Professional Documents
Culture Documents
than 200 trainings for local target groups, mobilizers and advocates,
population of Turkana.
COVER PHOTO
Couple attending a session at a mobile voluntary
counseling and testing (VCT) station in Nabute
village, Lodwar.
IRC KENYA / LIVING ON! / COUNTRY DIRECTOR’S MESSAGE 3
MESSAGE
FROM THE
COUNTRY DIRECTOR
With the support of the U.S. Centers for Disease Control and Prevention, the
IRC has provided a coordinated response to HIV/AIDS in Turkana since
2005. We have a long and successful track record in the region, providing
refugees and Kenyan communities with aid and medical services, including
HIV/AIDS treatment, since 1992.
Much remains to be done, but the IRC has significantly contributed to some
major improvements in the fighting against HIV/AIDS in Turkana.
CONTENTS Thanks to our efforts and engagement, the awareness of and the attitude
toward HIV/AIDS have improved, although social stigma
4 ACHIEVEMENTS remains an undeniable problem. We were able to expand our focus on
prevention activities that engage and empower local communities.
6 AIDS GLOBALLY, LOCALLY Furthermore, we assisted in securing accessible, comprehensive and high-
quality HIV/AIDS treatment services through both IRC and partner facilities. Our
8 TURKANA ESSENTIALS
approach is based on building local capacity, supporting homegrown structures
16 IRC IN TURKANA and attaining long-lasting impact that goes beyond treating HIV/AIDS.
theIRC.org
KELLIE LEESON, IRC KENYA COUNTRY DIRECTOR
4 IRC KENYA / LIVING ON! / ACHIEVEMENTS
Since 2005, the IRC has persistently and systematically worked with local and
refugee communities and with partner organizations to combat HIV/AIDS in
Turkana, and it has significantly contributed to the following
ACHIEVEMENTS
ENSURED AVAILABILITY AND
QUALITY OF HIV/AIDS
SERVICES IN TURKANA
The IRC has been instrumental in raising the awareness of HIV/
AIDS in Turkana. It has helped create a demand for basic services
by taking a lead in HIV-monitoring and providing voluntary
counseling and testing services (VCT). Moreover, by operating
medical facilities, establishing comprehensive care clinics and
supporting the region’s main healthcare providers, the IRC has
assured access to higher quality HIV/AIDS treatment in Turkana.
RIGHT Community
outreach session in a
village near
Lokichoggio.
IRC KENYA / LIVING ON! / ACHIEVEMENTS 5
IMPROVING
AWARENESS
AND
FIGHTING
STIGMA
The attitude towards HIV/AIDS in Turkana has notably improved and the IRC has played a crucial role in facilitating
this change. HIV/AIDS stigma has decreased among local and refugee communities, which have access to basic
information on its prevention and treatment. Although much remains to be done, this achievement is essential in
engaging the community to take the lead in fighting HIV/AIDS and in generating hope for the future.
Through its support for local partners and authorities, the IRC has contributed significantly to building local capacity,
improving basic healthcare services and creating better support structures in the region. By operating hospitals and
clinics, supporting partners’ facilities with staff and equipment, and providing management training, planning and
assessment assistance to local and provincial structures, our impact has gone beyond the HIV/AIDS response.
IMPROVED
LOCAL
CAPACITY,
HEALTH AND
SUPPORT
STRUCTURES
HIV/AIDS
GLOBALLY, LOCALLY
KENYA
Nearly three decades after the first cases of AIDS were recorded,
the disease remains a grave threat to health and development. It
affects individuals, families, communities and societies worldwide.
This modern plague has taken 34 million lives by 2010, making it
one of the most destructive diseases in recorded history. Kenya did not avoid the early HIV/AIDS pandemic, although it was,
at least partially, able to contain the disease’s drastic spread from
According to the latest global statistics, the number of people 1990 onward. The country’s HIV prevalence peaked at 13% in
living with HIV reached an estimated 33.4 million in 2008— a 20% 2000, when AIDS was declared a national disaster, and was
increase from 2000. In 2008 alone, an estimated 2.7 million new dramatically reduced to 6-7% in the following years, partially due to
HIV infections occurred and 2 million people died as a result of an increase in education and awareness, but also high death rates.5
AIDS-related illnesses.1 It continues to present a significant burden for Kenyan society
despite institutional and policy responses from the government.
The continuing rise of the population living with HIV clearly
demonstrates that humankind is struggling in our efforts to stop Determining the HIV/AIDS prevalence rate in Kenya is challenging,
the spread of the AIDS pandemic. But the growing numbers also with various estimates around 7%. Indicators for 20086 show a
reflect the beneficial impact of antiretroviral therapies (ARTs). The relatively stable HIV prevalence rate of 6.3% for adult Kenyans
accessibility of antiretroviral drugs (ARVs) increased drastically in between 15 and 49, which is comparable to rates reported in
recent years, particularly in low– and middle–income countries. 2003.7 But alternative studies have indicated an increased HIV
prevalence of 7.4% in 2007, reversing the previously reported
In times of increased global mobility, HIV/AIDS spares no decline.8 The most commonly cited factor for this increase is the
continent, nation or society, but patterns of the AIDS pandemic decline in HIV-related mortality, stemming from more rapid
differ considerably from region to region, afflicting some more treatment and the availability of ARVs. AIDS-related deaths in
severely than others. Kenya have also fallen by 29% since 2002. However, an increase
in risky sexual behavior may be playing a key role in the apparent
While the pandemic is spreading most rapidly in Eastern Europe reversal of epidemiological trends.9
and Central Asia, where the number of people living with HIV
increased 67% between 2001 and 2008, sub-Saharan Africa HIV prevalence in Kenya is higher among women (8%) than men
bears the biggest AIDS burden in absolute numbers. (4.3%) at both national and provincial levels,10 percentages in line
with regional trends in sub-Saharan Africa. Women’s greater
The region currently accounts for two-thirds of HIV-infected vulnerability to HIV stems not only from greater physiological
individuals globally. High poverty levels, slow response and the susceptibility to heterosexual transmission, but also to severe
underdeveloped health systems, along with cultural and behavioral social, legal and economic disadvantages.11
habits, are commonly cited as causes for such high regional HIV/
AIDS prevalence rates. An estimated 1.9 million new HIV Girls and young women are particularly at risk of becoming
infections occurred in sub-Saharan Africa in 2008, bringing the infected in Kenya. Those aged 15 to 19 are three times more likely
total number of people living with HIV in the region to to be infected than their male counterparts, while those between
approximately 22.4 million.2 20 and 24 years are 5.5 times more likely to be living with HIV
than their male counterparts.12
The rate of new HIV infections in sub-Saharan Africa has been
declined by 25% in comparison to the pandemic’s peak in 1995, Epidemics in sub-Saharan Africa have matured and models
but the total number of people in the region living with HIV suggest that the proportion of new infections among people in
continues to climb. In 2008, the adult HIV prevalence in the region stable, so-called ”low-risk” partnerships is often high. In Kenya in
(ages 15 to 49) was 5.2%, resulting in an estimated 1.4 million 2006, heterosexual sex within a union or regular partnership
AIDS-related deaths— a number representing an 18% decline in
annual HIV-related mortality since 2004.3
accounted for an estimated 44% of incident HIV infections approximately one million individuals aged 15 to 64 compared to
compared to 20% of new infections caused by casual heterosexual 400,000 in urban areas.15
sex.13
There are significant differences in HIV prevalence rates within
HIV prevalence in Kenya is higher in urban areas than in rural areas Kenya, which indicates regional heterogeneity of the country’s AIDS
(7% vs. 6%), although the pattern differs by sex. Urban women pandemic. Although numbers cited by different studies vary, the
have a considerably higher risk of HIV infection than rural women western parts of Kenya tend to have higher HIV prevalence rates
(10% vs. 7%), while rural men have a slightly higher level of HIV than those in the east.16 Three provinces (containing half of Kenya’s
infection than their urban counterparts (5% vs. 4%).14 However, population) have 65% of the country’s HIV infections: Nyanza
since approximately three-quarters of Kenyans live in rural areas, province accounts for over one-third, Rift Valley province (where
the majority of HIV positive people can be found there— Turkana is located) one-fifth, and Nairobi province one-tenth.
