Professor Elizabeth Ngugi has contributed enormously to the fight against HIV/AIDs and other sexually transmitted diseases (STDs) in Kenya. Through her rehabilitation centre, she is improving the wellbeing of women and girls in sex work and also children orphaned by AIDs in order to make them self-sufficient. She speaks to ESTHER KIRAGU about her outstanding work.

“Many people don’t think there is anything to worry about when it comes to sex. But sex is everything to worry about especially in today’s society,” says Prof Elizabeth Ngugi.

For a second, I assume she is giving me some motherly advice on sexual matters. I nod and smile albeit baffled by the direction of this conversation. Then it dawns on me this is what her heart beats for – sexual health matters.

“Many people don’t think there is anything to worry about when it comes to sex. But sex is everything to worry about especially in today’s society,” says Prof Elizabeth Ngugi.

For a second, I assume she is giving me some motherly advice on sexual matters. I nod and smile albeit baffled by the direction of this conversation. Then it dawns on me this is what her heart beats for – sexual health matters.

Prof Ngugi’s appointment as deputy chief nursing officer at the ministry of health in Nairobi in 1979 gave her a thrust into health matters. It was then that she began to envisage a society where every Kenyan had primary health education and especially on sexual health, a thought that excited her.

This would see her pursue a course in epidemiology (origin and spread of disease) and disease control in 1985, which was offered under a partnership between the World Health Organisation (WHO), the University of Nairobi and the ministry of health in Kenya.

This bubbled her passion for sexual health education even more, and a year later when she was promoted to National AIDs Coordinator in 1986, everything added up. She also began lecturing at the faculty of medicine at the University of Nairobi.

Through Prof Zanze whom she met at the university, she learnt that majority of the men treated with STDs at the Nairobi’s City Council clinic, on River road, then, claimed to have contracted the diseases from Pumwani also known as Majengo slums.

Determined to get to the root of the problem, she ventured into this o do research on STDs. Her aim was to understand the characteristics of the residents and find out what intervention measures would work to lessen the spread of STDs.

“The findings were an eye-opener. For instance, I learnt that female sex workers in this slum had unique ways of communicating to their clients about their trade. If they sat on a stool outside their house, it meant that they were ready for their next client. At the time, research had indicated that only four percent of female sex workers in Nairobi used condoms yet on average each had three to four clients daily. This was one of the main reasons why the spread of STDs was rampant,” she explains.

Reaching out to female sex workers in the slum…

She enrolled 300 women who were sex workers in Majengo slum and began educating them on sexual health. She was the first person to organise such women into peer group led system, where they could talk about the need to sexually protect themselves and their children; some of whom were already sexually active.

Her anticipation was for them to reduce their sexual partners, begin to use condoms whenever they had sex, and seek treatment promptly when they contracted an STI or STD.

The women would meet in small groups regularly and then converge together annually to empower each other and share their experiences.

“This structure worked and a lot of women were transformed. However, some researchers were doubtful that this structure could be reproduced elsewhere and give similar results especially in the absence of Prof Ngugi,” she recalls. They credited the success of the system to her being present to oversee it.

Keen to prove the system could be replicated anywhere, she sought funding from the Ford Foundation and introduced the peer-led support system among female sex workers in four sites in Nakuru, Thika, Machakos, and Nairobi’s Korogocho slums.

Through linking up with health facilities in these sites, she trained health care providers on how to handle female sex workers with dignity and without discrimination, assess women and treat them for STDs promptly and do follow ups.

The success in these sites was evident. With more funding from The Canadian International Development Agency (CIDA), an organization that administers foreign aid programmes in developing countries, she extended the project to other towns in Western province such as Kakamega, Busia, Bungoma, Butere and Mumias, as well as Salga town in Nakuru.

She ran this peer-led project until 1994 after which she got a similar project with the Centre for Disease Control (CDC) covering Eastern and Central provinces, which she oversees todate.

“With time we have added new concepts to the project because the HIV world evolves very fast and you need to keep up,” she says.

