The Death of a Village

Slow, painful and costly …
Ken Opala reports on how HIV/Aids threatens to wipe out a small town on the main highway linking Kenya with the rest of eastern and central Africa.

AS the big, heavy-load trucks approach this hilly hamlet, they move at an inordinately slow speed, almost 5km/hr. Salama trading centre, an hour’s drive from Nairobi, the Kenyan capital, is ringed by kiima kiu (black mountain, in the local Kamba dialect).
Teenage girls, some as young as 13, giggle on seeing the 20-wheel trucks lumber to their parking, their teeth glistening in the red light of the fading 6.30pm sun. The girls have just woken up to face a typical day, the Salama nightlife.
A good number of them have wrapped shukas around their lean waists, and most are dressed like schoolgirls in their Sunday best. But on Sunday, when all roads lead to the church as usual, they are asleep, smarting from exhaustion from Saturday’s outing, having sold their flesh to the truck drivers.
Like the speed at which the
trucks move, Salama is a town
in a slow, gradual death, the same pace at which the HIV assaults the body, killing the last defence and pushing the victim into a gradual slow-puncture-like decease.
At this time when Kenya is grappling with the HIV/Aids epidemic, the Biosafety News brings you the inside story behind the ruin and fall of a town once central to the country’s development but now edging towards the grave. It is a story about a “safe” town on the brink of a holocaust. (Ironically, salama is the kiswahili word for “safe”).
It is about corruption; how anti-Aids authorities neglected a hotspot because they never received kickbacks from area community-based organizations. As the evening approaches and the sky darkens, the spectre of death visits Salama and the black mountain closes in on the town.
Already, the holocaust threatens to reduce the continent’s life expectancy by 20 years, from 64 to 44 years. In fact, Aids has reduced average life expectancy in Zambia by about 20 years, from 56 to 37, according to the US Census Bureau).
In 1983, less than a million Africans were infected, and 10 years later an estimated 11 million had succumbed to the virus. In the last 20 years, about 30 million sub-Saharan Africans have been infected, while 14 million have already died from related complications.
By 1999, Africa had 12.4 million children orphaned by Aids. Zambia has the highest concentration as by 1999, more than half of all Zambian children had lost at least a parent.
Two months ago, Kenya’s President Mwai Kibaki said: “Africa is home to only 10 per cent of the world’s population and yet more than 70 per cent of the people living with HIV/Aids live in Africa. Clearly the burden of this menace is a major economic and social burden on our continent.”
But in Salama, policy statements hardly make sense. Life continues. And the disease spreads like bushfire. Most referrals to the Baptist church clinic are for sexually transmitted diseases, says the clinic’s assistant administrator.
On the outskirts of Salama is a village called Tangu that has a population of 600 in about 120 households. And Aids, one way or the other, has hit every home. There is at least a burial every week. “If things don’t change, the village will be wiped out in just three years,” says David Ndavi, deputy secretary of the Salama Development Women’s Group.
“Many people have died in the village. We used to record like 30 deaths in a few months,” says Kavoo Ndeti, the village manager (elder). He cannot give exact figures of those who have died of Aids, but but he says the first death linked to the disease occurred in 1988.
One of the families has lost six members – the father, the mother and the son and his wife and their two children. The local police station, only uplifted recently from a post, has lost about five officers in barely a year, among them a former head of the station.
Like a caged animal intent on breaking out of the zoo to attack its prey, Aids is now pulling out of its shell in Salama town and looking for an outside target. The neighbouring rural areas have started reporting deaths related to HIV/Aids, say medics.
I was intent on depicting the magnitude of the problem by identifying victims in each home. But it was a difficult task, a mission impossible. Salama is in self-denial.
No family confirms Aids-related deaths. Indeed, in Salama nobody has “officially” died of Aids. None of the four clinics here has any Aids/HIV testing kit, implying that even the opportunistic diseases that have claimed several hundred lives can hardly be linked to the deadly virus. No local non-governmental organization has received any funding from the state department, the National Aids Control Council, to carry out Aids-related work in Salama.
Instead, witchcraft claims have been let to explain the unusually high mortality among adults. “People are being taken to Kitui to be exorcised,” says Lens Inyangu. Kenya is full of myths about the potential of Kitui district witches in expelling evil spirits.
In a place with no medical facilities, proving that a death was caused by HIV and not witchcraft is a delicate undertaking.
“The hospital got test kit from friends in Tennessee, US, last week. We are yet to put things together to be able to start using it,” says Inyangu. This is the only public hospital, albeit the largest, in the area, the rest are private clinics. “I can see our people are dying,” he adds.
Up to 100 trucks dock here every night. Only the drivers and the turn-boys disembark, the bounty remains on load. But the drivers carry with them something deadly. Locals call it the “big one”, meaning Aids. Others merely call it “slim”, in apparent reference to the wasting away associated with the disease.
Girls from the hilly countryside, stricken by poverty, trek to this hilly hamlet to eke out a living. They sleep with the drivers and turn-boys for as little as $0.6 a night, enough money to purchase a packet of milk and a loaf of bread.
“I know it is dangerous not to use a condom, but what do I do? It is the man who has the choice. I can only up my price if he does not want to use a condom,” says Esther Mueni, a not so shy 19-year-old forced out of school by pregnancy. “Even if they use it, some malicious people even prick a hole in the condom, how will you tell if you are safe?”
“Sometime I make US$7 in a night, sometime it is only beer that I get,” she says, shrugging away, her lips tightening without much effort, as if in disgust. “It is not the kind of money that one can do good work with.”
The business that powers and fuels Salama can hardly be translated into investment. Here, sex is uncontrolled, excessive, dangerous and deadly. And of course, it is so cheap that it becomes a mere pastime, a hobby for the truck drivers and turn-boys.
The highway divides Salama into two. On the southern or eastern part is a concentration of beer holes, about a bar in every two buildings. Yet, almost every building is a lodging place accommodating about 300 drivers and turn-boys who check in at around 5pm and leave 12 hours later. Ndavi says the town has 700 lodging units.
Interestingly, Salama is a ghost town during the day; only a handful of traders – shopkeepers, bicycle repairers and street boys. It is at about 4pm that it starts to bubble.
Salama was only a few shops until the Sudan and the Great Lakes Region – DR Congo, Rwanda and Burundi – erupted into civil conflicts that triggered off massive humanitarian interventions. Everyday, trucks with the label of the Red Cross and the International Committee of the Red Crescent (ICRC) transported thousands of tonnes of relief food and medicines to these troubled areas.
Somehow, Salama became a stopover for the trucks when, several years ago, the then President Daniel Moi outlawed night driving for trucks because of their involvement in accidents on Mombasa-Nairobi Highway. Fears over safety were even reinforced further by highway pirates who preyed on the trucks as they lumbered slowly upslope.
By early 1990s, Salama had grown, big drinking joints and lodging and boarding houses mushroomed from what was initially empty bush. Today, the most magnificent buildings by the town’s standards are the bars and the lodges.
Then it stopped growing. Sex took over, and a town known for agricultural produce gave way to this age-old trade. Hundreds of women and men dumped their hoes, forsook their farmlands and went for what Salama knows best.
Yet, with tragic irony, it is sex that has put the death sentence to this small town of 1,000 people that developed 40 years ago to cater for the needs of workers constructing the main highway linking Kenya to Central Africa. This is what has been called the killer road.
Almost 300km away, just after Nakuru town and before the Kericho junction, is another town being pushed to the grave by Aids.
Salgaa hardly features on the Kenyan map, but it is a notorious point for the transmission of the deadly virus in eastern and central Africa. A town that is younger than Aids, having started only in 1990 as a small trading centre, has expanded so fast it is now home to about 2,500 people and attracts nearly 400 prostitutes each night, who prey on truck drivers and turn-boys, flaunting their flesh for as little as US$1.
For Aids workers, the name Salgaa evokes poignant feelings. Close to 40 per cent of the population is HIV-positive, according to Dr Kenneth Chemjor, who runs a private clinic here, Afya Njema Medical Clinic and Lab. Afya njema translates to “good health” in Swahili.
Yet, Salgaa is a whorehouse. Journalist Kevin Toolis once described this town in London’s The Guardian two years ago: “The entire town is built around the sex trade.” It has more than 300 prostitutes and 25 bars: about one bar for every 100 people, and a prostitute for every 10 people.
In the evenings, hearses draped in red ribbons turn off the highway into the spaced enough to accommodate trucks that fill it, making a walking-by task for pedestrians. Nobody cares. Nobody looks at the sight of the cortege. They have seen so many of them that it is not unusual anymore.
“There are many sex workers, some coming from Nakuru and others from the countryside’s farms around,” says a worker at New Paradise Hotel. He has only been here for a month but what he has seen is enough to give him a real picture of a sex paradise.
“Salgaa is bad,” says Dr Chemjor. “There is a lot of promiscuity.” Like Salama, Salgaa has no voluntary testing and counseling centre, popularly known as VCT. The clinics pronounce they have laboratories, but in fact, none of them has any. The clinics are dingy rooms hurriedly converted into dispensaries to cash in on increasing cases of sexually transmitted infections.
The case of Salgaa and Salama is a crude indictment on the performance of Kenya’s health infrastructure. Why VCTs have not been set up in two of Kenya’s top black spots for HIV/Aids baffles many.
At another level, it brings out the fraud in the anti-Aids battle. According to other reports, NGOs and CBOs have pocketed millions earmarked for anti-HIV/Aids programmes. Some of this money would have gone into establishing the VCT clinics in Aids hotspots countrywide.
In other parts of the country, attention to VCT has seen change in attitude although officials say not many people have gone for the free counselling and testing. By last month, only 142,000 people – out of an estimated 2 million infected—had gone for testing countrywide.
“VCT is a powerful weapon against the spread of HIV/Aids. VCT is a key entry point for needed medical, psychological, social, and legal interventions for HIV-positive Kenyans and their families,” says the USAID website. The agency sponsors the VCT project in Kenya.
At Salama, Ndavi takes me to places where he feels people have died of Aids. “Several hundreds”, he says, but he is not sure since none of them came out to announce their status before they died.
This is why it becomes difficult to isolate the sick from the healthy. The fight against Aids is far from being won. In Salgaa and Salama, many do not know their status because of lack of blood testing equipment. Without knowing their status, the drivers and sex workers are obliviously donating a virus that threatens to wipe out humanity.
During the day, the black mountain stares at Salama menacingly. All souls are aware of its existence because they can see it, feel it. However, at night, darkness cloaks the mountain, shielding it from view and therefore making it difficult for visitors to know about the its existence.
And this is how the virus spreads in Salama and Salgaa. The locals, sex the workers and the truck drivers know about Aids but at night, they deliberately forget about it. The danger of HIV/Aids is immediately moved to the back of the mind, and caution is thrown out to the wind.
The smell of sex, easy money, roast meat and alcohol conspire to blank reason and caution.
And the soul of the town fades, leaving behind buildings without occupants. It is a tragedy of unequal proportion.