HIV/AIDS has always been viewed as a pandemic of Kenya’s urban rate at 7%, close to the prevalence rates the IRC found during
population17 and therefore not acknowledged as an issue in testing in the region.20
scarcely populated Turkana. Available statistics have indicated,
however, that the region has not been spared the spread of HIV/ Access to ARVs in Turkana is greatly hampered by the isolation and
AIDS, consistently scoring above the national HIV prevalence rate. mobility of the nomadic community. According to the National STI
and AIDS Control Program (NASCOP) 2007 report, an estimated
Accurately assessing HIV/AIDS impact in Turkana is a challenge 2,883 people in Turkana were in need of ARVs in 2006, but this
due to the remoteness and vastness of the region, high mobility of number could be higher because of increased access to HIV testing
the local population and security concerns. HIV awareness in and counseling services in Turkana in recent years. Access to ARVs
Turkana has increased, with levels up to 98%, due to sustained has increased from an estimated 300 people on treatment at the
national and regional HIV/AIDS information campaigns. However, end of 2006 to about 1,500 in 2010.21
the region has reported some of the highest HIV prevalence rates
in the country in the last decade. In 2001 and 2002, HIV sentinel One of the leading causes of death among people living with HIV/
surveillance on antenatal mothers and patients with sexually AIDS is tuberculosis (TB). Its presence is an important eligibility
transmitted infections showed HIV prevalence rate of 13% and criterion for the initiation of ARV treatment. TB prevalence rates are
18%, respectively.18 high in Turkana among both pastoral and urban communities, and
the co-infection rates are sometimes shockingly high. A 2002 study
According to a 2007 study carried out among the rural Turkana showed that 80% of TB patients in Lodwar District Hospital were
population, HIV prevalence was 4.1% in rural areas and 8% in HIV positive.22
urban centers.19 In the same year, data from the District AIDS and
Sexually Transmitted Infections Coordinator (DASCO) in Turkana
Central indicated a prevalence rate of 6.7%, increasing to 14% in
some urban centers. Data from the 2009 Turkana Central District
TURN TO PAGE 19 TO LEARN ABOUT THE
Ministry of Public Health and Sanitation puts the HIV prevalence IRC HIV/AIDS PROGRAM
8
IRC KENYA / LIVING ON! / TURKANA ESSENTIALS
TURKANA
ESSENTIALS
Turkana is one of the hottest, most arid and remote Kenyan The region is an administrative part of the Rift Valley Province, also
regions, located in the Rift Valley Province in northwest Kenya. This known as the breadbasket of Kenya, but such labels are misleading
scenic region of plains, broken by lava hills,23 is bordered by Uganda as the area hardly permits crop farming. The local economy, which
to the west, Sudan and Ethiopia (including the disputed Ilemi relies on livestock, is regularly hit by droughts and famine. These
Triangle) to the north, Lake Turkana (with the Marsabit District on rough conditions make Turkana one of the poorest regions of
the lake’s opposite side) to the east, and the West Pokot, Baringo Kenya, with 74% of its population living in absolute poverty.24 The
and Samburu districts to the south. It encompasses an area of area is scarcely populated, with an estimated 539,263 people as of
nearly 77,000 square kilometers (30,000 square miles), similar in 2010,25 accounting for approximately 1.3% of Kenya’s total
size to Scotland or South Carolina. population. The region’s population is genderbalanced26 but
BELOW Kakuma Refugee Camp (Kakuma I) and the typical Turkana landscape.
GO TO PAGE 12 FOR IRC PROJECT SITES BELOW Cattle graze near FLORA AND FAUNA
GO TO PAGE 18 FOR HIV/AIDS PROGRAM Kakuma.
The vegetation of the area is
characterized by annual grasses
and shrubs in the plains and
perennial grasses and large trees
in the highlands. The lowlands
are crosscut with temporary
streams and rivers. The larger of
the river courses, the Kerio and
the Turkwell, support dense
gallery forests; acacia trees grow
along the banks of smaller
streams and river beds. Although
the region is arid, Turkana
benefits from numerous springs
and underground water sources.
Early travelers reported an
abundance of wild animals in
Turkana, but today most wildlife
is restricted to the forested areas,
and to the unoccupied areas that
serve as a buffer between the
Turkana and the tribal groups on
their borders.32
IRC TURKANA PROJECT SITES (2010)
Sudan
Ethiopia
Eastern
Rift valley
Uganda Somalia
KIBISH
Western N. Eastern
Lokwanya Central
Nyanza
!
( Nairobi
SUDAN ( Kaiemothia
!
Coast
Tanzania
Lokoilo
!
(
LAPUR
!
( ETHIOPIA
Namuruputh
Lomoru
LOKICHOGGIO !
(
Lokitaung
L. Turkana
Lokichoggio KAALING
p!
( !
(
Lodongoro
!
(
LOKITAUNG
( Moru
!
KAKUMA ( Murangering
!
!
( Kakuma
OROPOI MARSABIT
Kalokol !
(
KALOKOL
CENTRAL
UGANDA pLodwar
LOIMA TURKWEL
!
