisca Kivindyo, ASN, the administrative secretary of Upendo Village, said in a way, the village is a victim of its own success. As more learn of its services, more come for help. "We have limited resources to handle the demand," she said.

So its sponsor, Wheaton Franciscan Healthcare of Wheaton, Ill., is increasing its involvement and bolstering the fund-raising capabilities of Upendo Village.

A giving tree
About a decade ago, Sr. Florence Muia, ASN, with help from the Wheaton Franciscan Sisters formed a not-for-profit entity, Upendo Village, N.F.P., and registered it in Illinois. Some board members are Wheaton sisters. This organization helps raise money for Upendo Village, including through fund-raising campaigns with Wheaton Franciscan Healthcare employees, Illinois parishes and Illinois aid agencies. These funds supply about 80 percent of Upendo Village's income.

The Upendo Village board asked Wheaton Franciscan Healthcare to absorb that fund-raising operation in order to expand its capabilities, and the system did so in November 2011. Already, Wheaton has helped the fund-raising arm with legal support, it is publicizing Upendo Village's activities within and outside the system and it is enabling its employees to give to the program through payroll deduction. More Wheaton staff are donating than in the past, said Sr. Theresa Langfield, OSF, executive director of Upendo Village's fund-raising organization.

Sr. Muia, founder and director of Upendo Village, said it's been hard to turn down community members' requests for help for lack of resources. But, with more money coming in, she said, "we shall bring some sparkle back to the affected and infected Kenyan people."

A deep-seated crisis
HIV/AIDS spread quickly in sub-Saharan Africa in the 1980s and early 1990s. Sr. Muia said that was in part because government officials denied at that time that there was an HIV/AIDS epidemic. They silenced discussion and tamped down on media attention on the disease, she said. According to information from the Washington, D.C.-based Population Reference Bureau, as the disease was spreading throughout Africa, some political leaders spent time debating whether there was really a cause-effect relationship between HIV and AIDS, and some blocked the use of antiretrovirals because of their doubts about the drugs' efficacy.

The lack of productive discussion and public education gave HIV/AIDS time to take hold and spread, Sr. Muia said. Since few people knew how the disease was transmitted, the population at large did not know how to protect itself or lower transmission risk. Few sought to learn of their HIV/AIDS status, Sr. Muia said.

Cultural dynamics and customs accelerated the spread and worsened the impact of HIV/AIDS, Sr. Muia noted. With men the traditional sole breadwinner, and with many women lacking the education needed for jobs in the region, many women are unable to support themselves in many sub-Saharan cultures, she said. Many women feel they must put up with philandering husbands and other behavior that can spread the virus, Sr. Muia said.

In 1999, Kenya's president declared that HIV/AIDS was a national disaster, and that allowed prevention efforts to begin throughout that country — efforts that now are driving down the rate of new infection. But, much damage already has been done on the continent, and in Kenya alone there are an estimated 1.5 million people with HIV and an estimated 1.2 million orphans.

A 'love' village
Kenya native Sr. Muia was in the U.S. earning a master's degree in pastoral studies from Loyola University Chicago when she decided around 2000 she wanted to help people with AIDS back home. It grieved her that treatments and services available to AIDS patients in the United States were not routinely available in Kenya, where it was common for AIDS sufferers to be ostracized and to die alone. She determined to help Kenyans with AIDS live and die with dignity, and set to work.

Sr. Marge Zulaski, OSF, a Wheaton Franciscan Sister that Sr. Muia met in the states connected her with the Wheaton Franciscan congregation, which helped mentor her as she developed her idea for a program providing nutrition, life-extending drugs, counseling, orphan care and life skills training to people in Naivasha with AIDS and their families. With the help of the Wheaton sisters and her own congregation, the Assumption Sisters of Nairobi, Sr. Muia established Upendo Village — Upendo means "love" in Kiswahili — in 2002.

Holistic support
The Upendo Village campus houses a clinic, multipurpose hall and sisters' residence. Its 26 staff members include social workers, medical providers, teachers and others. Among Upendo Village's 15 volunteers are people living with AIDS who have benefitted from its offerings.

