The plight of drug addicts with TB

It is around lunchtime on a sunny Saturday in the Ukunda area of Diani, a renowned leading beach destination located in South Coast.

Despite being globally recognised as a tourist attraction site because of its pristine white sandy beaches, the neighbouring Shimba Hills National Reserve and its active nightlife, Ukunda town is battling heavy drug addiction among the youth.

At Ukunda Showground, at least 40 people who inject drugs are seated under a shade outside the Teens Watch Centre main building.

They are waiting to be served lunch by Teens Watch Centre, which started its operations in 2002, running an effective drug prevention and treatment programme for the thousands of youth in the locality.

Safia Jatani, a 47-year-old woman, is a recovering drug addict who has battled drug addiction for 19 years.

In 2002, when she was still a young girl, Jatani left Marsabit county her home for the coastal town of Diani to try and make a living. Before coming to the Coast, she briefly stayed in the capital city, Nairobi.

In the South Coast, Jatani seriously wanted to lose weight to become more attractive. A fantasy for many women who want to attract foreigners.

By that time, she used to occasionally smoke bhang. She had never tried heroin or any other hard drug.

Jatani noticed that her neighbour, who was then a peddler, drastically lost weight. She became inquisitive and wanted to know so she could also become slim.

“I was informed that he uses ‘unga’, a slang name for heroin at the Coast,” she says.

“I said to myself, I will also use the drug so I can become slim. However, I will immediately stop so I do not get addicted. It was a terrible mistake.”

By the time she lost weight, she had also become a ‘junkie’.

“I could not stop the addiction. I lost all my belongings and moved out of my house and started living in dens and open fields,” she says.

In 2018, while still living in the dens, the mother of two started coughing. She went to the hospital several times, but they could not find the illness.

After a third visit, an X-ray showed she was suffering from tuberculosis and she was immediately placed on a six-month medication.

“The third time, on behalf of Teen Watch, I was confirmed to be TB-positive. At the den, I was being stigmatised and no one wanted to associate with me,” she says.

After six months under TB medication, Jatani says, she went for HIV testing and her worst fears were also confirmed. She was positive.

“I was also placed on HIV treatment, and, therefore, had also to be talked out of drugs. I’m now under the Methane programme,” she says.

PEER PRESSURE

Since 2020, Hamisi Kaure has also been injecting drugs.

“Most of my friends were drug addicts, but I had never tried before. One day, I decided to try after falling into peer pressure,” he starts off the conversation.

He could not stop anymore because whenever he tried, he would become terribly sick.

Staying in the open drug dens, Kaure began feeling weak and all his joints were painful.

“I went to the hospital and was diagnosed with TB. I was directed to ensure that I take the medication every day without fail, but because I live in the streets and dens, it has never been easy,” he says.

At first, he was given a two-week TB dose. The medication got lost in the den.

“The doctors decided to trace me after I failed to return for the additional medication. A community health volunteer was sent to trace me and brought me back to the hospital,” he says.

He was to start the TB treatment afresh.

“This time round, I tried my level best to finish the dose, but one night it rained heavily and the medication got soaked in the rains,” he says.

He said he became more ill and could not go back to the health centre.

“Another person was sent to trace me after I failed to show up for the medication,” he says.

“I told them about my problems and a decision was made that a Community Health Volunteer will be bringing me my medication every day to my den.”

Because of being homeless, he was also registered under the Teens Watch Centre feeding programme for people who inject drugs.

“I’m given food twice every day. I also get my medication without fail,” Kaure says.

HELPING TB PATIENTS

Job Rodgers is among the peer educators who supply the homeless drug addicts who are TB patients with food and medicine every day at their dens.

Before he became a peer educator, he was a drug addict for 27 years.

The 46-year-old says he also suffered TB when he was only 24 years and in the drug dens. That was in 2011. By then, he was so discriminated.

“I got some many challenges that time. In the den, there was too much discrimination. However, I managed on my own until I fully recovered,” he says.

Rodgers says he started smoking bhang when he was only 15 years old and in secondary school. His father was then a senior official in the defunct Mombasa municipal council.

In 1997, when he was about to clear secondary school, he lost both of his parents within eight months. His siblings and him were taken in by relatives.

He came to Diani to his uncle’s place after Form 4.

“That is how I started using hard drugs. I have been to every den here in Kwale and Mombasa. I know every place and the challenges the people who are suffering from TB face,” he says.

After 10 years of drug addiction, Rodgers says, he started thinking of an exit plan, which included rehabilitation and even some time going far away from Kwale.