(Moruesis Kosipirr
!
( ( Lorukumu
! KERIO
IRC TURKANA PROJECT SITES
p Airfields
" Hospitals Lolimo
!
( Kakulit
!
( LOKICHAR
Kolitak
!
( Major Towns !
(
Naoiyapua
Lokichar
IRC Project Sites !
(
!
( !
( Loperat
Major Rivers Natapotimoru
!
( Kaloniwai
Major Roads KATILU
Nakwamoru
LOKORI
International Boundary !
(
!
( Kaputirr
Lakes
!
( Lokori
Division Boundaries KAINUK
Disclaimers:
TRANSNZOIA MARAKWET BARINGO
The designations employed and the presentation of material on this
map do not imply any opinion on the part of the Secretariat of the
United Nations.
12 IRC KENYA / LIVING ON! / TURKANA ESSENTIALS
LODWAR
Located in Turkana Central District, Central Division, population
40,000. Administrative and commercial center of northwestern Kenya.
The town of Lodwar is located on the banks of the Turkwell River, 50 kilometers from Lake Turkana’s western shore. It is considered the
capital of the region, housing local and governmental facilities, including Turkana’s biggest health facility and the main referral hospital,
Lodwar District Hospital (LDH).
The settlement was established in the 1930s by traders and soon became the seat of the Turkana district commissioner’s office, with a
small medical clinic and a government prison. During the colonial period, Lodwar functioned as a transit point for British officials moving
Kenyan political prisoners to the north. The town had developed a reputation as an isolated outpost removed from in the rest of Kenya, but
in recent years, Lodwar has expanded and gained commercial and economic prominence.
Lodwar is the seat of several of IRC’s Turkana operations, including the HIV/AIDS program.
KAKUMA
Located in Turkana West District, Kakuma Division. Population
138,000, including roughly 67,000 refugees in Kakuma Refugee
Camp. The largest settlement in northwestern Kenya.
Kakuma made it onto the map in the early 1990s after the establishment of Kakuma Refugee Camp, now the second largest refugee
camp in Kenya. Following the influx of refugees from neighboring Sudan and the transfer of refugee populations from numerous Kenyan
camps that began to close in 1992, Kakuma has turned into a multinational community. The camp currently provides a home to refugees
from over 20 ethnic groups and 12 African countries— Burundi, Central African Republic, Democratic Republic of Congo, Eritrea, Ethiopia,
Republic of Congo, Rwanda, Somalia, Sudan, Tanzania and Uganda. Somalis form the majority of the camp’s population (58%), followed by
Sudanese (28%), Ethiopians (9%) and Congolese (3%).
IRC is the exclusive provider of medical services in Kakuma Refugee Camp, where it operates a hospital and several clinics. It also
supports Kakuma’s Mission Hospital, which is the main referral hospital for Turkana North and West districts.
LOKICHOGGIO
Located in Turkana West District, Lokichoggio Division. Population 36,187. Former humanitarian
hub for Southern Sudan.
The town of Lokichoggio, often referred to a Loki, is located about 30 kilometers from the border with Sudan. Daily temperatures
frequently reach 40°C/100°F, and it is hot and dry year-round.
Loki was established in 1992 as the base for the U.N.’s Operation Lifeline Sudan, a response to the humanitarian emergency in Southern
Sudan in the wake of the prolonged civil war and famine. Loki became a transit center for refugees and and satellite location for
international organizations and NGOs operating in Southern Sudan. At the height of operations, the IRC partnered with African Inland
Church to offer comprehensive HIV prevention as well as support to aid workers. The partners opened the first stand-alone VCT center in
town, expanding its services over the next few years.
Due to its transitional location Loki became a vibrant commercial and multiethnic center— a temporary home for about 1,000 humanitarian
workers who lived alongside the local urban and rural Turkana populations plus the Kikuyu, Luhya and Somalis. . The recent relocation of
humanitarian operations to Juba in Sudan has downscaled and marginalized the importance of Lokichoggio, although the town remains the
main entry point for Southern Sudan.
The IRC has operational presence in Lokichoggio, working through and supporting the Africa Inland Church Medical Center, the main
medical facility in the area.
KALOKOL
Located close to the shores of Lake Turkana, in Turkana Central District, Kalokol Division.
Population 29,000.
Due to the proximity of Lake Turkana, fishing is one of the main livelihoods in Kalokol, which even has a fish-processing facility. The area is
windy, dusty, hot and dry— harsh even for local livestock such as goats and camels, allowing only limited pastoral activities and business
development. The landscape is characterized by lowlands that stretch along the lake’s western shores.
Africa Inland Church’s Kalokol Medical Center, which has been supported by the IRC since 2005, is the only medical facility in the area
and on the western shores of Lake Turkana.
IRC IN TURKANA
IRC Kenya operation is intimately linked to the Turkana region
where the IRC has been working since 1992.
HISTORY
The IRC began working in the region by providing health-related
outreach activities in Kakuma Refugee Camp, initiating a primary
healthcare program and establishing a network of clinics. In 1995
APPROACH
the IRC’s services were expanded at the request of the community
to include a small self-reliance program comprised of adult In the greater Turkana region, the IRC provides essential services
education and community-based rehabilitation. In 1997, the IRC through the implementation of its programs, which target two
took over the camp’s health services and became the sole groups of beneficiaries: thousands of refugees who have fled
implementing health-sector partner under the operational umbrella conflicts in other African countries such as Somalia, Sudan,
of the U.N. High Commissioner for Refugees (UNHCR). It then Ethiopia, Uganda and DRC, and Kenyan communities in need
assumed responsibility for the camp hospital, bringing all of humanitarian or development assistance.
preventative and curative health-sector activities under its
management. Since 2001, the IRC’s activities have gradually In order to assure maximum impact and effectiveness of its Turkana
expanded in scope and area, including Kenyan communities. The programs, the IRC bases its approach on thorough and
HIV/AIDS prevention and care program led the expansion of IRC’s continuous assessments of needs in the region; situating
activities across the greater Turkana region to Kakuma town in more programs in the same geography; integrated
September 2001, Lokichoggio in 2004, Kalokol in 2005 and mainstreaming of new services through existing ones to
Lodwar in 2007. This was followed by the introduction of reinforce results; and supporting and partnering with actors
region-wide child health and nutrition programs, a water and already present on the ground to avoid replication and build
sanitation program and a cross-border peace-building program local capacity.
operated with the IRC Uganda since 2009. The IRC also promptly
responds to emergencies like the devastating 2006/2007 drought
and 2009 cholera outbreaks.
LEFT Local woman vaccinated against tetanus in Kakuma Refugee Camp Clinic 4.
