COUNTY DIALOGUE FORUM ON HIV, TB, SEXUAL REPRODUCTIVE HEALTH AND HUMAN RIGHTS 20 - 22 February 2018 ,

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CONTENTS

ABBREVIATIONS...... i

Executive summary...... 1

Introduction...... 1

DAY ONE: ...... 2

Introduction and welcoming remarks...... 2

Reports by the Community Health Advocates...... 4

Participants’ reactions to the CHAs reports...... 5

The Constitution of Kenya 2010 and the right to health...... 9

Recommendations and way forward...... 10

Closing remarks...... 10

DAY TWO: ...... 11

Introduction and welcoming remarks...... 11

Reports by the Community Health Advocates...... 14

Reactions to the CHAs reports...... 14

The Constitution of Kenya 2010 and the right to health...... 16

Recommendations and way forward...... 17

Conclusion and closing remarks...... 17

DAY THREE: Constituency...... 18

Introduction and welcoming remarks...... 18

Reports by CHAs...... 19

Reaction/views from other participants...... 19

The Constitution of Kenya 2010 and the right to health...... 24

Recommendations and way forward...... 25

Conclusion and closing remarks...... 26

Annex 1: Participants...... 27

List of Participants - Likoni...... 27

List of Participants – Kisauni...... 28

List of Participants – Changamwe...... 29

Annex 2: Agenda...... 31

i ABBREVIATIONS

AIDS Acquired Immune deficiency Syndrome

AHF Aids Healthcare Foundation

ARV Antiretroviral

CHA Community Health Advocate

CSO Community Service Officer

CHV Community Health Volunteer

EPZ Export Processing Zone

FSW Female Sex Worker

GBV Gender Based Violence

GBVRC Gender Based Violence Recovery Centre

HIV Human Immunodeficiency Virus

IDU Injecting Drug User

ICRH International Centre for Reproductive Health

KELIN Kenya Legal and Ethical Issues Network on HIV & Aids

KP Key Population

MAT Medically Assisted Therapy

MOH Ministry of Health

MSM Men having sex with men

NGO Non-governmental Organization

OCS Officer Commanding Station

PLHIV People living with HIV

PRC Post Rape Care

PREP Pre exposure prophylaxis

SRH Sexual Reproductive Health

STI Sexually Transmitted Infection

TB Tuberculosis

WHO World Health Organization

ii Executive summary

The county dialogue meetings took place in County of Mombasa, within Mvita, Kisauni and Changamwe constituencies respectively. In all the three dialogue meetings, the discussions were carried out in an open forum where participants were called to share their experiences with regard to their different exposure on matters HIV, TB, reproductive health and human rights.

The forum drew different role players within including NGOs, health care providers and law enforcers. All these participants were called so as to enhance networking and to understand the linkages between HIV, TB, sexual reproductive health (SRH) and human rights.

In the process of sharing experiences participants also discussed mainly the challenges that they face in addressing HIV, TB, SRH and human rights violations within their communities and available mechanisms for redress.

The meetings brought about the day to day challenges faced by the community health advocates (CHas), community leaders, civil society organisations (CSOs) and the police officers in the course of their duty in the community. This was discussed at length in all the meetings with the participant coming up with working solutions that would make their role towards the affected community better felt.

The dialogue meetings ended with the participants suggesting a way forward for stakeholders to advocate for and monitor health accountability and improved service delivery.

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Introduction

The right to health is recognized in the Constitution of Kenya 2010 under Article 43(1) (a) which guarantees the citizen the right to the highest attainable standard of health including reproductive health care. It is against this backdrop that KELIN in all its engagement has been on the forefront in ensuring that the people of Kenya from all walks of life are made aware of this right and further promotes the aspect of participation and active involvement as a means towards successful implementation and governance at all levels.

The dialogue meetings held in the County of Mombasa therefore created a forum for community participation towards acquiring effective health care systems. Through the dialogue meetings KELIN aimed at recognizing and including diverse groups of people comprising the marginalized and vulnerable population whose ideas, concerns and challenges ought to be considered.

The meetings will create a forum for interaction with the affected and duty bearers and in the end come up with working solutions that will address the challenges that shall be raised.

DAY ONE: Mvita Constituency

Jambo Paradise Hotel, Mombasa

Tuesday, 20 February 2018

Introduction and welcoming remarks

Ms Nyambura welcomed all the participants present to the forum and asked the members to introduce themselves noting to mention the organization/institution they represent. Ms Lucy Ghati, Programme Manager TB and HIV (KELIN) to give the welcoming remarks. Lucy informed the participant that the forum is a dialogue and as such it is an open forum and participants should be free to discuss issues and challenges that they deal with in their day-to-day business. She emphasized that the purpose of the forum is to pick out issues to enable the community to enjoy health rights

Lucy further stated that KELIN aims to ensure that health related human rights on HIV and TB are integrated into policies, laws, and regulations. This is done by interrogating current laws and policies on HIV and TB, examining gaps at the county level and prepare recommendations for how to integrate relevant human rights. CHAs who have been trained by KELIN on health rights on HIV, TB and SRH sensitize the community to help them know how to protect their rights.

KELIN works closely with the government especially through the MOH and other partners present in the forum working together for the good of the community. She gave an example with regard to the constitutional provision for the right to health where the government provided for free maternity services yet for instance there was a case at coast general provincial hospital of women who had been held in hospital for unpaid maternity fees.

2 3 Ms Lucy Ghati of KELIN giving the welcoming remarks

She went on to state that these are the kinds of issues that need to be addressed through such dialogue meetings since all the stakeholders were present and to strategize a way forward that will work for everyone to make the community a better place.

Dr Salma, a representative of the chief officer of health Mombasa, concurred with Ms Ghati on the need to work together so as to support those that are affected. She stated that as a county they have tried to support those affected by HIV and TB to a great extent. She said that MOH have trained the county health volunteers to sensitize community members on HIV.

Dr Salma went on to state that her office has visited drug dens to reach drug users with services for HIV testing, care and treatment. She said that her office even have a mobile x-ray unit that enables the county to give services to the affected in their specific locations within the county.

Dr Salma further added that AHF in Mikindani has been very supportive with regard to promoting health rights of people living with HIV. She further said that the government is doing its best to be able to reach out and provide the basic right of health to all its communities. She thanked KELIN, for its work that has enabled them reach out to other clients who are either stigmatized or unable to reach our health facilities.

On the issue of the women held at Coast General Provincial Hospital for nonpayment of maternity fees, Dr Salma explained that with the government programme for free maternity services there is a requirement that one has to produce an Identity Card to access the free service. She added that this therefore follows that women who do not have Identity Card cannot access the service and hence the reason for the detention at the hospital facility. She however indicated that she will do a follow up on those still at the hospital to find a way to assist.

2 3 Elvina Mzungu, a social worker in the Ministry of Gender Youth and Social Development, thanked KELIN for the effort in exposing the coastal community to the importance of health rights. She said that the gender department exists to uphold human dignity. She added that her office has been on the frontline in addressing issues of gender based violence (GBV). Elvina further said that the ministry has held talks with the government to introduce the revolving fund which is a mechanism of giving loans to women and training them.

She mentioned that during the International Women’s Day on 8th March 2018, the ministry would work on empowering women in marginalized areas and this will be in Likoni. She welcomed the members present to the celebrations to help enhance the development of women.

