Street families and the tough choice of family planning
Street families in Kenya remain among the forgotten group, especially amid the outbreak of covid 19 pandemic.
Situated in the Rift Vally region of Kenya, Eldoret town is among the fast-growing urban centers harboring dozens of street families, the majority being mothers with babies as young as six months.
With no consistent housing, street mothers live in constant fear for their children’s safety.
Elizabeth Ameri, 32, a mother of 11 kids is one of the many women who hop from street to street in Eldoret looking for food for her young ones and a safer place to sleep when night falls.
Carrying her six month newborn on her back, while dressed in just a skin-tight and sweatshirt, Ameri who mostly lives around Kenyatta street in Eldoret town narrates her saddening story about how she got herself living in the streets at the age of 14 years,
“The conditions at home were not favorable for me as I was in constant feuds with my parents as they did not agree with my demands of going to school,” Ameri said.
She gave birth to her first-born child just a year after running away from her parent’s home in Turkana and settling in the cold Eldoret streets.
With tears lingering in her eyes, Ameri explained how hard it is for her and her fellow women living in the streets to practice family planning as they don’t get enough education on how these contraceptives work and how they are supposed to access them.
“We don’t have much information at our disposal, only a few of us who get to visit the hospital facilities get a little enlightenment on how these contraceptives work but the majority of the women here have never used them,” she posed.
“We are usually not given the best reception at the health facilities because we don’t look presentable enough, some of us go days without taking a shower and being women, we start smelling, this makes the doctors at the hospitals no turn us away without even tending to us.”
Despite the challenges posed by the streets, these neglected street families keep growing by the day and this is a ticking time bomb that poses a huge problem in the country as most of the street children are associated with social ills due to lack of proper upbringing.
Benson Juma, a reformed street boy said that it is high time the government comes in and builds rehabilitation centers for the street families as a hope for a better tomorrow for the young kids living here.
“The growing number of street families calls for the government to step in and put-up rehabilitation centers for them as this is a menace as street life is a bitter life as children are brought up with no basic moral values, no proper shelter, no education and with such bitterness they end up being a threat to the communities around them, “noted Juma.
Doctor Caleb Wata, a medical practitioner in Western Kenya says that the increasing number of street families will be a hindrance to the attainment of the 2030 vision by the government.
“At the end of the day the government needs to address several aspects including the reduction of infant mortality, and maternal mortality and these family planning practices are some of the ways to deal with issues like unwanted pregnancies,” Said doctor Wata.
Dominic Makori, a social worker says it is a big challenge to care for street families. “We don’t have systems that are helping these street populations and those that are there are fragile, are not working and so it becomes a challenge for us to take these children out of the streets and place them in specific children’s homes as it needs resources that we as social workers lack,” said Makori.
According to a World Health Organization (WHO) report, street girls are prone to unwanted pregnancies because they are unprotected to unprotected sex.
This is because their reproductive system is not fully developed; they are prone to complications related to childbirth, such as premature delivery and obstructed labor. These can cause injuries or death to the baby and the mother. In addition, the baby born to such mothers may have a low birth weight and may be prone to infections and illness.
The report further says that pregnant street girls may feel pressured into terminating their pregnancy as coping with infant babies’ demands is difficult in the streets. In addition, they often have no one to turn to for support and advice, and they may not have access to reproductive health services for safe termination of pregnancy.
These young girls end up seeking abortion services from unqualified persons or inducing the termination themselves. Unsafe abortions could lead to infections, bleeding, or even death and forceful termination may cause damage to the reproductive organs and eventually cause infertility (inability to have children).
The stress of the experience could also lead to psychological problems such as depression
Atelo says that young girls living in the streets fall victim to men who promise to take them in and better their lives and instead get them pregnant and abandon them.
”Most of these pregnant girls are forced to have sex with men in exchange for food, which eventually leads to pregnancies and they are now forced to raise the newborn alone in the cruel streets, “said the devastated Atelo.
The mother of ten commonly known as mama twinie (from the two sets of twins among her ten children) says that if only she was given good guidance on how to do family planning, she would not be having 9 of her children living in children’s homes.
“I have personally been using the injections but every time I forget to go for a renewal of the same and it costs me getting pregnant,” she said.
The youngest of her kids is barely six months and is already being subjected to the cold and harsh street life.
With no warm clothing, the babies are exposed to the dangers of pneumonia and other diseases like malaria since there are no nets in the streets.
In the neighboring county of Bungoma, the narration is not so different. We meet with Jay Nicole who is also a street mother of two.
“Abstinence in the streets is no option for us, as most of the men we get involved with demand to have raw sex saying that the sweet is no sweet when eaten with the paper wrapping, and if we had a permanent family planning con contraceptive we would avoid so many unwanted pregnancies, “said Nicole.
As a result, these cases of raw sex have led to an increase in the number of HIV cases among street families and other sexually transmitted diseases that most don’t get treatments for.
The WHO report published in November 2020 further indicates that out of the 1.9 billion women of reproductive age group (15-49 years) worldwide in 2019, 1.1 billion need family planning; of these, 842 million are using contraceptive methods, and 270 million have an unmet need for contraception.
The need for family planning satisfied by modern methods, Sustainable Development Goals (SDG) indicator 3.7.1, has stagnated globally at around 77% from 2015 to 2020 but increased from 55% to 58% in Africa.
Only one contraceptive method, condoms, can prevent both pregnancy and the transmission of sexually transmitted infections, including HIV.
The use of contraception advances the human right of people to determine the number and spacing of their children.
It offers a range of potential non-health benefits encompassing expanded educational opportunities and empowerment for women and sustainable population growth and economic development for countries.
The number of women desiring to use family planning has increased markedly over the past two decades, from 900 million in 2000 to nearly 1.1 billion in 2020.
Consequently, the number of women using a modern contraceptive method increased from 663 million to 851 million, and the contraceptive prevalence rate increased from 47.7 to 49.0 percent.
An additional 70 million women are projected to be added by 2030 to gender-based barriers to accessing services. As these barriers are addressed in some regions, there have been increases in demand satisfied with modern methods of contraception.
Amid these interventions, there is also concern over the quality of healthcare they receive, especially when a global pandemic is ravaging communities.
“The county and national government should come up with a budget to reach out to these street families and try to help them,” says Pastor Joseph Mukolwe of Eldoret.
Uasin Gishu Governor Jackson Mandago said they collaborate with the children’s department to take all the children to the rescue centre to be taken care of there.
“We will give them food, medical support and even educate them. For the ones with parents, they will go back home after their families agreed with the courts that the children will keep off from the streets,” said Mandago.
As the world continues with efforts to encourage and support family planning across many nations, street families in sub-Saharan Africa continue to be ignored by stakeholders.
This, according to experts, is a danger that can only be solved when the welfare of this group is handled on time.
After delivering her eleventh child at Moi Teaching and Referrals Hospital, Elizabeth Ameri underwent a successful bilateral tubal ligation surgery where her fallopian tubes were cut to prevent further pregnancy cases.