Although intended primarily for the refugee population, many locals use IRC-run
medical facilities in the camp.
IRC KENYA / LIVING ON! / IRC IN TURKANA 17
WATER PROGRAM
(KENYAN COMMUNITIES)
From 2007 to 2008, after Turkana was heavily affected by
droughts, the IRC implemented a comprehensive water
program, providing towns like Kalokol or Nadapal with
gravity flow systems or similar infrastructure projects that
provided thousands with access to drinking water.
IRC KENYA / LIVING ON! / HIV/AIDS PROGRAM
IRC TURKANA
HIV/AIDS PROGRAM
19 BASICS
20 PROGRAM OBJECTIVES
22 TIMELINE
23 IRC BCC STRATEGY: KAKUMA CAMP PILOT
24 STATISTICS
28 BEST PRACTICES
49 LESSONS LEARNED
IRC KENYA / LIVING ON! / HIV/AIDS PROGRAM 19
BASICS
HISTORY The ORIGINS of the IRC’s HIV/AIDS program in Turkana date
back to the 1990s, when IRC Kenya became the main provider of
health services in Kakuma Refugee Camp under the operational
umbrella of UNHCR. With HIV prevalence rates in Kenya rising and
hitting remote areas like Turkana particularly hard, it became clear
that there was a need to help the Kenyan government address the
issue in a comprehensive manner. Relying on the support of
individual donors and ultimately the U.S. Centers for Disease
Control and Prevention (CDC), IRC Kenya started an HIV/AIDS
prevention and care program in the Turkana region, beginning in
Kakuma town (2001) and spreading to Lokichoggio (2004),
Kalokol (2005) and Lodwar (2007).
Offering comprehensive services is crucial for successful care and treatment in underserved areas.
The knowledge of HIV/AIDS in the region is limited and the sources of information scarce.
Knowing an individual’s status is a starting point for addressing HIV/AIDS issues and providing treatment.
Sexually transmitted infections (STIs) increase the chances of HIV contraction and HIV/AIDS patients are more
susceptible to TB infections.
Blood safety is a basic requirement for the prevention, control and treatment of HIV/AIDS.
Turkana is vast and its population extremely mobile, presenting a challenge for HIV/AIDS data collection.
Home-based care is vital to assuring HIV/AIDS treatment for patients unable to access medical facilities.
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
D
2006 2010
O Networking with MoH Active membership in Technical
N HIV/AIDS structures at Working Group at national level
district, provincial and
O national levels.
2007 (NASCOP).
Lodwar
R MoU with LDH to Direct support to Provincial Health
S 2006 implement HIV/ 2008 Management Teams.
Lokichoggio AIDS program. Lokiriama,
& MoU with AIC – stand St.Monica, 2010
alone VCT and HIV/TB. St.Catherine, Expansion
2007 Lokori strategies through
P 2006
KRC
POA project and
MoU with NCCK MoU with DOL.
A Kalokol
to implement life
APHIA plus
R MoU with AIC to run HIV/ project.
skills for youth.
AIDS program.
T 2008
2001 Organizational 2009
N KRC
2005
Participating in
KRC 2006 capacity
E UNHCR-funded Repro- CDC funding, integrated Kakuma 2007 assessment MoH Annual
R ductive health program HIV/AIDS program. MoU with KMH to run HIV/ KRC (OCA) exercise Operations
AIDS program. GLIA funding. among partners. Planning.
S
IRC KENYA / LIVING ON! / HIV/AIDS PROGRAM 23
IRC’s Kakuma operation was chosen as the pilot site IRC BCC FRAMEWORK
because its health program and team are among the
strongest in the IRC, providing for a positive
environment to launch the 12-step approach to BCC.
Additionally, the complex mix of ethnic groups, cultures
and languages in a setting like Kakuma Refugee Camp
requires a carefully planned and targeted
communication strategy, particularly in relation to
behavior change for culturally sensitive issues related to
reproductive health, sexuality and HIV/AIDS.
IRC’s BCC strategy was rolled-out in Kakuma Refugee Camp and across other IRC country programs in 2007.
HIV/AIDS PROGRAM
IN NUMBERS
VCT SERVICES
The data demonstrates a gradual and consistent
increase in the number of clients who have
accessed voluntary counseling and testing
services supported by the IRC, and a shift from static
to mobile or home-based services. Acknowledging
that access to medical services is one of the main
problems in Turkana, the IRC adopted a multipronged
strategy of proactively reaching out to the population
and bringing HIV/AIDS treatment services closer to
the people, either where they congregate, do
business or live. In addition, mobile VCT services also
targeted pastoralist populations in remote and rural
areas with few or no medical facilities. Some locations
were several days’ walk from the nearest hospital,
clinic or dispensary. The overwhelming majority of
clients accessing VCT stations use both, testing and
counseling services.
PMTCT-RELATED TESTING
Prevention of mother-to-child transmission (PMTCT) is crucial to IRC’s HIV/AIDS intervention in Turkana. Identification of women in
need of PMTCT treatment presents one of the major challenges in remote areas with limited healthcare facilities. Providing testing
with antenatal care offers an ideal opportunity for identifying HIV-positive women. The number of women tested for HIV in IRC-
supported facilities while attending antenatal care has risen since 2005.
ANTIRETROVIRAL THERAPY
The number of people initiating and
adhering to the antiretroviral
therapy in Turkana has traditionally
been low for reasons of limited ac-
cess to healthcare facilities and
high ART costs. The IRC has
provided ART available free of
charge since the early stages of
HIV/AIDS program’s
implementation and increased the
ARV coverage along with the
expansion of its activities. ARV ad-
herence remains a major
challenge for various reasons,
including the high mobility of local
communities, their remote location
and limited health knowledge. The
data shows a gradual increase in
the number of individuals who have
newly initiated ARV treatment.
The IRC data from 2007 to 2009 on ARV defaulters reveals that approximately 600 individuals discontinued their ARV treatment.
About 15% were transferred to locations outside of IRC’s coverage and the rest ether defaulted or the IRC lost track of them. About
20% of the individuals died during the survey.
GO TO PAGE 43 FOR HIV/AIDS DATA MANAGEMENT BEST PRACTICES
HIV/AIDS AWARENESS
During the early stages of the HIV/AIDS Turkana intervention, the IRC expanded the scope of its HIV/AIDS awareness activities and
channels. New and innovative ways to spread the message about HIV/AIDS, from radio to formal education, were introduced, a
strategy intended to address one of the biggest challenges in the region— reaching out to and raising awareness among populations in
the most remote and rural areas of Turkana. Since 2010, the awareness outreach is more targeted and focuses increasingly on
specific groups at-risk.
