Haba na haba, hujaza kibaba: Tumaini Family Planning

The Tumaini children's center held a family planning outreach session for the girls who live on the streets on Saturday. The organization does its best to reach out to the street kids. However, the girls are a difficult population to work with because it takes longer to gain their trust and the issues that they need to discuss are often extremely sensitive. The Tumaini outreach workers have been working hard since December to introduce the idea of family planning to the girls and encourage them to attend Saturday's session to receive counseling and a depo provera shot (a form of contraception that will prevent pregnancy for 3 months).

The burden of having and raising a child on the street is incomprehensible. In Montreal, focus groups with street girls have demonstrated that street girls unanimously felt that their lifestyle was incompatible with pregnancy. However, the concern for pregnancy does not always translate into disciplined contraceptive use. In Kenya, it is not culturally acceptable for women to suggest condom use because it is believed that the man is responsible for making this decision. Furthermore, many of the street girls are raped which obviously leaves the girls with no say. To complicate matters even more, once pregnant, girls will often resort to homemade abortive measures which can be extremely harmful (one of the common techniques in Kenya is to drink bleach).

The outreach session was very well received and we were able to administer >20 pregnancy tests and about 10 depo shots. The Tumaini outreach workers first talked to both the boys and the girls regarding family planning. Interestingly, although the boys often hurt the girls, they are also very protective and want to know everything that is happening to their fellow street children. After the combined talk, the girls came to the outreach tent and we had one of the visiting obgyn residents lead a discussion with them. Then they individually met with the doctors for counseling and the shot if they were interested and gave consent.

I am happy that I was able to be a part of this event and I hope that Tumaini will be able to host another in 3 months to ensure that these girls continue to get their shots. Many of these girls were forced into living on the streets for a variety of reasons, and they deserve a choice to access health care and preventive services that can improve their quality of life. Family planning outreach is a small step towards this goal.

The Outreach Tent