Counties count on providing work for women to stem spread of HIV

In Summary

Several studies show a high prevalence of HIV infections in fishing communities, which are also bedevilled by problems such as lack of proper health care facilities. In these communities, women are particularly at risk since they are poor and engage in the sex-for-fish business out of desperation. But now there’s hope for them.

By ANGELA OKETCH AND ELVIS ONDIEKI It is early evening and we’re on Ogenya Beach on a tiny island in Lake Victoria.

Along the shores are women selling food, mostly fried fish, while others are waiting, troughs in hand, for fishermen to land their catch.

A little distance away, seated in a group, are several women, smoking and drinking beer.

Juliana Atieno, one of the food vendors, informs us that the merrymakers are commercial sex workers, waiting for the men fishing in the lake to return.

After a long night in the lake, many of the fishermen unwind by spending the night with the sex workers, she says.

After a little while, a boat docks on the shore and the commercial sex workers and women with troughs take strategic positions, waiting to get the attention of the fishermen.

Earlier, we had learnt that a fishing session sometimes begins at around 5pm and ends the following morning. And when the fishermen have sold their catch, some head to bars located far from the shores because they would not want to be seen with the commercial sex workers.

After about an hour, several boats dock in close succession. The women start calling out different names which, we learn, are the names of their lovers.

One of them, who requested anonymity, says that her lover, like many other fishermen involved in the fish-for-sex business, do not take kindly to being asked to use condoms.

Auma says she has only one lover, but adds that many of the women who operate along this beach have more than one lover, who in turn also have multiple lovers.

And while she says she is faithful to her man, she acknowledges that he sleeps with other women when she is not around.

From Usenge Beach in Siaya County to Mbita in Homa Bay County, there is an unsettling trend, if the figures recently released by Aids monitoring organisations are anything to go by.

Several studies point to a high Aids prevalence rate in fishing communities, which is why DN2 took a trip to a number of beaches to see first-hand what happens there.

In June 2013, three researchers published the results of one such study on the website of the National Centre for Biotechnology Information, a US-based body.

Carol Camlin, Zachary Kwena and Shari Dworkin noted that some of first people to be infected with the human immunodeficiency virus (HIV) in East Africa were populations living near the shores of Lake Victoria in Rakai District in Uganda, Mwanza, and Kagera provinces in Tanzania, and Nyanza Province in Kenya.

And according to the “National HIV and Aids Estimates Report” released in August by the National Aids Control Council, counties in Nyanza had the highest prevalence rates, ranging between 10 and 28 per cent.

It showed that Homa Bay had the highest new infections with 25.7 per cent, followed by Siaya (23.7 per cent), Kisumu (19.3 per cent) Migori (14.7 per cent) Kisii (8 per cent) and Busia (6.8 per cent).

The beach communities account for a considerable portion of the incidences, given that the Lake Victoria Fisheries Organisation estimates that 40 per cent of the fishing communities are HIV positive.

On visits to Ogenya, Dunga, Nyamware, Ogal, Usenge, Mbita and Lwanda K’Otieno beaches, DN2 found out that the people’s lifestyles were very similar, despite variations in population, activities and leadership.

According to Helgar Misioki, the key population programme manager of the National Aids and STI Control Programme (Nascop), beach communities are a fertile ground for the spread of HIV.

“Several known HIV risk factors converge around fishing activities, though not all are present in all fishing communities,” she says.

Ms Misioki adds that, since fishing is considered a low-status occupation, it can cause “exaggerated forms of masculinity that challenge the norms in society, one of which can be courting multiple sex partners”.

Ms Misioki says that fishmongers are 2.7 times more likely to contract HIV compared to people in other occupations because of their lifestyle, noting that most fishing communities lived in clusters in isolated locations.

Most of the fishermen live like nomads, migrating from one place to another in search of (fish), which has contributed to the spread of HIV/Aids among them.

“Many of the fishermen stay away from their homes and mostly fish during irregular working hours. When they are not fishing, they engage in various groups, which favours prostitution,” she says.

She notes that some of the factors that have contributed to the high prevalence rate of HIV in fishing communities are poverty and irresponsible sexual behaviour.

