 Good morning to you and thank you so much for tuning in to why in the morning my name is Dareva Hillary. This morning we are looking into matters health and law. We want to see how people living with HIV and tuberculosis, how the treatment is and what are some of the problems they go through. I am joined in studio by a team from the Kenya Legal and Ethic Issues Network on HIV and AIDS as well as MTB. I have Tumothi, Tumothi wa Fulastifinanguva and Vivian Natino are my guests this morning. Keep it Y25 for sending all your comments or questions to all our social media platforms that Y254 channel. My handle is at Moraeni Hillary. Welcome to the program. I want to begin with you Tumothi. Your organization began so many many years ago and it was established in Akragantufakaston creating a country based on network that interests intersect low ethics, human rights and HIV. So the question would be why was this important? Thank you very much. Good morning to all the viewers. So Kelin which is the Kenya Legal and Ethical Issues Network on HIV and AIDS was established in 1994 as you have rightly said that was a time that the issues of HIV had had just a reason. There was a lot of issues. People did not understand many many many many problems that were coming up at that time and so the Kelin was formed as a result of the problems that were arising at that time in relation to HIV and mostly legal and ethical issues. So given that there was a lot of stigma, there was a lot of discrimination and this was giving rise to many legal and ethical challenges that were arising. People living with HIV were being discriminated against, they were being disinherited, they were being aside from their jobs and all those things. People did not understand what HIV was and because of that lack of information it was giving rise to many legal and ethical problems. So Kelin as an organization is an organization that focuses on promoting and protecting the right to health of the vulnerable and the marginalized. So it was formally registered in 2001 and it works across all, it works with to protect the rights of people who are marginalized. People are living with HIV and focuses on promotion of health rights for all the marginalized communities. So as at the moment Kelin works under four areas. It focuses on HIV and TB and this focus on HIV and TB primarily relates to protecting the rights and how do we work around protecting the rights of people who are living with HIV and people are affected by TB mostly by ensuring that the laws and policies that are put in place do not protect the rights, promote the rights and do not infringe on the rights so that we have a sound legal framework in place to ensure that the rights of people are protected. So that's primarily what Kelin does and it also works in other departments. The sexual health and reproductive health rights works on women land and property rights and also works with key and affected populations, key and affected populations in this sense relate to people who are at a higher risk of contracting HIV due to mostly legal social and cultural exclusion that is there and in this case the government and all actors in the HIV field recognize that they are key and vulnerable given that they are excluded from the community especially for example sex workers are men who have sex with men are injecting drug users and other vulnerable populations. We will be getting to those vulnerable population and maybe how you have been able to counter the problems they are going through. I want to come to this statistic that this is the latest Vivian in 2018 1.6 people were living with HIV in Kenya and HIV incidence per 1000 infected the number of new HIV infections among the unaffected population over one year among all people of all ages was 1.02 now HIV prevalence it is believed to have to have the highest percentage of 14.7 percent between the ages of 15 to 49 and 46,000 people were newly infected with HIV back in 2018 by 2018 that is and 25,000 people died from AIDS related illness for the for the period of time that your organization has been operational these are the people 1.6 million people have been those who are having HIV how has the organization advocated for their rights to get treatment because that is one of the things that you do. Okay good morning one of the things that maybe my organization has done is I work under BLAST also and I am under Stop TB partnership and as a BLAST member we what we advocate for is we go to institutions we mostly because when you look at the rate of infection HIV infection amongst us the youths it's very high so mostly we go to the institutions and they resensitize people we can talk to them and we also give out the quantum and before you even give a quantum to a fellow youth some people do not even know how to use the quantum and some may tell you sorry I quote this some may say that we prefer not to use not to eat a sweet with the rapper I'd rather use minus the rapper so we try so much to put them into into a way that they can use it and mostly most of them do not know how to use the CDs and this the F2 the female quantum most women don't prefer using it because it looks like it's so so funny so you have to go to an extent of you have to work with the samples of the models of the vagina thing and you have to sample up on how it is used so basically we talk to the youth we go to the institutions that is in campuses we've got the BLAST campus hard thing that is where we go to most of the schools and we even go to the communities where we go to the border borders people we talk to them also and we tell them we just try to advise them on what precautions that they can take in advance yeah all right steveen how about the TB ah good morning my name is steveen I'm Vashikoli I'm the national coordinator of the network of TB champions in Kenya so why we came up with a network of TB champions is because previously we had people that are affected or living with tuberculosis used to face a lot of violation a lot of stigma silently then Kelvin came up with the case of TB is not a crime where we had a case where people are being put to prison because of having TB but they were not given the correct information so through that process when Kelvin won the case then the government brought in the directive that people with TB are supposed to be protected and are supposed to be supported where they are