We returned this evening from two days spent in the westernmost parts of Kenya near the Ugandan border and the shores of Lake Victoria. HIV prevalence near the lake is much higher than in most other areas in Kenya, and AMPATH's focus in the area reflects this fact. After Tuesday morning clinic (more to come from Anne, I hope), Dennis recommended a quick diversion to lay eyes on the lake.He shared his insights into the relationship between the lake & the spread of HIV. Two stand out. Fishermen work hard, staying out several days at a time, and get paid relatively well, especially for an area as diffusely poverty-stricken as any one of many lakeside villages. Young men with money & little else to do often choose to involve themselves in alcohol and sex... hence HIV spreads. And two, the fishermen fish, leaving the wholesaling of their catch to middle men just yards away, at least in Port Victoria. It is no doubt a competitive market (see a sample of Nile Perch on the bidding table below). In cases where the middle men are women, it was suggested that sex may become piece of the transaction. Dire straits to be sure.
Interesting or not, for me these anecdotes highlight the complexity of this pandemic. Antiretroviral medications do a really good job of treating a virus. Poverty & stigma are different and far more daunting beasts to confront. AMPATH, nonetheless, is making remarkable headway.
Tulikula samaki kwa ugali halafu tulishiba,Joe
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