The complaint that for women to access free maternity service they have to have Identification Cards came as a shocker to Elvina since she is aware that there are children who give birth to children some as young as between 9-15 years of age. This according to her simply means that such cannot be beneficiaries for the free maternity services offered by the government. She called ok KELIN to look into this issue and push for equal of rights even for the children.

She also reported that the ministry has also been working with children as well as the police on issues of GBV.

Reports by the Community Health Advocates

Ms Anne Nyambura, team leader for the CHAs Mombasa County, introduced this session on the reports from the CHAs based on their advocacy activities in the community areas. She informed participants that KELIN trained CHAs to represent key, vulnerable and priority population groups and they are committed to champion the rights to health in their communities. She said thatat the training, the CHAs were equipped with skills and knowledge to roll out community-based participatory advocacy for treatment literacy, and reduction of stigma and discrimination. Anne added that the CHAs were also empowered to champion access to health services and advocate for accessible, acceptable and quality health services in their communities.

She stated that so far they have faced numerous challenges especially in regard to reporting cases to the police for justice processing. She reported that such cases normally are not adjudicated upon conclusively due to various reasons ranging from lack of witnesses, delay/adjournments in courts, corruption and intimidation to the complainants and witnesses. In respons, a representative from Sauti ya Wanawake- Mvita Chapter, first acknowledged that they have been working with the CHAs and that working within the networks present makes their work easier. She went on to say that they have two cases in court for attempted defilement of a two-year-old girl who was living with the grandmother; and a ten-year-old girl who was living with her sister, and was defiled by her brother-in-law. These cases have been pending before the courts for long. Further she blamed parents as the ones who have neglected their roles in the raising children and thus exposing them to these predicaments.

She requested for more networking with all the stakeholders present and more so with KELIN since violence against women is very rampant within the county of Mombasa.

4 5 Ms Esther Nelima, a CHA representing , gave her report which noted some of the issues she has identified as common health problems in the community such as drugs and substance abuse, cases of children defilement and stigma in relation to HIV. She said that there is need for stake- holders to embrace collaborative work to ensure that when cases of human rights violations come up they are handled to conclusion with documented success stories.

She said that so far, they have handled 20 cases where 6 are in court, 5 are still at the police station level whereas others have been withdrawn and in most instances by the complainants for fear of revenge attacks or intimidation by the accused persons. She stated that there is need to sensitize complainants or victims of these human rights violations, of their rights noting that the main reason for their withdrawal or giving up on the case is due to the long judicial process of follow up for justice provision. She added that knowledge on human rights is important for the community for their own defense against human rights violations. This should also include the process followed in processing justice for human rights violation.

Nelima also noted that the police officers do not give the victims of such violations the right procedure to follow to ensure proper recording of evidence and follow up. She said that there are over 50 cases where victims of human rights violation have OB (Occurrence Book) numbers but do not know what to do thereafter. According to Nelima, cases of stigma regarding community of persons living with and affected by HIV is still rampant and a lot needs to be done to reverse such trends. She also added that there exist stigma and harassment to sex workers and also on people’s sexual orientation and gender identities more so the LGBTI groups. She added that unfortunately stigma mainly comes from health care facilities’ service providers. For instance she said that she has three cases where someone’s HIV status was disclosed in the community and this has really affected her relationships within the community. There is also stigma on Injecting Drug Users whereby they are referred to as thieves or “teja”.

She also reported on cases of sexual abuse on both mother and child. She emphasized on the need for collaborating working relationship among stakeholders to be able to help victims of rights violations find prompt justice. She urged for further attention to the plight of rights violations to community of persons living with and affected by HIV.

Participants’ reactions to the CHAs reports

Mr Taib, CEO of Reach out Centre Trust, pushed for the continued partnership with KELIN. He said that the CHAs should be empowered to fully address the emerging issues in respect of HIV, TB and SRH. Being more involved with IDUs, he said that drugs are major issue within the Mombasa County and the nation as a whole. Drug use and abuse is still rampant in Kenya and the users are the ones who are mostly affected yet the drug lords are still on the loose. He said that though the government has declared a war on the drug dealers, the users are the ones who suffer the repercussions of lack of drugs in the market.

According to Mr Taib, drug users have not been given a proper direction in the community. He blamed the Act No. 4 of 1994 which is the Narcotic Drugs and Psychotropic Substances (Control) Act which he said is porous and has not been of any help to drug users in any way.

4 5 Stigma against IDUs is prevalent. He appreciated KELIN and its partners for organizing the dialogue and encouraged for more such forums to adequately address emerging issues. He also challenged KELIN to look into the issue of the law against drug users to make it friendly especially for recovering addicts.

Mr Taib, CEO Reach Out Centre Trust giving his contribution at the forum

Mr Swaleh, a recovering addict from Reach Out, spoke about the challenges he has faced so far. Mr Swaleh had been an IDU for more than 15 years but was now one year free from drugs. He felt grateful to Reach out Centre Trust for the transformation he got and also for the opportunity to assist other users on how to safely use the drugs and stay safe from HIV. Mr Swaleh’s main challenge was isolation by his family. He also talked of a victim whom he was assisting but was completely rejected by his family. He said that they tend to face several challenges with the police for harassment and violating their human rights.

He provided an example in which at the Central Police Station Mombasa, people who use methanol when arrested receive fabricated and exaggerated charges. They are also denied access medication and as such withdrawal symptoms kick in. He said that for some time he had difficulty accessing people arrested for methanol at central police. He paused a question to the stakeholders present on how to address the issue of stigma against IDUs.

Rose Mwangi, a police officer at the AIDS Control Unit, stated that police officers are also human beings yet they are in most cases forgotten. She said that Police officers are also prone to HIV infection just like any other human being. She added that Police officers also work with colleagues some of who are living with HIV and also going through family challenges.

6 7 Rose requested that as KELIN advocates for the rights of other KPs, the Police officers are also at risk of to the same rights violations and need support. She said that, “Police officers have not been sensitized adequately on HIV and other health rights. They need knowledge on drug users, withdrawal symptoms and other challenges facing PLHIV.”

These comments elicited a debate from the participants in the forum. KELIN confirmed that it has offered training to police officers though due to limited resources only a few get to benefit. She also reported that there is also the challenge of the arbitrary transfer of police officers, thus there is no guarantee of trained police officers remaining in their stations for long periods to offer their services appropriately.

One of the participants challenged the Police officers that a transfer to another location should not be an excuse for not offering proper services to key and affected populations in whatever capacity or station that they work in. Mr Paul Wanjiru from AHF stated that they have 2 areas that so far need intervention from the stakeholders present:

a) How to deal with clients who default medication. b) Need for boardroom advocacy.

For the boardroom advocacy, she gave an example of EPZ employees who are unable to access treatment due to stringent working hours since the employees work from 8.00am to 5.00pm when the clinics are already closed. They are free on Saturdays yet the clinics do not operate on Saturdays. As such the clients are unable to access medication. She also said that students also have a challenge of accessing medication. Some of the teachers do not understand why the students go for treatment. She suggested that schools should at least allow for medication on site or the student be allowed to carry the medication to school.

On the issue of carrying medication to school, there are instances where students may be stigmatized as teachers become curious on why they have so much medication and may end up exposing them for stigma from fellow students. It was agreed that there is need to sensitize teachers and more so take advantage of the head teachers’ convention that is held annually to have a session to sensitize them on HIV and SRH and the right to health care.

