Delivering condoms by camel-back

From IRIN, a story about a unique way of bringing condoms to remote Kenyan nomads.

In the remote and rural district of Samburu, northern Kenya, where paved roads are scarce and motorised transport hard to come by, reaching the mostly pastoralist and nomadic inhabitants with HIV/AIDS services requires an unusual approach.

John Lokolale, 21, a Samburu Moran (warrior), said he did not know what the word condom meant until recently. "Now I know a condom because I have seen it," he told IRIN/PlusNews. "These days, when I get a girl I tell her I will use a condom because I have a stock in my house. They brought it here with a camel, and I kept many for myself."

The Nomadic Communities Trust (NCT), a community-based health services organization, started using camels to reach the Samburu people with mobile clinics in 2006.

"We realized we had to be innovative ... and we looked around; we are glad camels have come in handy in [delivering] not only condoms but also drugs and other reproductive health services," said Rose Kimanzi, an NCT field coordinator.

The camel clinics offer family planning services, antenatal care, palliative care, HIV testing and condoms. NCT has trained 45 local people to provide information about HIV and condoms and they have so far reached more than 68,000 people.

According to the 2007 Kenya AIDS Indicator Survey, Samburu district has an HIV prevalence of 6.1 percent, slightly lower than the national average of 7.4 percent.

"When people come to places where we have set up camp they can receive all the services," said Kimanzi. "We have witnessed comparatively wide acceptance of condom use and family planning services."

Michael Lol'ngojine, a community health worker trained by the NCT project to provide HIV counselling and testing services in Samburu, said people in the area had gradually changed their attitudes.

"When I started working here [five years ago], you couldn't mention the word condom, or even tell people about family planning; telling them to test for HIV was like an insult," he told IRIN/PlusNews.

"Today I am happy because they now seek services ... When they see the camels, they come along because they appreciate the need to test and they appreciate the need to use condoms," Lol'ngojine said.

"Here people still believe in traditional medicines, and if you don't test them for HIV ... even those who are ailing from HIV-related diseases will just seek herbal treatment."

Kimanzi noted that high levels of poverty, illiteracy and cultural practices like polygamy and early marriage have led to high levels of HIV infection among the Samburu and other nomadic communities in the region, where around 60 percent of the people live on less than a dollar a day.

"Poverty makes many parents marry off their daughters early, putting them at risk [of HIV]. Many of these young girls are married off to men who are already in polygamous unions, and when you mix that with illiteracy, then the situation becomes difficult."

Besides these cultural practices, "Tribal conflicts amongst the Samburu and Pokot [a rival pastoralist group] have hindered the provision of health services, including HIV/AIDS services," Kimanzi said. The two communities carry out frequent cattle raids against each other.

The government struggled to bring HIV/AIDS services to the people, said Dofa Abdi, Samburu District HIV/AIDS and STI (sexually transmitted infection) Coordinator.

"We appreciate any efforts to offer HIV prevention services to nomadic communities here because they do not visit health facilities, nor is it easy to get to them since most government services are static."