As demonstrated throughout this document, the implementation of the IRC’s HIV/AIDS program in Turkana has had significant effects
on the behavioral patterns related to HIV/AIDS in the region. It is essential to secure further funding to support program activities and
local partners beyond the 2005-2010 program phase.
27
Many lessons and best practices have been drawn from the IRC’s experience
working with local communities and numerous local, national and international
partners in Turkana for more than two decades, along with five years of
coordinated response to HIV/AIDS. The IRC strives to reflect upon its
experiences and apply them to its programs and activities. The IRC also shares
them with partners and donors on a regular basis to contribute to the continuous
improvement of development and humanitarian programs in Turkana.
BEST PRACTICES
28 COMMUNITY THEATER
32 TARGET-GROUP ADVOCATES
34 HIV/AIDS AWARENESS ON RADIO WAVES
37 PREVENTION WITH POSITIVES
40 FAMILIES MATTER!
43 HIV/AIDS DATA MANAGEMENT
44 VCT AND INTEGRATED OUTREACH SERVICES
46 PMTCT, EARLY CHILD DIAGNOSIS AND HOSPITAL DELIVERIES
LESSONS LEARNED
49 THE IRREPLACEABLE POWER OF PARTNERSHIP
51 NEED FOR ALTERNATIVE WAYS TO UNDERSTAND THE CONTEXT, REACH OUT TO
THE POPULATION AND DELIVER THE HIV/AIDS MESSAGE
52 THE BENEFITS OF LINKING AND MAINSTREAMING HIV/AIDS THROUGH OTHER
PROGRAMS
52 NEED FOR A STRONGER PUSH FROM THE GOVERNMENT ON THE HIV/AIDS FRONT
53 INSEPARABLE THREATS: HIV AND TB
54 MORE STRUCTURAL INVESTEMENT IN TURKANA
IRC KENYA / LIVING ON! / BEST PRACTICE
BEST PRACTICE
COMMUNITY THEATER
IRC KENYA / LIVING ON! / BEST PRACTICE 29
Since many youth in Turkana are out of school but unemployed, the
IRC seeks to engage them actively in HIV/AIDS awareness
campaigns to reach out to their peers. Community theater groups
are usually composed of local youth who have undergone voluntary
HIV/AIDS counseling and testing and were then recruited to help
with community outreach.
BANJUKA (Kalokol)
The theater group from Kalokol has been active since 2007. Lucy, Susan,
Florence (below, first row from the left), Rose, Said, Jacqueline (second
row) and their colleagues practice twice weekly and perform in the
villages of Kalokol division at least six times a month. They say the best
way to attract attention through theater is to make people laugh, even
when topics are serious. They are proud of their work and believe they
have influenced their audience—condoms, sexuality and STIs are topics
that do not cause negative reaction
anymore. Although they must travel
to remote locations and have
problems informing communities
about upcoming performances, the
group remains ambitious and wants
to perform outside of the Turkana
region.
TARGET-GROUP
ADVOCATES
The IRC has worked extensively with most-at-risk populations in who to turn to for additional information. The women work in pairs,
Turkana, including commercial sex workers, truck drivers en route reaching out to different villages and settlements twice a week. An
to and from South Sudan, and the fishing communities of Lake initial outreach at a specific location is repeated,
Turkana. Initially these groups were considered only as target focusing on the same topic or addressing a new issue,
groups for behavior change communication and HIV/AIDS-related depending on the needs.
messages. If properly educated, trained and supported, they can
become an effective advocacy group for continued This approach has proven extremely efficient in addressing basic
behavior change communication on HIV/AIDS and general health hygiene and health-related misconceptions persistent among the
among their peers and in the local community. locals or in fighting HIV/AIDS and the related stigma. People are
more ready to listen and trust the members of their own
Young women and girls are particularly vulnerable to HIV, more so community, even more so when talking about personal matters
when frequently changing sexual partners or as a result of such as health or sexuality.
commercial sex activities. The IRC has designed outreach
activities in Lokichoggio and Lodwar specifically for these groups. Even though the primary aim of such community outreach is
curtailing the spread HIV/AIDS, such activities provide basic
Initially the objective was to make them aware of the risks linked
information on hygiene and nutrition, diseases such as diarrhea
to such behavior and to encourage them to reach out to their
and pneumonia, and issues such as home delivery, referrals,
peers, sexual partners and, in some cases, customers. After
antenatal and child care. Community members are encouraged to
training 20 young women in Lokichoggio and attaining the initial
visit health facilities sooner rather than later, although financial
objective of disseminating information through them to their peers,
considerations remain an important deterrent to seeking medical
eight girls from the group were mobilized for further
assistance. It often happens that locals do not go to the clinic for
outreach.
fear that they will need to pay for treatment, even if it is provided
free, as in the case of HIV/AIDS antiretroviral or tuberculosis
Their engagement is particularly valuable since they have
treatment.
privileged access to the local communities. They were also
already trained on HIV/AIDS or issues of general health and know Frequent access to all communities, particularly the remote ones,
IRC KENYA / LIVING ON! / BEST PRACTICE 33
HIV/AIDS AWARENESS
ON AIR
IRC KENYA / LIVING ON! / BEST PRACTICE 35
BEST PRACTICE
PREVENTION WITH
POSITIVES
Raising Awareness Through Empowered HIV-affected
Community Advocates
Prevention with Positives (PwP) is an innovative way of spreading The first and crucial step of the approach is the engagement of
awareness of HIV/AIDS in the community and is based on the HIV/AIDS-affected individuals. IRC does this through
active involvement, reintegration and empowerment of those psychosocial support groups at its comprehensive care centers in
affected by the disease. People living with HIV/AIDS can and the region, which provide support and counseling for individuals
should play a significant role in the design and implementation of recently tested positive. Group facilitators help identify individuals
HIV/AIDS prevention and care programs. Because of their who are recruited for prevention activities. They undergo a two-day
personal experience, they are unique advocates for reducing training workshop on behavioral change communication
stigma associated with HIV/AIDS, promoting accurate self-risk focused on HIV/AIDS issues, positive living, disclosure of HIV/
perception and correct and consistent condom use. AIDS status, opportunistic infections, stigma and discrimination and
presentation skills.
Joseph is HIV-positive and has been a PwP advocate for six months,
helping to spread information about HIV/AIDS in local communities.
He comes from a village near Lokichoggio that was hard hit by AIDS—
many people were sick or dying, including his wife and four children.
When he finally sought medical assistance, he was extremely weak,
weighing only 30 kilos (66 pounds), but his health has gradually
improved since he began antiretroviral therapy. He is proud to say that
he currently weighs 60 kilos (132 pounds). As part of IRC assistance to
those testing positive, Joseph became involved in the activities of the
psychosocial support group and was recruited to assist with HIV/AIDS
outreach.