From ICRH, Madam Saida had a host of challenges that she faced as a social worker. Post rape care (PRC) forms are not filled in good time as is required. They have a shortage of staff; she is the only staff under ICRH stationed at Coast General Provincial Hospital. She suggested that if the GBVRC could be open to offer its services on Saturdays and Sundays, then this would help in minimizing backlog and spill over of cases which are usually overwhelming on Mondays. She also mentioned a challenge in the process in a case of defilement, where the victim is not supposed to bathe before filling of the PRC form. This process may take long and thus become distressful for the victim.

She blamed poor parenting skill as a cause for the many child defilement cases. The delay in reporting defilement cases was seen to contribute to the many cases of underage pregnancies. She urged for the need for comprehensive sex education which should be given to children in schools to provide basic life skills to understand the repercussions of some actions that may be done to them.

6 7 Ms Biberone Umazi, Deputy OCS- Makupa Police Station, concurred with her colleague that it is important to acknowledge that the police are part of the community and that their core duty is to maintain law and order and crime prevention. She said that drug users have been condemned countrywide and when they arrest some of these drug users, they arrest them on offences against the law. The police officers therefore need to know how they can assist them especially those on T.MA

Deputy OCS-Makupa police station Ms Umazi giving her contribution in the forum

She stated that there is no proper communication between the police officers, victims/survivors and the complainants to enable the police know how to handle the cases. Victims of GVB are not well informed of their rights and end up not reporting or fail to do follow up after reporting. She said that their greatest challenge especially for victims of GBV and defilement is lack of rescue centers. She went on to explain that when some cases of defilement are reported and they have to do investigations before apprehending the perpetrator, they have nowhere to keep the victims.

They have to return to the community where they have been violated and this leads to compromising the case. Another challenge she reported was the lack of witnesses to conduct trials conclusively. This is especially after the many adjournments from the court and witnesses get tired of the repeat activity. The judicial process also takes very long to an extent that at the time of conclusion of the case, evidence is watered down and the case is dismissed.

Madam Deputy OCS stated that the police cannot work successfully on their own. They need to work together with all the stakeholders to ensure justice is served to victims of SRH, HIV and other forms of human rights violation.

8 9 The Constitution of Kenya 2010 and the right to health

Ms Lilian Fwaya a pro bono advocate with KELIN introduced this session by informing the participants the role of the government with regard to the provisions of the Constitution. She said that the government has a role to respect, protect and fulfill its mandate under the constitution with regard to human rights.

She went on to explain that it is necessary to understand provisions that are important to the work a person is engaged in, especially on the bill of rights. She listed the rights as provided for under the constitution with emphasis on the importance of the right to health which is recognized as a right in the basic law of the land. Mentioning that the Provisions relating to health- Articles 43, 2, 21, 46

43. (1) Every person has the right—

(a) to the highest attainable standard of health, which includes the right to health care services, including reproductive health care;

(2) A person shall not be denied emergency medical treatment.

She emphasized on the importance of the participants to understand the provisions of the Constitution with regard to health more so because of the cases they handle. This is because once one is aware of the legal provisions to back up a case they will have more confidence in pursuing justice for the victims.

She noted that in most cases victims are denied justice due to lack of knowledge of the legal provisions of their case. She mentioned some of the constitutional provisions as:

• The right to life (Article 26). • equality and freedom from discrimination (Article 27) • human dignity (Article 28) • freedom and security of the person (Article 29) • Freedom of conscience, religion, belief and opinion (Art. 32) • access to information (Article 35[1] [(b]) • Freedom of association (Art. 36) • Assembly, demonstration, picketing and petition. • Political rights • Freedom of movement and residence. • Protection of right to property. • Access to justice. • Rights of accused persons • Economic and social rights (Article 43) • the right to health care services and consumer rights (Article 46)

8 9 In conclusion she called on all the participants to familiarize themselves with the provisions of Article 4 of the Constitution as that is where all the rights of Kenyan citizens are enshrined, and for us as a community to enjoy these rights we must be aware of these provisions as provided for in the Constitution.

Recommendations and way forward

1. Need to integrate the police, community officer, county government to follow up for partnership. 2. Need to follow up on the Act No. 4 of 1994; the Narcotic Drugs and Psychotropic Substances (Control) Act

3. Strengthening partnerships amongst stakeholders. 4. Need to fast track defilement cases since most are dropped due to the prolonged judicial process. 5. Advocacy to EPZ management to ensure that they understand the importance of their employees to get access to health services as a human right.

6. Need for more awareness creation among people with disabilities. 7. Sensitize the judiciary, the police and the health care workers on positive attitude and non- judgmental approach to all members of the community irrespective of their socio-economic class.

8. Need for a strengthened working relationship between CHAs and other stakeholders

Closing remarks

George Kissinger, Mombasa County AIDS/STI Control Programme Coordinator, thanked KELIN and the participants for taking the time out of their schedules to discuss these pertinent issues. He went on to state that GBV is a big issue in Mombasa County and one of the key concerns.

He said that the government has tried its best to sensitize its health officers on GBV and HIV and on the importance of documentation. He reported that there is a technical working group that deals with the key populations but it is important to work together as a team. According to him, he law is there and everyone is subject to the law but with time people tend to lose focus on the law and move to concentrate on the individual.

In closing he said that there is a solution to everything and as such it is important to work together in all the cases that are handled to ensure that they are finalized with success stories. He urged for more collaboration between and among the stakeholders present at the meeting owing to the enlightenment gained at the meeting.

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DAY TWO: Kisauni Constituency

Action Aid Hall, Ziwa la Ng’ombe

Wednesday, 21 February 2018

Introduction and welcoming remarks

CHA team leader for Mombasa County, Ms Anne Nyambura invited one of the village elders present to officially open the meeting. The village elder welcomed the participants to the dialogue forum and thanked KELIN and its partners for the opportunity to sensitize the community on issues of HIV, TB and SRH. Ms Nyambura then led the participants in self-introductions. She went on to give a brief description of their role as CHAs and how they came into being thanks to KELIN. She said that their main role is to create community awareness on HIV, TB and SRH.

Ms Lucy Ghati, Programme Manager TB and HIV (KELIN) proceeded by stating that the forum was for a dialogue meetings whose main objective is to discuss the challenges faced by the community with regard to HIV, TB and SRH. She said that at the end of the meeting, the participants will be expected to come up with strategies of tackling the challenges that will be identified in the forum.

She urged the participants to take note that health related rights are intertwined and that must be addressed as universally i.e. education, information and health just to mention a few. She said that through financial support from the AIDS and Rights Alliance (ARASA), KELIN is implementing a national programme in 5 counties on HIV, TB, SRH and human rights. The CHAs were trained and dispatched to the counties to help in creating awareness and advocacy towards realization of the right to health. She urged the members present in the forum to work together with the CHAs so as to ensure realization of the attainment of the highest standards of health services by community members

She called on the members present to give their views and also to state the challenges that they face in their working with the KPs, victims of human rights violation, and any other form of challenges with regard to HIV and TB. Ms Ghati emphasized that this is an open dialogue and that there is no right or wrong answers to any question as the aim is to come up with practical way forward to address the many challenges that will come out of the dialogue. It is also a forum to enable community members to be able to know the various stakeholders in the area for purposes of referrals and assistance in health care and rights interventions

Dr Jackline Tsuma, Mombasa County STI and HIV Control coordinator, thanked KELIN and its partners for the opportunity to enlighten them and the community as a whole. She welcomed KELIN to Mombasa County and encouraged them to keep up the good work to enhance the health of the community.

10 11 Dr Jackline Tsuma making her opening remarks

A participant who worked for an organization that does follow up for child defilement and rape cases, spoke about the issues of defilement and rape that keep arising yet the community has not opened up to talk about it.She said that in follow up, the victims’ mothers are in most cases not very corporative. The judicial process is slow due to the many adjournments which end up causing delay in getting justice for the victims. She added that there is need to have more community based volunteers to cre- ate awareness of these challenges.

On TB, she said that there is still stigma. The community isolates TB patients and in most cases TB patients are associated to be living with HIV. There is need for more awareness since it is well known that not all TB patients are HIV positive.

World TB day does not impact patients in Kenya. Some patients still prefer herbal medication and some even seek traditional means for treatment or associate the illness with witchcraft. She encouraged the use of media to raise awareness and make work easier for the health care providers. She called for cooperation among all the organizations that deal with KP, MDR-TB and drug users, and more so awareness for those affected i.e. parents and siblings.

Dr Tsuma, said that it is good to have such dialogues more often as there are many challenges at the health centers and the community. The KP need more support from the community health care providers as health care givers cannot do the follow up beyond the health facility.

Those affected should be given the best care which in most cases they get at the health facilities. She stated that persons living with and affected by HIV need acceptance and understanding in the com- munity. This more so affects women who after childbirth are expected to breastfeed their newborns. When advised not to breastfeed, then they start getting worried of people’s perceptions if they are not seen breastfeeding their born babies.

12 13 She also added that the government hospitals nowadays do not discriminate against the KPs. The KPs ought to be protected from stigma that is prevalent in the community. She emphasized the need to avoid calling the KP with names that degrade them rather they should be called by their given names to help them fit in the society and live as a family. There is need to stand up for the KPs and protect them against human rights violations.

Dora, a social worker from Rainbow Women, indicated that they deal with lesbians, intersex and bisexual women. Their main challenge is the fear to speak especially when they are affected with TB and HIV. She said that they have engaged with KELIN for a while but they would like a deeper engagement so as to adequately address the challenges that they face as an organization and their members who are human beings and ought to be treated as such. Dora added that there is need to ensure that women are well informed of their sexual right and to protect their identity as women.

Salome, a health care officer in charge of HIV testing and counseling shared the challenges that they face in the course of their work. Firstly, when defiled children are brought for assistance at the health facility, the parents later withdraw the cases to settle them at the village elders’ level. This discourages to them in most cases since they do not know what step to take after such a decision has been made. Secondly, only the victims for instance in cases of rape or defilement are brought to the facility for testing and counseling yet even the perpetrator is at risk of infection. Thirdly, the KPs do not go for HIV testing or other health care services and if they go they do not inform the health care workers of their status.

She went on to say that they are trained on how to handle key populations but have challenges reaching out to the KPs to provide legal and medical support. In the case of married couples, partners do not go for HIV testing and majority of those who go for testing are women while their spouses shy away. Joska, a representative from Initiative for Equality (INET), stated they do research on Key populations that majorly target those who are affected or who are the perpetrators and the violators of their rights. For example they have realized that those that affect Key population in terms of violation are the bodaboda riders. They therefore target the bodaboda riders to sensitize them on the issues of KPs, HIV, TB and SRH. She indicated that it would be important for them to work together with the CHAs to be able to sensitize more people on the challenges facing KPs and other vulnerable and marginalized groups.

Marilyn, a representative of ICRH-Kisauni, stated that they do research and implement programmes for sex workers within the community. She stated that every woman is a potential sex worker. She noted that it is important to assist sex workers as some of them it is not their wish to be in the trade. Lifestyle in the family also affects the children. Sex workers also have challenges in the course of their work and as concerned members there is need to address the challenges that they face. Sex workers also need assistance to accept and help them be accepted in the community.

She announced that in Kisauni there will be a public participation forum and she encouraged the members present to attend and also encourage others to attend so as to hold the Government accountable. She emphasized that public participation is very important for any member of the community and it is important for residents to attend such forums.

12 13 Reports by the Community Health Advocates

Ms Mwanakombo, CHA for Nyali Constituency, started off by stating that as CHAs in Mombasa County they have handled over 30 cases which they have been able to link with the health care facilities for medication and assistance as needed and some have been reported at the police stations and filed in courts, some have been successful but some are still pending. She went on to say that it is not only about Public Participation, there is need to follow up to know if allocation has been done and to hold the respective government representative accountable. She went on to give an account of the challenges that they face as CHAs in Kisauni. She reported that defilement cases, especially where the perpetrator is the child’s father, as the mothers are protecting their husbands. She stated that they have handled about 38 cases in Kisauni and Nyali Constituencies with respect to PLHIV.

With respect to the defilement cases only 6 have been successful. She blamed the Judiciary for most of the failed cases as a result of several adjournments for instance a case of defilement which was reported in 2014but still in court up to 2018. The judiciary is causing an actual delay in getting justice for the victims. They have faced a great challenge with regard to defilement where she feels that the women/mothers forget that even the children who have been violated have rights that need to be protected. She gave an example of a house girl who is HIV positive and was abused by the employer with regard to her status. This is a case that they have taken up and are pursuing it at the HIV tribunal.

She also reported that most HIV related cases handled at the HIV Tribunal get justice. She also urged for all on the need to advocate for Children’s rights owing to the fact that CHAs are volunteers and therefore need support to be able to effectively work within their communities as deployed. Ms Mwanakombo reported that key population groups are discriminated within most of the communities in Mombasa County of which she urged all participants present in the forum to be ambassadors of human rights of the key populations. She also gave an example of a Case of an employee who has been demoted for being PLHIV in a church setting.

Another challenge they face from the community is that the community is not supportive in justice processing for instance when witnesses of rights violations demand payment to provide information during investigations. She added that Wazee wa Mtaa (village elders) also do not assist much in provision of justice. Some of the village elders thwart cases due to corruption and complacency which leads to there being a lot of violation of human rights in Nyali and Kisauni. She also said that Mwakirungi cases are not going through because of a lot of compromise from mothers/ victims’ parents who are willing to compromise the cases out of fear or embarrassment within the community.

Reactions to the CHAs reports

The CHA reports drew a storm of reaction with one of the village elders present asking for contacts of the CHAs, police officers and the community service officers to forward cases that come to him. The elder went on to blame women/mother as they are closer to children than fathers and should therefore know their children’s fate and be able to seek assistance. He asked KELIN to visit the villages and wards to increase awareness in the community.

14 15 He gave an example where for instance a person known to the parents defiles a child, the parents then do not report to anyone and when Village elders follow up the parents are not willing to cooperate. In such cases they cannot do much as village elders.

The elder also reacted by saying that parents hide issues of their children even on issues of children born with disabilities. He thanked KELIN through the CHAs for the opportunity to be able to provide a feedback on their elders’ work and promised to pass the message to fellow village elders. It was also noted that in cases of defilement, the support from the parents of the victims is important and it such cases end up not being addressed appropriately and a child ends up suffering for life.

A participant shares her experience in the forum

Participants reported that in some cases it is difficult to assist the victim since when perpetrators are taken to court and released on bail they return to the very community thereby threatening the victims and destroying evidence and eventually the whole case is thrashed. Another participant whose organization provides Education and Library Services for children within vulnerable communities around Kisauni stated that they create awareness to children to embrace reading as a culture. This came about when they realized that the children are left alone in some areas within Kisauni and therefore become victims of preying old men within the community. He stated that they too have had a big challenge with the Judiciary and there is need for connection with an advocate to push for the fast tracking of reported and filed cases.

