When Mary Muli and her husband failed to conceive a child, they followed the long-held tradition among the Kemba in Kenya's Eastern Province and brought another woman into their home to bear children for them.
"We were married for 30 years when we realised we would die without children," Muli, 60, told IRIN/PlusNews from her home in Kitui District. "I brought Teresia to bear us children and to one day remain behind when we are all gone."
The four children Teresia Nthenya, now aged 38, bore for the couple are considered to be Muli's. "She is my property and my husband's duty was only to bear children with her," Muli said.
Although the arrangement is considered successful because of the children, it has had disastrous consequences: Nthenya is HIV positive, while Muli's husband died 18 months ago from tuberculosis, a common opportunistic infection associated with HIV. Muli herself coughs constantly, but brushes it off as nothing more than a symptom of old age.
"I used to sleep with him and he also slept with his real wife; we used no condoms," Nthenya said. "I am HIV positive and I know I got it here, from the man."
|I brought Teresia to bear us children and to one day remain behind when we are all gone|
According to Dr John Lugedi, the Kitui District medical officer, the tradition of surrogate wives is a significant contributor to the spread of HIV in the area.
"The risks of this kind of culture are very high because the people involved do not use condoms," he said. "Men do not want to believe that it may be them with the [infertility] problem and they keep on [trying to have children with different women] hoping to be lucky some day. What you have is a chain of infected people in the process."
He noted that the high levels of poverty in Kitui, where more than 60 percent of the population lives on less than US$1 per day, had allowed the practice to flourish. Women become child bearers, he explained, because they know that as long as they bear children, their basic needs will be met by the family they live with. "When you let poverty mingle with such risky cultures, the result can be very devastating in the war against HIV/AIDS," Lugedi added.
"Most of the widows and orphans that we support in the district are from this kind of marriage arrangement," said Liz Mwendwa, coordinator of a local NGO, Arms of Hope. "There is a need to concentrate awareness on the eradication of this practice or to look at safer ways of doing it, but I think it would be a daunting task to encourage condom use when the end goal is to have children."
Although the HIV prevalence rate in Kitui of 3.9 percent is lower than the national average of 7.4 percent, the risk factors for HIV are high. Poverty and food shortages can drive women into commercial sex work, and the region's arid climate forces many men to spend long periods away from home as migrant labour.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions