The village with no men: a community crippled by HIV/Aids

The little community of Ahero, in western Kenya, provides a haunting illustration of the human cost of a merciless epidemic. Steve Bloomfield reports

Joseph Okoth is something of a rarity. In a bright pink polo shirt, and with machete in hand, he flops down in a plastic chair inside his small wood and mud house with a corrugated iron roof.

"There used to be so many of us," he says. "Now ... now, we are so few. There are no men left here. We are all dead."

Joseph is one of just eight men in Ahero, one of a handful of villages scattered across the Nyanza region of western Kenya which are home to a thousand or so people. In some villages, there are no men. HIV and Aids have ravaged this area on the shores of Lake Victoria in a way not seen elsewhere in Kenya.

It is partly because of poverty and the lack of education. Poor standards of health care and ignorance about antiretroviral drugs (ARVs) used to treat HIV infections have not helped either. Many HIV sufferers consider ARVs to be a cure, allowing them to sleep with a partner once they have been taking them for a while.

But health experts say the main reason for Nyanza's HIV epidemic stems from the traditional culture of the Luo people. Luo men are not circumcised something that other Kenyans often mock. A US study last year appeared to show that circumcision could halve the risk of a man contracting HIV. The World Health Organisation says that circumcision could save millions of lives but, so far, efforts to convince Luo men to have the procedure have failed.

The other damaging tradition is "wife inheritance". When a husband dies, his wife can be "inherited" by his brother, cousin or neighbour. Obviously, if the man died of HIV, the chances are his widow has it too.

"Men are inheriting," says Mr Okoth. "That's why so many are dying. Maybe they should not do it any more." He has just spent a day helping to build a new home for an old woman in the village. "There are not other men to help. We have to bring in people from other communities," he says.

The dearth of men has put a terrible strain on the local economy and proved an intolerable burden for women. Most women in Ahero and its surrounding villages have been forced into casual labour, picking up 20 shillings here, 40 shillings there for a day's work on the nearby rice plantation, or for smearing a new home with mud to protect it from the rain.

But many of them have HIV and the numbers succumbing to Aids are rising every month. With most of the men already dead and many of their wives sick, it is left to the grandmothers to raise Ahero's families.

Heleda Aloo Akumu is one of those elders. She works in the paddy field when she can which isn't often. "I cannot do very well," she wheezes. "My knee is bad and my breathing is not good." On the days she is able to get work she earns no more than 50 shillings (40p). Heleda thinks she is 79 but cannot be sure. She sits down against the wall of her small mud hut as four grandchildren gather at her feet. Three-year-old Beatrice plays with a football sticker while Valenta, five, methodically scrapes dirt off her legs. Emmauel, four, and two-year-old Vera huddle close to their grandmother.

"When we don't have food God helps us survive," says Heleda. "It is very hard, but we survive."

By the time Nyanza women reach Heleda's age, they do not expect many of their children to still be alive. When asked how many children she has, she first recalls how many she gave birth to, before counting off the dead.

Heleda had four children three boys and a girl. By the time her husband died last year, two sons had already contracted HIV and died. Months later, her only daughter's husband died of Aids. Within four weeks, her daughter was also dead. Her last remaining son, Joseph, has HIV, as does his wife, Movince. Neither is well enough to work or look after their children.

So it has fallen upon Heleda, with her chesty cough and bad knee, to take care of the couple and her four grandchildren.

"Sometimes my neighbours support me," she says. "But not often. I am so worried. To get food is a big problem. We don't have anything. It is very hard to take care of the grandchildren but I can't throw them away. They are mine."

To make matters worse, Heleda has just contracted a nasty bout of diarrhoea. In a country like Britain that means little more than a day or so on the lavatory; here it can be a death sentence.

Heleda doesn't know if she has HIV she has never taken a test and doesn't think it is worth it. If she found she was positive, she says, she wouldn't be able to afford the treatment. "When I am sick, like now, I just pray. God always injects me," she laughs. "This disease is always coming. Who knows, maybe I have it. People are dying all over here. It is like malaria everyone has it."

Heleda's house, a simple wood and mud structure, has a new roof. HelpAge International, a charity which provides assistance to elderly people in Kenya, paid for new corrugated iron sheets and a sturdy wooden door. They also provide Heleda and family with a daily supply of porridge. "I don't know what we would do without the porridge," Heleda says. "We'd probably all die."

To walk from Heleda's house to the home of Regina Akelo, you pass several similar wood and mud huts with thatched or iron roofs. No men live in any of them. "There used to be so many men here," says Regina, the proud grandmother to 30 grandchildren. "But they are all dead. It is quite different today. We have just young boys in the village."

She pauses, and looks over at two teenagers sheltering from the sun under a tree. "The young boys are dying very fast now too."

Regina had 10 children seven girls and three boys. Her first two daughters died from Aids, as did their husbands. Her first son was killed in an accident, and the second died from an illness she did not know. Her four remaining daughters all have HIV and every one of them has lost their husband to the disease. Her son is HIV-negative, Regina thinks, although his wife, Mercy, has tuberculosis and has not yet had an HIV test. Mercy lost one of her four children a few days ago.

Six of the 30 grandchildren live with Regina, and she also provides what little she can to her children. She cannot work these days a stroke has paralysed her right arm. "My daughters are all jobless," she says. "They try and work in the rice fields but often there is no work there."

Kenya's government made ARVs free for all who needed them in 2006. But patients still have to pay for multivitamins and other drugs to fight off opportunistic diseases. Such drugs are beyond the spending power of Regina's daughters. More worrying, though, is the lack of understanding about what ARVs can do. "Now they are taking them they are safe," Regina says. "I am not sure if they can remarry yet. Maybe they have to wait. But one day they can."

This entire community relies on its grandmothers. Without them there is no one to look after children, care for sick relatives, or bring in money. Just how much families rely on them is obvious at the home of Leonida Anyango. The 84-year-old was sole carer for five young children, all of them orphaned when their parents died of Aids. The youngest is 18-month-old Alice. A few weeks ago, when The Independent first visited, Leonida was playing with Alice, bouncing her on her knees. Leonida died 10 days ago. Her grave, a still-fresh mound of earth with a shaky wooden cross at its head, lies just yards away from the house. Alice bursts into tears every time she goes near it.

Leonida's daughter-in-law, Younis Agal, has returned to the village to look after the children. She believes she might be sick too but does not want an HIV test. "If you go for a test, you have to have money. We don't have money," she says, simply. "If I had money, I would go."

Younis doesn't know how long she can look after Leonida's grandchildren. She makes what little money she has by making sisal ropes. She makes 30 a week and sells them at a market for five shillings apiece. On a good day she sells 15, on a bad day maybe three. Alice is sat on her grandmother's grave, crying her eyes out. "She misses her," says Younis. "We all miss her."