The participants were encouraged to mobilize other likeminded partners in case a matter is going to court so that they can show their might to “intimidate” the court in such cases and also use the press to amplify the cases. He encouraged those who have taken up community service to do it whole- heartedly without fear. Participants present from Mwakirunge agreed on the challenges faced in Mwakirunge as reported by the CHA stating further that most of their cases involve defilement or rape.

14 15 Teachers discourage children from doing proper follow up of cases through intimidation and unnecessary embarrassments to the children. They shared an incident where a doctor conducted an abortion on a girl who had been defiled and the girl is yet to get assistance. Participants urged everyone to be vigilant on village elders who assist the perpetrators to cover up cases in order to scut- tle justice.

The Constitution of Kenya 2010 and the right to health

Ms Lilian Fwaya a pro bono advocate with KELIN introduced this session by informing the participants the role of the government with regard to the provisions of the Constitution. She said that the government has a role to respect, protect and fulfill its mandate under the constitution with regard to human rights.

She explained that it is necessary to understand provisions that are important to the work a person is engaged in, and in particular the bill of rights. She detailed these rights as provided for in the Constitu- tion with emphasis on the importance of the right to health which is recognized as a right in the basic law of the land. Mentioning that the provisions relating to health- Articles 43, 2 ,21, 46

43. (1) Every person has the right; (a) to the highest attainable standard of health, which includes the right to health care services, including reproductive health care; (2) A person shall not be denied emergency medical treatment.

She emphasized on the importance of the participants to understand the provisions of the Constitution with regard to health, more so because of the cases they handle. This is because once one is aware of the legal provisions to support a case they will have more confidence in pursuing justice for the victims.

She noted that in most cases victims are denied justice due to lack of knowledge of the legal provisions of their case. She mentioned some of the constitutional provisions as:

• The right to life (Article 26). • Equality and freedom from discrimination (Article 27) • Human dignity (Article 28) • Freedom and security of the person (Article 29) • Access to information (Article 35[1] [(b]) • Protection of right to property. • Access to justice. • Rights of accused persons • Economic and social rights (Article 43) • the right to health care services and consumer rights (Article 46) •

16 17 The participants were concerned on how they could fast-track their cases in court and to avoid the numerous adjournments as this was a major cause of delay and withdrawal of cases especially defilement, rape and GBV cases. Ms Fwaya responded that the only way to ensure that avictim obtains justice from the courts is by being vigilant in follow up with both the police and the courts. An accused person has a right to access to justice and also speedy trials. They should therefore do follow up and make inquiries where they suspect foul play or intentional delay by the judicial officers or police. In conclusion she called on all the participants to familiarize themselves with the provisions of Article 4 of the Constitution as that is where all the rights of Kenyan citizens are enshrined and for us as a community to enjoy these rights we must be aware of these provisions as provided for in the constitution and what your rights entails.

Recommendations and way forward

1. Need for networking among stakeholders. 2. Need to sensitize the community on proper recording and documentation of cases for easy follow up. 3. More community awareness on health related human rights 4. CHAs to have a close working relationship with the village elders. 5. Make use of the suggestion boxes in the health facilities/report to the in charge. 6. Encourage persons living with and affected by HIV to accept them. There is also the need for regular sensitization and training to the community members to be able to handle others in special ways that respect their shortcomings or challenges. 7. Need to end discrimination against key population and those living with or affected by HIV in the community. 8. Religious leaders were also challenged to encourage their followers to take their drugs for proper treatment even after going for prayers. 9. Awareness creation on forms of SGBV amongst children in the community. 10. Need for support to the NGOs and LGBTI community when they have cases in court. More involvement in any available training. 11. Train health care workers to be sensitive to the clients and avoid stigmatizing language or questions that keep people away or infringe on their rights.

Conclusion and closing remarks

Ms Mwanakombo concluded the session by calling on the participants to sing a song while shaking each other’s hands saying “…we are here to assist each other”. Dr Jackline Tsuma in her closing remarks stated that there is need to embrace and support each other to assist in meeting the demands of those who are vulnerable in the community. She added that the dialogue meeting was a good forum and that there should be more of these to enable stakeholders to get to know more of the challenges and more on how to move forward. She thanked KELIN and all partners and said that the doors of Mombasa County are open for further dialogue.

16 17

DAY THREE:

Changamwe Social Hall

Wednesday, 22 February 2018

Introduction and welcoming remarks

Ms Ann Nyambura, the Mombasa County Team Leader welcomed the members present to the dialogue forum. She then introduced the other CHAs present and informed the participants of roles of the CHAs having been trained and engaged by KELIN. She informed the members that the dialogue forum was meant to address some of the gaps in the community with regard to HIV, TB, SRH and human rights violations that need to be filled up.

Reports by CHAs

Ms Nyambura explained that there are 5 CHAs who are volunteers. KELIN in partnership with ARASA and other partners have sponsored the forum. The main aim is to deal with cases related to HIV, TB, and SRH among others, and ensure realization of health related Human Rights. They have worked for the last one year and so far they have identified some issues and challenges that affect realization of the right to health.

Ms Nyambura reported that referral can be done for someone who is HIV positive or who suspected to have TB, but instead of going to the health facility, the person opts to go for prayers for fear of stigma and non-confidentiality of information. She also stated that they have a challenge in follow up with patients who are already on treatment for HIV or TB who default medication. This affects their work which is mainly to follow up to ensure that the clients are up to date with their medication for their better living.

She concluded her introduction by saying that they work with community health volunteers who would agree with her that the greatest challenge they face as volunteers within the community is high expectation from the community and financial challenges. But with all the challenges that they face within the community she did mention that they have success stories and with the help of some village elders and community health workers and with recommendations from this forum there is bound to be more of the success stories.

Ms Nyambura invited the participants present to give their views and challenges that they face with regard to the work they do. She then called on the participants to introduce themselves together with all the CHAs present. She asked one of the senior chiefs in the meeting Madam Lucrenga to officially open the dialogue forum.

Madam Lucrenga, a Chief, in her opening remarks thanked KELIN and its partners for the opportunity to create awareness with regard to HIV, TB, SRH and human rights violations. She noted that the forum would open the stakeholders present to more understanding of the KP and how to handle them in their various capacities. She thereafter declared the meeting officially opened.

18 19 Ms Lucy Ghati representing KELIN, gave a historical background of KELIN’s work and engagement with communities to date. She emphasized that this aimed at identifying the challenges in Changamwe area, addressing them and finding a way forward. She said that it was an open dialogue and everyone is encouraged to talk as they represent those that were not in the forum.

Ms Ghati reiterated that with regard to HIV and TB that if someone is not infected then they are affected in one way or another. She called on the participants to be free to generate issues and a way forward for challenges that face the community. She said, “All representatives here are affected or infected and we wish for all to be active and to move and sensitize our neighbors and friends where we are. For instance if we isolate those with HIV and or TB or if we fail to give treatment we in the long run expose others within the community to infection.”

She noted that the biggest challenge is stigma. And she posed the question, how is the issue of stigma handled here in Changamwe? Noting that people fail to realize that in one way or another they are affected especially by their reactions towards those infected. Other challenges for instance in cases of defilement, she noted that follow-up with the Judiciary or speedy justice is eryv elusive.

Reaction/views from other participants

Mr Joscath Kithusi, Deputy OCS – Changamwe, gave his views and indicated that he was speaking on behalf of the police officers not just within Changamwe and in Kenya as a whole. He started off by saying that some of the Police officers are living with or affected by HIV but there is stigma within the Police service due to fear owing to the fact that they are simply ‘police officers’. Some officers are on medication for HIV and TB but do not and cannot talk about it. Some even do not want to go for medication.

