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Bringing Hope and Health through Better HIV Care

The day gets off to an early start in Esther Adiambo Ombewa’s house. As early as 6 AM, she is in the kitchen preparing a breakfast of porridge and beans for her four children. After the three eldest head off to school, Esther, 30, and her toddler son, Joab, go to the nearby sugarcane fields for a day of work. It is a simple daily routine that just a few years ago seemed unimaginable: Esther assumed she’d be dead by now.

While pregnant with Joab, Esther was diagnosed with HIV. She accepted the news stoically. “When I learned my HIV status, I was not really surprised; I suspected it,” she said. “I was only sorry for my unborn child, who I was sure would be born HIV-positive too.”

Esther lives in the village of Get, along the shores of Lake Victoria, in Nyanza Province in southwestern Kenya. The area has the country’s highest HIV prevalence, and EngenderHealth led a comprehensive project there, called APHIA II Nyanza, which incorporated a range of services addressing HIV, malaria, tuberculosis, and maternal, reproductive, and child health. The three-year project partnered with Kenya’s government to make high-quality holistic care available to Nyanza’s residents. This meant integrating services so that a couple can bring their child in for vaccination and receive family planning counseling for themselves, as well as treatment for HIV—all at one facility.

A hallmark of EngenderHealth’s approach is reaching out to communities. In the Nyanza province, where 15% of adults are living with HIV, men and women are encouraged to get tested for HIV and to seek out treatment.

After losing her husband to AIDS, then finding out that she, too, was HIV-positive, Esther felt isolated. In her culture, widows are stigmatized. But, community health workers trained by EngenderHealth encouraged her to visit the local hospital. There, Esther got information on how to prevent transmission of HIV to her baby and was given antiretroviral treatment to improve her own health. She was advised to deliver at the hospital, where doctors could supervise the birth, but due to the long distance between her home and the facility, the nurse gave her a dose of the drug nevirapine in case of an emergency delivery.

Fortunately, Esther made it to the hospital in time, and her son, Joab, was born HIV-free. “The services I received gave my child a chance to have a healthy life, and this renewed my strength,” she said.

Esther’s own life has changed in many ways since that fateful day in 2006. From working in her sugarcane fields, she has built a stable financial base, as well as a bigger house for her family.

She has also won the respect of her community, becoming an inspiration to hundreds of women in the area by reaching out to them with information and sharing her own experience with HIV.

Through a local support group, she spends many evenings advising local women to get tested for HIV, counseling those who test positive, and encouraging them to register at the clinic and take the antiretroviral treatment that will save their lives and the lives of their children. One of the countless women she has counseled, Mary, commented, “If it weren’t for Esther, I would have given up. But because of her and the care I received, my baby is HIV-free—and the source of my happiness.”

In Nyanza, nearly 40,000 mothers have benefited from services to prevent transmission of HIV to their babies, enabling women like Esther and Mary to protect the health of their children and to ensure the future of their families.

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