A Force for Change in Kenya: An advocate for women’s and girls’ sexual and reproductive health

Advocating for women’s and girls’ sexual and reproductive health and rights is not an easy job. Many of us in the field know this going in and manage to stay the course. While others, no matter how passionate they are, lose steam. I remember co-hosting a youth sex education radio show in Montreal, Canada, almost 10 years ago and had to respond to callers who were challenging our right to be on the air. The opposition can be exhausting, even when the work is rewarding.

But recently I met Monica Oguttu (pictured, left), a strong advocate and leader who is making significant advances for girls and is an example of what determination can achieve. Monica is the Founder and Executive Director of Kisumu Medical and Education Trust (KMET), an IWHC partner organization located on the shores of Lake Victoria in Western Kenya. KMET is located in Kisumu County, a region struggling with high rates of adolescent pregnancy and maternal death due to unsafe abortion. Facing poverty, many girls there trade sex for food, school fees, and even menstrual pads. As you can imagine, Monica does not have an easy job.

And many local community leaders are not ready to discuss sexuality. They consider it to be a private matter, and see it as “bad manners” for girls to talk about such a taboo topic. As a result, many girls and young women do not understand their bodies or their rights.

Monica is working to change this by challenging prevailing social norms. Upon returning from the landmark International Conference on Population and Development in Cairo in 1994 — where the international community finally put women’s rights at the center of development — she founded KMET.  Monica could not ignore the need for safe abortion and sexuality education in her community. Despite these services being, in her words, “elephants in the house”—necessities that no one recognizes—Monica knew they were essential. Young women and girls cannot reach their full potential without access to critical information and care, that allows them to make informed choices about their lives and bodies. Monica has been a fierce champion of these rights ever since, “the day I stop talking about abortion, is the day I’ll be dead.”

KMET is a force to be reckoned with. The organization supports women and girls in a holistic manner, providing medical, educational, and vocational services.  Among other services, they operate a public, youth-friendly clinic and fully-equipped pharmacy. Kenya’s new National Adolescent Sexual and Reproductive Health Policy, launched in September 2015, provides a framework for which KMET can operate and advocate for change.

Monica’s passion and ability to foster dialogue has kept her going. “Advocacy is the oxygen I breathe. When I go to meet my colleagues at the county level, I share stories from the field.” She speaks to girls and women who come to KMET for services and reports their needs directly to policymakers, making sure their voices are heard.

While a fierce advocate, Monica is also known for her ability to promote collaboration between government officials who need to work together to get the job done. Recently she initiated an important dialogue between the county level Ministry of Health and Ministry of Education. Each ministry was blaming the other for the rise in early pregnancies. She mediated a discussion between them, and the result was huge: both ministries agreed to move forward in providing comprehensive sexuality education and committed to allocate resources, train teachers, and monitor the quality of this education.

Monica succeeds because she creates trust and respect between the government ministries and herself, and she’s not afraid to hold them to their promises. It’s organizations like KMET that fight to turn these commitments into reality.

With a leader like Monica, who brings everyone into the fold to solve problems, I know KMET is in good hands. The future is bright for girls and young women in Kisumu. As the holiday winds down, and 2016 starts up, I draw inspiration from Monica’s enthusiasm. She inspires me to keep up my own work to advance women’s and girls’ health and rights.

Article by,

Erin Williams, Program Officer, IWHC.



Where are the men of Sigomere, Siaya County?

IMG_0134The role of a man-husband even in the bible starts with leadership, same applies to the traditional roles of men and women who were established to ensure the power of the head of household.

But what happens when it comes to accessing health services? This is a question I ask myself when you visit health facilities only to meet long queues of women and no man at all.

According to the report by the Commission for Revenue Allocations in the year 2013, Siaya is noted in top ten with people living with HIV/AIDs (100,400) and with highest infection too coming at number four after Kisumu, Homa bay and Nairobi Counties.

Despite having such a large number, it is still evidence that residents of Siaya County still shy off going for HIV/AIDS testing and counselling despite the services being offered for free and at their door steps.

To reach the undeserved community with accessible, sustainable quality health and education is the only Kmet’s commitment. That is why we hit the roads to reach out to Sigomere residents in Siaya County for HIV and AIDS Testing and Counselling, Cervical Cancer screening, TB screening as well as give them health talk and emphasize on the importance of having quality health.

To our astonishment, a larger number of those who came for the services were women of around 35 years and above. This left us asking, where are the men of this county, how about sons and daughters of the women who came for the services?

HIV testing and counselling, cervical cancer screening and TB screening forms a gateway for proper care, treatment and needed support for the persons in need.

