Drug abuse, early sexual debut, HIV/Aids and STIs, sexual abuse and
violence are burdens that the average Kenyan adolescent. GRAHIC |
NATION
Rasheed Mutaha just turned 18. By all standards he is young, but
his teenage face and thick spectacles neatly cover a four-year battle
with drug addiction. In his less than two decades on earth,
he has abused drugs, lived on the wild side of life, and got expelled from at least two high schools.
he has abused drugs, lived on the wild side of life, and got expelled from at least two high schools.
Rasheed has
smoked bhang, used cocaine, and popped ecstasy, all sourced by and
shared with some of his friends. For four cold years he did more drugs
than he will ever remember. The fleeting high was too sweet, too
enticing to live without; and that momentary feeling of being on top of
the world made him believe he was indomitable, some sort of god at whose
feet all, especially his small harem of girls, worshipped.
“I
tasted my first alcohol when I was 13,” he says. A friend convinced him
that he was old enough to partake of the “drink of adults”, and soon
that friend brought him bhang, then cocaine, then ecstasy, and then the
women. At home he was the model child, but immediately he stepped out he
shed off his cloak of innocence and transformed into this
attention-hogging, drug-popping maniac.
“It
was as crazy as it was fun, or so I thought. In the hazy cloud of
illicit romance I did not care whether or not I was using protection. I
was neck-deep in the mess,” says the first-year university student.
“Whenever
I was high on drugs, I was the coolest bloke among my friends. The only
approval I wanted was from my peers. They were my advisers and source
of information. However, we all relied on the Internet as the truth.”
However,
Rasheed discovered that the Internet was not all that it promised to
be. It knew a lot, but not everything. And the answers were templated
into a fit-all instruction manual than could not address his most
private and pressing needs.
“I would
google what is sex only to end up on porn sites. I could not ask my
teachers, and I just could not bring myself to talk about these issues
with my parents,” he says.
His
turning point was when, after a few years of casual, unprotected sex, he
developed the signs of a sexually transmitted infection. “I remember my
friends asking if I had slept with a certain girl who was popular in
the neighbourhood. I couldn’t remember whether I had or had not, and
that scared the bats out of me. And then, at about the same time, my
father started dropping hints about HIV/Aids and how it was ‘a real
killer’. That messed me up emotionally.”
MISPLACED ENERGY
A
friend noticed that he was not himself and asked him what was
happening. Rasheed confessed that he was not himself, that there was
something eating him up from inside, and that he needed help. His
friend, a Muslim, told him he could help, and from then on they became
the closest buddies as Rasheed slowly weaned himself off drugs.
Eventually,
the boy who had been born David Ndun’gu Mutaha became Rasheed Mutaha,
converted to Islam by his friend’s dedicated care and concern over his
welfare.
That young boy, too, is just
one of the many other adolescents in the country who are struggling
with one form of drug addiction or another. Just this August, for
instance, a group of high school students hired a bus on closing day and
proceeded to binge-drink, lap-dance and cavort as they “toured” Kiambu
County before the bus was stopped by traffic police over the loud music.
When
the police climbed into the bus to see what was going on, they came
face to face with the emblem of misplaced teen energy and arrant
mischief. The students were all sloshed and in various degrees of
undress.
“We are only talking about
it because they were caught,” says Rasheed, hinting that this was not an
isolated incident. “To the adolescents, such boundless ‘fun’ is normal
on school closing day.”
Drug abuse,
early sexual debut, lack of contraceptives, HIV/Aids and STIs, sexual
abuse and violence are burdens that the average Kenyan adolescent
confronts today, and some carry these nagging loads into their youth. If
not dealt with early and adequately enough, the results of such
misadventures scar them for the rest of their lives.
It
is as a result of this that the Ministry of Health, alongside other
partners, has drawn up the National Adolescent Sexual and Reproductive
Health Policy, set to be launched today in Nairobi. The policy intends
to bring adolescent sexual and reproductive health rights into the
mainstream sphere of health and development.
It
describes reproductive health as a state of complete physical, mental
and social wellbeing, and not merely the absence of disease or
infirmity, in all matters relating to the reproductive system, its
functions and processes.
In his
foreword to the document, the Cabinet Secretary for Health, James
Macharia, says the revision of the Adolescent and Reproductive Health
and Development Policy developed in 2003 is necessitated by the fact
that “a lot of things have changed at the national and international
levels that needed to be taken into account”.
Adolescents,
described as any person between the age of 10 and 19 years, comprise
nearly 9.6 million of Kenya’s 40 million population. According to the
Ministry of Health, this population has implications on the country’s
health and development agenda “as it is likely to put increasing demands
on provision of services”.
Rasheed
knows it. He has been there, done that. Luckily, he survived to tell the
story, but many more others never get the second chance, the rebirth,
he got.