to treatment so we came up with this network of TB champions whereby every voice of a TB survivor or a TB champion is heard and wherever they are facing any challenge at the grass root level they are raising it up to the national level and we are able to sit and dialogue with a national TB program and tell them these are the gaps and then we are able to break the gaps and ensure that people with TB are treated with dignity the respect and they are given an opportunity to continue with life knowing well that uh TB is just something that when you get it's an airborne disease that all of us are at risk when I cough and I have TB and have not been treated then I'm exposing everybody because our statistics say that one person can affect up to 15 people with tuberculosis so we we brought in the network so that we can create more awareness and ensure that people all over they know about TB that TB is not it's not a disease for the poor it's a disease that can affect anybody children uh young people youths adults and even senior citizens that are above 60 years and TB is treatable and it is curable at a space of six months and somebody that has been affected with TB takes treatment and there's treatment then they are back to their normal life there's no need of stigmatizing people with TB or even uh some of them were being chased away from school uh or from their workplace people are being laid off because they have TB the bosses are saying that eh you might affect us with TB so the network is coming in to to tell even those employers that this person once they have been diagnosed with TB they need this support so that when they are there to treatment and they are well they get back to their duty with TB when you take your medication and you are there to treatment around three weeks you can't spread the bacteria to anybody so there is no need of being laid off or being sent off from school yeah all right so uh Timothy when you came in with the laws and uh that will govern the treatment of this kind of people who have been stigmatized what is that particular one thing that you came up with and you see it has worked because uh like he has mentioned you came into the case of the TB and now people are getting treatment how about the HIV what are some of the laws because stigmatization is there it's only that people don't talk about it but it has been there and it is still there and a lot needs to be done but what are some of the uh policies that you feel if the government maybe uh were lenient on this area then would be speaking of speak of a lesser population with HIV okay thank you very much so one thing that um Kelvin does is um one just trying to sensitize the community about the existing laws and policies that are there and right now as all of us know we have a constitution that guarantees and protects the right to health and article 43 so that is a very good framework that guides all of us that to know that everybody has the right to health everybody needs to obtain health services everybody uh needs to know that they have rights that's that's the starting point um so with relation to HIV one we are starting with the constitution which is um the supreme law in Kenya just to that guarantees us our our rights so under the constitution we have the right to health the right to privacy the right to dignity the right to life and all rights that are guaranteed in the under the constitution then with HIV uh as you rightly said and as they as they have shared there is a lot of there are a lot there are a lot of legal issues and there are a lot of ethical issues uh there's a lot of stigma there's a lot of discrimination that exists there's issues of information and all that so what we do is train and and empower people just to know the rights that they have the laws that the frameworks that protect them and how now they can champion for for their rights so for example with HIV we have the HIV prevention and control act which is a law that exists specifically that addresses issues around HIV so for example uh that um with testing for HIV there must be consent of the person being tested uh the law prohibits discrimination of a person based on HIV status so for example if I need to be employed uh and somebody asks for my HIV status and denies me the job because of my HIV status that's a violation of my right that I cannot be denied education because of my HIV status and this is in the law uh there is the issue of privacy and confidentiality which is the one that now leads to a lot of stigma and discrimination that if if my privacy and confidentiality is breached people know about my status then I will be faced other violations so the law prohibits disclosure of HIV status of a person without their consent and now we when we talk to communities we talk to professionals we tell them that if you disclose if somebody discloses your status without your consent that's a violation of your right and you need to take to take action so that is that that is that so we we and and and um so we know that we have laws in place but the problem at times becomes that people might not be aware one uh people do not have the information and violations continue to exist and people brush them off and and move on as if nothing has happened so that is the reason why for example we work now with uh every other person we work with other organizations the network of TB champions blast just to empower everybody so that we move to the community and empower the community and tell and tell the community tell professionals tell health care workers tell the government that we need if we have to deal with HIV and TB we need to respect rights of people and if we protect and respect rights then we'll encourage more people to come out and get tested more people will be willingly going for medication and will be able to achieve the targets of ending HIV and TB and maybe just to allude to the case that you talked about there was uh there was with TB we know about the infectious nature of TB there is also a lot of stigma and discrimination given that people do not understand uh TB and the reaction was that once a person has TB everybody wants to run away from from them and what uh the measures that were being taken in uh at at at uh previously was that if you do not adhere to medication then you are jailed you are taken to jail that and that is what now we are killing and working in the