IRC started the PwP program in 2010 and has so far engaged and
trained 19 advocates who have reached out to approximately
5,800 individuals in Turkana project sites. Each advocate takes
part in approximately eight outreaches per month and is on duty in
the local comprehensive care center to provide post-test support.
Simon and Jane are HIV-positive PwP advocates from Kalokol. They say that there is always more work than time, but they enjoy what
they do and take pride in their efforts.
Their work can be hard, and they had to get used to answering many questions, especially after revealing their positive status. People
often do not believe them and their story of living positive, forcing them to show their ARV medication or their training certificates.
Still, they emphasize that it is important “to build trust even before you start talking about unconventional topics like HIV/AIDS, or
health in general.”
The hardest thing to explain about HIV/AIDS treatment and positive living, according to Simon and Kane, is the individual’s lifelong
fight against the
disease and the
necessity to em-
brace a healthy
lifestyle. Much of
their time is dele-
gated to finding
those who
stopped their
ARV treatment
and HIV-positive,
they say.
BEST PRACTICE
JAMII INAFAA!
FAMILIES MATTER!
IRC KENYA / LIVING ON! / BEST PRACTICE 41
BELOW “You are the best teacher for your child!”, Families Matter
program slogan.
IRC’s target outreach for Families Matter! is 25% of families with TOP RIGHT Program participant
TOP LEFT A program
children between 9 and 12 in all IRC Turkana sites. To date, the graduate in Lodwar is in Kalokol reviews the lesson with
IRC has trained 39 facilitators who take groups of parents and/or congratulated by an IRC his class.
guardians, called “waves,” through five weekly sessions on sexual staff member.
topics and sexual risk reduction. Participants graduate after the
completion of their “wave,” and further participants and groups are
recruited for new sessions. Fifteen waves have been
completed by mid-2010, reaching roughly 517 parents and 813
adolescents. The next challenge will be expanding the program to
other locations in the region and planning follow-up sessions with
the waves of graduates.
LEFT 2010 graduate waves from Lodwar (above) and Kalokol (below).
IRC KENYA / LIVING ON! / BEST PRACTICE 43
BEST PRACTICE
HIV/AIDS
DATA MANAGEMENT
Providing Reliable and Accurate
Data on HIV/AIDS Care and Treatment
Vast and remote regions like Turkana, especially when inhabited Possessing an accurate and reliable HIV/AIDS data system,
by pastoralists, are particularly difficult to survey for accurate and available at all program sites, is particularly valuable when
reliable HIV/AIDS-related data. monitoring and tracking patients’ movements in the region, a
common phenomenon in the Turkana region where nomadic
Apart from understanding regional prevalence rates and patterns, lifestyles are common. Accurate information also allows for easier
researchers must cope with particular date-management tracing of ARV defaulters.
challenge of the ARV therapies (ART) themselves.. Individuals
often begin a therapy only to default because after finding it On the other hand, the need remains for trained data
difficult to access to healthcare facilities and services, or because management staff to oversee data reconstruction, particularly
they lacked knowledge or understanding about medication intake. reconstruction involving multiple databases. In order to be able to
These problems only compound the task of collecting and extract useful information for programming response, data must be
maintaining accurate information and data to monitor and run HIV/ collected systematically over long periods across the entire region,
AIDS response programs. a task that requires consistent staffing, methodology and funding.
BEST PRACTICE
COUNSELING AND
TESTING FOR EVERYONE!
Knowing an individual’s status is the foundation and starting point services is assured for more than half of the population of
for any HIV/AIDS treatment or awareness activity. A successful Turkana, access for all of these services in remote rural areas
HIV/AIDS program must allow community members to access remains challenging due to lack of roads, vehicles, personnel and
testing and counseling instantly and affordably. The IRC is directly financial resources.
implementing or supporting several types of counseling and
testing geared to the location and needs of the environment.
Providing a Comprehensive
Package of Counseling, Testing
and Integrated Outreach Services
RIGHT Local Turkana men approach IRC’s mobile
VCT site in Lodwar to inquire about counseling and
testing.
PMTCT,
EARLY CHILD DIAGNOSIS
AND HOSPITAL DELIVERIES
The chances of an HIV-positive pregnant mother transmitting the
virus to her baby is as high as 30%, but can be significantly
reduced with prevention of mother-to-child transmission (PMTCT)
interventions. Mother-to-child transmissions account for most
infections of children under the age of 15, 90% of which occurred
in Africa in 2008.37
HOSPITAL DELIVERIES
Delivery presents a particularly risky event
during which an HIV-positive mother is more
likely to transmit HIV to her newborn.
Providing professional pre-, intra- and
post-delivery care to HIV-infected women is
an effective way of minimizing the risks of
Acknowledging that an average Turkana woman would not be able to afford such transmission, a goal easier achieved if
substitute milk, the IRC provides formula milk free to women who pass the AFASS delivery is performed in a medical facility in
criteria. IRC-supported community health workers also try to ensure that the presence of medical staff. This is
HIV-positive pregnant women and mothers complete prophylaxis, deliver in health particularly challenging in Turkana where, due
facilities and have their babies tested at six weeks. to the remoteness of the area, lack of medical
facilities and cultural habits, the rate of
Many challenges are associated with successful prevention of mother-to-child
hospital deliveries is below 8%.
transmission interventions. It is particularly hard to identify and retain women who
need PMTCT services due to the distance of health facilities from their homes and
In order to reduce maternal mortality rates,
low involvement and support of their partners. To bridge these gaps, the IRC is
and scale up safe deliveries supervised by
focusing on integrated outreach services supported by targeted and mass
professional staff as a PMTCT intervention,
awareness campaigns.
the IRC has been actively advocating for
hospital deliveries among pregnant women in
Turkana, particularly those future mothers that
will require a PMTCT intervention.
LESSONS LEARNED
THE IRREPLACEABLE
POWER OF PARTNERSHIP
Working together with partners, a cornerstone of the IRC’s approach in the region, has proved instrumental for the
achievements and implementation of the IRC’s HIV/AIDS program. Based on experience, this strategy has been most effective
in building local capacity and achieving a sustainable regional HIV/AIDS response. When targeting local communities, the IRC
partners with local faith-based organizations—the major providers of healthcare services in the region as well as with local
nongovernmental organizations and community-based initiatives. Offering support in human resources has proved to be
valuable and effective, as well as assistance with equipment and medical supplies, and management and technical expertise. In
Kakuma Refugee Camp, the IRC finds strong partners in local and international governmental and nongovernmental
organizations such as UNHCR, IOM, World Food Programme (WFP), National Council of Churches of Kenya (NCCK), Lutheran
World Federation (LDW), Jesuit Refugee Service (JRS) and FilmAid.
