Kanine's story
At the government-run Machakos General Hospital in eastern Kenya, Kanine Muindi, 30, waits her turn on one of the crowded benches outside the Comprehensive Care Centre. With her are her three-year old daughter, Mwende, and their neighbour, Mwende Matata.
Kanine is HIV-positive, and so is little Mwende. The centre caters for patients diagnosed with the virus, providing counselling, nutritional information, treatment for opportunistic infections and anti-retrovirals (ARVs).
Mwende stands on the ground and lays her head on her mother’s legs.
“She is my youngest and I have six other children, but they are not sick. Only Mwende is sick,” Kanine explains. The children are from four different fathers.
Kanine is thin, very thin. Her voice is small and high, almost like a child’s, and her tiny head is covered in downy, baby-soft hair. She complains of dizziness, weakness and abdominal discomfort. But despite it all she wears a ready smile, and speaks easily. Her clean flowered frock and green canvas shoes mirror her weakened body and fighting spirit: well worn, but determined to go on.
Their journey to the hospital had begun the day before. It’s a three-hour walk from their home in Muselele village.
This is their second visit to the hospital. Mother and child were diagnosed with HIV during a free mobile clinic in their village. Too weak and poor to make the journey on her own, Kanine asked her neighbour, Matata, to accompany them.
Kanine lives with all her children in a small cubicle in the corner of a dry patch of land belonging to her uncle. Every evening, the family crowds into the little room to sleep on the bare earthen floor, a potentially catastrophic situation considering that Kanine and Mwende were diagnosed with TB a year ago.
Kanine is too weak to work and the family often goes hungry. Once in a while, neighbours give them some food.
On their first visit to the hospital, Kanine and Mwende received 5kg of protein-rich Unimix flour each, which should have been sufficient for the two weeks until their next appointment. But there was nothing to eat at home, so Kanine used it to make ugali for the whole family. It lasted three days.
Because of lack of funds, Kanine and her daughter cannot afford the CD4 count, liver and other expensive tests that should be done before they are put on ARVs.
“Most of our patients are very poor,” says Teresiah Mutuku, the nursing officer in charge of the Comprehensive Care Centre. “For these, the hospital waives the cost of the CD4 count, and does free basic blood and urea tests that give us a good indication of the level of infection.”
Kanine will go home with her first instalment of ARVs today. But for little Mwende there are no ARVs for babies, besides Nevirapine, which is given at birth, ARVs are not yet available for children in public hospitals in Kenya. Instead, Mwende will be given Septrin to protect her from infections like pneumonia, diarrhoea and malaria.
“I would like to get better so that I can take care of my children and no longer be a burden on my neighbours,” Kanine says.