Roadside clinics tackling HIV on highway

The North Star Alliance has been establishing clinics along major transport hubs to provide sex education, HIV counselling and testing and treatment of sexually transmitted infections. The result has been well-informed truck drivers who share HIV prevention and healthy living messages as they travel, writes NJOKI CHEGEEvery week, Mercy Wambui, 22, visits a certain roadside wellness clinic in Mai Mahiu for free condoms and VCT services. For the past five years, Mercy has been a commercial sex worker in Mai Mahiu, a major transport hub along the Nairobi-Naivasha highway. The town, like many others in the transport corridors, has been a hotspot for HIV and Aids.The wellness clinic Mercy attends is one among seven other drop-in roadside wellness centres established by the North Star Alliance in Kenya. Formed in 2006, North Star Alliance wanted to create awareness on the toll of HIV and Aids along the transport corridors. They set up their first roadside wellness clinic on the Mwanza border crossing between Malawi and Mozambique and its success triggered many other clinics in the African transport corridors. In Kenya, North Star Alliance has seven wellness clinics situated at major border crossings and truck stops — in Burnt Forest, Mai Mahiu North, Mlolongo, Mombasa, Namanga, Emali and Salgaa. The Mombasa clinic was the first to be set up in Kenya in 2009. The clinics provide sexual health education, HIV counselling and testing and treatment of sexually transmitted infections, specifically for long-distance truck drivers and the communities with which they interact directly, including sex workers. The clinics also provide basic health services and referrals to local health facilities. The alliance aims to create a cadre of well-informed truck drivers who are knowledgeable about HIV and STIs (sexually transmitted infections) so that they share HIV prevention and healthy living messages as they travel.Eva Mwai, the North Star Alliance General Manager for the East African Region, says these services have elicited a positive response from the beneficiaries. "Today, the commercial sex workers are more vocal, informed and empowered about HIV prevention measures. Some sex workers even volunteer at the clinics when they are not working," says Eva.However, as she points out, visiting the centres is not easy for these women as they have to contend with stigma."Stigmatisation is a big challenge for the sex workers and for us because some may fear being seen near the clinics seeking knowledge on HIV and Aids," Eva adds.Her sentiments are echoed by Alice Wairimu a commercial sex worker, who has to lie to her four children that she is a waitress at a local hotel, to account for the nights she spends outside their home. "My husband left me two years ago. How could I single-handedly feed, clothe and educate four children? I don’t like this job, but I have to fend for them. I lie to them so that they won’t ask too many questions," Alice says.Venting frustrationBut that is not all. Rape, gender-based violence, police harassment, poor pay and the biting cold are common in their line of work. "One day, I met a client; we agreed on the terms and payment before we spent the night together. However, after the business, he slapped me hard across the face when I asked him for my money. He beat me up, stole my mobile phone, confiscated my clothes and shoes…. I had to run away in the dark stark naked," says Mercy, who has a five-year-old son to fend for.On a good day, the commercial sex workers will pocket at least Sh800, but on a bad day some go home empty-handed even after servicing several clients who won’t pay. The sex workers line up along several streets in Mai Mahiu for the clients to sample and choose ‘their type’.With the emergence of the roadside wellness clinics, the sex workers have found a place to vent their frustrations as they share their pain and struggles with the clinic staff.Lucy Wanjiru, a ‘social mobiliser’ and staff member of the Mai Mahiu clinic is upbeat that the clinics are able to meet the health care needs of the commercial sex workers. "The commercial sex workers have a positive attitude towards the initiative. They stream in daily for free condoms and free sexual health advice. They also share their fears with us; I now understand them better. The better I understand their reality, the better North Star can meet their health care needs," Lucy says.While the commercial sex workers are receptive towards this initiative, some of the truck drivers are jittery about visiting the clinics. "The drivers go to the clinics in the dead of the night when the rest of the world is asleep. Some might even refuse to visit the clinic when you suggest it to them," claims Mercy.PartnershipsOliver Simiyu, the North Star clinical officer at the Mai Mahiu clinic affirms this."The most popular need is that of free VCT services and condoms. However, some truck drivers don’t realise the importance of knowing their HIV status and are in such a hurry to leave. I take the time to explain the basics to them and hope that in the future they decide to get tested," says Oliver.The clinic is open until midnight, giving the people enough time to visit.The core partners of North Star Alliance include: The International Transport Workers’ Federation (ITF), UNAids, ORTEC NV, TNT NV and the World Food Programme with support from the Ministry of Foreign Affairs of The Netherlands. The East African region has also received support from USAID and the Embassy of Japan in Kenya. North Star Alliance is also in partnership with national organs set aside to deal with mobile populations and vulnerable groups and transport companies."The synergy is amazing. North Star’s approach has always been to work with and through partners across sectors to ensure the greatest impact," says Eva. North Star Alliance also works with stakeholders in the transport sectors to identify HIV and Aids hotspots along major transport corridors."Our ultimate goal is to strengthen HIV and Aids awareness in the mobile populations and the transport corridors communities," Eva concludes.

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