A community dealing in a dangerous currency

Lake Victoria is vast. It's the world's largest tropical lake, spanning 26,600 square miles. It reaches Tanzania, Uganda and Kenya, connecting the countries through a transient fishing community who move with the fish. Watching the sunrise from a boat fishing on the lake is like something out of a film, but the reality of life back on shore is not so picturesque.

Siaya, a county on the shores of the lake, has some of the highest number of adults living with HIV in Kenya and the lowest proportion of people who sleep under a mosquito net to prevent them from contracting malaria. 

As mosquitos lay their eggs in water, the lake is a breeding ground for the disease carrying insects, yet just 37.5 per cent of people sleep under a treated net. George Onyango Ondero, chairman of the Luanda Kotieno beach management unit, made up of fisherman, boat owners, traders and boat makers, shared his views on some factors behind this: "I know the government has given nets, but you find some people using the nets – because of poverty – to fish with. They prefer to have food than keep themselves from malaria," he said. Some fishing is done overnight, leaving them even
more vulnerable to mosquitos, but even at home some aren't safe, George said. "These fishermen live in makeshift houses and sleep on the curtains. There's nowhere to hang the nets." 

Most people have been affected by malaria, the chairman went on. "You feel it in your body, but you just have to go down to the lake to work." They simply can't afford to be ill. 

Sitting in the small room the fishermen call their office, they tell me about the most recent case of malaria in their community. "There's a mother lying in the mortuary now from malaria. She refused to go to the hospital. Many people die from malaria, but we need not now." The closest facility is five kilometres away. For a sick person, it take three hours to walk there, the fishermen tell me. Some people just can't get help in time. 

Those particularly susceptible to malaria include people living with HIV, of whom there are many in Siaya. 

In some communities around the lake, sex is currency. Those fishing tend to be men, but those buying and selling the fish are often women. The overfishing of Lake Victoria means the catch is sparse and there are more women to sell the fish than there is fish to sell. In order to be considered as a potential customer for a boat's small haul, "one or two things need to occur", George explains.

I spoke to Rose Odundo, a member of the beach management unit. She was open about the way things were – it seems to be all this community knows: "If a boat offers fish but asks for 'friendship', you have to comply very quickly. Some of us are widows, and so we don't have anyone to look after us.

"It breaks my heart and I cry when I think about it. If we had more opportunities I wouldn't have to do it. I'm not doing it because I want to." 

Rose told me some days she has to go through this, only to find there's no one to buy her fish anyway. "You've already given your body, but then you have to give away the fish."

Another beach management unit member, Nera Aguko, who is 62, says she feels "disempowered" and "shameful", as everyone in the community knows what these women have to do. The fisherman estimated that 60 per cent of the women have to trade fish for sex. 

"We feel embarrassed and ashamed. The Bible says if I have a husband I should stick with them, but we have to go against that," says Nera. 

Another fishing village we visited believe bringing electricity to the village would help. 

"Fish is a perishable commodity. It takes just 45 minutes for the fish to go bad. We don't have electricity, so no freezer. We have to sell to the big lorries that have ice or it will go bad." These lorries come to the villages from the city, buying the fish far below market value, and selling on in shops and restaurants at incredibly marked up prices.

The beach management unit is saving for a transformer to get electricity to the village. It will cost around 60,000KSH – about £400. Once they've raised this, which could take some time, they believe the desperation for fish will decrease and prices increase – the fishmongers won't be forced to sell to the first agent that arrives, as they can freeze the fish until the price they are offered is fair.

Until then, the community is worried nothing will change.

One fisherman called Mordecai said that while this practise of fish for sex is traditional, it has increased recently due to poverty in the area. "You have to eat. It's like the hard way is the only way," the fisherman told me. Many women believe they don't have an alternative. "We need to be creating awareness of the dangers and the consequences."

This is what Anglican Development Services Nyanza (ADS Nyanza), a partner of Christian Aid, is trying to do. 

The inter-denominational charity is working in the area to educate the community. A community health volunteer visits families here, teaching them about the risks and how to stay safe. Trained by the ADS Nyanza, these volunteers act like community nurses, giving basic medical advice and teaching to people how to live healthier lives. They're also working hard to encourage people visit the facility when the first symptoms of malaria appear. 

With support from Christian Aid, ADS Nyanza has provided motorbikes for some of the volunteers, which they are able to transport patients on – slashing the six-hour round journey. 

There is still a stigma surrounding those with HIV, which stops some people getting tested. But the community health volunteers are trying hard to break through the silence. 

The fishermen I met were pleased to tell me the signs and symptoms for the common illnesses in the area, and the measures they can take to prevent them. The information these community health volunteers are offering is being taken on board, and the unit members know their community needs to change.

One person trying to change the mind set of communities like this is the Rev Vincent Yoga, a vicar of the Anglican Church of Kenya. "We know the Church is an agent of transformation. The Lord in Matthew said we are the salt of the world. When we put our heads together the transformation takes place." 

The vicar is using the pulpit to bring about this transformation. He teaches parishioners to sleep under mosquito nets and clear the rainy season, as mosquitos hide in plants during the day, as well as stressing the importance of visiting the clinic and listening to the advice given by officials.

"I'm a spiritual leader and I know the God that called us to serve is the God of relationship." He believes God is using the community health volunteers as His hands and feet, and the health of the Church is key.

"When the Church is growing unhealthy – when we are sick – we can't spread the gospel. The Church is like a vehicle that takes people to where they are going, but if we don't maintain that vehicle, it can't move. 

"The Church will only be content when the community is healthy." 

In recent months, Christian Aid has  been raising funds to improve access to healthcare for vulnerable communities in developing countries such as Kenya, and where the need is greatest. To find out more about the charity's work on malaria, visit: http://www.christianaid.org.uk/malaria.