That is why we encourage people who might have doubts about their health history to visit health facilities for verification because;
· It is proven that early and regular cervical cancer screening reduces incidences of maternal mortality as late stage at which women get diagnosed reduces their chances of survival.
· Early HIV diagnosis means a healthier life since you protect yourself as well as your partner hence avoid being infected of other sex related infections, and lastly you will be able to make right decisions such as if to have more children and take precaution measures to ensure the child is not either affected among other things.
· According to reports in the medical literature and CDC surveillance data, the Advisory Council for the Elimination of Tuberculosis (ACET), People who are in close contact with person suspected to have TB, persons infected by HIV, people who inject themselves with illicit drugs, infants and medically underserved-low income populations are at high risk of contracting TB hence should be screened.

As much as accessing the services should be voluntary it still important to embrace them as we visualize a community where there is accessible, sustainable quality health and education services and facilities.

That is why we urge everyone regardless the age and gender to know their health history to live healthy.

IMG_0244 (4)

We empower and educate the vocational way



Education of girls is essential in the drive by nations to achieve development goals.

Despite this fact, the girl child is often perceived and treated as inferior and has been socialized to put their needs second after everyone’s thus undermining their self-esteem.

Many girls hardly get the relevant type of education that would make them overcome the social, cultural and health challenges.

As a result many girls end up dropping out of school for a number of reasons. To empower such girls so as to attain knowledge and skills that help them make a change in their life, KMET came up with SFC (Sisterhood For Change) program.

The SFC program empowers girls to attain knowledge and skills that will improve their economic independence and soundness.

The goal of SFC is to increase access to livelihood opportunities and sexual reproductive health information/services to adolescent girls and young women from poor backgrounds.  Participants are trained in vocational, reproductive health or life skills besides hairdressing, dress making and food and beverage courses.

For those who wish to enroll and have children; no need to worry because KMET has also established a daycare facility to take care for the little ones as their mothers learn.

SFC works with a range of stakeholders into meeting some of its objectives. These includes the police, Government ministries, local administrators, community leaders, religious leaders, parents whose mandate is to provide ongoing support, guidance, contribute to the growth of the program and feedback to the KMET management on how best to improve quality of services offered at SFC. This forms a committee named the Youth Advisory Committee (YAC).

In addition, KMET offers referral sites on health related matters affecting the adolescent girls at SFC to bring in positive health seeking behavior among the adolescents and young women to reduce the social and structural factors that contribute to HIV vulnerability.

Once the participant is through with Vocational training they are placed in a 3-month internship, where they develop their vocational skills.

Courses Offered.

Food and Beverage  (6months)
Hairdressing Beauty Therapy  (6months)
Dress making  (one year).
The courses run for six months apart from the Tailoring course that runs for one year.

Intake is ongoing. If you wish to enroll please contact:
Jennifer Musuya
Cell: 0719364388
You can also reach us by visiting our website: http://www.kmet.co.ke or follow us on Facebook and twitter.

How to use the Female Condom


With a little practice, female condoms are very easy to use.

To insert the female condom

  • Put spermicide or lubricant on the outside of the closed end.
  • Find a comfortable position. You can stand with one foot on a chair, sit on the edge of a chair, lie down, or squat.
  • Squeeze together the sides of the inner ring at the closed end of the condom and insert it into the vagina like a tampon.
  • Push the inner ring into the vagina as far as it can go — until it reaches the cervix.
  • Pull out your finger and let the outer ring hang about an inch outside the vagina.

If you want to use the female condom for anal intercourse, follow above instructions for inserting it into the anus.

During vaginal intercourse, it is normal for the female condom to move side to side. Stop intercourse if the penis slips between the condom and the walls of the vagina or if the outer ring is pushed into the vagina. As long as your partner has not yet ejaculated, you can gently remove the condom from the vagina, add extra spermicide or lubricant, and insert it once again.

If your partner has ejaculated outside the female condom into your vagina, you may want to consider using emergency contraception (morning after pill). Emergency contraception can prevent pregnancy if started up to five days after unprotected intercourse. The sooner you start it, the better it will work.

To remove the female condom

  • Squeeze and twist the outer ring to keep semen inside the pouch.
  • Gently pull it out of the vagina or anus.
  • Throw it away. Do not flush it down the toilet.

Do not reuse the female condom.

Source: http://www.plannedparenthood.org

Betrayal of Trust: Father impregnates and infects daughter of 12

Ruth* was 12 years old when she got pregnant. The minor’s mother had noticed striking physiological changes in her daughter including nausea and vomiting. She decided to carry out a home pregnancy test that confirmed her worst fears.

A community health volunteer reported the case to KMET in late 2013 having learnt about KMET’s Young People Health and Empowerment program. We traced Ruth by paying a visit to her school but her teachers were reluctant to disclose any information.

