Maureen Overcomes HIV and Hunger
Adolescent Care & Treatment
Maureen Esekon, 15, knows well the gnaw of hunger. She knows the lightheadedness that comes when she gathers firewood on an empty stomach in the sweltering heat of Lodwar, Kenya. She knows about the weak knees that make each step a struggle as she walks the dusty paths to school without having eaten breakfast.
Hunger is a frequent, but unwelcome, visitor to Maureen’s manyatta—a traditional home of sticks and mud—where she lives with her mother, Esinyen; her sister, Nancy, 20; and brother Godwin, 7.
“Sometimes I go three days without eating because of lack of food,” says Maureen. “When I wake up in the morning, I feel weak, and it is hard to start my day.”
Food scarcity of this scale would be a challenge for any growing adolescent. But it is particularly difficult for Maureen because she is living with HIV, and she is supposed to take her antiretroviral (ARV) medication with food. When she takes her ARVs on an empty stomach, she feels dizzy. For this reason, she did not adhere well to treatment in the past. But now she takes her medicine faithfully—even if she does not have food.
“When I feel dizzy, I sleep and I persevere,” says Maureen. “But I always take my medicine.”
Each morning, Esinyen gathers firewood in the arid expanses around Lodwar. She then converts it to charcoal by burning it in a pit and sells it by the side of the road. This is the main source of family income.
“Getting food is a problem,” says Esinyen. “But I will go out and do extra work for my family. I also do laundry and wash dishes in order to feed them.”
With 90 percent of the population living below the poverty threshold, Turkana County is the poorest region in Kenya. Cut off from the rest of the country by poor roads and a harsh climate, Turkana County frequently faces drought—which threatens livestock, the main source of sustenance and income. Crop cultivation is limited.
“Data from our Turkana program shows that more than half of our clients either have moderate or severe forms of malnutrition,” says Lazarus Momanyi, M.D., a manager of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)’s Timiza 90 project. “Malnutrition in HIV weakens the body immunity and hastens disease progression.
“In response, EGPAF in Turkana is currently using a multi-sector approach working with other nongovernmental organizations like World Relief and World Food Program to link children and their families to nutritional and livelihood support,” says Dr. Momanyi.
With support from EGPAF, the Lodwar County Referral Hospital has linked Maureen to nutrition support, providing her with Food by Prescription—fortified flour for a healthy porridge that can meet the energy needs of a growing adolescent. EGPAF also supports the preparation of wet foods during pediatric and adolescent clinic days at the facility.
“Porridge is prepared and provided for the children and adolescents as they wait to see the clinician,” says Carol Mukami, the project officer for EGPAF’s nutrition component. “Apart from providing additional nutrition, this has led to improved appointment-keeping at the facility.”
Although Maureen has missed several years of school because of illness, now she is in Class 5 in her primary school. She is determined to continue on to secondary school and graduate.
“I faithfully go to school because I know that education is my future,” says Maureen. “I want to go the university in Nairobi. I want to get married and have five kids.”
Perhaps it is fitting that Maureen dreams of a career that will take her out of Lodwar’s harsh environment—high above Kenya.
“I want to be a pilot,” Maureen says.