Upendo Village and its programming operate on a $250,000 annual budget. Staff and volunteers visit community members to teach them about how HIV/AIDS is transmitted. They also aim to dispel myths about the virus and to encourage community members to support — not shun — HIV/AIDS patients. Upendo Village also provides AIDS testing, nursing care, lab services, some drugs and treatment of AIDS-related conditions, both in the program's clinic and in people's homes. Upendo Village partners with two hospitals that provide antiretroviral medications to patients.

It offers food and nutritional supplements to people with the condition and formula to AIDS-infected mothers so they do not have to breast-feed their infants and risk transmitting the virus.

Upendo Village sponsors six support groups, including one for people with AIDS, another for grandmothers and aunts raising kids orphaned by AIDS, another for children with AIDS.

Staff attempt to help AIDS sufferers and orphans to build their self-sufficiency skills, through vocational training; sponsorships for schooling; and access to microeconomic programs, including loans and support for craft-making, goat raising, bee-keeping and farming.

Joy and tears
Sr. Muia is inspired "when I see people recovering … when they are going from being bed-ridden to walking and being able to care for themselves. And when I see parents (who have AIDS) helping their kids, it makes my day — when we can extend the life of a parent so they can see their children grow, that's the best gift."

But, sadness also comes with her role, particularly when a client suffers or dies. "It's difficult because they have become part of our lives," she said. Praying and sharing her feelings with others helps her to deal with the sadness.

Hope ahead
Sr. Muia said that client deaths are fewer and farther between than they were a decade ago, in large part because of the availability of new AIDS drugs and the nutritional help Upendo Village is providing to clients. She is optimistic that more improvements are ahead. With new funding that may be opened up through the support of Wheaton, Upendo Village may build an indoor kitchen and a social services center so that social workers no longer have to share space with medical providers in the congested clinic.

Sr. Muia has made Upendo Village "a safe haven for Kenyan women, men and children." Although the fund-raising continues in earnest, her primary goal for Upendo Village is spiritual.

It is to create "a community of love … for people infected and affected by the HIV and AIDS pandemic," she said.

Poverty amplifies impact of AIDS

In Kenya, as in much of Africa, poor economic conditions compound the vulnerability of people with HIV/AIDS.

The CIA World Factbook says Kenya has an unemployment rate of about 40 percent, and about 50 percent of the population lives in poverty. Flower harvesting is a principle source of employment in the area around Naivasha that Upendo Village serves; but there is heavy competition for those jobs.

Sr. Florence Muia, ASN, founder and director of Upendo Village, said particularly when a family's breadwinner contracts or dies from AIDS, the remaining parent and/or orphaned children are at a severe disadvantage in trying to find work or other support. Many turn to the sex trade, which can make them even more vulnerable" to HIV/AIDS infection.

Sr. Muia said that each situation is different when it comes to the fate of the children of deceased mothers. "There are some men who are responsible enough to care for the children … while we have some cases where the man disappears."

When that happens, the maternal grandmother normally cares for the children, Sr. Muia said. Upendo Village provides a support group for relatives raising orphaned children. Fifty-two grandmothers participate in the support group.

Catholics support plan that reduces mother-to-child transmission of HIV

Catholic News Service

WASHINGTON (CNS) — Catholic health care workers are offering enthusiastic support to an ambitious global plan to stop the transmission of the virus that causes AIDS from pregnant mothers to their children.

Discussed during the XIX International AIDS Conference July 22-27 in Washington, the plan involves increasing the availability of the drugs that reduce HIV levels in the body so that transmission does not occur. In wealthy countries, the availability of such drugs has lowered transmission rates to virtually zero, but that's not the case in countries most heavily affected by the HIV epidemic.

"We really do have hope that we can stop AIDS in children," said Msgr. Robert J. Vitillo, a special adviser on HIV and AIDS to Caritas Internationalis who sits on the 15-member international steering committee that is supervising the program.

In 2010, 390,000 children were born with HIV and more than 700 children died each day, almost all of them in India and 21 countries of sub-Saharan Africa, according to the United Nations.