After some probing, the teacher in charge of guidance and counseling eventually disclosed that Ruth exhibited symptoms of trauma. She said she could however, not establish the rumors around school that a family member was abusing Ruth since the girl was not willing to talk about the topic.

Early 2014, KMET involved the services of a Community Health Volunteer who lived closer to Ruth’s home. She formed a close relationship with Ruth’s mother all the while offering targeted information on sexual reproductive health and child rights to mother and daughter.

Ruth later disclosed that the father used to threaten her with a machete. “He warned to kill me should I speak to mama about what he used to do to me,” she narrated. The father reportedly used to molest and have intercourse with her on a number of occasions.

With this revelation, KMET involved the authorities but Ruth and her mother vanished after a few days while the case was building momentum. The minor had also tested positive for HIV.

After a few months, Ruth reappeared but this time she was not pregnant. We later established that the perpetrator had been threatening her family to get rid of the pregnancy. In Luo culture, it is chira (a curse) to conceive and carry your father’s ‘seed’.

The authorities pursued the case but before a court process was initiated, the father passed-on with a crime unpaid.

KMET implores you to join forces with us and other partners to put an end to sexual gender based violence by reporting any known case to the police or any civil society group around your area.

Call us for free on 0800724500 or contact these numbers for help; Child line Kenya-116 and Health Assistance Kenya-1195.

Help us break the silence on such instances of human rights violation by sharing your story with us. It is through the documented cases that we can demonstrate how real the situation is and influence programs to support survivors and their families.



Illustration Courtesy of www.behance.net

Ruth* is not the survivor’s real name. Some information has been omitted and/or altered to protect the subject’s identity.

To write to us email info@kmet.co.ke and/or marketing@kmet.co.ke


Importance of Cervical Cancer Screening.


Kisumu City is the third largest city in Kenya with a population of 968,909 with 50.1% being women population. Even though there have been concerted efforts by both the private sector and the government to raise awareness on the benefits of early cervical cancer screening, studies show that a paltry one third of the women have ever heard of cervical cancer.

Early cervical cancer screening averts cases of full blown and complex cancer by identifying the disease at its early stages. When identified early, cervical cancer can be treated in a simple procedure known as cryotherapy.

Cryotherapy is medical procedure that destroys abnormal tissue on the cervix by freezing it. It destroys some normal tissue along with the abnormal tissue. During cryotherapy, liquid carbon dioxide (CO2), which is very cold, circulates through a probe placed next to the abnormal tissue. This freezes the tissue for 2 to 3 minutes.

Should one be diagnosed with cancer at advanced stages, more complex treatment procedures will be required which is not only expensive but also slow.

For example in  Kisumu, cancer patients seeking treatment at the Jaramogi Oginga Odinga Teaching and Referral Hospital have to wait for one week for admission to undergo chemotherapy as the hospital lacks enough staff to carry out the treatment even though there is enough equipment. It is reported that one clinician serves about 30 patients. Most of them are treatment of cervical cancer.

A clinician should handle at least five patients, but due to many women not going for regular screening many of them turn  up for cervical cancer  treatment when it is full blown hence many patients to be attended to.

It is proven that early and regular cervical cancer screening reduces incidences of maternal mortality.  Studies show that the late stage at which women get diagnosed reduces their chances of survival.

Diagnosis of cervical cancer requires visual inspection of the cervix, this  is a screening tool for low resource setting and it’s economical and it provides immediate results and do not require any Laboratory support. This can be performed with acetic acid (VIA) or Lugol’s iodine (VILI). The procedures are also known as Visual Inspection with Acetic Acid (VIA) or Visual Inspection with Lugol’s Iodine (VILI).

Another method is a Pap test  which  is performed by opening the vaginal canal with a speculum,  then collect cells from the surface of the cervix and vagina ,a sample of cervical tissue (called a biopsy) is  then taken and analyzed under a microscope to find out if they are abnormal. It’s also called a Pap smear.

It’s advisable to have screening in the middle of your menstrual cycle, halfway between one period and the next; this enables the cytologist to examine the best possible specimen to achieve the best possible report, when going for screening do not have sexual intercourse 24 hours before your screening, do not use a tampon for at least two days, wear a skirt, be relaxed to avoid discomfort.

Call:  (0800724500) from 8am-8pm free of charge should you want a VIA and VILI or for more information.

Tom Mboya Estate, off Kondele-Airport Ring road

P.O Box 6805-40103. Kisumu

Website: www.kmet.co.ke

Email: info@kmet.co.ke

You can also visit our clinic: Kmet Health Complex Headquarters for quality but affordable preventive and curative services.

Done by Beryl Onyango and Ashiembi