Background Information

Amina’s Year of Birth: 28th December 1980
Human Reader: Fatuma Abdi Yusuf
Sub – Location Highridge,Location ; Korogocho,District ; Nairobi,Province Nairobi
Tel No.: Fatuma Abdi 0724443756 (ToT Grace Karanja 0724814178)
Impact
Amina Yusuf is 30yrs of age and has been raped twice while attending “Madarasa” Muslim religious classes at the mosque but she did not report to the mother hence no legal action was taken since the mother did not know about it as they are not in good terms.
Some of her siblings mock her and hate her. Amina evidently lacks true family love hence she has developed emotional disorders of hating them in return she complained that the family always wish for him to die and this has discouraged her to have confidence in sharing anything with them including her personal issues.
Amina claims that her family does not give her enough food, When Grace visited her she complained that when they serve food they always give her a small portion but they serve themselves big portions and this was evident from the physical appearance as she looks highly malnourished to a point that she is unable to walk.
The family solely depends on the father who is a hawker yet there are seven children to feed and dress in the same family. The social and economic level of the family is abject poverty as they are housed by a relative.
Aminas mother is just a housewife. She is totally dependent on her husband who is a hawker and his income is unpredictable.
Challange
Amina does not have anyone in the family to support and take care of her. Having been sexually abused twice with no action taken against the perpetrators it is a situation that needs quick intervention. Amina might have contracted HIV/AIDS or any other STI but it is hard to tell considering that the support for her welfare from the family is lacking.
Initiative
After Grace did the assessment for Amina, the Mental Disability Specialist designed an individualized intervention strategy that could confront her specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on e.g. the importance of understanding their sexuality, HIV/AIDS prevention and how to prevent spread of HIV/AIDS.
This intervention has been designed with the severity of the PWIDs intellectual disability in mind, and caters for his unique communication needs. From the new follow up tool we will be able to establish whether the lessons taught were taken up by both the HR and PWID.
Recommendations
Amina needs support to live in a safe environment as well as the family who are economically needy. The barely get enough to eat hence Amina is malnourished. Amina needs a carer to take care of her closely as the parents can go out find some income generating activity. Amina can benefit from vocational training skills like beadwork, knitting that do not require minimal supervision, which she can learn quickly as well as keep her busy unlike being confined in the house for the whole day.
Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Background Information

Beth’s Year of Birth: 12th December 2010
Human Reader: Anthony Thuo
Sub – Location Kaheria,Location; Kiamwangi, District; Thika,Province; Central
Tel No.: 0720942199 (Rosemary ToT)
Impact.
Beth Njahira is the second last in a family of eight siblings. There are ten members in the family including the father and mother. One of the family members passed away and the cause of death was unknown. The family lives in Gatundu Kiamwangi sub-location Katununia Village. Mr. Mwatha is the father of the eight children five of them are intellectually disabled and Mrs. Lucia Wambui 57yrs is the mother and also intellectually disabled.

The first born is called Anthony Thuo, he is married and has three children, one of his children is a slow learner but the other two are normal. Joseph is the sole bread winner for the entire family because none of his family members is able to provide for themselves considering that most of them are PWIDs. The father doses not provide for the family needs apart from Joseph who is a casual laborer and he earns Ksh.100 per day.
Hannah Nduta is the second born, she is married and has four children, according to his first born brother one if her children has mental disabilities. Hannah is 33yrs.

Peter Njuguna is the third born in the family, but people have been taking advantage of him. He does casual work which he is paid Ksh 30. Peter pays for sexual favorers with this money he gets to anyone willing to have sex with him, he has been having sex with different people and on of the sex partners he had an encounter with passed away and when asked what was the cause of death he says it was caused by HIV/AIDS. It is advisable for the PWID to be tested and know his status.

Joseph Muchiri is the forth born. He is a PWID and confessed that sometimes they share sex partners with his brother Peter Njuguna.
Joseph Mwaura is the fifth born, he is 24 yrs and has moderate mental disabilities
Beth Wanjiku was the sixth born she was normal with no signs of mental disability but passed away and the cause of death was unkown. She used to support her family financially but this was cut off with her demise.

Beth Njahira is the seventh born 20yrs, she is the case study we are highlighting because apart from being a person with intellectual disability, she had been frequently sexually assaulted and at one time she was raped, got pregnant and give birth. She is enticed with gifts and sexually abused. Before she was raped Beth’s father had given her away for marriage but it did not last long because her husband found him with another man in their matrimonial bed having sex and he decided to chase her away.

Beth says that when this happened she had been enticed with gifts to sleep with this man. Now they are separated with the husband because she used to sleep with other men during day time. She also informed us that when the husband found them in bed with another man she fought both of them and she was sent back to her home. Beth’s husband had introduced her to birth control pills but when he realized that she was forgetting to take the pills she took her for family planning injection. At school Beth is an athlete and had been awarded there certificates in different racing competitions.
Mary Njeri is the last born in the family she is 16 yrs old. Currently she is attending a special unit for the mentally handicapped.
Challenge
Beth used to attend special school but she can no longer do so because of the responsibility she has of taking care of her 8mounth old baby.
The family is very poor and the mother, who is a PWID, has been infected by jiggers. The house they live is very small to host such a big family. The facilities they use especially the toilet is in a deplorable state with no walls not even iron sheets.
The family lacks basic needs that include food, shelter and clothing and medication as well.
Initiative
KSMH visited the family on 21st May 2010 and we were able to evidently observe the situation on the ground exactly as it is. It was sympathetic and it is through the intervention done by Ann Wanjiku the TOT that we proved this to be true.
Through the HIV/AIDS PWID intervention program. Ann the ToT did her assessment after which the Mental Disability Specialist will design an individualized intervention strategy that could confront Beths’s specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on, e.g. the importance of taking ARTs and how to prevent further spread of HIV. This intervention has been designed with the severity of the PWIDs intellectual disability in mind, and caters for her unique communication needs.
Furthermore, the ksh 2000 which Ann gives the HR for facilitation of each intervention strategy will enable Beth and her family to buy food. KSMH also gave the family some floor to support the family with food.
Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Anne’s Year of Birth: 1985
Brian’s Year of Birth: 1994
Human Reader: Cellestine Okeyo (I.D.: 13604210)
Sub - Location: Kahawa Wendani, Location Githurai, District Thika, Province Central
Tel No.: 0734894068 (husband’s phone) ToT Rosemary Njau 0720942199

Family consists of 7 children, including Anne and Brian. Their siblings are 26, 18, 12, 6 and 5 years of age. All children except the eldest are in full-time education. Brian and Anne are not attending any schools, although Anne received vocational training at Chesire Home, however she has been unable to find somewhere to work. The eldest child is currently unemployed. Brian and Anne’s father is also unemployed; however he generates approximately 2,000ksh a week through casual labour. Cellestine earns approximately 600ksh in profit from a small fish selling business.

Cellestine’s business is located near the home to allow her to care for Brian and Anne whilst earning money. However, when she leaves the home there is nobody to care for them. Anne, who is a lot more competent and able than Brian, is often left to feed and care for her brother if they are alone for a prolonged period of time.

Although they eat most days, they often must go without food in order to buy necessities such as clothes. Most of the clothes they own have been donated. All nine family members reside in the small two-roomed housed. They have 5 beds between them. The rooms themselves are so small that Cellestine must ask the others to leave the house when she washes Brian. Cellestine also finds it difficult to entertain so many children as they do not have any television or radio.
 They family receive no community support. Many people in the neighborhood point at them when they leave the home. Cellestine feels they are scared and simply do not understand. Regardless of the lack of community support the family unit remains strong. Brian and Anne’s disabilities have not had any negative impact on their parent’s marriage and their siblings share a deep love for them.

Anne’s Condition:

Anne was not born with a disability, but acquired brain damage and epilepsy after developing polio at the age of two. Her hand has also been left disfigured from the polio. She has good communication abilities and can speak and understand Kiswahili. She has attained essential life skills such as feeding and bathing herself. She is on daily medication for epilepsy. Behaviourally she does not have any major problems, however her mother reports that she is prone to bouts of “gloominess”.

Brian’s Condition:

Similarly to Anne, Brian was born without a disability, but developed meningitis at 3. He is completely bed-ridden and dependent on his primary care-giver. He has not attained any life skills and is unable to even feed himself. The only semblance of language he has acquired is augmentative, making noises when he is distressed. He is on medication daily. Cellestine has hoped to find a home for him that can provide the full-time care that he needs, however they have all proved to be too expensive. Brian has a wheelchair, although he cannot push himself. The only time he leaves the house is to go to church once a week. The church provides free physiotherapy for him; however Cellestine believes it has had no impact on him due to his age.
Case compiled in 2010
Michelle O’Sullivan
Program Officer
KSMH

Background Information:

Helen’s Year of Birth: 2003
Human Reader: Esther Njeri Mwangi
Sub – Location Githurai, Location Githurai, District Kasarani, Province Nairobi
Tel No.: Esther Njeri 0721620508 ToT Rosemary Njau (0720942199)
Impact
Lives in Githurai 44, before they lived in Korogocho. She is 7rys of age an orphan but lives with her caregiver a lady Esther Njeri she calls grandmother. On visiting them Rosemary found out that they were going to Nairobi Women’s Hospital for Helen to be tested.
Esther Njeri informed Rosemary that Helen is an orphan, her mother died of HIV and Aids and that before her mother died she was sleeping with different men that could be the possibility for her to have been infected with the disease and passed on. Esther is Helens Care giver she runs a small business and lives in her own house hence she is able to support her own PWID daughters and Helen as well. Helen now lives in a safe environment.
The sad bit was that Helen revealed to the care giver that after the men slept with the mother they in turn slept with her. This happened when the mother was asleep from her drunken state of alcohol that made her drunk; hence she could not know what was happening to her little girl.
In the morning Helen reported to the mother what she was going through but the mother insulted the men in her presence that they are “dogs and prostitutes”
On follow up Rosemary was told by the grandmother that Helen was tested and found to have vaginal infections, as for HIV/AIDS test they were told to go back another day.
Grandmother also revealed that when she is bathing Helen, Helen complains of pain in her vaginal area. A neighbor also gave evidence that at one point she gave Helen a bath but she complained of pain. Rosemary asked Helen where she feels pain and Helen pointed at her vagina.
Challange
On getting this information Helen’s HIV status was unknown they were yet to go fot the HIV test.
Helen has been in school for more that 4 years but she cannot write her name and is suspected to have developed intellectual problems from the mother reckless behavior of alcoholisms before she gave birth to her.
Now she is in a nearby private school. The Caregiver doesn’t know whether she is a PWID but Rosemary advised her to take Helen for assessment at KISE (Kenya Institute for Special Education) because she lacks writing skills, and her head is bigger than her body that when she talks she bends her head.
The Human Reader also has two PWIDs so she took Hellen because they relate well.
Initiative
Through the HIV/AIDS PWID intervention program. Rosemary the ToT did her assessment after which the Mental Disability Specialist will design an individualized intervention strategy that could confront Helen’s specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on, e.g. the importance of taking ARTs and how to prevent further spread of HIV. This intervention has been designed with the severity of the PWIDs intellectual disability in mind, and caters for her unique communication needs.
Recommendation
Through the assessment that was conducted by Rosemary on Helen KSMH has been able to identify the necessary action to be taken in order to support the PWID in obtaining vital information regarding HIV/AIDS and in accessing required services.

Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Background Information:

Irene’s Year of Birth: 16th June1984
Human Reader: Mbithe Rose Mwova
Sub – Location Githurai Location Githurai, District Kasarani, Province Nairobi
Tel No.: Mbithe Rose 0720003743 (ToT Rosemary Njau 0720942199)
Impact
Irene Mwikali sister to Naomi Mutheu was abused by the foreman who worked on her grandmother’s farm. He lured her to go and pick fruits with him then he raped her. She cried often but the grandmother could not understand what was wrong. The grandmother decided to inquire from her which she later confided in her on what happened to her. It was shocking news to the grandmother since she couldn’t suspect the foreman who had worked for her for many years.
On realizing she would be caught the foreman run away never to be found again. Irene’s mother was later informed of what had happened this made her feel unwanted in the community since her girls had been sexually assaulted and they were PWIDs.
Irene was threatened not to reveal what had happened to her or she will be killed. The person who attacked her also harshly commented that “he will get rid of the stupidity in her”. Irene could no longer keep to herself what had happened to her because of the pain she was feeling from the terrible ordeal. Thus she told her mother what had happened.
Irene also shared with Rosemary that when she is on her monthly periods she knows what to do; sometimes she takes old clothes and tears them into sizable pieces that she uses in place of pads.
Irene has developed convulsions that can take last for 48 hours.
Challenges
People have stigmatized the mother because of her two daughters Naomi and Irene for their intellectual disability. The environment in which they live is very risky for Naomi and Irene evident from the terrible ordeals they have gone through. This two girls live in an area where drug trafficking is high and there is brewing of illicit liquor
Naomi’s mother is very afraid this has resulted to her not wanting to take her daughters to school as a result her daughters are missing out on education which is very important.
The mother seems to have taken the initiative to talk to her daughters thou Rosemary observed that she was hiding information pertaining to the life skills she has given to the daughters. The body size of the girls is big and rumors in the neighborhood were that their mother was giving them contraceptives.
Both Naomi and Irene do not know their HIV Status. Naomi has no interest to go to school unlike her sister Irene Mwikali who is also a PWID.
Initiative
Naomi’s mother has taught them some defensive skills, this days Naomi is very defensive and anyone who approaches her for sexual favors she shouts to back at them that she is not a prostitute or anybody’s wife to be misused.
The mother has taught them how to make beaded work which they make and sell, since she is not comfortable taking them thorough any learning institution after what they have gone through.
Recommendation.
Both Naomi and Irene need counseling and someone to guide them to go for VCT services.
Through the assessment that was conducted by Rosemary on Naomi and Irene KSMH has been able to identify the necessary action to be taken in order to support the PWID in obtaining vital information regarding HIV/AIDS and in accessing required services.
Case compiled in 2010
Valarie Jumba

Program Coordinator KSMH

Impact
Rosemary knew Naomi’s family from their neighborhood where she lives in Githurai. Naomi has a sister who also a PWID is called Irene Mwikali. On her way home Rosemary got into a conversation with the mother and she informed her that she also had a child who was physically challenged. The mother became interested to talk more with Rosemary where she told her that her PWID children have been despised by everyone throughout their life. The mother said that there has been a lot of stigma towards her children and that she trust no one in their community.
Naomi’s mother works at Kahawa barracks as a casual laborer. Naomi and Irene are children from her first marriage. Their mother has other children from her current marriage who are hard working in school so little interest is given to Naomi and Irene.

Rosemary informed her about Kenya Society for the Mentally Handicapped (KSMH) and the services they provide, she advised there mother to make a point of visiting KSMH and get more information of how she can register her two PWID daughters. Back to her purpose of visit she did assessments for the two girls.
The mother narrated to Rosemary that the daughters are Rape victims. As for Naomi Mutheu’s case she has been sexually abused more than once. In the first incidence Naomi was raped while she was in boarding school by the watchman at night. This was traumatizing to the mother that she discontinued Naomi from school.

The second incident that befell Naomi was when a male friend to the father visited them at their house and found the two daughters alone. He gave them sweets and lured Naomi into the bedroom closed the door and raped her. This incident was revealed to Naomis mother by her sister Irene who was left in the living room when Naomi was abused. And also when the mother came home to hear the horrifying news she found Naomi’s dress with stains of ejaculations and also on her thighs. This was enough evidence to report the matter to the police, Naomi was given treatment at Nairobi Women’s Hospital and the case taken to Millimani court and the man sentenced to jail at Kamiti Prison.

In another incidence Naomi had gone to fetch water but she took a longer time to return home, her mother followed her to the water point shockingly to only find the Jerri can that Naomi had for fetching water. She could out loud for Naomi but there was no response. Naomi on narrating the incidence that had befallen her she said that the attacker threatened to kill her if she tried to shout for help and there was a lady who had tricked her to go to the bushes and set a trap leading her to the rapist. Her mother tried to inquire from Naomi to show her the lady but she has never done so despite the fact that the lady leaves in the neighborhood and she can recall her.

Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

James’s Year of Birth: 29th September 1995
Human Reader: Pauline Wanjiku Miringu
Sub – Location Ruiru, Location Ruiru, District Thika, Province Central
Tel No.: Pauline Miringu 0720454470 ToT Rosemary Njau 0720942199
Impact
James Miringu is 15yrs and lives with her mother Pauline Wanjiku in Githurai 45 Nairobi. He went to school at Maji Mazuri school, St Lucy Igoji for two weeks and star disability for two years but discontinued because the mother could not afford to pay for his schooling. Currently he is at home but only lives with the mother since his father does not come home on regular basis but occasionally and spends many days away from home. James has cerebral parsley, he cannot walk, stand or feed himself and hyperactive as well hence the mother has to chain him to the seat and lock the house so as to go and look for their daily food.
Sometimes the mother lives him with the neighbour in case she is to go to look for work. James uses convulsion drugs. Pauline has another child 3yrs and 8 months who goes to school.
James has scars he got from burns due to the hyperactive state. He gets them when he is left in the single roomed house alone without being chained. He also got burnt from playing with matches and hot liquids that were within his reach.

James is one of the PWIDs who have been assessed and an intervention done for him from the HIV/AIDS program which is funded by CARE Kenya.
The mother survives on casual jobs she gets like washing clothes for people and then she is paid at highest 100 ksh per day. Which she uses to buy food for the house since the husband does not support him.

Challange
James dose not have anyone in the family to support and take care of her. James is disadvantaged because when he is left alone at home he can be harmed from the surrounding. James needs support especially from the mother who is the caregiver as well as the Human Reader, this includes right to freedom but with support to ensure that he is well protected and cared for at home and not left alone in the house.
Initiative
After Rosemary the ToT from KSMH did the assessment for James, the Mental Disability Specialist designed an individualized intervention strategy that could confront his specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on e.g. the importance of social relations, the rights of PWIDs to make choices and supported decision making.
This intervention has been designed with the severity of the PWIDs intellectual disability in mind, and caters for his unique communication needs. From the new follow up tool we will be able to establish whether the lessons taught were taken up by both the HR and PWID.

Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Background Information:
Mathew’s Year of Birth: 5th February 1945
Human Reader: Jane Wanjiku Kinuthia
Sub – Location Kiamwangi, Location Kiamwangi, District Gatundu, Province Central
Tel No.: Jane Wanjiku (0724599945/0718934851) Grace Karanja (ToT 0724814178)
Impact
Grace one of the TOTs visited Gatundu to carry out an intervention on Mathew Karanja who is a PWID. On her visit she found out that Mathew karanja is 60yrs old and a widower. His wife died and left her with children one of them is a girl who is 20yrs old.
KSMH built a house for him by providing Iron sheets. The house is poorly partitioned. Grace inquired form Mr. Karanja who plays the role of a wife in his home and he declined to reveal this information. He confided to Grace that he has been intending to marry for the last 5yrs but, Grace asked him how he has been living with her daughter alone who is also a PWID but he did not reveal the information.
During their conversation Mr. Karanja gave naughty remarks to Grace like he wanted to marry her and that he was very strong to have a woman to sleep with him any time. Grace silently questioned herself of the motives of the man. His zip was also opened as the conversed.
Challange
Mr. Karanja revealed that her daughter had given birth but the baby was taken by a Good Samaritan. Mr. Karanja sister in law has been supporting them with the basic needs and she is also the HR (Human Reader).
Grace asked Mr. Karanja whether he has been tested and he said no, the daughter to has not been tested. Despite being a PWID. Mr Karanja understands most of the information on sexuality from the conversation they had with Grace.
The girl is at risk of being abused by the father, because they live together and the father seems not to be willing to disclose information on how they live with her daughter. The girl has been abused before that resulted to her getting pregnant and gave birth hence this could happen.
The two of them do not know their status hence the girl is at risk of being sexually abused by the father who seems to have a strong liking and urge for sleeping with women.
Initiative
The Mental Disability Specialist designed an individualized intervention strategy that could confront Karanja’s specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on, e.g. the importance of understanding their sexuality, HIV/AIDS prevention and how to prevent spread of HIV. This intervention has been designed with the severity of the PWIDs intellectual disability in mind, and caters for his unique communication needs.
Recommendation
Through the intervention that was conducted by Grace on Mathew, KSMH has been able to identify the necessary action to be taken in order to support the PWID Mr. Karanja in obtaining vital information regarding HIV/AIDS and in accessing required services.
Complied by in 2010
Valarie Jumba
Program Coordinator

