Independent Appeal: Trading fish for sex - how HIV spread in western Kenya

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Tiny waves lap around the simple wooden fishing boats moored to the shore as the early morning sun beats down on the fishermen unloading their catch. A mother guts a foot-long tilapia fish while her daughter splashes near by. Teenage boys bathe next to women washing clothes.

On the beach, three men stand over broken wooden planks and tangled strips of metal. It is all that remains of a boat which capsized two days earlier killing all 20 people on board.

Despite the bright sunshine and the laughter, the spectre of death looms over the fishing communities of Lake Victoria in western Kenya, threatening their very existence. But it is not fishing accidents that are doing the damage, rather the deadly trade in the fish which is caught.

For increasing numbers of women, the tilapia and Nile perch have become a deadly catch. Women who want to buy the fish so they can sell it at local markets often struggle to raise enough money. Instead they offer to have sex with the fisherman as payment. It is a transaction known as jaboya and it is having a devastating effect on the small communities across Lake Victoria.

Ziphla Atieno is 35 but looks far older. Despite the warmth, she wraps her cardigan tightly round her frail body as she talks. She first came to Uterere, a small village of 500 people on the banks of Lake Victoria, after her husband died three years ago.

"When my husband was alive I used to pay for the fish and go to the market," she said. "After he died I needed to give something else for the fish because I didn't have the money. I used to do it every day."

But no more. Mrs Atieno began to experience chest pains just over a year ago. She took a test and discovered she was HIV positive.

It is only in the past 12 months that Mrs Atieno could even take an HIV test in Uterere. It is one of eight beach communities on Lake Victoria where Merlin, one of the charities supported this year by The Independent Christmas Appeal, operates. Two days each month, two nurses, a clinical officer, an Aids counsellor and lab technician take the boat out to Uterere from Sindo, the main town in the area.A local theatre group performs in the village, drawing large crowds and encouraging people to visit the clinic. Education sessions teach the community about how HIV is contracted and bust local myths that the virus can be caught from mosquito bites.

"I now know how to get treatment and how to carry on living," said Mrs Atieno.

Cleophas Odada Giloo has a wife and three children who live an hour's walk away up the hill. He spends his days on the lake and his nights in the local bar. He admits to practising jaboya before Merlin arrived. "There was so much of it," he said, "and we were not aware of safety. Truly I may be tempted because I am human, so I carry this now," he said, pointing to a condom in his pocket.

The difference Merlin has made is enormous, Mr Giloo, 25, said. "People knew nothing about HIV. If they [Merlin] had not been around I don't know what would have happened."

There have been noticeable increases in men abstaining from sex and being faithful, as well as a large increase in condom use. Numbers using the Voluntary Counselling and Testing Centre have also risen, with 40 per cent of men and 31 per cent of women attending at least once.

But Uterere still bears the scars of an HIV pandemic. "There's still so much more to do," says, Emma Llewellyn, who is leading Merlin's work. "We need to expand our medical and education activities, but above all, we need to help women find alternative sources of income. This would mean they will no longer be reliant on fish and the jaboya system."