A Day I Will Never Forget

On Thursday, Michael and I started our day off by meeting Protus, Nyumbani's chief manager, at the Nyumbani Children's Home which is in a suburb of Nairobi called Karen.

I've been told that Karen is one of the wealthiest parts of Kenya. Lots of Europeans vacation in nice homes in Karen and for a minute you can forget about the vast poverty surrounding you throughout the country. We were meeting Protus because he was supposed to give us a ride into Kibera so we could meet Paul Mulongo, who runs the Nyumbani Clinic and Day Care in Kibera.

Kibera is the largest slum in Kenya and the second largest slum in Africa. The Nyumbani clinic and day care in Kibera is part of Nyumbani's Lea Toto Program, which is a community outreach program that serves over 2,000 HIV positive children and their families. In addition to Kibera, Nyumbani has clinics in 5 other slums in Nairobi. Lea Toto is funded by the United States Agency for International Development (USAID) and the President's Emergency Plan for AIDS Relief (PEPFAR). It receives food from the World Food Program and the food is distributed to the families Lea Toto serves.

As we turned off a main street, Protus told Michael and I we were very close to Kibera and sure enough in a snap of a finger we were there. No joke- the difference between where we had been not more than 45 seconds ago and where we were now was the difference between night and day.

However we didn't get to see much of the area then because we pulled up to the Lea Toto clinic and immediately went inside where we got a briefing of the Lea Toto program. Paul and his assistant Daniel explained to us the ins and outs of their growing program in Kibera which works with 400 HIV positive children.

They offer voluntary counseling and testing. Any adult who is found to be HIV positive is referred to the nearest health institution or NGO where they can be assisted, while HIV positive children are enrolled in the program. As part of the program, Lea Toto children have access to a day care where sick children can come and get nutritional support until they are healthier.

They also have access to additional medical services, nutritional services (such as WFP food rations), home visits and nursing care. Antiretrovirals are given to needy children and currently 700 of the Lea Toto children are taking ARVs. Serious cases are referred to the Nyumbani Hospice at the orphanage in Karen, which acts as an intensive care unit where children who are HIV positive receive specialized medical attention. Lea Toto also provides support groups to help caregivers be empowered on how to disclose to their children that they are HIV positive. These support groups also provide skill training on how to offer home-based care to their children and education on the virus and the correct usage of antiretroviral drugs.

In an effort to promote sustainability, Lea Toto provides training for caregivers on income generating activities linking families to credit and loan facilities as well as supporting the initiation of small scale businesses. Lastly, Lea Toto offers training programs for HIV positive children (the older ones) on how to live with HIV and recreational therapy aimed at bonding the children together.



After the briefing was finished, Sister Joyce, who is a social worker that makes daily home visits, took us to meet a few people at their homes. As we left the Nyumbani clinic, the reality began to set in. The smell of Kibera greets you quicker than the thousands eyes gazing at the lone white person in the forgotten village. The poverty is so vast it's hard to fully get your mind around it.



The smell of trash, feces, and extreme body odor overtakes you. The densely populated slum is covered with squalid mud huts. One million people live in Kibera, which is the same size as New York City's Central Park, about 1.5 square miles. And at one million people (which is one third of Nariobi's population), the population in Kibera is 30 times that of New York City.


It's as if the world has ended and this is what is left over.



The ground is covered with trash. In certain areas, the ground resembles a landfill.

The Kenyan government does nothing about it. It provides no water, no sanitation, no toilets, no medical clinics or hospitals, no roads and no schools. There is no running water in Kibera. Instead private dealers pipe in water and charge double what people pay for the same service outside the slum. And no running water means two things. One, people have to walk 10-20 minutes to purchase water for drinking, cooking and bathing. Two, people have no toilets. There are public toilets people can use but are required to pay 5-10 shillings each time they need to use the restroom.

This leaves many people with no choice but to use "flying toilets" which simply means doing your business in one of the thousands upon thousands shredded plastic bags and leaving them outside their doors adding to the mountains of trash and filth and mud.

The first place we visited was a Christian day care run by a middle-aged woman named Martha. She takes care of 16 children- 8 of who are orphans and several who are HIV positive.

Martha uses her rented 15 x 15 feet shack as an office, kitchen, bedroom, classroom, and orphanage.

I couldn’t believe my eyes- 17 people crammed in this one little room. But what touched me most is realizing that most of these very young children don’t know any better.

They don’t realize that there is a better life out there- one where you’re not living in a house made with a mud floor and iron sheet walls supported by sticks. Where you don’t have to walk 15 minutes to get drinking water while dodging mud-soaked trash piles and fly-infested feces on the way. Where your chances of becoming infected with HIV when you grow or even when you're born are not astronomically high.


The next place we visited was a home to a family of six. We met the parents, Alise and Moses, who welcomed us into their house. I couldn’t help assuming that this was one of the better homes in Kibera.

Inside, there were two twin beds, a couch, an makeshift entertainment center with a television. Alise and Moses met and were married in the Nyanza province. Moses was trained as a mechanic and came to Nariobi to find work bringing his family along. Moses and Alise are both HIV positive as well as 2 out of 4 of their children. Both of the children are enrolled in the Lea Toto program and have started taking ARVs. Both Moses and Alise are also taking ARVs but Moses is very weak and thus has not been able to work.

All of their four children are girls- something that in African culture is seen as a curse. And if a woman cannot produce a boy for her husband, she is often times abandoned. “Most people will say if you can’t get a boy with this lady, throw her away,” Moses said. “But she’s a good wife. She’s very kind. If she’s not kind, she goes away.”

After leaving their home, we walked back to the Lea Toto clinic. We had to leave early to catch our ride to go to a rural village in Kitui, Kenya three hours from Nairobi.

As we drove away, I was overtaken by guilt because I was getting to leave, because I had a way to get out, because I was eventually going back to an apartment that had electricity, running water, wireless internet, enough food for a week, and money still in my pocket.

Seeing Kibera was by far the most humbling sight I’ve ever witnessed and it made me respect people like Paul and Daniel who witness it day in and day out. I asked them both does it ever get to be too much? Do you feel like your work ever is in vain or that you’re working at a problem that will never be solved in our lifetime?


“It’s not easy for someone to commit themselves to this kind of work. You need to have the heart. Anything that affects these people, affects you. Put yourself in their shoes and there’s your motivation,” Paul said. “The reality is that it’s a big thing to tackle. But even though it’s huge, I ask myself what part can I do to help the hugeness of the problem and then I do my part.”

“The journey of 1,000 miles starts with only one step,” Daniel added.



Paul explained that conquering the HIV epidemic is a slow process because changing someone’s behavior is very difficult. “Behavior change is very slow because it has to come from within,” Paul said. “Because you can give someone a condom, but you can’t follow someone to their bedroom and make sure they use it.”

But Paul and Daniel are committed to trying to teach enough correct knowledge to make a difference. While 6,000 new people are infected with HIV every day, and at least half of those are people living in Africa, there is a stigma against talking about sex, naming certain body parts, or being educated on safe sex. “They live what they learn and they learn what they live so you have to give them appropriate information,” Daniel said. Mobilization and awareness give people no choice but to accept that HIV is a reality. Talking to Daniel and Paul restored my faith in the human race.


Paul encouraged me to encourage the people I’m communicating with back home how important it is to see for yourself what’s happening in places like Kibera.



“It’s very important to give and hear but it’s much better to give, hear, and see what’s happening on the ground because you can then talk to others about what’s truly happening,” he said.

My hope is that I can do just that.