Background Information

Peninnah’s Year of Birth: 1994
Human Reader: Mungai Wambui Peninah
Sub – Location Wemba, Location Makuyu, District Muranga, Province Central
Tel No.: Pennina Mungai 0721927066 /ToT Patrick Ngunyi 0721927066
Impact
Patrick Ngunyi is one of the ToTs at KSMH who works in Muranga district. On 5th March 2010 he identified and assessed Peninah Wambui a PWID and forwarded the documents to KSMH for development of the intervention Strategy.
Two weeks later, he received the information that the PWID was offered gifts and was sexually abused by the teacher and when the wife of the teacher discovered she set a trap for them.
One day she followed them to their secret hide out and caught them having sex. Out of rage the wife confronted Peninah with a knife and stabbed her on the thighs leaving her in pain. Peninah Wambui was then taken to hospital for medical attention.
On visiting the family’s home to follow up with the case Patrick was denied entry to interrogate Peninah and get the full story of the person who assaulted her from Peninahs uncle. On further inquiry Patrick found out that the school teacher who sexually abused her had conspired with the uncle and the area chief and was given a bribe to cover up the case and let go as unreported.
The uncle also denied Patrick Ngunyi the medical supporting documents that would have enabled KSMH do a thorough investigation and follow up the case. The uncle explained that he was the only one to deal with the case having lied to Partick that he was willing to ensure justice was done. When Patrick went back to implement the intervention strategy the uncle changed his mind to follow up the case on his own.
Peninah has since recuperated and the wounds have healed but she has been taken to another place to work far from home.
Challanges
Patrick the ToT was denied the supporting documents to follow up the case, and there seems to have been a collaborating deal between the uncle and the area chief as the local authority to cover up justice for Penninah.
Peninnah has since been moved to another area so that no one can interrogate her, but she is still at risk of being abused, and possible chances are that she could be infected by HIV/AIDS but the medical proof has been hidden so no one can tell.

Initiative
The Mental Disability Specialists have designed an individualized strategy that could confront Peninnah’s specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on, e.g. the importance of understanding their sexuality, HIV/AIDS prevention and how to prevent spread of HIV. This intervention has been designed with the severity of the PWIDs intellectual disability in mind and caters for his unique communication needs.
Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Background Information
Richard’s Year of Birth: 29th November 1991
Human Reader: Gerald Muriuki Nderitu
Sub – Location Ngei 2, Location Huruma, District Nairobi, Province Nairobi
Tel No.: Gerald Muriuki 0726066424/0721560210 /ToT Ann Wanjiku 0727491070
Impact
Richard Okongo is a Person With Intellectual Disability, He is 15 years and lives in a slum village known as Ngei 2 in Huruma. Richard goes to school at Salama Primary school. He has been frequently sodomized by the neighbor hence he has developed the negative habit and abuses other boys and girls in school.
The neighbor who has been sodomizing Richard is older than him and lives near their house and gives. Richard Ksh. 10 every time he sexually abuses him. Richard revealed to his teacher that it was the neighbor who taught him the behavior, after other school children reported the matter to their teacher.
On observing Richard his skin is rough and unpleasant to look at. One can tell that he is suffering from a skin disease that has not been medically attended to.
HR Gerald Muriuki who is a teacher at the school informed Ann that most of the sexually abuse related cases reported in school had been linked to Richard as the suspect. The teacher found out about Richards abuse by the change in his walking style.
The neighbor who abused Richard was reported to the authorities but no action has been taken against him. The said neighbor is still at large.
Challenges
Richards HIV/AIDs status is unknown as the mother who is the care giver is not willing to help Richard by confronting the issue and the root cause.
Initiative
Ann took the effort to visit the mother about 5 times and report but the mother is not cooperative nor is he willing to assist his son. Richard has been counseled at school but his behavior is still the same.
Richard needs to be educated on HIV/AIDS and personal safety in order to ensure that she will never experience sexual abuse again. Furthermore, she needs to be referred to organizations which provide services for PWIDs, this will ensure that he attains his full intellectual potential, and will help safeguard him from future abuse.