Adolescents, described as any
person between the age of 10 and 19 years, comprise nearly 9.6 million
of Kenya’s 40 million population.
PHOTO | FILE
SECOND ACT: The strategy also addresses the needs of the following
At-risk youth groups
Adolescents
living in informal settlements: Young people in slums are exposed to
early sexual debut, low contraceptive use, transactional sex, sexual
abuse, high burden of unintended pregnancies, and drug and alcohol
abuse. In Nairobi slums, about 11 per cent of males and nine per cent of
females initiate sexual activity before the age of 15, according to the
Status Report on the Sexual and Reproductive Health of Adolescents
Living in Urban Slums in Kenya.
Adolescents in the labour market:
According
to the Kenya Integrated Household and Budget Survey 2005/6,
approximately one million children aged between five and 17 years were
working, yet the law recognises the age of employment as 16 years and
above. Due to low educational attainment, child labour is associated
with limited access to reproductive health information and services, as
well as opportunities for self-advancement.
Adolescents with disabilities:
People
with disabilities cannot easily access health services, and this has
implications on their sexual and reproductive health. The prevalence of
disability among adolescents in Kenya is estimated at about four per
cent, with one out of six reporting their first pregnancy by age 20. Of
these, about 87 per cent are married or in a relationship, but only 12
per cent are using a modern contraceptive method.
Adolescents living with HIV:
Adolescents
living with HIV face unique challenges as they transition to adulthood
because they are less likely to be in school, likely to be orphaned,
lack appropriate services and are often unable to negotiate
contraceptive use or even access contraceptive methods. Of the
approximately 1.6 million Kenyans living with HIV in 2013, about 16 per
cent were children and adolescents (0-19 years).
Married adolescents:
Married
adolescents, as expected, experience sexual intercourse more frequently
compared with those who are not married, with very limited condom use
despite a higher risk of HIV.
Orphaned adolescents:
According
to the 2012 Kenya Aids Indicators Survey, there are about 1.8 million
orphans aged zero to 17 years in Kenya. Nearly half of the estimated
number of orphans in Kenya is as a result of the HIV/Aids epidemic,
which has also contributed to the increased number of adolescents
heading or living in child-headed households, a particularly vulnerable
group of orphaned adolescents. Orphans tend to lack guidance and support
which is associated with increased vulnerability to risky behaviours
among children.
Adolescents in emergency situations:
Displaced
women face particularly high levels of maternal mortality, unmet need
for family planning, complications following unsafe abortion and
increased gender-based violence as well as sexually transmitted
infections, including HIV. In addition, there are usually no services
designed to meet the sexual reproductive health needs of adolescents in
these populations.
FIVE BATTLES
EARLY SEXUAL DEBUT and CONTRACEPTION USE
One
in three adolescent married girls have an unmet need for family
planning. As a result, approximately 18 per cent of adolescents between
15 to 19 years have begun child-bearing. PHOTO | FILE
Although
the average age of first sexual intercourse has been increasing, from
16 years in 1993 to 18 in 2008/9, according to the Kenya Demographic
Health Survey, about 12 per cent of girls and 22 per cent of boys
reported to have had sex by the age of 15. Similarly, 37 per cent of
girls and 44 per cent of boys aged 15 to 19 years have had sex. In
Rasheed’s case, sexual debut was at 13 years. Coincidentally, one in
three adolescent married girls have an unmet need for family planning.
As a result, approximately 18 per cent of adolescents between 15 to 19
years have begun child-bearing.
Evidence
from KDHS 2008-2009 shows that among adolescent girls who started
child-bearing by age 18, 98 per cent were out of school, indicating that
early pregnancy means the end of education for almost all girls. The
UNFPA Country Representative Siddharth Chatterjee says “unintended
pregnancies cause several thousands of girls — about 13,000 — to drop
out of school in Kenya”.
Poverty,
lack of education and limited economic opportunities among girls may
also contribute to adolescent pregnancy rates. Mr Chatterjee adds: “Teen
pregnancy is self-perpetuating because children of teens often become
teen parents themselves.
Everyone
must respond to the duty to help our children make good choices and to
make the most of their own lives.” In the event of pregnancies,
adolescents may not maintain a healthy pregnancy due to poor health
education, inadequate access to antenatal care and skilled birth
attendance among other healthcare services, or the inability to afford
costs of pregnancy and childbirth.
Solution:
The
policy proposes age-appropriate sex education on sexuality and
relationships by providing scientifically accurate, realistic and
non-judgmental information, as well as enhancing provision of “high
quality post-abortion care services to adolescents”.