In 2020, when he was 44 years old, he decided that enough was enough.

“I wouldn’t want to get into my 50s still hard on drug addiction. I quit, this time round for real. I did not even enrol for methadone. I faced the bull head-on,” he says.

Teens Watch Centre employed him as a peer educator.

“I do monitoring, screening and testing of drug addicts for TB. When they test positive, the doctors give them medication and I do regular follow-ups,” he says.

Currently, Rodgers has three TB patients that he takes care of daily. He supplies them with medication and food.

CELEBRITY RECOVERING ADDICT

Lucy Kimani, alias Queen Sheba, is a celebrity among the Kwale drug addicts. Two years ago, she even got featured in a Netflix documentary, ‘The Drug Business’.

Sheba has never suffered TB before, but she lost the father of one of her kids to TB.

The 47-year-old left Nairobi when she was only 24 years old. She comes from a family of nine siblings, and she is the eldest among the daughters.

Her parents had separated.

In Mombasa, she started dancing in the clubs for the rich foreigners.

She was ‘fortunate’ to get a Mzungu, who was ready to marry her. They left Kenya for Germany within a few months after they met with a foreigner in a club.

“I did not know the foreigner was actually a drug peddler and a pimp. Everything was rushed and we left Kenya for German in 1994,” she says.

After about three years in a foreign nation, her documents had all expired. The man she was staying with was also arrested for drug peddling and possessing a firearm illegally.

“I was arrested alongside my boyfriend and I was sent to prison for 10 months. I was deported back to Kenya after I finished my sentence,” she says.

In Kenya, she met another man, whom she got married to and got her first child with, a daughter she named Angel.

It was not long before she totally became consumed with drugs.

She got hooked up with yet another man and she got her secondborn, a boy she named Lucky.

“However, I became an absent mother for my children. I was always in and out of rehabilitation. I lost my daughter, Angel, when she was just six years in a very mysterious way,” she says amid sobs.

The father ran away after the death of his daughter for fear of being arrested.

“It is believed he might have played a role in her death,” she says.

The father of her secondborn died while Sheba was in rehabilitation for the umpteenth time. She says the man died from TB.

After 10 years of drug addiction, Sheba decided to change for the better. She is currently under the Methadone programme and a peer educator at Teens Watch.

“I have 42 clients under my watch. I usually meet with them at the dens and enlighten them on regular TB testing. I have three clients who are on TB treatment,” she says.

PREVALENCE OF CASES

Caroline Omondi, a programmes coordinator at Teens Watch, said since 2018, they have handled about 35 TB cases among their clients and staff members.

Teens Watch has two facilities, one for Female Sex Workers (FSW) and another facility for Injective Drugs Users (IDUs).

At the FSW centre, they have 3,000 women working with them and 2,065 injecting drug users at the other centre.

“We have a population of 75 HIV-positive patients among the 2,065 IDUs and another 122 HIV patients among female sex workers population of 3,000,” she says.

For the last four years, they have been treating TB patients within the organisation.

“In 2018, we had 10 cases of TB, the following year 2019, the number went down to nine cases and in 2020, we had six cases,” she says.

They registered five cases a year in 2021 and 2022.

“We have had at least 35 cases of TB at Teens Watch, and you will realise some of the patients were actually our staff members,” she says.

Five staff (two peer educators and three outreach workers) were diagnosed with TB.

“Most IDUs do not cough when they have TB. You are seated next to them, taking care of them, not knowing that you are exposed,” Omondi says.

She says they decided to ensure all the staff members are given Post-Exposure Prophylaxis TB treatment because of being exposed.

“We are very exposed and we need to be cautious,” she says.

For the TB clients who are homeless, Teens Watch gives them two meals a day and assigns a peer educator to ensure they take their medication very well.

Sylvia Ayon, senior policy manager at Kenya Aids NGOs Consortium (Kanco), says they have been working with communities and organisations in Kwale and Mombasa counties to combat TB.

Their programme is supported by the Global Fund.

Ayon says TB is among the leading cause of death among IDUs because most of the addicts do not show the symptoms at an early stage.

"The substance they use (heroin) is a very strong painkiller; it would actually not have been easy to notice the symptoms of TB when one is high on the substance,” Ayon says.

"TB symptoms are noticed at a very late stage among the IDUs."

She says Kanco has been supporting local organisations in Kwale county to ensure that drug addicts are tested regularly for TB and are monitored throughout the medication period.