A Discussion with Helen, Social Worker, Nyumbani Center, Nairobi, Kenya

With: Helen Berkley Center Profile

June 6, 2016

Background: As part of the Education and Social Justice fellowship project, undergraduate student Khaliyah Legette interviewed Helen, a social worker at Nyumbani Center in Nairobi, Kenya. The Nyumbani family of programs provides HIV/AIDS services to children and affected families in Kenya. In this interview, conducted in June 2016, Helen discusses the myriad challenges, joys, and successes of overseeing the admission and education of the HIV-positive orphans at Nyumbani.
What is your name and what work do you do?

I am Helen, and I am a social worker—social work and counseling.

What are some of your responsibilities in this position?

We do the admission and open the children’s files; we organize for a care plan. From admission we have to make a care plan for each child, and then place the child in the cottage. And of course, admission will only be done when there’s availability of a vacant seat, so we also have to prepare when we admit now; we will know in which cottage we will place each particular child. So, we have to prepare the children and the mum in that cottage, tell them that there’s this child who’s coming from this place and will be joining. So, when the child is being admitted, the other children are already expecting that we have another addition. In fact, if you delay they ask: “What happened to the child who was supposed to come?” So, we admit in the home, we open the file, we organize the individual care plan, we place them in a cottage, and we organize for admission in school. If they are of primary age—because we only have a pre-unit here—so if they are a tender age like 5 years old and below, we will admit them at the same point, but if they are above 6 or 7 years old, we admit them to the primary school outside.

So we also have to make our arrangements for the admission, organize for a meeting, and then buy the uniforms, supplies, everything. And of course that is the primary level and pre-level. Then after primary, we have a class eight examination, nationwide. So after that examination, depending on the marks that child has got, we will arrange for placement in secondary education. When they have good marks, as in 300—because it’s out of 500—if they get like 350 and above, we are assured that they have a government placing. There’s a selection for the children who have passed, and they can go to secondary public school. But sometimes we are challenged; where they get below 350, we are forced to look for their school. So, again, it’s us—the social office—who does the placement and searching for the school. Of course, sometimes we talk to the relatives and friends to help us get the schools and place them in the schools.

Then after secondary, again we have admission, secondary examinations, and after that, depending also on the marks that one has gotten, we place them again in college. And of course, after secondary, while they are in college, now they don’t stay here. Some have finished, some are still in college, so we arrange for the payment of hostels outside Nyumbani. Because colleges are far off, so they cannot be coming from here to there. And of course we have our educational policy which we follow. So our policy is in primary, they’ll go to public primary within the neighborhood, whereby they are taken by school bus and brought back. In secondary, they’ll go to the school where their marks will allow them to go to, and it has to be boarding. Then, of course, college, you choose the career that you want to do, and we’ll facilitate that. Then we also do the family follow-ups and home visits. When the child is being admitted here, we have to have the committal order, which is found in the court to commit the child to us. So we have to apply for the committal orders, ensure that the children get the committal orders. We also do counseling. So we do a lot here.

What are some of the greatest challenges you face?

Our children are orphans, total orphans, abandoned, and HIV-positive. The greatest challenge is stigma, though there’s a lot of awareness and it’s not as bad as it was before, when getting the children into public school was not easy. And I would say the major, major challenge that it seems we’ve been facing is when the children go to secondary school, because they are used to being with us here. We take them to primary school by school bus; they are brought back here. Now when they go to public schools, they go to various public schools, and they have to take care of themselves. They have to be responsible with their medicine. And sometimes, not every child would accept his or her status to be disclosed. Though we try to talk to them, to counsel them to prepare to go to secondary, because we also make arrangements such that the ones who are already in secondary, we have a session with them so that we tell them what might be the expectation: this is what you might expect, this is what you might get out there. Maybe, some will ask why you’re taking the medicine; some might know, with teenagers being who they are.

So before we take them to secondary we ask: “Would you like to disclose your status?” And there are some who are like: “Okay, I would like somebody in school to know my status.” The government schools, and some private schools, have a medical section whereby they have a school nurse, and in all public schools they have a school counselor, so you weigh the situation. You talk to the school counselors, to the school nurse, and by talking to them you can gauge whether this is somebody you can confide in or not. So if, after weighing the situation, you confide in either the school nurse or the school counselor that this child is on medication, and we would like you to follow up for us—ensure that you keep the particular medication for this child. Because, you see, a term consists of three months, so they take medicine for three months, which is quite bulky.

And you see, in boarding schools they have periodic, unexpected checks. There are times they call everybody and go to the dormitory and they are like: “Okay, bring your books,” and they start checking. That is to avoid theft, and things like that. So occasionally, there could be a check like that, and even if you have reported, they have to check, so you have to carry your medicine outside because, you know, on the first reporting date you can imagine you’ve put your bulky medicine in a box and have somebody opening it and asking: “What is this?”