With this vast experience, Prof Ngugi was made part of the team that first drafted The Kenya National AIDs strategic plan, during president Moi’s government.

She however regrets that despite urging for the inclusion of working with sex workers in this plan, it wasn’t adapted early, possibly because sex workers are not socially acceptable.

“The situation only changed in 2012, when the then government decided to include working with sex workers as part of their National AIDs strategic plan,” she says.

Emergence of HerStory centre…

Weary of seeing that not much was been done about the plight of sex workers most of whom were trapped in this lifestyle due to lack of economic empowerment, Prof Ngugi began the Kenya Voluntary Women Rehabilitation Centre, in 1992. The centre, which has since changed its name to HerStory Centre, is located in Pangani, Nairobi.

The centre started with a group of sixty women and girls who resided in Nairobi slums and city centre and were in the sex trade business. She got some funding from donors and a rented room to use in training the women and girls in tailoring so as to be self-sufficient.

“With time research showed there was a significant change in the lives of these women. Some had reduced their sexual partners significantly, were using condoms whenever they had sex, and sought medical treatment promptly upon contracting an STD or STI. Others had even abandoned the sex trade,” says Prof Ngugi.

Currently the centre has 2500 members. About 1500 of the members have benefitted from credit facilities to enable them make choices beyond sex work. Some of the women, whose lives have been transformed, work at the centre as community mobilizers, while others have been facilitated to start their own business and yet others have acquired various jobs elsewhere.

The centre has evolved over time and not only hosts women and girls, but also children of both genders who are orphaned through HIV/AIDs. Some of the children who come through the centre are resettled with their families or guardians.

Those who perform well are sponsored through all levels of education. Other intervention programmes offered at the centre include referrals to hospitals for those who have contracted HIV/AIDs/STIs, counseling, home-based care for those who are HIV positive and sick, and vocational training.

Through an annual road show, a run and a walk, the centre extends free HIV testing and education in the slums with the aim of reaching out to many people.

Prof Ngugi says that while there has been a decline in HIV infections in Kenya, more needs to be done to get to zero HIV New infection prevalence rates. She urges political and religious leaders in society, as well as individuals to join in the fight against HIV/AIDs.

“As the centre marks twenty-two years of existence this year, I hope to put up a permanent building for the centre, which can also generate some income to make the operations self-sustaining, since we are currently heavily dependent on donor-funding,” remarks Prof Ngugi.

Reflections on family life…

“It’s heartbreaking to see young girls barely in their teenage years engaging in sex trade because of poverty. Others are children yet they have given birth to children of their own. Can we forgive the world for such ordeals?” she asks somberly.

Through her interaction with orphans and her experience as a mother, Prof Ngugi says all children need to be loved, guided and given a sense of belonging.

She therefore encourages parents and guardians not to relinquish their parental responsibility and control because children grow so fast and when they become adults they hang on to something from their upbringing. “As a parent, learn to listen more and also don’t smoother your children,” she advises.

Family means many things to different people. Prof Ngugi is a mother to one son who is a practicing lawyer in Nairobi. In addition, many orphans who have passed through her hands refer to her as their mother.

On her office window is a display of cards given to her by some of the people who have passed through her hands. One of them reads: “To the only mum I have. You are one of the most thoughtful and kind people I have met. I don’t think I could ever thank you enough for what you have done for me. Thank you very much. Love Johnstone (not his real name).

She explains that Johnstone is one of the orphans who passed through her hands after the death of his mother, a sex worker who died of AIDs. Johnstone is now a civil engineering graduate, is married, has a family and works with an international non-governmental organisation (NGO) in Nairobi. He exemplifies that people have great potential.

“I wish more people understood that as they get into careers and advance themselves they also need to know of their social responsibility. Making money is great but you also need to make an impact in the society.

That doesn’t mean you dish out money to the less fortunate. It means empowering the less fortunate to become self sufficient,” she says in conclusion.

Published on March 2014