Following a recent visit to Kenya with People’s Postcode Lottery, I was lucky to visit two other MSF projects in the north of Nairobi and nearby Kiambu County.
Kiambu County borders the north of Nairobi and has one of the highest rates of drug use of counties in Kenya.
Of an estimated 1,300 users linked to drug dens in the county, only a small number had been enrolled in Medically Assisted Therapy for opioid substitution – the drug Methadone – at the Ngara clinic in Nairobi.
It takes at least one year of Medically Assisted Therapy in a controlled environment for a user to wean off heroin, but it can take much longer.
With daily visits necessary, this is time-consuming and costly to get to, meaning it is out of reach for all but a few.
We visited the first Medically Assisted Therapy clinic in Kiambu, established by MSF in collaboration with the county government, where construction was well underway ahead of an autumn opening.
The clinic will be a one-stop service for people who use opioids such as heroin, as well as providing outpatient care, including services for HIV, tuberculosis, hepatitis C, mental health, wound care, sexual and reproductive health, and non-communicable diseases.
This innovative and simplified patient-centred approach has been developed to improve access to care for people who use opioids; it’s a holistic approach that aims to reduce morbidity and mortality associated with illicit opioid drug use, as well as reducing the risk of HIV and hepatitis C infection and transmission.
Psychosocial counselling, for both individuals and groups, and family integration sessions aim to help integrate users back into their homes and society.
The heroin user
We also visited a drop-in centre close to the clinic run by one of our local partners, LVCT Health, which provides outreach services to drug dens in the county.
The drop-in centre is a safe space for people who use drugs and LVCT prepares the drug users for induction into the Medically Assisted Therapy programmes at the Ngara clinic and the newly opened Kiambu clinic.
We met one of the centre's patients, who told us his story. Now aged 36, he started using heroin around 2004 when his wife was pregnant with their first daughter.
I hadn’t appreciated before just how uncontrollably addictive heroin can be. He told me that in his case, it started when a friend offered him what he thought was a normal cigarette but was laced with heroin.
By the time he’d had three, he was addicted, through no fault or intent of his own. After he moved from his home to the street, and later to a drug den, he was found by the outreach team.
He had been stealing to buy heroin and support his addiction, which was costing upwards of 2,000 KES a day (approximately £15) – a huge cost when average earnings are comparatively low.
It is a quick addiction followed by a long road to recovery.
One year and nine months
Following a controlled schedule of Medically Assisted Therapy, the man has been clean for one year and nine months, with two months of treatment to go.
He has been able to return home to his wife and children, including a new baby, and told me “life is back to normal”.
...to come out of 16 years of heroin addiction and to be in a positive place, back living with his family and helping others to turn their lives around was truly inspiring to hear
He now works as a peer educator, going out into the community and trying to change the futures of others.
He had an incredible energy about him; to come out of 16 years of heroin addiction and to be in a positive place, back living with his family and helping others to turn their lives around was truly inspiring to hear.
I was honoured to meet him and to hear his story.
Goodbye, for now
During our week in Nairobi and the surrounding counties, it was great to meet so many of my MSF colleagues and to put faces to names after months of emailing.
It was also fantastic to experience MSF logistics in action. Everything ran like clockwork, from being at the right place at the right time to popping into one of the guesthouses to shower before our night flight home.
I hope it will not be too long until my next fill of ugali and sukuma wiki!