'We feel exposed': HIV patients hit hard by changes in Nakuru referral hospital

Despite interventions by the county government, HIV/AIDS patients are now feeling the effects of the USAID funding cuts that took place earlier this year.

Among the programs impacted under the USAID Tujenge Jamii (UTJ) project were essential services like HIV prevention, maternal and child health (RMNCAH), water, sanitation and hygiene (WASH), and nutrition.

Mateo* says he first noticed changes in late January when he visited the Nakuru Level 5 Comprehensive Care Center (CCC), which caters to people living with HIV. At first, he noticed things were slowing down but didn’t think the changes would have a lasting impact.

Later, during another visit, he found the CCC section closed. When he asked for help, he was referred to the casualty unit and told to speak with the cashiers. He hoped he would finally be attended to.

“When I got there, I explained that I was only there for CCC services and needed direction,” he says. “But they told me I had to pay a consultation fee and wait in line like everyone else, even after I showed them my CCC card.”

Despite the long queue, Mateo waited his turn. When he finally saw the doctor and explained he needed medication, the response shocked him.

“He asked me, ‘What medication?’ I handed over my card, hoping he’d understand. But he looked at it and said, ‘Hii kadi ni ya nini?’ That stunned me. At the CCC, I never had to explain myself. The staff understood my situation. Now I had to say out loud why I was there and what drugs I needed.”

Mateo says that not everyone is bold enough to disclose they are on HIV treatment. Some of his peers have said they would rather find other centers than go through this process.

He also notes that youth support talks, which once offered connection and comfort, have stopped entirely.

“Now people just come, collect their medicine, and leave. There’s no community anymore,” he adds.

This integration, he says, has made them leave a lot of information to many unnecessary people, who did not need it in the first place, just before they get the right help. Their privacy has been infringed.

“Right now it’s going to be a bit tough for many youths. A lot of people also suffer from self-stigmatization, if this is exacerbated by the undertone stigma by the public many will fall off their treatment plan,” he says.

Unfortunately, he says when the changes happened, they were not informed of anything which a source who works closely with HIV patients echoes.

“We’ve seen patients drop off their treatment plans, mostly youth, because of stigma,” the source says in our phone interview. “Very sick patients are also forced to queue like everyone else at casualty and pharmacy, sitting there for hours before being seen.”

They lament that since the changes, support groups have ended.

“Before, patients could share their burdens, talk about what they’ve been through, and find strength in each other. Now, that’s gone. They come in with their wounds and leave with their heartaches. Hiyo maguruneti mtu akibeba mtu tu anajua tu prescription (That tin, the moment someone sees you carrying it, they immediately know it’s a prescription),” the source says.

They believe the integration of services should have been done more gradually, with real input from patients. Instead, it has exposed them to new stigma and logistical hardship.

Earlier this year, Mtaa Wangu contacted the county about the USAID Tujenge Jamii (UTJ) project.

In a phone interview, Chief Officer of Public Health Services Joyce Ncece said, “We’ve developed short-term solutions, such as integrating services like HIV and TB under one roof so that patients can access all services at once. We’ve also started administering longer doses to prevent overlap or patient overload after providing necessary counselling.”

But patients say the integration, in practice, is not working.

“This integration may look good on paper,” Mateo says. “But on the ground, it’s costing us our health, our privacy, and our peace of mind.”