Participants listen to the Deputy OCS Mr Kithusi as he makes his remarks

18 19 He also said that one of the challenges they face within the station especially with regard to cases of HIV and TB or KP related, is when for instance a victim reports an incident where he or she has been called HIV positive (exposure of HIV status), they do not come with full information. The police are left asking awkward questions which in turn do not help the victim.

Secondly, some detainees do not inform the police at the time of arrest or at any time thereafter during their detention that they are on medication. This he noted might be due to fear of social stigma and status disclosure by other arrested persons or police officers. He went on to state that they at times handle cases where spouses do not inform each other that they are on HIV medication and only get to know of it when under arrest. He said that the police are very willing to help but they cannot help without proper information. He encouraged the Community Health workers to sensitize the community on giving information when anyone who is affected is arrested and or detained by the police.

Cases of couples accusing each other at the Police station are nothing new to the officers. There is need for education and awareness creation among offenders at the Police Station. They also have a challenge where victims of human rights violations and GBV give up on cases due to numerous adjournments at the courts and thereafter the police have difficulty in tracing victims in such cases.

He encouraged the participants not leave the Police officers with the whole burden of ensuring victims get justice. He also encouraged members to make use of the suggestion boxes which are in all public facilities to give their views and complaints. He indicated that delay of Justice is usually occasioned by the victim/parents/witnesses and not the police officers as is usually assumed.

On the issue of defilement and rape cases, he said that they have a challenge as there is only one doctor who fills P3 forms and is the one required to give evidence in court. On the day of hearing the doctor may have too many cases, and thereby unable to testify in all matters listed for the day. In such an instance it does not mean that there is delay in the judicial system rather the backlog of the cases.

An issue was raised to the OCS that in most cases the Police officers do not give some victims time to explain themselves especially those who need to take medication. It also came out that there is need to sensitize Police Officers to know how to deal with HIV and TB patients who need to take medication especially those who have not disclosed their status upon arrest and detention.

The Deputy OCS in response to the issue explained that things have changed and that the police officers nowadays handle victims with more caution and respect. This was sharply disputed by the participants who insisted that the police are the worst violators of human rights. A member explained that he was arrested at 10.00 am and taken to Nyali Police Station for no offence. He was later released after being told to clean the Police Station.

The Deputy OCS was at pains to respond the participants’ allegations but offered to give assistance where possible when it came to matters of HIV and TB patients and also victims of GBV. The issues raised revealed that the police violate human rights. The Deputy OCS indeed confirmed that through such dialogue and in cooperation with the stakeholders present the police service can become better law enforcers.

20 21 The village elder present appreciated the opportunity to interact with the deputy OCS. She informed her of the challenges she faces with drug users and Police. She stated that upon reporting to the police that there are people selling drugs to kids, the Police Officers arrest them and later the peddlers are released and later she receives threats to her life. To this the Deputy OCS advised her to visit the Police Station to get proper assistance.

Finally, the Deputy OCS invited all members present who had issues of human rights violations to visit him in person for assistance. The Deputy OCS was very open to the forum and appreciated the opportunity to get enlightened on matters of HIV, TB and SRH. He agreed that there is need to create more awareness of these issues especially to the police officers. It came out that everyone has a responsibility in promoting human rights.

The Sub County TB and Leprosy Coordinator, Mr Evans then informed the participants that they deal with TB and Leprosy. He went on to explain that TB is communicable diseases and if one does not take medication others are exposed. So far they have handled about 741 TB cases in Jomvu where 5% of the cases stopped medication. He noted that the main reason for discontinuation of medication is drug use. Second reason is when a patient is out of station of initial treatment whereby they have a difficulty in picking up their treatment in a new health facility.

He stated that they are now targeting drug users for treatment against TB and they seek cooperation from the members present to encourage their clients to take medication. His main concern that he posed to the participant was on how to assist those who default TB medication He said that he is hoping that by 2035 TB will be completely cleared as put by the WHO report.

Ms Priscilla, the TB and Leprosy Coordinator Jomvu, informed the participants about TB stating that TB is air borne and everyone need to protect themselves and others against infection. She encouraged working together as stakeholders to assist those on MDR medication by sensitizing the community on the importance of medication when infected with TB. She also stated that the notion that TB patients are HIV positive should be dispelled and awareness created to the effect that HIV also has medication and someone can live longer than expected when on proper medication. She called on for more community dialogue to eradicate TB from the community.

A question was raised with regard to MDR TB, how the victim can be assisted. Participants recommended cooperation with the local chiefs in assisting some victims. It was suggested that those victims who default should be reported to the chief. This recommendation was rejected as reporting patients who default on TB medication to the chiefs may subject them to further defaulting due to fear of dealing with the authorities or harassment by the authorities.

It was also noted that the mode of treatment for TB and MDR i.e. daily injection for about 6-8 months can be overwhelming to the patients. Ms Pricilla responded to this by stating that TB treatment is standard though MDR-TB requires intense treatment without which it may not be effective. The intense treatment for 8 months or more only comes up where a patient has defaulted in the initial 1 month or 2 months dose treatment. As a way forward with regard to defaulters in TB treatment where it was noted that sometimes TB patients who default medication do so out of fear of medication and due to lack of food. It was suggested that there should be strategies to provide food for victims.

20 21 This was countered by the TB coordinators who said that there is food support for TB patient’s countrywide. Some are treated from home and given support by the medical facilities whereas some are given food support by various NGOs promoting health rights. They pointed out that there is a challenge where TB patients are given money for support since most of them being former drug users instead divert it to buy drugs.

TB Coordinator, Mombasa County, Mr. Samson Kioko, emphasized that Chronic TB can be treated. He stated further that they now give patients freedom to choose health facilities of their own choice at an affordable price. And tests now take 1-3 hours. He clarified on the issue of testing that they had a challenge of testing MDR but now they have machines that can analyze the bacteria between 1-3 hours. He emphasized the need to educate parents on the issues of TB and HIV so that they can take the necessary action when their children are affected to avoid deaths and spreading the disease unlike HIV, TB is communicable and airborne.

TB Coordinator Mombasa County Mr Kioko giving his remarks.

Participants agreed that stigma from service providers is still prevalent though the TB coordinators indicate that it is something that they are working on through sensitization among their health care officers. In case of any stigmatization or violations from the health care officers patients should report this, that way necessary action is taken to ensure that that patients are well taken care of and to eradicate TB. Participants were also called to liaise with coordinator’s office in for assistance of the KP that they deal with.

22 23 A suggestion was also raised that TB patients who default should be imprisoned and forced to take medication. However, Ms Esther Nelima CHA Likoni, was quick to inform meeting that imprisonment for the sake of isolation is against the law, and TB treatment can be done at a health facility. On the issue of arrest by police officer, Ms Nelima informed the participants that they have a right to ask a police officer the reason for his her arrest.

The Chief from Chaani stated that he supports the stakeholder’s initiative in assisting patients with TB and HIV. He called for further dialogue to ensure that violation of the rights of such patients is not committed. The Chief from Port Reitz, said that TB is a big issue within Changamwe constituency. This has come out from the reports that were given by the County Tb coordinators. He stated that as chiefs they have tried dealing with defaulters. They have done follow up on some and they too have success stories of TB patients who have taken medication successfully and recovered completely. He however confirmed that at times they require the assistance of the Police to effect compliance on some patients though the Police in most cases do not cooperate. He agreed as has been suggested in the dialogues that there is need for network for proper follow up.

Another participant agreed with the statement that KPs are in danger of getting HIV and even TB. He went on to state that the Government became concerned to disseminate information on HIV so as to reduce infections. He appreciated the efforts of the CHAs trained by KELIN who have been able to create awareness within the constituency and they have done a good job as many have come out for HIV and TB testing and treatment.

Lily Baya, a representative of ICRH, said that what the general population does not understand is that there is PREP. And the challenge is that those who should be getting the medication fear carrying them home due to stigma. Further once one is known as KP they are isolated/neglected and thereby more exposed to the dangers of HIV. She said their biggest challenge is loss of clients. Once they record some patients, they disappear and they do not know how to trace them since most patients give very scanty information due to the stigma as they would not want anyone to know their status. Everyone has rights and should be respected.

Another challenge that they have is with young girls who are out as sex workers. They take their services of distributing protection commodities to sex workers at hot spots and they are met with children. They deal with 16 year olds who have HIV viruses and they are unable to help. The challenge that they face here is that they are jobless and they have children who they should be taking care of. The question that comes to mind at this point is the FSW have information on protection, but what about female children sex workers?

A village elder also concurred with the notion that they in many cases advise most patients of TB and HIV to go for treatment but later they disappear. He further stated that they do not have resources to do follow up on such patients and as such they are left to their suffering.

Ms Odongo, of Coast Women for Women which advocates for diverse families, concurred that they face stigma as they are judged the way they are especially from health care providers.

22 23 A representative from Sauti ya Kina Mama - Changamwe an organization which Advocates for children and women said that they have success stories where children have been defiled and they have reported to the police who eventually took the cases to court and the cases been prosecuted to finality and perpetrators convicted. She also stated that they advocate for use of protection among female sex workers though acknowledged that they also face the challenge of child prostitution which at times they find difficulty in addressing.

Boniface, a PLHIV, suggested that there is need to be assisted to vet the under 18 who are among the PLHIV to be able to assist them appropriately. This came about after a discussion on the agreed age of testing where it was realized that there are teenagers who are PLHIV but cannot come out and talk due to the stigma.

It was also agreed that PLHIV should come out clearly about sex and its consequences. Issues of sexuality are very important and there is need for proper education and clarity especially among the youth and teenagers.

Ms Mwanakombo, the CHA Kisauni encouraged the participants on the need to come up with strategies to be able to handle patients with TB especially defaulters. This is because most of the representatives in the forum were in one way or another involved in advocating for health rights of KP and the minority in the community. The purpose of the dialogue is to enable the ones involved in the community level to bring out the challenges faced in Changamwe.

Again the issues of lack of opportunity to go for medication due to stringent work rules came up with the example of EPZ employees. It was evident that this was a big challenge since EPZ is a big company and takes in very many casual laborers who are either PLHIV or TB patients. However due to their strict working hours these employees are unable to access medication as is required. This was discussed at length and finally it was agreed that there is need for sensitization and awareness creation for the employers at EPZ to enable understand more about the health issues of their employees.

FSWs were urged to be their sister’s keeper. This was more so with regard to the challenges that they face in the course of their business. It has become a matter of great concern as some FSWs just disappear and their fellows cannot give any information even to the authorities in that regard only to be discovered after a few days murdered or raped and left for the dead. FSWs face a very hostile environment and therefore the need to look out for each other.

The Constitution of Kenya 2010 and the right to health

Similar to previous sessions held previous meetings, Ms Lilian Fwaya a pro bono advocate with KELIN introduced this session by informing the participants the role of the government with regard to the provisions of the Constitution. She detailed the different articles in the Constitution in relation to the right to health. She also encouraged participants to familarise themselves with the bill of rights.

24 25 Mentioning the Provisions relating to health- Articles 43, 2 ,21, 46

43. (1) Every person has the right— (a) to the highest attainable standard of health, which includes the right to health care services, including reproductive health care; (2) A person shall not be denied emergency medical treatment.

She noted that in most cases victims are denied justice due to lack of knowledge of the legal provisions of their case. She mentioned some of the constitutional provisions as:

• The right to life (Article 26). • Equality and freedom from discrimination (Article 27) • Human dignity (Article 28) • Freedom and security of the person (Article 29) • Freedom of conscience, religion, belief and opinion (Art. 32) • Access to information (Article 35[1] [(b]) • Protection of right to property. • Access to justice. • Rights of accused persons • Economic and social rights (Article 43) • The right to health care services and consumer rights (Article 46) It was observed that the people of Changamwe had many challenges and complains against the judicial procedure. Ms Fwaya advised them to be more proactive in their cause when it comes to prosecuting cases. Fortunately from the interaction with the Deputy OCS who was present the participants were encouraged to utilize the opportunity to be able to achieve their cause and prevent human rights violations.

Recommendations and way forward

1. Have a platform to create awareness for underage children involved in FSW and educate children on sexuality and consequences of early sex. 2. Find a way to engage underage children who are neglected. 3. Community sensitization on health rights and avoiding stigma 4. Sensitization of local leaders on the need to ensure justice prevails to all 5. Training more people on community advocacy for human rights. 6. Vigilance in handling cases of child neglect through the local leaders and the Police. 7. Networking with all the stakeholders and the local leaders. 8. Stakeholders to address issues and challenges as they arise. 9. Sensitize the EPZ employers and supervisors on matters HIV, TB, SRH and human rights 10. Sensitize health care givers on the need to be sensitive to all clients and avoid stigma and discrimination in any way

24 25 Conclusion and closing remarks

As an ambassador there is need to advocate more for the rights of KPs especially in health facilities. Need to sensitize pastors and Muslim leaders on key population issues. There is also an issue of non-disclosure of HIV status by the employee to the employer which needs to be discussed to ensure rights of workers is respected and protected.

The CHA Changamwe gave a vote of thanks and encouraged the participants to disseminate information gathered from the dialogue and help making the communities a better place to live in. Madam Chief in her closing remarks said that she has been enlightened through the dialogue forum but challenged the organizers that a half day of learning the issues is not enough to get information since the time was very limited but all in all they were grateful for the opportunity to learn.

She said that the dialogue has been an eye opener for them as local leaders and they will go down to the community with the information and sensitize them. She also added that they will also take up the issues raised in their specific areas especially with children and matters of education.

26 27

Annex 1: Participants

List of Participants - Likoni

No. Name Organization 1. Zaka Mohamed Kenya Red Cross 2. Alice Owino Sauti Ya Wamama-Mvita 3. Elvina Mzungu Youth Gender Sports Ministry 4. Mike Bibi DOH-Likoni 5. Faith Nyangena Village Administrator 6. Ali Chege PEMA-Kenya 7. Benta Joseph COSWA 8. Mwanajuma Mbaruku Midodoni CHV 9. Wevin Muganda HAKI Africa 10. Ali Futo HAKI Africa 11. Rose Mwangi National Police Service ACU 12. Hamisi Juma LICODEP 13. Dr. Salma Swaleh CDH-Mombasa 14. Sila Rose ICRH 15. Raphael Makena HAPA-Kenya 16. Felix Matekwa HAPA –Kenya 17. Saida Mwinyi Nurse-CGPH 18. Gideon Muyuku Care For Aids 19. Mahmud Yaro Imam 20. Mariam Antonet Likoni 21. Hiram Mwalaa Journalist-Radio Salaam 22. Maryam Ally Likoni 23. Taib Abassheeb Reach Out Centre Trust(RCT) 24. Abdulrahim Mohd RCT 25. Fatuma Nuri Mrima C.U 26. Nema Hamis Likoni B.I 27. Hassan Omar RCT 28. Stephen Nyawa Chief 29. Jael Mghoi Mtongwe Health Centre 30. Zuhura Salim CHV-Mtongwe 31. Annet Ndule Senators Office 32. Shalom Mbua Likoni PWP 33. Biberone Umazi NPS 34. Muradswaleh RTC 35. Nickson Mwakazi PEMA-Kenya 36. Hajj Salim Media 37. Anne Nyambura KELIN 38. Esther Nelima KELIN 39. Alfred Mbati KELIN 40. Miriam Andebe KELIN 41. Martin Kyana KELIN 42. Mwanakombo Said KELIN 43. Alfred Sigo Pwani Yetu Network

