Traditional healers and circumcisers who use needles and blades to treat their patients and circumcise boys and girls are a big menace and contribute greatly towards the increase of HIV / AIDS cases. For instance, in a girl rites of passage ceremony, an organized great event for the whole village, many girls are circumcised at once with one knife.
The more girls a circumciser cuts in one ceremony the more money she will earn. With increased awareness of HIV/AIDS pandemic they, but not all of them, have resorted to use one razor blade for each girl. The exercise is hurriedly done without disinfecting the used knife. The result of using a dirty knife for all the girls, who are circumcised, increases the spread of HIV/AIDS. But the married girl will become a wife in a polygamous family setting as part of a strong tradition within the Maasai-culture.
If infected with HIV/AIDS during the ceremony, the girl will very likely spread the disease among the whole family. In the same way an infected husband either due to infidelity will spread the HIV/AIDS to all of his wives. Such ceremonies, referred to as Ntalengo, involve large gathering of people who drink alcohol more than normal, feast and socialise and possibly lead to irresponsible sexual behaviour.
This explains the necessity of educating the community of the relationship between FGM, early marriage and polygamy and the increased number of HIV-infected community-members. Early marriages encourage the exposure to early sexual activity of the young girls which is harmful on their reproductive health. In Kenya the estimated average age at first sex for a girl is 16.8 years but among the Maasai it is even before the girl reaches puberty stage.
Yet sexual debut for a girl at this age in TransMara is considered culturally acceptable. Therefore, a more vigorous campaign is appropriate that challenges unhelpful attitudes and stigma while providing information about HIV infection, HIV tests, harmful traditional practices, healthy eating and medicinal drugs. As part of their culture the society mainly but not entirely relies on traditional medicine or herbs for treating infections. It has been noted that those affected with HIV/AIDS and sexually transmitted diseases shy away from hospitals and resort to go to the traditional healers for treatment.
It is likely that they may go to quacks since there are many practicing traditional healers who are not licensed. Besides it has been identified that these herbalists also need to be sensitised about HIV/AIDS STI control just as much as the community does. Unlike in other districts the level of HIV/AIDS STI awareness in TransMara is still very low. You will find that the communities still have misguided and wrong perception of HIV / AIDS. Some believe that HIV / AIDS is a traditional disease. Condom use as infection preventive measure is also very low. Cases have been noted of condom recycling and sharing.
As a result HIV/AIDS pandemic is now a major primary cause of death. Besides FGM, early marriage, wife sharing and wife inheritance are among the cultural practices embedded in the community that are known to marginalise women and encourage HIV infection. Also the girl child is denied access to health and education in preference for the boy child.
There is need to target peer educators and AIDS patients caregivers to enhance their capacity to give support to one another and to HIV/AIDS patients whom they take care of and are experiencing problems like rejection, stigmatization and discrimination after their positive diagnosis and eventually upon the death of spouses as a result of HIV/AIDS and also the orphans upon the death of their parents.
Summary of the limitations of HIV /AIDS prevention and control Activities in TransMara district:
- Poor infrastructure in the district.
- Lack of transport for dissemination of information in most parts of the district, especially during the rain season.
- High illiteracy levels in the communities hampering in information flow.
- Inhibitive cultural traditional practices e.g. wife sharing, FGM