Source: IRIN
When IRIN/PlusNews recently visited Nuna Kahiro, 75, in Kenya's Rift Valley town of Nakuru, she asked the same question she asks everyone who visits: "Did you bring me anything to eat?"
Kahiro had not eaten for two days; her last meal was maize-meal and cabbage, which her neighbour had brought. Diagnosed with HIV in December 2010, she has been unable to take her antiretroviral (ARV) medication regularly because taking the drugs on an empty stomach leaves her feeling sick.

"Those drugs are too strong, when I take them I feel dizzy and this feeling is worse when I take them without food," she said. "Even if I got a cup of tea every day, I would swallow the drugs at least once a day, but with an empty stomach, taking ARVs is like signing my own death certificate."

Joyce Nyambura, a volunteer social worker in Nakuru, says these days she is seeing more and more such cases. She tries to help a few people by giving them bread and a cup of tea to take their ARVs, but her own funds are stretched.

"Most of them have stopped taking ARVs due to lack of food; I wish I could feed them but I do not have enough for myself, let alone for anyone else," she said.

Severe drought

The East African region is experiencing a severe drought that has left an estimated 2.4 million Kenyans food-insecure; acute malnutrition rates of more than 25 percent have been recorded in the arid north-east of the country. According to government statistics, food prices have gone up by about 15 percent over the past year.

Hidaya Mugure, who lives in Nakuru near Kahiro, does casual laundry and gardening jobs to support her mother and her six children. Mugure, her mother and her seven-year-old son are all HIV-positive; on days when she cannot find work, they all go hungry.

Her son, who was due to have started taking ARVs in February when his CD4 count - a measure of immune strength - tested a very low 120, still has not begun treatment. "How could I start him on the drugs while I do not have a good diet to go with them?" she asked. "Every time I imagine how weak I feel after taking the drugs without eating, I stop thinking of starting my son on ARVs."

Mugure has lived with the virus for over a decade, and understands only too well the importance of a nutritious diet. "We are advised to take balanced meals every time - vegetables are very important especially to keep the skin looking healthy, but they are too expensive," she said.

The most regular meal in her house is maize meal and salty water and even that is only available when she has a little money.

Pastoralists suffer

In Kenya's arid eastern and northern regions, health workers are noticing a higher number of malnourished HIV-positive people visiting health centres. Many of the inhabitants are pastoralists who have lost thousands of head of livestock; many have migrated to neighbouring Uganda for water and pasture.

''Every time I imagine how weak I feel after taking the drugs without eating, I stop thinking of putting my son on ARVs''

"The success and effectiveness of the drugs are being diminished with an increased number of malnourished AIDS patients; the cases are high in remote parts of Isiolo and Garbatulla districts [in Kenya's Eastern province]," said Stephen Kirigia, Isiolo District HIV/AIDS and Sexually transmitted infections Control Officer. "It's quite hard to help poor HIV patients; without food or water to take the drugs, their risk of illness is increased and so is the likelihood of developing resistance."

In Kambi Ya Juu village on the outskirts of Isiolo town, Mary Aukot and her neighbour Sarafina Asiri Nachui have formed a support group of 40 people to try to help each other with food.

But as the drought has worsened, the group's ability to help its members has faltered. "We used to buy and sell milk and livestock to make money and buy food, but the animals are longer available - most have moved away, some have been stolen and many have died as a result of the drought," said Nachui.

The International Federation of the Red Cross/Red Crescent Societies has launched a US$5.4 million appeal to help ease the effects of drought in the north and northeastern pastoral areas of the country. Kenya's government has announced plans to provide food assistance to about 800,000 Kenyans while the UN World Food Programme (WFP) plans to reach another 950,000 people with food rations. However, WFP's efforts are threatened by an 82 percent funding shortfall for its 2011 Kenya operations.

A very poor diet means Nuna Kahiro can't adhere to her ARVs


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