community and everybody we said that no if a person has uh TB we need to provide support to that person rather than uh criminalize uh the particular person do we know the reason why this person did not adhere to medication do we have we provided support and all that so that's why we took we had the case in court whereby the court declared that uh jailing of TB patients is unconstitutional and they need to provide a proper isolation if the if if circumstances uh if the circumstances allow so they need to provide more support rather than uh penalize or uh become punitive to people who are who have TB or who have HIV just a quick follow-up about the employment if someone is denied a chance because they are HIV positive considering TB is a airborne disease how then if someone has been denied a job opportunity because of their condition or maybe they may be under treatment but still if the employer feels i will not have this kind of a person at this particular time say they are working in an industry where they will the there's a big population who that person be violating their rights yes that person will be violating their rights so one thing we are saying for HIV and TB that these health conditions should not be preconditions for you to to get to get to get into employment so or if i'm in employment then you want to discontinue my employment because of my HIV status that's a clear violation of of the right so with TB you've rightly said that TB is uh is is is airborne and infectious so but we know that there's there's an employment law yeah there's an employment law in place that talks that that gives you the right to get sick leave uh the right to get any other leave that that you need so and properly we know that with TB once you start your medication after two weeks you are no longer infectious so after two weeks you are no longer infectious you can come back to your place of work and continue working such that a person does not need to lose their employment because of their TB status so what we are saying is that we make people not to um not to adhere to medication because they are afraid of even telling the employers that i have TB because they think that if i tell my employer i'll be i'll i'll lose my my job and that is not the right approach the approach should be does the employer have information about TB uh what support is the employer giving to the employee so as to ensure that the employee is able to get their medication so the support given that maybe they can give the employee some time off seek off which is provided for under the law and also just uh when this employee comes in if if it's a it's it's an industrial setting does that industrial setting have proper ventilation does it have what is the support system within that place to ensure that people do not become sick and also those who for example have TB are supported to continue their medication so that is so it's just about having the right information and following due procedure supporting rather than uh that the first reaction being denying rights so the first reaction should be supporting rather than denying rights so that is what we we advocate for mostly uh Steven on on on TB now that he has mentioned uh you can still undergo uh or you can be employed because after two weeks uh you are not you are no longer infectious but also uh which other load you feel or a policy that has been in place and you feel the government should work on this or the stakeholders involved in this particular area they need maybe to stretch this a bit or listen this a bit so just looking at uh thank you very much just looking at what is available and what can be strengthened uh in terms of TB every patient pack the TB patient pack which comes in for the patient to take the for six months it comes in with a with a paper that is called patient charter this patient charter has the rights and responsibilities over specific patient and it is for every person that has been affected with TB once you start TB that paper is inside so uh all patients should be encouraged and should be empowered on that which tells them about their rights and what they should do when their rights have been violated and what are their responsibilities it starts from their information when you give a somebody the correct information then the others becomes correct and then the next level is supporting them to adhere to treatment since you have told them these are your rights these are your responsibilities by doing so you have reduced the chances of people interrupting or default defaulting from treatment and then adherence will be good the other thing is about empowering the community from the grassroots ensuring that even when the government brings in policies or new guidelines we are part and parcel so what the network of TB champions has come in with support from Stop TB partnership and Kelvin is that wherever there is a new policy in regard to TB we are first empowered we give our views and our views are being put in place like when it came when the isolation policy came because there is an isolation policy they came and got the views from the people that are affected with TB because we are the people who know where it hurts or where it pains and we know what is good for the next person that is being diagnosed today with TB we know what we went through and we had TB and we know what is good for anybody that has been affected with TB so our views are well taken care of and when they are being put into the policies we try and act as an oversight and monitor if the implementation is done very well then when there are those gaps maybe there is a maybe violation of those things that are being laid down in the policy then we we knock on the doors of Kelvin to say that here and here it's where we are seeing this gap this is in the policy it's in the constitution it's in the patient charter but there is somebody somewhere that is violating this right maybe it's a health care worker maybe it's an employer maybe it's a teacher anybody can can be violating these rights without knowing so Kelvin comes in and interprets what the law says and how we should implement the other thing that we do as a network we train our communities to we train them and we empower them more on their rights and what they should do so that they don't raise an issue that is not a violation and they don't be quiet when they are being violated for