AFRICA INLAND CHURCH’s health facilities were started by missionaries in the 1970s and handed over to the local community in
the early 1990s. Government support has been extremely scarce or nonexistent, with the maintenance and provision of services
almost exclusively funded by user contributions (in a region with high unemployment rate and extremely low incomes) until the CDC’s
and IRC’s involvement in 2005.
AIC Kalokol Health Center is the sole static health post in the
Kalokol Division on the eastern shores of Lake Turkana. Prior to
2006, IRC HIV/AIDS intervention activities did not exist in the
Kalokol area, hard hit by tuberculosis. Samuel Losuru, the center’s
administrator, says that challenges are numerous but that partnership
with the IRC has been “exceptional and critical for delivering a
comprehensive HIV/AIDS treatment package, as well as vital for
providing other health services in the area.”
50 IRC KENYA / LIVING ON! / LESSONS LEARNED
LODWAR DISTRICT HOSPITAL (LDH), a government facility with a large clientele and outreach, is the main referral hospital of
Turkana. The IRC partnered with LDH in 2007 to strengthen its systems capacity and improve the general clinical care for HIV/AIDS.
This is an important part of an initiative to assist the Government of Kenya in response to HIV/AIDS, a crucial determinant of a
successful response.
Gilchrist Lokoel, district medial officer of health, notes that Turkana is, slowly but
steadily, catching up with the rest of Kenya in response to HIV/AIDS. The role of
the IRC has been vital: “The IRC does not seek to establish parallel structures on
the ground but builds on what is already existing or being implemented.”
THE CATHOLIC DIOCESE OF LODWAR (DOL) provides an extensive range of primary healthcare services and is supported
by the IRC to increase HIV/AIDS outreach, particularly in rural areas. DOL is working through the Kakuma Mission Hospital (KMH), the
main referral center for northern Turkana, including patients from the IRC-run Kakuma Refugee Camp Hospital.
At the Kakuma Mission Hospital, the IRC assists with equipment, financial support, expertise
and staffing. Through this partnership, which started in 2006, the IRC has supported an average
of 17 employees every year. Sister Elizabeth Mwaniki, KMH administrator, mentions countless
problems: cost-sharing, staff retention, high electricity costs and cuts, irregular supplies, lack of
transport, floods of referrals and ineffective follow-up with patients. “Without the IRC support,”
she says, “the hospital could not offer HIV/AIDS or other services at current levels!”
LESSONS LEARNED
NEED FOR ALTERNATIVE WAYS TO
UNDERSTAND THE CONTEXT,
REACH OUT TO THE POPULATION
AND
DELIVER THE HIV/AIDS MESSAGE
HIV/AIDS is a social problem with
region-specific permutations. Turkana is no
exception. It is a vast and heterogeneous
region with many remote areas, high
illiteracy rates and various cultural practices
that influence modes of HIV/AIDS
transmission, treatment and perception.
ABOVE Talking about HIV/AIDS and STIs during an awareness outreach in Kalokol.
RIGHT IRC staff member talking about HIV prevention during life skills training for
teachers in Lokichoggio.
BELOW Primary school teachers attending life skills training in Lokichoggio. The IRC
sponsors such trainings and provides instructors who conduct modules on HIV/AIDS
awareness, prevention and treatment.
52 IRC KENYA / LIVING ON! / LESSONS LEARNED
LESSONS LEARNED
THE BENEFITS OF
LINKING AND MAINSTREAMING
HIV/AIDS THROUGH
OTHER PROGRAMS
The IRC’s HIV/AIDS program in Turkana has made tremendous efforts to ensure and increase access to HIV/AIDS prevention,
care and treatment services in the region. However, the region remains heavily afflicted by factors that demand other
emergency interventions, particularly in healthcare and nutrition, and is often affected by cattle rustling and other incursions
from neighboring communities. The achievements and success realized in one area can easily be eroded by complex
emergencies. The implementation of the HIV/AIDS program in Turkana has shown that due to other pressing needs the
importance of HIV/AIDS-related problems is too often scaled back by the local population.
An integrated and holistic approach to healthcare programming is needed in areas like Turkana. Such an approach includes the
integration of health systems and primary health, nutrition, HIV/AIDS and community health interventions, as well as water,
sanitation and livelihood programs. The IRC has recognized the benefits of this approach compared to other competing health
and social issues in Turkana and emphasizes specific interventions to mainstream health systems in order to increase access.
The IRC also improved health outcomes by working in collaboration with the community using a mix of health promotion
interventions. This not only leads to better long-term impact and results on the ground, but also provides for more
cost-effective spending of donor funds.
LESSONS LEARNED
An integral part of such a push by authorities will require more local capacity building. A concrete recent and immediate step
toward improved local capacity was the revamping of the national HIV/AIDS training guidelines and curriculum, taking into
better consideration the specific needs, background and potential of trained staff.
IRC KENYA / LIVING ON! / LESSONS LEARNED 53
ABOVE Young Turkana girl gets her tuberculosis medication at the AIC
Health Center in Lokichoggio.
LESSONS LEARNED
INSEPARABLE THREATS:
HIV AND TB
Tuberculosis remains a public health and social issue with a significantly
negative impact in Turkana. Due to the intrinsic connection between TB and
HIV/AIDS, the gains being realized in the fight against HIV/AIDS could be
eroded or slowed if there is no commensurate investment in TB prevention
and control. As much as the IRC has supported the Ministry of Public
Health and Sanitation on TB/HIV collaborative activities, a great deal
remains to be done.
RIGHT Tuberculosis
ward at the IRC-run
Kakuma Refugee
Camp Hospital.
54 IRC KENYA / LIVING ON! / LESSONS LEARNED
LESSONS LEARNED
Turkana is a region with vast cultural and economic potential, the realization of which depends on sufficient resources and
investment, proper leadership, and local involvement in and ownership of development initiatives. Decades of sub-optimal
regional development combined
with a challenging environment will
require a strong push and
momentum for Turkana to catch up
with the rest of Kenya in obtaining
sufficient transport, health,
education system and communica-
tions infrastructure.
ENDNOTES
1 UNAIDS. 2009 AIDS Epidemic Update. Geneva: UNAIDS, 2009; at 7.
2 Ibid, 21.
3 Ibid.
4 Ibid, 29.
5 NACC. United Nations General Assembly Special Session on HIV and AIDS, Kenya Country Report. Nairobi: NACC,
2010.