As a result, the Joint United Nations Program on HIV/AIDS — known as UNAIDS — in 2011 announced a plan to prevent transmission of the disease to children by assuring that pregnant women get the testing, treatment and counseling they need to stop the virus from spreading. With funding from the U.N. and the U.S. government, The Global Plan towards the Elimination of New Infections among Children by 2015 and Keeping their Mothers Alive takes aim at the 22 hardest hit nations.

Msgr. Vitillo said an important key to the program's success is testing women early, so that any who are found to carry the virus can be put on antiretroviral medications. The women then continue the medication through birth and breast-feeding. While initial programs had discontinued women once the child stopped nursing, Msgr. Vitillo said that approach has been largely discarded in favor of keeping the woman on antiretroviral drugs indefinitely.

"We don't want to save the children and then have them lose their mothers," Msgr. Vitillo told Catholic News Service.

Another part of the program involves early testing of children so that if any are infected, they can receive prompt medical treatment.

Msgr. Vitillo said the program faces challenges that bedevil the entire response to HIV.

"To make this work, we have to figure out what obstacles women face, why they cannot access testing or if they do get tested why they may not come back for the results. It's often a problem of stigma and discrimination, and we need to combat that by involving the entire community in the HIV response," he said.

Health planners say the program can succeed only by becoming "male friendly" in order to prevent male partners from discouraging women of getting involved or from continuing treatment. Men have been a focus of voluntary circumcision programs in several African countries since studies revealed that the procedure drops their susceptibility to infection by more than 50 percent.

Msgr. Vitillo said both Catholic Relief Services and the Catholic Medical Mission Board have worked to design programs for women that intentionally reach out to men. "Sometimes direct communication between husband and wife isn't present or effective, so it takes a little encouragement for the men to be convinced that it isn't just women's business," Msgr. Vitillo said during a July 25 news conference.

In some cases, Msgr. Vitillo said, a woman who comes alone might be urged to write a "love letter" to her partner, inviting him to come along on the next visit. In other programs, a woman who shows up with her male partner is seen more quickly.

Catholic participation in the program was detailed in a report by the Catholic HIV/AIDS Network, released during the conference.

According to researcher Becky Johnson, the survey included 40 Catholic programs in the target countries. While 95 percent of the programs were involved in the national AIDS programs within their respective country and thus follow national guidelines for treating the virus, only 17 percent of the programs had been previously involved in planning or implementing the global plan.

Msgr. Vitillo, one of four civil society representatives on the global steering committee, said that while the church's role was well respected both internationally and in local communities, there often was resistance in the middle — national governments — where officials, "concerned about losing funding or losing control of the programs, have a mixed record of including civil society in designing their response."

Catholic agencies face several challenges in implementing the program. The survey found a need for resources beyond just what is needed for testing and treatment. Johnson said many of the agencies also need funding to help women travel to testing and treatment. Nutritional support also was identified as a critical need.

Maryknoll Fr. Richard Bauer, who until this year ran a wide-ranging HIV education and treatment program in Namibia, said that country's experience proves that combining the church's reach with an emphasis on mothers will yield significant results.

"With more than 2,500 Catholic AIDS Action volunteers, every time one of them saw a pregnant woman on the street they would grab her and say, 'Do you know where the clinic is? Do you know there's a medicine that can help your baby be born HIV-negative?' It has become a joke of sorts that if you're pregnant you have to watch out for the AIDS volunteers," Fr. Bauer said. "But that enthusiasm has made Namibia a success story in combating AIDS."

The priest explained that the church is well-suited to carry out such a program.

"In order to inform women of the choices they can make to have their baby be HIV negative, we need the community's involvement," Fr. Bauer said. "We especially need the churches, and we need to preach about this on Sunday. This is the work that the church has always done well, and its involvement makes me hopeful it will really happen."


To contribute to Upendo Village, contact Sr. Theresa Langfield, OSF, executive director of Upendo Village, N.F.P., at (630) 909-6691.


Copyright © 2012 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2012 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.