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Page last updated at 01:41 GMT, Friday, 15 February 2008

Aids patients hit by Kenya crisis

By Karen Allen
BBC News, Nairobi

A displaced woman in Kenya outside a Red Crescent tent
More than 600,000 people have been displaced in the violence

A Kenyan woman crouches in a tent by the only possession she retrieved when she fled her home last month - a brown-paper bag packed with HIV drugs.

"I was told by gangs that I was going to be raped because I am Kikuyu. That's why I left my house and came to this camp," she says about the attack on her slum home in the capital, Nairobi.

"This was the only thing I was able to carry from my house, because I know what it means to miss these drugs," she says, pointing towards the packs of different medicines.

They may help save her life but with just one meal a day, she is unable to tolerate the medication. She is so weak, she can hardly stand up, and so the temptation to skip a dose is huge.

Out of 600,000 people who have been displaced in Kenya's post-election violence, at least 15,000 are HIV-positive.

Tip of the iceberg

Many depend on anti-retrovirals drugs to survive. It is a complicated regime and many need close medical supervision.

Yet in some clinics, a fifth of patients have failed to turn up, and that could be just the tip of the iceberg.

Walter Kizito, clinical specialist
If patients cannot access their medication, HIV could kill more people than injuries from bullets
MSF clinical specialist Walter Kizito

Patients have either fled to their ancestral homes or are too frightened to venture outside their camps or homes, for fear of fresh violence erupting.

One HIV-positive woman in Nairobi's Kibera slum was stranded at home for four weeks.

By the time health workers had managed to reach her, an infection had taken hold and she was rushed to hospital in a critical condition.

David Okello, the country representative of the World Health Organization in Kenya, says that at the moment, clinics in violent flashpoints were just about "coping".

With peace talks under way, the situation has settled down, but if fresh violence were to erupt he warns that Aids patients would be in "big trouble six months down the line".

Stark

Without medical supervision not only is there the problem of accessing medication, and getting regular blood tests that hold vital information as to how anti-retroviral drugs are performing, but failure to stick to the complex drug regime increases the likelihood of drug-resistant strains of the disease taking hold.

Health workers sorting antibiotics in Kibera, Nairobi
Medical camps have be set up to help those affected by the crisis

That would mean more and more patients with the Aids virus would be harder to treat exposing more of the population to infection.

In times of peace Kenya has performed relatively well in getting anti-retroviral treatment out to people with the Aids virus, but the current disruption could cause irreparable damage.

Walter Kizito - a clinical specialist at a Medecins Sans Frontieres clinic in one of Nairobi's slums - puts it in stark terms.

"If patients cannot access their medication for anti-retrovirals - and here we are talking of insecurity - HIV could kill more people than injuries from bullets, from violence basically," he says.

It is a sentiment many others in the Aids field have expressed too.

That is the worse-case scenario and efforts are now under way to try and reach patients in camps.

Infectious

Bathwell Nyengweso runs a team of volunteers who visit the camps on the edge of Nairobi's slums, trying to identify HIV-positive patients.

Bathwell Nyengweso (l) and his team
Volunteers visit camps trying to identify HIV-positive patients

At Mathare slum in Nairobi there are 64 tents. Twelve have been identified as having patients in urgent need of medical attention.

Amongst them is one man who also has multi-drug resistant tuberculosis.

He is in an extremely infectious state and would normally be in isolation, but it is impossible to do that in a displaced people's camp.

The health volunteers are extremely concerned. The tent the man has visited houses a three-day-old baby in the corner.

The little girl has already showing signs of exposure, and they are concerned that she could be infected with TB.

Health officials are still trying to assess the impact six weeks of violence has had on the country's battle with Aids.

Just how big a setback this has been may only emerge once a durable peace deal is in place - for some Aids patients that might simply be too late.


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