6 KNBS. Kenya Demographic and Health Survey 2008-09. Nairobi: KNBS/NACC/NASCOP/MOPHS, 2010; at 210.
7 2003 Kenya Demographic Health Survey estimated prevalence rate among adults (15-49) at 6.7%. CBS. Kenya
Demographic and Health Survey 2003. Nairobi: CBS/MOH/KMRI/NCPD/ORC/CDC, 2004.
8 NASCOP. KAIS/Kenya AIDS Indicator Survey 2007. Nairobi: NASCOP/KMRI/NACC/KNBS/CDC/USAID/UNAIDS/, 2009.
9 UNAIDS. 2009 AIDS Epidemic Update. Geneva: UNAIDS, 2009; at 29.
10 KNBS. Kenya Demographic and Health Survey 2008-09. Nairobi: KNBS/NACC/NASCOP/MOPHS, 2010; at 215.
11 UNAIDS. 2009 AIDS Epidemic Update. Geneva: UNAIDS, 2009; at 22.
12 Ibid, 31. KAIS 2007 shows similar trends.
13 Gelmon et al. Kenya: HIV Prevention Response and Modes of Transmission Analysis. Nairobi: 2009, NACC.
14 KNBS. Kenya Demographic and Health Survey 2007. Nairobi: KNBS; at 216-7.
15 NASCOP. KAIS/Kenya AIDS Indicator Survey 2007. Nairobi: NASCOP/KMRI/NACC/KNBS/CDC/USAID/UNAIDS/, 2009.
16 Nyanza province has an overall prevalence of 14%, double the level of the next highest provinces—Nairobi and
Western, at 7% each. All other provinces have levels between 3% and 5%, except North Eastern province where the
prevalence is about 1%. KNBS. Kenya Demographic and Health Survey 2007. Nairobi: KNBS; at 217.
17 Practical Action. Breaking the Siege - Mainstreaming HIV/AIDS in Peace Building. Practical Action PEACE Bulletin,
December 2003, http://www.itdg.org.
18 MOH/NASCOP. KAPB Survey, Central Division – Turkana. Nairobi: NASCOP, 2003.
19 NASCOP/NACC. National HIV Prevalence Report June 2007. NASCOP/NACC, 2007.
20 MPHS/MMS. 2009 Health report, Turkana Central and Loima Districts. MPHS/MMS, 2009; at 6.
21 NASCOP/NACC. National HIV Prevalence Report June 2007. NASCOP/NACC, 2007.
22 Owiti, J.A. Tuberculosis and HIV/AIDS are Like Co-Wives: The Conception of HIV/AIDS and Tuberculosis Among Urban
Turkana population at Lodwar Township, Kenya. International Conference on AIDS, July 7-12 2002, abstract no.
WePeD6409.
23 McCabe, J.T. Encyclopedia of World Cultures. 1996.
24 GOK. Turkana District Development Plan 2002-2008. Nairobi: GOK, 2002.
25 Kenya National Bureau of Statistics website—http://www.knbs.or.ke.
26 According to the 1999 Kenya national census 50.2% females and 49.8% males, respectively. Ibid.
27 OCHA. Kenya Humanitarian Update, Vol. 61, 23 June-21 July 2010.
28 Von Grebmer et al. 2009 Global Hunger Index. Bonn/Washington: WHH/IFPRI/ConcernWorldwide, 2009.
29 IASC. Kenya Drought Alert, July 2009; and Malnutrition Crisis in Northwest, IRIN, July 16 2009,
at http://www.irinnews.org/Report.apsx?ReportId=83003.
30 Ibid.
31 Kenya Interim Independent Election Commission, Regional Voter Registration Statistics As At Close Of Registration,
2010, at http://www.iiec.or.ke/sites/default/files/statistics-1_0.pdf .
32 McCabe, J.T. Encyclopedia of World Cultures. 1996.
33 UNAIDS. 2009 AIDS Epidemic Update. Geneva: UNIADS, 2009; at 22.
34 Freedom House. Freedom of the Press 2009: Kenya. New York: Freedom House, 2009; also at
http://www.freedomhouse.org/template.cfm?page=251&year=2009
35 Hannah Bowen. Information at the Grassroots: Analyzing the Media Use and Communication Habits of Kenyans to
Support Effective Development. InterMedia/Africa Research, 2010.
36 PlusNews. Kenya: HIV Carries Moral Stigma, at http://www.plusnews.org/Report.aspx?ReportId=89316. Okal, J. and
Bergmann, T. HIV in Emergencies Case study: Northern Kenya. London: ODI, 2007; at 4-7.
37 UNAIDS. 2009 AIDS Epidemic Update. Geneva: UNAIDS, 2009.
57
theIRC.org
INTERNATIONAL RESCUE COMMITTEE KENYA
P.O. Box 62727-00200
Nairobi, Kenya
+254 20 272 0064
ircnbi@kenya.theirc.org
PUBLICATION CREDITS
WRITING, EDITING, PHOTOGRAPHY and PRODUCTION DESIGN: Matija Kovac
BACK COVER PHOTO COMMENTS, CONTRIBUTIONS and REVIEWS: Peter Mutanda, Kizito Mukhwana, Lizzy
“Moonlight” voluntary counseling and Masila, Prafulla Mishra, Felister Nekesa, Geoffrey Luttah, Kellie Leeson, Sophia Mwangi,
testing (VCT) session in Lodwar. Katherine Sarkis, Gretchen Larsen, Melissa Winkler, Steven Manning, Symon Wambugu,
Kenneth Sisimwo, Jemimah Khamadi, Raphael Lokol, Paul Wasike and other IRC staff
members
COPYEDITING: Rex Roberts
MAPPING SUPPORT: UN OCHA Kenya, Information Management Unit
LAYOUT and PRINTING: Ecomedia
DESIGN based on prototype by Radley Yeldar, London.
CONSENT HAS BEEN SOUGHT AND SECURED FROM ALL INDIVIDUALS WHO
APPEAR IN THE PHOTOS FEATURED IN THIS PUBLICATION.
This publication was made possible
by financial support from the U.S.
Centers for Disease Control and
SEPTEMBER 2010 Prevention.
IRC TURKANA HIV/AIDS PROGRAM
Since 2005, the IRC has assisted the local and refugee populations of Turkana, Kenya, in their response
to the HIV/AIDS pandemic by providing basic clinical services, fighting stigma and raising awareness.
As of August 2010 we have tested more than 110,000 people, provided access to free antiretroviral
therapy to more than 1,500 patients, supported local partners with staff and equipment worth more than
$3 million US, conducted more than 200 trainings for local target groups, mobilizers and advocates,
supported more than 2,000 awareness outreaches and assisted in building institutional and response
capacity through training, financial support and expertise. We are effectively reaching out to more than
half of the population of the Turkana region.