Liverpool Volunteer Community Training

As I promised, more about LVCT...this organization is dedicated to health care focused on HIV/AIDS. At their main clinic in Nairobi, they presently have 11,000 people they are following, the majority of which are on ARVs (anti-retroviral medications). A huge part of their work is via their home-based program, which targets areas which are at particularly high-risk for the transmission of the virus...areas in which people are poor and often poorly-educated.

First, the agency identifies such an area. Then- because, in Kenya, health is not an individual issue but a community and family issue- they make contact with key people in the community known as the gatekeepers or the elders to explain the program and what they hope to be doing. Gaining the trust and support of these individuals is a very important first step. Next, they contact the community health workers, who are chosen in each area by the people of the community itself. These folks are they trained by LVCT and following the training, door-to-door mobiizations begin. The community health workers do the "bookings" and direct the counsellors to the correct houses, where testing and education is then done in the home.

Being home-based has several advantages. Since these people are mostly poor, transportation is a problem and with this program, the services come to them. Also, there is still, in many communities, a great deal of stigma attached to HIV/AIDS and in this way, with so many homes being visited (the goal is 80%), it is not obvious just who might be testing positive. When the results are available, another visit is made. If negative, a risk-assessment is done to determine if this person needs further follow-up. If positive, a second test is done in one month with a second positive resulting in a referral to a community clinic for treatment. LVCT continues with follow-up for 3 months, but further follow-up is then left in the hands of the treating facility.

The particular challanges being faced by this program are:
    -the gap between knowledge/information and behaviors
    -the prevalence of multiple concurrent relationships, quite
          acceptable in Kenyan society
    -the problem with disclosure when one partner is positive and
          the other is not

We'll be heading into the Kanuku slum with  health team on July 19th, so you'll be hearing more about this work in the future.
Nzuri mchana, rafiki. (Good afternoon, friends.)