Drought, poverty forcing young women into risky commercial sex

As night falls in Makindu, a truck stop on the highway between the capital, Nairobi, and the port city of Mombasa, the fluorescent lights and blaring music of the bars and lodges signal the start of yet another evening of brisk business. "Every week I drive from Tororo [eastern Uganda] to Mombasa and back. I stay in about four towns each way - I have a regular lodge in each one," said Masaba [not his real name], sipping his beer. Towns along the Nairobi-Mombasa highway, like Makindu in the Makueni district of eastern Kenya, have experienced a mini-boom, while their rural surroundings languish in poverty. The ongoing drought that has left hundreds of thousands in eastern Kenya facing severe food shortages has driven many rural people into these towns in search of work and food. Children are sent from deep within the interior to the roadside to sell honey and homemade crafts. In an even more disturbing trend, parents have resorted to sending their young daughters into the towns to trade their bodies for money to feed their families. A RISKY TRADE "Because food reserves have run out and mothers can no longer afford to feed their children, many decide that the only way out is to 'go to the street'," said Iris Krebber, regional coordinator of the NGO, German Agro Action. "Many times, the girls are as young as twelve." They find a ready market in towns like Makindu, where truckers welcome their company in the bars and in their beds. The result of this potent mix of sex with multiple partners and excessive alcohol consumption is that Makindu has an HIV prevalence rate almost double that of the general population in the district. "The prevalence here is 11 percent, compared to about six percent in Makueni district," said Dr Richard Onkware, the head of medical services at the government's Makindu Hospital. "We attribute this to the town being on the highway and the large number of truck drivers and commercial sex workers here." Onkware said the drought, which had deepened over the past two years, had exacerbated the problem of young women coming from their villages to engage in commercial sex work. "I came to town four years ago - I was 17," said Alison [not her real name], a commercial sex worker who only agreed to be interviewed under cover of darkness. "When I finished primary school my parents had no more money to send me to secondary school, and said I was old enough to fend for myself." She works four nights a week on average, charging as little as 100 Kenya shillings (US $1.40) per customer, having sex with up to seven men a night. Alison said she never had sex without a condom, although some men were willing to pay up to ten times the usual price. Asked whether she had ever visited one of the town's voluntary counselling and testing (VCT) centres for an HIV test, she laughed shyly and shook her head. "I am too scared, I would rather not know my HIV status," she said. Alison knows the risk - she contracted gonorrhoea two years ago - but feels she has no choice. It is simply "bad luck" when a condom breaks. She said she enjoyed drinking in the bars with the men, and admitted that it was always harder to insist on a condom when she was drunk. Many girls, she said, were raped after a few drinks. "I have to eat, and I'm not qualified to do anything else," she pointed out. "I would quit if I had enough money to open a shop, or if I had a man to look after me." A camaraderie of sorts has grown between some truckers and commercial sex workers. "When I come here, I always come to the same bar, I call my girl and we have a few beers and some food together before going to my lodge," said Kalule [not his real name]. "I get up in the morning and continue my journey, but I leave her with some money to buy a few things till the next time I'm in town." Kalule - who has two official wives and several children - said he knew she had sexual relations other men, but felt safe because he wore a condom every time they had sex. A Ministry of Health survey in 2005, 'AIDS in Kenya: Trends, Interventions and Impact', found that men who slept away from home more than five days a month had an HIV prevalence rate three times higher than those who slept away from home for five or fewer nights. MOONLIGHT VCT Makindu has three VCT centres, two of which offer mobile as well as on-site counselling and testing, but the fear of being stigmatised keeps people away from the centres in town. "At the VCT centre at the hospital we may get only about three people per day coming for testing," Onkware said. "This is a small community, and they are scared that the hospital personnel will spread the word about their status." People actively discriminate against commercial sex workers, so the stigma is even greater; truck drivers are rarely in the town during the day, as they usually arrive at night and leave early in the morning. In an effort to reach these high-risk groups, one of Makindu's VCT centres, 'Chagua Maisha' (Choose Life), runs a 'moonlight VCT' service, visiting bars and nightclubs in highway towns at night, holding counselling sessions, offering tests and handing out condoms. "We cannot escape the reality of the activity that goes on in our town - we must reach those high transmission areas like bars and clubs," said Andrew, a VCT counsellor at the centre. "We are now considering getting one of their own [commercial sex workers] to join our team, so the message can really hit home." Despite high attendance at the sessions, he said, it was difficult to tell whether they were having any effect. Alison said she had been to several of them but was still reluctant to be tested. According to Onkware, "What we need is an integrated approach that deals with the core problems of poverty and drought so that we can, first and foremost, get these girls off the streets."