When mystery ‘sex disease’ came to Kenya

By JAMES MWANGI

One would hardly expect Karura Forest to be associated with the history of HIV and Aids in Kenya.

But one day in March 1985, a distraught man waded into the copious greenery, clutching a pen and a piece of paper. He had meticulously planned his death after confirming he had Aids, which is caused by HIV.

At that time, contracting HIV was viewed as a direct death sentence. Newspapers called it the sex disease, and with it came fear, shame and disgrace.

When police carried the man’s body from the forest on March 14, it had partly decomposed.

“Because of Aids, goodbye my lovely wife and everybody,” he had written in a crumpled suicide note found beside his body. So profound was the discovery of the body that it made the front-page headlines the following day.

It was probably the first suicide case as a result of Aids that was reported by the media.

This was a few months since the first HIV and Aids case had been confirmed in Kenya.

Three months earlier, on January 15, 1985, The Standard carried this headline: ‘Killer sex disease in Kenya.’

The story said “the dreaded sex disease, Aids, has claimed its first victim in Kenya. A 34-year-old Ugandan journalist died from the disease on May 8 last year”. The article cited a report in the East African Medical Journal.

The article said the disease “affects homosexuals and it is not known why” but it could be transmitted to heterosexuals, the paper said. It was now spreading in Nairobi and at the Coast.

Three days later, another newspaper headline: “Horror sex disease in Kakamega”.

People spoke in whispers. Media reported about a strange disease  that had ravaged distant lands.  It had killed a child in Britain, a mother in Australia had infected her baby, and it could be eliminated by cats.

But now, the Acquired Immune Deficiency Syndrome was in Kenya. The news spread panic. If a person was found to have it, it made headline news. Scared patients committed suicide rather than face the shame that came with the disease, which was said to afflict people of low moral standing and prostitutes.

It was an era of fear, death, anguish, uncertainty and confusion. Doctors and researchers did not understand it. They attended to patients wearing masks and gloves. Around the world, pathologists declined to handle bodies of people who had died of Aids-related complications.

Joe Muriuki, the first Kenyan to go public about his HIV status recalls the stigma thus: “Doctors would tell us to go and prepare our wills and bid goodbye to our relatives and families. Nobody would give you hope of living past three months after testing positive. It was disheartening.”

Muriuki declared his condition publicly in 1989, when aged 28.

 “After revealing my status many people started avoiding me. If I boarded a matatu they would disembark immediately. When I entered a hotel, they would leave right away.”

In some quarters Aids was believed to be a curse and others coined awful names to refer to the disease and victims. It was referred to as ‘Mdudu’, ‘kifo’ and similar stigmatising names. The Kikuyus called it ‘mukingo’ - the disease of the long neck. This is derived from the emaciation effects of the disease which made one appear to have a long, slender neck.

The first case was discovered in 1984 and between 1983 and 1985, 26 cases had been reported, largely affecting sex workers.  A HIV prevalence rate of 59 per cent amongst a group of sex workers in Nairobi was reported in 1985. A National Aids Committee was established marking, the beginning of a long battle against the epidemic, one occassioned by numerous hiccups.

Towards the end of 1986 there was an average of four new AIDS cases being reported to the World Health Organisation each month. This came to 286 cases by the beginning of 1987, of which 38 people had died.

Three decades later, Aids-related illnesses have killed hundreds of thousands of people in Kenya and claimed over 25 million lives globally. The syndrome spread rapidly, and there are about 1.6 million people infected in Kenya today.

Muriuki notes that misconceptions about those who died from Aids were deeply entrenched and sometimes the provincial administration would supervise their burials. Relatives were kept at a distance, away from the coffin.

This dissuaded many people from seeking to know their HIV status

Journalists were not helping by referring to patients as sufferers and victims. They wrote passionately about the horror disease and described how it ravaged the victims. By the turn of the century, there was a campaign to train journalists to stop the use of such names, which only added to the stigma.

In 1987, an estimated 1-2 per cent of adults in Nairobi were infected with the virus. In the same year, the World Health Organisation formed the Global Programme on Aids. And in 1985, Kenya’s Ministry of Health issued guidelines stating that patients should be informed of their HIV status.

However, between 1989 and 1991 HIV prevalence in expectant women in the city rose from 6.5 per cent to a staggering 13 per cent. Around this time the embattled government even ordered the seclusion of people living with Aids. However, this was not implemented.

While some people were aware of the existence of the disease, there was little information about how it is was transmitted and how it could be prevented.

Burials of the dead were conducted in curious ways, with some corpses stuffed in polythene paper.

Prof Omu Anzala, a microbiologist and programme director for the Kenya Aids Vaccine Initiative (KAVI) says the aggressive nature of the virus and how quickly victims died got many people worried. This he explains was the reason the dead were buried in polythene bags for fear of infection. KAVI has been researching and carrying out tests on a vaccine for the last 13-years. 

Anzala says this also entrenched stigma and fear that caused discrimination against infected persons. He says, “Aids was equal to death. When people realised they were infected they didn’t have hope of living anymore. Likewise medical practitioners did not have a lot of information about the mysterious illness as well about drugs such as ARV’s that would help suppress the virus”.

Josephine Akanga, who tested HIV positive in 1998 attests: “If you realised you had the virus you knew you were dead. I gave up living and felt hated. My husband run away and everybody in the society accused me of bringing the disease to him”. Ten years after HIV was detected, the country had recorded 100,000 deaths and a prevalence of 10 per cent amongst adults. In 1999, President Moi declared the epidemic as a national disaster. This was followed by the establishment of the National Aids Control Council (NACC). The same year he promoted the use of condoms as a preventive measure but over a long time this did not auger well with sections of clergy.

Following this move, HIV prevalence started indicating a progressive decline that came as a result of increased education and awareness and increased use of condoms and other preventive measures. However, about 150,000 deaths were recorded in 2003 alone. Today, things are looking up. There are over 20 types of ARVs that can be used to suppress the progress of Aids.