26 27 No. Name Organization 44. Halima omar Likon CBO 45. George Kissinger DOH MOMBASA 46. Joanne Musau CHEC 47. Amina Juma Sauti Peace And Cohesion 48. Mealii Hamis Shunda CU 49. Robin Mutinda CHEC 50. Lilian Fwaya KELIN 51. Francis Nganga Kenya edcross 52. Paul Wanjiru AHF KENYA 53. Aziz Issa Sauti ya wanawake 54. Masood Mbarak Youth & sports ministry 55. Fatuma Salim Likoni CBO 56. Samuel Mwakirungi Mvita CBO 57. Juma Muleo COSWA

List of Participants – Kisauni

No. Name Organization 1. Yusuf Bakari MCA Mtopanga Ward 2. Justine Orucho HAPA-Kenya 3. Joskar Amondi INEND 4. Robert Mbotela UPENDO 5. Siwatu Matano Mwakirunge LIP 6. Zawadi Japhet Sauti-mwakirunge 7. Zubeida Samir Sauti-mwakirunge 8. Jeniffer Odaido Sauti- mwakirunge 9. Rachael Makena HAPA Kenya 10. Said Ibrahim P.T.I 11. Felix Matekwa HAPA -Kenya 12. Jackson Tunje HAPA Kenya 13. Munira Faraj SUPKEM 14. Charo M. Tangai KICODEP 15. Rev. Nzaka Wanje ACK 16. Mtana Mwaringa Media 17. Judith Aura Kisauni CBO 18. Abdalla Hipuba Chief –Kazandani 19. Mareilyne Laki Kisauni PE CBO 20. Asha Nyakundi Kongowea Health Centre 21. Saada Mbarak Kongowea Health Centre 22. Salome Maingi Health Centre 23. Dee Wakio Rainbow Women Of Kenya 24. Kanini Manyenze Bamburi Support 25. Salome Wanjiru Mombasa Youth Advisory 26. Masika Hamisi Bulo CU 27. Grace Siwillis MOH –Nyali 28. Jackline Tsuma MOH-kisauni 29. Fatuma Ahmed NUJJAHDEEN WASG –shanzu 30. Elizabeth Kalume Bulo CU

28 No. Name Organization 31. Grace Saha Bamburi CHV 32. Prudence Salama Mtopanga 33. Anne Nyambura KELIN 34. Esther Nelima KELIN 35. Aisha Mboko Bamburi 36 Charo Kazungu Kisauni 37. Lilian Fwaya KELIN 38. Mwanakombo Said KELIN 39. Alfred Mbati KELIN 40. Martin Kyana KELIN 41. Miriam Andebe KELIN 42. Meshack Wafula PEMA Kenya 43. Zainab Bakari Bamburi CHV 44. Munira Faraj Bamburi SUPKEM 45. Kazungu Kalama Mtopanga

List of Participants – Changamwe

No. Name Organization 1. Colata Adhiambo Jomvu Model 2. Mishi Mbegei Bokole CDF 3. Amina Maloba Bokole CDF 4. Nancy Omolo Magongo Health Centre 5. Rose Wanje Magongo Health Centre 6. Anna Kamende Village Elder-Changamwe 7. Mohamed Juma Village Elder Portreitze 8. Siproza Mwakoi Village Elder Chaani Mbuyuni 9. Asha Abdalla School Committee 10. Hassan Shason Youth Group 11. Saumu Mriwa Youth Group 12. Phigoner Musundi ICRH 13. Leila Ramadhan ICRH 14. Binti Ali Ramadhan JILINDE 15. Lilian Achieng ICRH 16. Said Buya CHV 17. Miriam Mubaga Chaani Dispensary 18. Boniface Wasawo Village Elder Chaani 19. Ali Abdalla Imam 20. John Gengu Youth group 21. Lily Baya ICRH-Kenya 22. Dancan Otieno NCRH 23. Charus Kasai PTI Kenya 24. B.A.Odongo Coast Women For Women 25. Jackline Wanyonyi PEMA Kenya 26. Rasto Mbayi PEMA-Kenya 27. David Ojwang Magongo Health Centre 28. Evans Nyayiema MOH

29 No. Name Organization 29. Priscilla Mutua MOH 30. Joscath Kithusi NPS 31. Matilda Achieng NLVCT 32. Lucrenga Mbarak Chief portreitze 33. Ben M. Valasa Chief –chaani 34. Mando Hassa Changamwe 35. Samson Kioko MOH 36 Rose Joseph Meland 37. Amenya Achims WACHA 38. Lilian Fwaya KELIN 39. Rose Geno SCACC-Changamwe 40. Vincent Mwai Chabeat School 41. Mwanakombo Said KELIN 42. Anne Nyambura KELIN 43. Esther Nelima KELIN 44. Miriam Andebe KELIN 45. Alfred Mbati KELIN 46. Martin Kyana KELIN 47. Hawa Salma Musa Jomvu CBO 48. Solomon Mugita TSC 49. Halima Hassan Magongo women

30 31

Annex 2:

Agenda

COUNTY DIALOGUE FORUM ON HIV, TB, SRH AND HUMAN RIGHTS IN MOMBASA COUNTY ON 20th to 22nd FEBRUARY 2018

Agenda

Objectives of the County dialogue meetings;

. Enhance the capacity of Community members on new and emerging issues related to HIV, TB, sexual repro- ductive health and human rights;

. Enhance the understanding of the linkages between HIV, TB, sexual reproductive health & human rights, challenges in addressing the same & available mechanisms for redress;

. Experience sharing amongst health stakeholders and duty bearers in relation to the implementation of HIV, TB, SRH interventions and legal services.

. Discuss the strategic role Community members play in advocacy and monitoring health accountability for improved health service delivery.

Time Session Facilitator 08:00- 08:45am Arrival and registration CHA team leader 08:45- 09:15 am Introductions; Lucy Ghati

• Welcoming remarks

• Objectives 09:15 -09:30 am Opening remarks from County/Sub-county leaders Lucy Ghati 09:30- 10:00 am Remarks/reports by Community Health Advocates based on their CHA team leader-Anne work in the community regarding HIV, TB, SRH and Human rights. Nyambura 10:30-11:30: am Reactions to the CHA reports by; Lucy Ghati

a) Community persons or leaders

b) CBOs, CSOs representatives

c) County/Sub County Coordinators for SRH, TB & HIV. 11:30am-12:15 pm The Constitution 2010 and the Right to Health Lillian Fwaya 12:15- 12:30am Questions and answer session CHA Team Leader 12:30- 12:45 pm Conclusion, recommendations and way forward Lucy Ghati 12:45 – 1:00pm Closing remarks and departure County/Sub County officer

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