from All Africa
By Geofrey Kamadi
Rina Awinja, her 5-month-old baby, Stanley Lumumba, and her husband, George Oyange, are HIV-positive.
The young family depends on Lea Toto, an organisation that takes care of orphaned and vulnerable (OVC) children, providing both nutritional and ARV support.
For the past few months, life has been particularly rough for the family, which lives in Nairobi's Kangemi slum. The assistance from Lea Toto has now become inadequate due to rising food prices.
"Lea Toto is a great help to us, but we are required to cook the food, which has meant that an alternative income source is required," says Awinja.
Paul Mulongo, an administrator at the centre, explains that nutrition assistance was initiated at the centre as an HIV intervention strategy to supplement what these families already had.
"However, the situation has deteriorated so much so that these families do not have any other food alternatives. They are now relying on whatever we give them, because this is the only food they have," observes Mulongo.
As a result, a new trend is emerging in the slums. It has been noticed other HIV-negative family members are now moving in with the HIV-positive families to benefit from the free food.
"Relatives have been moving into the HIV-positive families solely because of the food rations," says Keziah Mathei, a nutritionist at Lea Toto.
According to Mathei, not only has the number of family members increased, but new HIV-positive families are coming out in the open to enrol with the centre in large numbers.
"Our resources are now stretched beyond the limit," says Mulongo.
Rose Makungu, a single mother to two and a half year old Christabel Kamayo, attests to this growing trend among families with a HIV-positive member.
Her situation was so dire that she was compelled to physically chase away some relatives whom she caught helping themselves to the little food she had been given at the centre.
"This was not right. I and my little girl are ailing, yet relatives could not appreciate my situation," says Makungu, who earns a living washing clothes in Kangemi. Her daughter receives a daily dose of ARVs.
According to Mary Njoki, the nutrition programme manager at the National Aids & STI Control Programme (NASCOP), inadequate nutrition can be detrimental to an HIV-positive person especially a child.
"Nutrition demand for children is greater than those for adults because they require more kilocalories per kilogramme body weight due to their higher basal metabolic rate (the rate when asleep or resting)," says Njoki.
She adds that for an HIV-positive adult, who is in the third stage of infection (when opportunistic diseases begin to attack), for instance, the energy requirement increases 30 per cent compared with 50 per cent for a child.
Even though a breastfeeding programme is provided at the centre, this too is being overwhelmed.
"There are just too many cases coming in. In as much as we encourage breastfeeding, as long as the mother is not feeding properly, it poses risk for the child," says Mulongo.
Njoki concurs: "The viral load in the mother goes up and the CD4 cell count drops, hence the danger of transmitting the virus to a HIV-negative child." She adds that the viral load increases due to cross-transmission from the mother in the case of a suckling HIV-positive baby.
Lea Toto has six centres in Nairobi located in Kangemi, Kawangware, Kibera, the Mukuru slums, Dandora and Kariobangi.
The centre has been working closely with the World Food Programme since 2005. The world body provides a fixed amount of food to be offered to families. But not all clients in the programme are on food rations.
There are 2,591 HIV-positive children in the six centres in Nairobi with the exception of the Nyumbani Orphanage and another centre in Kitui.
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