According to statistics from the Ministry of Health, National Aids & STI Control Programme (Nascop) in The Most at-risk Population Surveillance Report 2012, fisher folk had the highest prevalence, standing at 33.7 per cent, compared with other occupations.

According to the report, the main risk factor for HIV transmission in the fishing sector was amilies living apart.

Fortunately, efforts are now being made to stem the spread of HIV among those earning a living from the world’s second largest fresh water lake.

In fact, so serious has the situation become that community-based organisations and county leaders are coming up with strategies to stem the spread of the disease.

According to two governors from the affected counties, the practice of exchanging sex for fish around Lake Victoria beaches and wife inheritance are two of the major contributors to the spread of HIV.

Homa Bay Governor Cyprian Awiti and his Siaya counterpart, Cornel Rasanga, have said they will step up measures to curb the pandemic.

Governor Awiti’s government has formed an inter-sector committee to map out strategies for combating the virus.

“I feel disturbed every time my county emerges top despite all the efforts we are making. In the next survey, Homa Bay must climb down,” he said.

He has developed a strategy for reducing the impact of HIV/Aids on fishing communities by studying the root causes of the epidemic and tackling them.

“The first problem is poverty, and we have started savings schemes for vulnerable women and girls in fishing communities to promote self-reliance, which can be viewed as a measure for reducing the sex-for-fish transactions,” he said.

Mr Awiti has ordered a mandatory campaign against the virus in all public meetings.

Meanwhile, Governor Rasanga has appealed to those infected with HIV to be responsible and help reduce its spread by living positively and avoiding reckless sexual behaviour.

He promised to improve the income of fishing communities by improving the infrastructure and taking health services closer to the people because poverty predisposes them to risky behaviour.

However, Mr Rasanga said that the challenge the county is facing is lack of equipment for monitoring the viral loads in the people infected.

Misioki, the Nascop manager, said they are out to ensure they focus on, and address, the specific risks and vulnerabilities of the fishing communities to reduce the transmission of HIV.

“If we reduce the prevalence, it will be an added advantage to the general public. We are working together with the county governments around the lake to put up centres for HIV testing on the beaches,” she said.

For long the groups have been neglected, we are going to develop and roll out specific programmes and policies with tailored interventions targeting the fishing community.

“We will help address other problems facing fishermen communities, including access to education, health centres, electricity, safe water and roads,” she said.

Meanwhile, the Victoria Institute for Research on the Environment and Development (Vired) has, with the help of donors, been running a project dubbed “No Sex for Fish”, which entails providing women with boats whose cost they are expected to meet within a certain period.

The money is then used to acquire more boats, which are distributed to other women in the project.

The Vired project hopes to bring an end to the sex-for-fish menace on most of the beaches by 2015.

Prof Okeyo Owuor, the organisation’s director, says they plan to extend the project to all the beaches along Lake Victoria.

“It was distressing to know that scores of young men with so much potential to succeed in life were engaging in unprotected intercourse with multiple women in spite of the risks Sinvolved.

“After more debate, we realised that we could only do away with this practice by empowering the women, who were at the mercy of these men, who for whatever reason, would not use condoms,” Prof Owuor said.

Another way to eradicate this risky behaviour, he noted, was to support women living along the beaches with grants that enable them to start income-generating activities to reduce their reliance on fish.

“If these women had other options of making money, they would not engage in risky sexual behaviour to earn a living,” he says.

According to Lake Victoria Fisheries Organisation, there are about 142 beaches along the Lake Victoria shoreline, where some 19,000 men work within the fishing industry as boat owners, fishermen, net-makers and repairers, and brokers.

Factors that put women at risk

NASCOP MANAGER Helgar Misiokis says money-hungry women are drawn to beaches because of the opportunities to sell sex.

She says that poverty among young women, adolescents and widows has contributed largely to the sex-for-fish economy, which leads to irresponsible sexual behaviour, adding that most of the men and women in these relationships are married.

“Gender inequality, compounded by poverty, puts women at risk of exploitation and makes it difficult for them to insist on condom use because they need the money,” she says.

The situation is aggravated by the fact that fishing communities have limited access to sexual health services.

“Lifestyle factors like high mobility and irregular working hours would seem to put the fisher folk among those least likely to access anti-retroviral therapy, yet they are among the vulnerable,” she says.