A Question of Life or Death - Human Rights Watch

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Copyright © 2008 Human Rights Watch All rights reserved. Printed in the United States of America ISBN: 1-56432-412-5 Cover design by Rafael Jimenez Human Rights Watch 350 Fifth Avenue, 34th floor New York, NY 10118-3299 USA Tel: +1 212 290 4700, Fax: +1 212 736 1300 hrwnyc@hrw.org Poststraße 4-5 10178 Berlin, Germany Tel: +49 30 2593 06-10, Fax: +49 30 2593 0629 berlin@hrw.org Avenue des Gaulois, 7 1040 Brussels, Belgium Tel: + 32 (2) 732 2009, Fax: + 32 (2) 732 0471 hrwbe@hrw.org 64-66 Rue de Lausanne 1202 Geneva, Switzerland Tel: +41 22 738 0481, Fax: +41 22 738 1791 hrwgva@hrw.org 2-12 Pentonville Road, 2nd Floor London N1 9HF, UK Tel: +44 20 7713 1995, Fax: +44 20 7713 1800 hrwuk@hrw.org 27 Rue de Lisbonne 75008 Paris, France Tel: +33 (1)43 59 55 35, Fax: +33 (1) 43 59 55 22 paris@hrw.org 1630 Connecticut Avenue, N.W., Suite 500 Washington, DC 20009 USA Tel: +1 202 612 4321, Fax: +1 202 612 4333 hrwdc@hrw.org Web Site Address: http://www.hrw.org
December 2008 1-56432-412-5 A Question of Life or Death Treatment Access for Children Living With HIV in Kenya Map of Kenya ........................................................................................................... 1 I. Summary ............................................................................................................... 2 Key Recommendations ....................................................................................... 6 II. Methodology ........................................................................................................ 7 III. Background ....................................................................................................... 10 HIV/AIDS Treatment for Children ....................................................................... 10 The Epidemic in Eastern and Southern Africa ..................................................... 12 The Global Fight against HIV/AIDS ..................................................................... 14 Fighting HIV/AIDS in Kenya ............................................................................... 15 IV. Barriers to Treatment for Children Living with HIV .............................................20 Perceptions about HIV and Lack of Accurate Medical Information ......................20 Stigma, Fear, and Silence as Barriers to HIV Testing and Treatment ................... 23 Lack of Care, Neglect, and Abuse of Children Living with HIV ............................. 30 Caregivers’ Failure to Take Children for HIV Testing and Medical Care ................ 36 Children with No Caregivers: Child-Headed Households and Street Children ..... 43 Economic Barriers to Testing and Treatment ...................................................... 45 V. Treatment Access during the 2008 Post-Election Violence ................................. 54 Impact of Post-Election Violence on the Health Sector and on ART ..................... 54 The Emergency Response Treatment in IDP and Transit Camps .......................... 56 VI. First Adults, Then Children? Government Health and Protection Policies .......... 62 Pediatric HIV Policies and Practice in Kenya ...................................................... 62 Government Policies to Improve Protection of Children with HIV ........................ 75
Page 1: A Question of Life or Death Treatme
Page 5 and 6: Map of Kenya 1 Human Rights watch D
Page 7 and 8: care of other relatives, but can su
Page 9 and 10: It is indicative of the current lac
Page 11 and 12: II. Methodology Field research for
Page 13 and 14: statistics by the UN classify child
Page 15 and 16: Treatment of HIV and of opportunist
Page 17 and 18: The case of Kenya Kenya has a gener
Page 19 and 20: AIDS, Tuberculosis and Malaria prio
Page 21 and 22: Following political conflict and po
Page 23 and 24: (EU). 61 There are also two importa
Page 25 and 26: stigmatized. Such beliefs are still
Page 27 and 28: Many patients distrust antiretrovir
Page 29 and 30: A community health worker in Mathar
Page 31 and 32: discriminatory experiences to relat
Page 33 and 34: According to a nurse at an HIV/AIDS
Page 35 and 36: decided to go to Nairobi with the c
Page 37 and 38: often by themselves, and it has bec
Page 39 and 40: know why. I’m afraid that he will
Page 41 and 42: [Carolyn’s] mum died when she was
Page 43 and 44: Both my parents died. I had two ste
Page 45 and 46: een told about their HIV status. Fo
Page 47 and 48: the very least, a child above 10 sh
Page 49 and 50: een raped by police. 169 Sexual exp
Page 51 and 52: We think that children are dying of
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way that she could adhere to our pr
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Sometimes caregivers start children
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Sometimes at the clinic, the treatm
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At this writing, health facilities
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mother, who already has an older ch
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are even more vulnerable to these s
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concern when the Kenyan government
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Despite this gap, change is finally
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Up until 2006, the large majority o
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Young people under 18 who are marri
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make cotrimoxazole widely available
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The need to make ART for children a
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normal for patients with life-threa
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treatment. For example, we were int
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access to health care. Both the gui
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VII. Legal Framework National and i
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The child’s right to the highest
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Every child shall have a right to h
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International law requires states t
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In Kenyan national law, under The C
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VIII. Detailed Recommendations To t
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To the Kenya Food Security Steering
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To UNAIDS, the World Health Organiz
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shared with us their analysis and a
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A Question of Life or Death - Human Rights Watch

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