And, on the school rules, they say no drugs. And if you are on medication, you need to disclose what kind of medication you are on to the school authority. But, you see, you can’t just go and start saying: “This child is HIV-positive,” at first. I remember there was one case we disclosed, and after we left, we waited for the procedure of admission, then after we had gotten the admission and everything, we decided now is the time we could tell somebody. So we disclosed to the deputy principal and said: “Okay, this is our situation: our son is on medication.” Then they said: “No, you should have told us first." So you see from previous experience, we’ve learned we don’t disclose first. We just go through the admission process, get to the admission, get to the classes and what have you, then afterwards we say: “Okay, we need to talk to you.”

So after that particular time, when the teacher was like: “You should have told us earlier,” we ask: "Why? We have done these other procedures which were very important, and we felt you would need to know, because I believe there are so many other positive cases who have not come clean, but us, we are honest enough to be, but it always brings problems." So after sometime, I think after two days, the school called us, and they were, like: “Can you come to school? Because it’s very urgent.” He had talked to the school management—and this was a private school—so we went and they told us: “You have to go with your son.” They tried to explain: “You see, you see…”—it was the stigma, still. But we just stood our ground and reminded them that we would take the child to the necessary authority, because HIV was declared a national disaster in Kenya, and it was clearly stated that no employer, no school should deny anybody a vacant seat because of their status. So, medicine is a major challenge.

And then we have the drug fatigue. One takes medicine day in, day out, and you get tired of it, and now adherence becomes a problem. Or maybe some don’t adhere because they don’t want their friends to see they are taking that medicine. And the aftereffect for that can sometimes be catastrophic, because we find a situation whereby you become resistant to the first line, then you end up on the second line. Again, if you play around with the second line, you will go to the third line. And now third line is not as readily available as the first and second. So I would say that is a major, major challenge.

And then, of course, we have isolated disciplinary issues and performance. Some just give up. They start off so well; in primary they do so well. In secondary they’ll do well, then out of nowhere...we don’t know what happens to some cases here. So I would say the major challenge here is drug adherence and the disclosure in the school.

And then, of course, the school visits. Now, we have so many in secondary, and the social office has to ensure that school calendar dates—we have the clinics, we have meetings, we have the general school visits. So there are times you will find that on a particular Saturday, there are six schools to be visited, six different schools, and the three of us here in the social office (currently we are two), and we agreed that we also involve the house mums who have brought up these children to also visit. Then for those ones with relatives, because we tell them once we are getting secondary schools, we have with the marks, sometimes there’s a problem, so we engage the relatives and friends to help us get schools. And, we ask them to find a school convenient to them, such that when we are called upon at least we have somebody nearby who we can call and say: “Can you talk to this school?”

What are some of the greatest successes you have had?

Of course we have those that excel so well in school, like we have one who is practicing law. There’s one who is in school for nursing. Then we have another one who finished IT. We have one who is pursuing education. She just started, but she’ll go for four years. We have quite a number of successes here.

Do you see a lot of the kids coming here for more social support?

This is the home that they’ve known. And they know all the support they’ve been getting here. And we have an annual get-together of Nyumbani alumni, so we see how they’re faring. And we allow them to share the challenges that they are facing. Where need be, we’ll come in. We came out of some family. As old as I am, when things go bad, I have to go back home. And, I talk to my parents or my relatives, and they pitch in whenever necessary. So, it’s just the same case with our children. Whenever they have any challenge, they come to us. But, we try to empower them by giving them education, giving them their training, journeying with them to see if they can get employment. So, they come, and we support where we can. But we try to empower them as much as possible.

The one who says “I can do this,” we will ensure he can do that. Because we have one who is in western Kenya in a town bordering Uganda, and he is well integrated into the community. And there is a sister who is a business person there, and I think they kind of initiated him into business, and he came here and told us: “I believe if I am given a motorbike, I will be able to enter the business of transportation.” And Nyumbani bought him a motorbike. And he’s doing well for the past—I don’t know how many years. Recently, he came here because the motorbike had mechanical problems, but the spare part could not be found in his town. So he had to come here to Nairobi, and the social worker office organized for him to go into Nairobi and get that spare. So he’s back to his transportation business.

What is the most rewarding part of your position?

The most rewarding part is normally on initial admission, because sometimes when we admit the children, their health is so, so compromised. They are so compromised that sometimes you look and you wonder whether this child will survive. They are emaciated; health-wise, they are not doing well. But then after three months or so, you see the changes. Because you take a photo, and then after maybe three months you look at the child and you say: “Wow, is this the same child?” So you just feel like you’ve done something.

And now when they are grown, there are some that will come and say: “I appreciate what you did for me.” Because sometimes they can be so hard as a mother. Not that you hate them, but you just want them to be on track. But especially when we are integrating them, we give them an opportunity to speak, and you will hear them speak well about us. So at least you feel you’ve done something. And when you see they’ve achieved their goals, like those one who are working, you see that and you’re, like: “Bravo, at least I’ve done something.” Not all will be successful, but when we see one came here as a child, has matured, is now working, comes to visit us, and is now a young, happy woman or man, we are happy.
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