NAKURU, Kenya, Oct 7 – Dira, that is the word sex workers at Salgaa in Nakuru County call their regular clients who also assist in paying rent, shop for food and perform other ‘husband’ duties.
“Such clients have identified only one person (sex worker) whom they deal with when they come,” explains a sex worker at the centre.
Salgaa is a popular township on the Nakuru- Eldoret highway, infamous for its nightlife as it is a busy road for transporters.
The sex workers here target truck drivers.
Although illegal in Kenya, sex work still thrives in most parts of the country and according to the sex workers we talked to, most of their clients do not like to use condoms.
“If they use condoms, they pay less and sometimes you are hard pressed for money so you go without it,” says another sex worker.
This leaves them (sex workers) vulnerable to unplanned pregnancies leading to abortion and diseases like HIV/AIDS.
And as the world population is projected to hit the seven billion mark in October according to the United Nations Population Fund (UNFPA), we are here to find out how sex workers protect themselves against unplanned pregnancies.
We talked to five sex workers in the area on condition of anonymity on how they protect themselves against unwanted pregnancies as they engage clients.
“We normally use various family planning methods but the most accessible are pills and injections,” says one of them.
Unfortunately, they are not able to access all the family planning methods they may want because they are not available in the nearest public health facility which is Rongai Health Centre.
“They tell us there are other available methods but they don’t have them. Sometimes you want Norplant or a coil but it is not available and you have to go to Nakuru which is about 25 kilometres away,” they say.
Zachary Keyah, a Program Coordinator at a non governmental organisation known as Family Aids Initiative Response (FAIR-APHIA II) in Nakuru says supply of family planning has not been consistent in government health facilities in the county.
“The assumption is that health centres in the country have all the family planning methods but the reality is that they don’t,” he states.
“Sometimes you will go to that health centre, in the service charter it is a sub district hospital but you find the supplies are for a health centre and it has only one clinical officer and this affects service provision including family planning,” Keyah adds.
He gives the example of Rongai Health Centre which he says was upgraded to a sub district hospital because of the many accidents that occur on the highway but continues to receive the supplies of a health centre.
Director of Public Health Dr Shahnaaz Shariff acknowledges that there is a problem with access to some family planning methods in public health facilities.
“Yes we have a problem with access to long term and permanent methods of family planning in public health facilities, but we are working on that,” he says.
Apart from spacing children, medics say family planning is important because it contributes towards improving the quality of life of a mother. This, they argue, is one way of achieving the Millennium Development Goal on improving maternal health.
It is recommended that women should space their children by at least three years to give them time to heal.
In Kenya the uptake of family planning is at 46 percent nationally, which Dr Shariff terms as very low. He attributes this to myths and misconceptions about their use.
Limited access to preferred family planning methods is another issue that has led some women to do away with it.
“The major issues the sex workers face is the attitude of the service providers. They become judgmental if they know one is a sex worker,” Keyah says, a point emphasised by one sex worker who accuses the health providers of asking “irrelevant” questions like whether one is married.
The sex worker says minimal information on family planning also hinders their uptake and calls on the government to create more awareness on the subject and involve local communities and most at risk groups like them (sex workers).