the sake of because they are fearing you know most of our community member they fear that if I'm being violated at this level and I go and I take this to the next level maybe the court session will take me long or the case will or I'll be banished from my community so we empower communities and tell them no we are not going to take somebody to court but we are we are going to ensure that there is proper implementation of these policies and these guidelines so since Kelvin has lawyers that are well equipped with this knowledge they come and empower the communities and at some point they also train health care workers on how they can protect and promote the rights of people if we if we promote the rights and we protect people's rights and we ensure that people are adhering to their treatment then even the TB cases are coming down because people are affected when you don't adhere to treatment high chances of you affecting the next person you have high chances they are almost a hundred percent but when you adhere to your treatment the the risk becomes low so the best place is ensuring that we have better medication policies are there and people are protecting the rights of people then adherence will be smooth All right Vivian we're speaking of young people are the most vulnerable among other groups of people you have been I believe you've been working closely with young people other than telling them how to use of contraceptives like the condoms what other programs do you run and what are some of the laws governing that particular area Okay on what we do basically is when you look at the youths now in Kenya not even in Kenya let me say in the world probably they they don't adhere to medications so they have a lot of problems facing them so we we usually go on one one by one if maybe I know one one individual one individually they'll come to me and I'll get to talk to them so by then I'll hear out their problems and by that I can get to share with the people who are ahead of me maybe I if it's dealing with TB I'll have to look for my head on TB that is top TB partnership and then I'll explain maybe the reason the challenge this person is going through is maybe the person is not adhering well to medication because of A B and C and that I'll be able to talk to maybe Steve and through Steve he can be able to help me and I'll even connect to the person then the person might get help and relating to HIV I might even talk to another head of mine maybe in on the department of HIV then maybe if it's adherence or maybe lack of lack of food or lack of something that is making the fellow person not adhere well we can look into the issue then maybe if I forward the issue if they can handle it I'm only on the basis of maybe I can help I'm not in up I'm not in the best position to help out but at least giving that shoulder to lean on or maybe tell me what the what the problem is I can get it to share it to another person then through that we can be able to help out yeah that will beg the question how do you reach out to these people do they come to you or how do you get to know them we go on the ground I'm I'm on the community so basically the hospitals or oh yeah we we we are also based on the ground as in I can go maybe on this boda boda people you can go talk to them and the charmas we just it's it's for us to decide you to people who are suffering not even people who are suffering okay you know most of the youth lack knowledge so it's me it's me being an advocate it's me to go down to the ground it's not that I know you have TB or I know you have HIV that I have to come to you so that I can give you that knowledge you know I have to go down me myself to come to you and tell you anything so long as even if you're not infected or if you're not infected that knowledge is much more important so through that you'll help tell other people or tell spread the knowledge to other youths then at least they'll get the concept yeah so Timut in terms of law uh there has been a problem with our country accepting uh to pass a bill or the law on LGBT and these are kind of people who are more vulnerable and stigmatized as Kelvin what have you done to ensure that these people are taken care of okay thank you so um when we started I mentioned that Kelvin also has a program that works around key and affected populations so and in this sense um we have programs that target people who are more vulnerable to HIV and we have to also accept the fact that the government itself has recognized in its policies in its strategic plans that we have groups of people who are more vulnerable to HIV and uh so we have sex workers for example we have men who have sex with men we have injecting drug users we have people who are in prison and and and any and and all other people who are vulnerable so first of all the government has accepted that when it comes to HIV the uh the key and affected populations are more vulnerable to HIV and there should be targeted measures towards the uh the the key and affected populations so what Kelvin does one is following the same model um educating people going to the community and doing trainings sensitizations dialogues about the rights so what is the message that we we give out one everybody has the right to health everybody regardless of your sexual orientation regardless of your social status regardless of any other factor article 27 of the constitution talks about equality and freedom from discrimination so you cannot discriminate against any person based on any based on the status rest language sexual orientation health status and all that so that's the starting point that everybody has rights everybody has the right to health so and in this case we are saying that given that the key and affected populations are more vulnerable then we need to have we need to think why are they big why are they more vulnerable what what what is the cause and one thing that has been coming up mostly is around the existing laws and policies that are there that we have populations who have been criminalized and because they have been criminalized then access to services for them becomes more difficult so for example i will use an example for example of a sex worker they we have criminalized sex work then if a sex worker faces violation in the streets they for example are are raped in the streets they fear going to the police station to report because and they