HIV/AIDS and STIs
Adolescents
between the ages of 10 and 19 years represent about nine per cent of
persons living with HIV and 13 per cent of all HIV-related deaths in
Kenya. PHOTO | FILE
HIV
prevalence has decreased significantly among young people aged 15 to 19
years, declining from about 3.0 per cent in 2003 to 1.1 per cent in
2012. Overall, adolescents between the ages of 10 and 19 years represent
about nine per cent of persons living with HIV and 13 per cent of all
HIV-related deaths in Kenya. The HIV prevalence rate for adolescents
living in urban areas has higher HIV prevalence rates (2.2 per cent)
compared to their rural counterparts (0.5 per cent). For those who
report first sex before 15 years, HIV prevalence is 5.3 per cent among
young women and 0.3 per cent among young men. About 53 per cent of
female adolescents and 34 per cent of their male counterparts aged 15 to
24 years who had their first sexual encounter before the age of 15
years report condom use during their sexual debut, compared to 70 per
cent of females and 65 per cent of males aged 15 to 24 years who used
condoms during their sexual debut at 15 years and above.
Solution:
The
new policy suggests the supporting of provision of accurate information
on HIV/Aids and other STIs to adolescents for risk reduction and ART
adherence. It also proposes the promotion of screening and treatment of
reproductive tract infections, including STIs. Another solution is
through the global launch of the All In Campaign in Kenya in February
this year, which seeks to prevent adolescent HIV/Aids infections as well
as work with affected youth to better manage infections.
SEXUAL ABUSE and VIOLENCE
Adolescent
girls aged 13 to 17 were more likely to have experienced sexual
violence in the previous 12 months (10.7 per cent) compared with a
similar age group of boys. PHOTO | FILE
According
to a 2012 national study by the United Nations Children’s Fund (Unicef)
on violence against children in Kenya, adolescent girls aged 13 to 17
were more likely to have experienced sexual violence in the previous 12
months (10.7 per cent) compared with a similar age group of boys (4.2
per cent). Adolescents who suffer sexual abuse are more likely to be
exposed to unintended pregnancy, unsafe abortions and STIs, including
HIV.
Solution
The
policy proposes to strengthen the provision of medical, legal and
psycho-social support for teen survivors of sexual and gender-based
violence; and to enhance the capacity of law enforcers and health care
teams on response to and mitigation of such violence.
DRUG and SUBSTANCE ABUSE
18
per cent of adolescents aged 15 to 17 reported ever using any drug or
substance, including tobacco, khat (miraa), narcotics, and inhalants.
PHOTO | FILE
According
to a 2012 rapid assessment of drugs and substance use in Kenya by the
National Authority for Campaign against Alcohol and Drug Abuse (Nacada),
about 18 per cent of adolescents aged 15 to 17 reported ever using any
drug or substance, including tobacco, khat (miraa), narcotics, and
inhalants. Specifically, about two per cent of females and four per cent
of males aged 10 to 14, and about 11 per cent of 15-to-17-year-olds
reported ever using alcohol. The United Nations Office on Drugs and
Crime estimates ecstasy users to number approximately nine million
worldwide, the vast majority of whom are teenagers and young adults. The
use of alcohol and drugs is used as a strategy for most young people to
cope with problems such as unemployment, neglect, violence, sexual
abuse and poor academic performance. Despite the need for services to
address substance abuse, very few drug rehabilitation programmes and
counselling centres are available for adolescents in Kenya, and these
tend to be urban-based. For adolescents, substance use and abuse is
associated with increased risk for early sexual debut, multiple sexual
partners and early child-bearing.
Solution
The
policy proposes the support of provision of medical, legal and
psychological services at all levels, including rehabilitation for
adolescents exposed to drug and substance abuse; as well as support of
the enforcement of relevant legislation on drug, alcohol and other
substance abuse among adolescents.
FGM and EARLY MARRIAGES
Girls
who have undergone FGM as a rite of passage are likely to drop out of
school, experience child marriage and early child bearing. PHOTO | FILE
Female
Genital Mutilation (FGM) is a deeply rooted cultural practice that
remains prevalent in Kenya despite being outlawed in 2001 by the
Children’s Act and Prohibition of FGM Act 2011, and being a violation of
rights. According to the National Council for Population and
Development, Kenya Population Situation Analysis, among young girls aged
15 to 19, FGM declined from 26 per cent in 1998 to 15 per cent in 2008,
then to 11 per cent in 2014. Girls who have undergone FGM as a rite of
passage are likely to drop out of school, experience child marriage and
early child bearing. Also, according to KDHS 2008-2009, six per cent of
females were married by age 15 and 26 per cent by age 18. Child marriage
is associated with dropping out of school, increased risk of HIV
infection, heightened risk of gender-based violence, early child-bearing
as well as high fertility rates. There is also a risk of high infant
mortality as well as maternal morbidity and mortality.
Solution
Support
the education of communities on existing legislation and policies that
protect adolescents from harmful traditional practices; as well as
support sensitisation programmes that advocate the reintegration to
school of adolescents in early marriage and FGM situations.
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