Recommendation.
Re assessment carried out by Ann Wanjiru ToT at KSMH has revealed the ills that happen not only to the girls but to the boys as well and in this case by the neighbor whom many would not suspect to have any ill motives towards Richard but in real he is the root cause to Richards negative habit towards other children.
It is through Ann that Mental Disability Specialists from KSMH will develop an individualized intervention program, which will assist Richard to shred the negative habit in turn reach out to the caregiver to ensure that the surrounding in which Richard lives is positive and holistic for his growth and development.
Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Background Information
Stella’s Year of Birth: 5th July 1989
Human Reader: Rhoda Wambui Ngingo
Sub – Location Dafur, Location Kariobangi, District Nairobi, Province Nairobi
Tel No.: Rhoda Wambui (0728562170/0722666096) ToT Ann Wanjiku (0727491070)

Impact
Anne Wanjiku, one of KSMH’s ToTs, is extremely active within her neighbourhood. Not only is she aware of all the PWIDs within her area, but she actively campaigns for their welfare and protection. In 2007, Anne was visiting a PWID whom she was well acquainted with called Stella Kabura. Stella is only 21yrs of age and lives in Kariobangi.

During her visit Stella confided in Anne that she was having difficulties urinating. Anne immediately sought out a private location where Stella could discuss this problem securely and confidently. After Anne asked her whether anyone has abused her or touched her body inappropriately and without her consent, Stella revealed a harrowing and distressing case of sexual assault.

Challenges
Stella narrated the painful experience she went through. A man in the locality, whom she refers to as “Mtu wa Nguruwe”, a person who works in a slaughter house, bought Stella chips in order to lure Stella with him. On reaching his place the man violently sexually abused Stella and subsequently burnt Stella between her thighs with a hot iron rod. Anne requested to examine the PWID, and unfortunately made the grim deduction that Stella had been violently sexually assaulted just as she has explained.

Anne took immediate action and reported the matter to the authorities. Through the mobilization of women from the neighbourhood and the cooperation of the local authorities, the man was arrested. However, Stella’s mother does not understand the gravity of her daughter’s situation, leaving Anne to provide essential supports without the assistance of Stella’s primary caregiver.

Initiative
Since being sexually assaulted Stella has not accessed HIV/AIDS services. This project gave Anne the opportunity to give Stella the fundamental information she needed to access HIV/AIDS intervention services.

The assessment which Anne conducted revealed that Stella was completely ignorant of HIV/AIDS. She had no idea how her sexual assault could affect her health in this manner. After implementing the individualized intervention strategy designed for Stella it became clear that Stella would require a HR to provide supported consent in accessing VCT services. Unfortunately Stella’s mother would not cooperate, leaving Anne to take the initiative to bring Stella for VCT. Anne took Stella for VCT three times on different days, and each time they refused to attend to her because Anne was not her mother. The VCT centre recognised that Stella was unable to give independent consent due to intellectual disability. Anne the TOT was informed at the VCT that Stella could only be attended to with the consent of her biological mother or a spouse of Stella.
Recommendation

Unfortunately, many parents are not appropriate HRs such as was Stella’s case. The case of Stella shows how PWIDs are deprived of essential HIV/AIDS services when they are accompanied with the HR of their choice. Stella still lives with her mother, and still is unaware of her status after being sexually assaulted. However, Anne has been counselling her and is reaching out to her mother as well. KSMH hopes to provide crucial support needed by Stella to access HIV testing and counselling. KSMH is working to change the inadequacies of VCT centres.
Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Background Information
Veronica’s Year of Birth: 1996
Human Reader: Wamae Wangechi Grace (I.D.: 3185075)
Sub – Location Korogocho, Location: Ngomongo, District East Nairobi, Province Nairobi
Tel No.: 0723766613 (Wamae Wangechi) / (ToT Grace Karanja) 0724814178

Impact
Grace Karanja is one of the ToTs (Trained Trainers) in the KSMH PWID HIV/AIDS intervention program. She went to Mathare Special School to introduce herself to the teacher of children with intellectual disabilities.