have shared we have documentation of this that if they face violence in the streets they fear seeking justice because they think that if i go to a police station i will be arrested because i'm a sex worker and they will not go and report the issue that the violence or the issue that has faced them they are also mocked yes they are mocked and all that so same with lgbti community we have a law that has said that you are criminalized based on your sexual orientation so now we have if the person faces violations they fear accessing services they face violence from the community they when they go to health centers then they face stigma they face discrimination even from health facilities and if a person is facing stigma discrimination and all these social exclusion from the society this person is not able to access services and what happens what's there what's the consequence of that that one means that they are more now because they become more prone to hiv if they have hiv they're not accessing medication and all these issues so that's that that's the messaging that we want we need to relook at the laws these laws what the purpose of these laws are these laws promoting more stigma promoting more discrimination promoting more exclusion and if we are saying that the law there should be no discrimination that all of us are equal and we are free from discrimination what the effect that these laws are having on key and affected populations accessing specifically for example health services if they cannot access health services how are our measures helping to reduce hiv are we if we reduce hiv among for example the general population and then we leave a certain group to have hiv are we helping the society that those are some of the the question so what kelinda's is we have these dialogues we have the trainings we review the laws and policies we provide feedback to the government about the impact that the laws and policies that they have has on the community uh and we try we we've we've even we provide access to to justice so if a person has first violations we are able to take their case to to court and seek justice on their behalf all right we are running out of time and i want us to get the final question and i'm coming to timothy now integrating patients care and prevention in your team what are you doing to ensure that these people now we have the law in place we have people to work with like kelin and you in your organization you're looking to work with these people and ensuring their health has been taken care of what more thing or other things do do to ensure that now with the law and the people affected we are going to achieve our target okay what we do as the network they have the structures that we have we the network is for all kenyans and especially people that are affected with tb so we have people in counties that go and create awareness in health facilities and empower patients people that are currently on treatment by telling them do you know these your medication you should take it for this time you should adhere and this is a path that is called then we have the patient charter we empower them more on patient charter and how they can report so that they know if i face any violation i know how to report it so when we integrate that and we ensure that even the health care workers they know that these are the people's rights and these are how we can support the people who are there to treatment then they are even them themselves that used to used to violate their rights using the public health that now they are they are able to say oh kumbe we have been violating these rights so we will now reduce the violation so we start from creating awareness at the ground then whenever there is any any issue that raises we are able to tackle it from the national tb program we are able to link up with the tb program all right yeah okay uh we are out of time yes just to add on what we are saying as youth uh they are they support groups that help bring up the youths together whereby they speak out whatever they are going through and all the challenges they are going through and mostly in facilities they can say the facility that i am a peer mentor in is in koptik that is gongredi and we have these friendly youth peer mentors whereby we we go there then maybe if there is a youth who has a problem and he or she cannot face be able to face that older person who is a counselor he can come to us or she can come to us and talk to us as a peer mentor then we can be able to maybe if we cannot help to solve that thing at that particular time we forward it to the now to the counselor all right yeah okay uh steven and viven you will allow me to give this chance to timodi to give us the final remarks because we are out of time what will be your final recommendation sir okay um so thank you very much for hosting us and our final remarks will be around the issues of just the community knowing first of all understanding that we have the right to health uh we have rights and um we need to understand the issues we do not we should not stigmatize we should not discriminate against we should not violate the rights of other people that are in the community that we will be able to uh eradicate we will be able to deal with hiv and eradicate tb if we provide more support rather than uh stigmatize or discriminate against people and we have so many programs we have so many organizations that you can go to to get uh information to get support and and and all and all these issues so yeah that's mine that we need to provide more love uh to people who are affected by tb and hiv rather than stigmatize and discriminate against them uh in accessing services all right i i see you have a pressing issue and okay thank you very much i just wanted to remind our viewers that we celebrate world tb day on every 24th march and this year's slogan or theme is it's time for free tb kenya so mulika tb maliza tb all right so i think i would have left that very important information my apologies thank you so much for keeping us company value be up next uh with a nutrition they have been my guest atimodi wafu la viven nanyango and steven wavunga uh decade anguva thank you so much for keeping us company my name is edereva hilary now you know the rights governing treatment of ita v and tuberculosis be aware and maybe share the information with the rest uh out there see you in a bit goodbye