The teacher was pleased but requested Grace to visit their branch in Ngomongo before she conducted any assessments. It was here that she became acquainted with another teacher, Mrs. Wamae. After introducing herself she explained the purpose of her visit, and was subsequently informed of the case of Veronica Wambui, a HIV positive PWID. On going to the PWIDs home in Ngomongo slums, Grace and the teacher passed by the chief’s office, where she was advised to go with security. This was Grace’s first visit to Veronica. She interviewed Veronica and conducted an assessment with the support of Veronica’s teacher who acted as the Human Reader (HR). Veronica is 15yrs old and lives in Korogocho. Veronica is an orphan of HIV/AIDS, and Teacher Wamae recommended that Grace meet Veronica’s grandmother who has become her primary caregiver

Challenges
After visiting Veronica’s home, Grace realized that her teacher had not in fact been the most appropriate HR. On the second visit, Grace returned to Veronica’s home and repeated the assessment, this time using the grandmother as the HR. Veronica’s grandmother explained to Grace that Veronica’s parents died when she was only 1 yr. Much to the grandmother’s scepticism, neither her relatives nor her siblings wanted to take care of her. Wracked with concern for Veronica, she decided to take Veronica for Voluntary Counselling and Testing (VCT) despite her age. It was after accessing these VCT services that Veronica’s grandmother learned that her granddaughter was indeed HIV positive.
Veronica’s grandmother narrated how she has gone through many challenges with Veronica. Not only must Veronica live with HIV, but she must also contend with being intellectually disabled and epileptic. However, it was the rejection that Veronica experienced as a result of this, from both her family and community, which gave the grandmother the strength to take care of Veronica.

At the moment Veronica is on ARTs (Anti-Retroviral Therapy). On observing Veronica her skin is in extremely poor condition and appears rough. Her eyes are sunken and they have no food apart from the little they had been given by a well-wisher. Their minute shamba, which is located in the heart of the slums, is constructed with scrap iron, and old caustic soda bags have lined the inside of their house. Despite these appalling living conditions, Veronica’s grandmother perseveres, and is determined to provide what little care that she can for her.

Initiative
The Mental Disability Specialist designed an individualized intervention strategy that could confront Veronica’s specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on, e.g. the importance of taking ARTs and how to prevent further spread of HIV. This intervention has been designed with the severity of the PWIDs intellectual disability in mind, and caters for her unique communication needs.
Furthermore, the KShs 500 which Grace Karanja gives the HR for facilitation of each intervention strategy will enable Veronica’s grandmother to bring food to the table for a small while longer, easing the weight of her mind if only for a few days.

Recommendation
Through the assessment that was conducted by Grace on Veronica, KSMH has been able to identify the necessary action to be taken in order to support the PWID in obtaining vital information regarding HIV/AIDS and in accessing required services.
Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH

Background Information
Elizabeth’s Year of Birth: 4th November 1982
Human Reader: Margaret Waithira Kibathi
Sub – Location Spring Valley, Location Kayole, District East Nairobi, Province Nairobi
Tel No.: Margaret Waithira (0717031053) (ToT Grace Karanja 0724814178)
Impact
Grace Karanja went for an intervention in Kayole at Waithereros home. Her mother informed Grace that she was raped at 20yrs. The matter was taken to court and the man who raped Waitherero was jailed.
Challenge
Waitherero roams around and she is at a high risk of being abused again, at the moment she is 27yrs, her mother is the sole bread winner. She sells grass but at the moment she doesn’t get much profit because of the rainy season where not many are buying from her since there is plenty of grass and the demand is not high as compared to the drought seasons. The husband died
In the same family they have a PWID who works in the slaughter house from 6.30am to 7.00pmto help supplement for the household needs.
Waitherero has two children both are PWIDs and this has become an overwhelming responsibility to handle.
Initiative
After the rape ordeal Waitherero was taken to Nairobi Women’s Hospital where she was tested and the HIV/AIDS test was negative
The Mental Disability Specialist designed an individualized intervention strategy that could confront Waithereros specific issues. This intervention targets many key issues which both the PWID and the HR must have detailed information on, e.g. the importance of taking ARTs and how to prevent further spread of HIV. This intervention has been designed with the severity of the PWIDs intellectual disability in mind, and caters for her unique communication needs.
Furthermore, the ksh 500 which Grace Karanja gives the HR for facilitation of each intervention strategy will enable Waitherero to support her pressing need.
Recommendation.
Poverty has affected many PWID families and it is due to their poor state that they are unable to support themselves hence they are taken advantage of. Grace has been counseling Waitherero and is reaching out to her mother as well. KSMH hopes to provide crucial support needed by Waitherero putting in mind she has other PWID members in their home. Through the intervention carried out areas that Waitherero needs support have been highlighted so as to address their needs effectively.
Case compiled in 2010
Valarie Jumba
Program Coordinator KSMH