Blast from my past: Risk and a verse

Back when I was in high school I dabbled in verse because I was bored. The education system was so intent on theory and rote learning, while I prefer something more fun, exploratory and practical.

I doodled all over my notebook instead of taking down notes, before I discovered a different way to daydream - by writing verse. My mother came across my collection and was shocked because (I guess) I had composed something a bit more grown-up than she would have expected. I stumbled on her reading it, and cursed myself for not hiding my notebooks in a safer place, but it was too late. She asked me: Is this what they teach you at school? And of course I had no answer, as I fidgeted uneasily and avoided her eyes.

I continued to compose verses till I completed school and a while longer thereafter. And that practice in writing random verses was not in vain because it won me a few Canadian dollars four years after I left high school.

Below is the winning entry in the text category of the 2008 YAHAnet's contest on risk and HIV/AIDS.

The poem illustrates that a person will engage in a behaviour which they know puts them at risk, because they are getting some sort of payoff (reward) for engaging in that behaviour. This perceived reward ensures that the person persists in a behaviour which they know has negative and unwanted consequences for them. For instance, in this poem, a girl has a boyfriend who has multiple sexual partners.The girl goes ahead to have unprotected sex with him, even though she is aware of the risk (of getting HIV) involved. She persists in this risky behaviour because she values the feeling of love she gets from this relationship so greatly, that it becomes the payoff that sustains her risky behaviour.

The verse was inspired by Dr Phil. I had just read one of his books.

PS- I do not consider myself a poet.

Deadly Payoffs: Why I Risk It

Dear auntie, when you sat me down

And told me to be careful in my relations with men

I knew you did it out of love

Don't get me wrong, I listened

And took in all you had to say

But auntie, I did not have a boyfriend then

So I thought, "It's so easy to be safe."

Dear auntie, I was so lonely

O how I longed to be loved by a man

Then he came into my life

And swept me right off my feet

I remembered your advice

And vowed to keep myself safe

But I did not know I would fall so deep in love

So I said, "I'll be safe, It's so easy"

Dear auntie he treats me so well

I feel like a princess, a star

And then came the moment

He asked me to have sex

I did not know his status, neither he mine

But it felt so natural, so safe

Even without protection

The only risk on my mind was

"Would I get pregnant?"

Dear auntie, he has three other girlfriends

I found their photos, and some used condoms at his house

I felt uneasy, could I be at risk?

And when I confronted him, he assured me

Nothing to worry about

We still do it unprotected

I wonder, "Am I really at risk?"

Dear auntie, they teach us all about HIV

In school, on tv and on the radio

Why then, do I not make good choices

To keep me safe from HIV

Auntie, I've never felt so loved before

And I do not want to lose his love

So even with all I know, I still put myself at risk

http://yahanet.org/gallery/written/271

Give me a clean needle for my vice

Burying one's head in the sand must be the most comfortable thing to do.

How else would anyone explain, the constant refusal to deal with issues that won't go away unless someone deals with them realistically? 

But it is so much easier to act like they do not exist. After all, some of these issues do not quite affect us - at least not directly.

Like the drug problem.

Once in a while a sordid television documentary shows us dazed zombies in drug abuse hot- spots. They speak of living in a self-inflicted hell that they cannot get out of; and tell of the careless risks they take to get money to feed their drug habit, without which their lives would be incomplete. And as they share the spoils of violent robberies, the needles, the blood, the high - they also share the virus.

 

Since most of us still have hearts, we are moved into wordy protests by the helplessness of the drug abuse victims.

“The drug lords are well-known and should be arrested!” we bay for blood, before we resign to fate as we realize that it is a complex affair; and slowly slide back to our relatively drug-free existence.

But for public health officials, drug users, particularly those who inject drugs, pose a big problem in their efforts to control the spread of HIV.

A report by three UN organisations  indicated that HIV prevalence among injecting drug users in Kenya was at 21 per cent. In Nairobi an estimated one in three injecting drug users are infected with HIV.

As they share needles, and possibly infected blood, they are not only a risk unto themselves, but also to the general population.

Thus, this is a group we cannot afford to ignore as we talk about getting to zero new infections. Remember the promise? 

It is against this backdrop that Kenya will join 82 other countries, worldwide, that have needle exchange programmes. The programme will be rolled out in Nairobi and Mombasa this month, and targets 49,000 injecting drug users. 

In needle exchange programmes, injecting drug users are provided with clean/sterile needles and syringes, and safe disposal of used syringes; to reduce sharing of needles and the spread of HIV, Hepatitis C and other blood-borne diseases.

Moreover, needle exchange programmes are not just about providing clean needles, they also provide an opportunity for drug users to learn about safe injection practices and disposal, safe sex and get referral for therapy, rehabilitation and treatment.

The evidence speaks for itself in countries that have adopted this kind of programme.

According to avert.org  a 1997 study carried out in 81 cities worldwide, found that HIV infection rates increased by 5.9 per cent in 52 cities without a needle exchange programme. The study published in The Lancet also found that the infection rate decreased by 5.8 per year in the 29 cities that had a needle exchange programme.

Moreover, in a ten-year study of injecting drug users in New York, HIV prevalence fell from 54 to 13 per cent following the introduction of needle exchange programmes.

However, needle exchange programmes are controversy-rousing affairs. Should government (taxes) fund programmes to give people who are self-destructing clean needles?

It is no different in Kenya, where as soon as the plan (funded by the Global Fund) was announced, opposition against it began. Many have claimed that it will only escalate the drug problem and attract new users.

It could also be argued that those who get HIV in the course of using drugs are reaping the sins of drug abuse and the risks that come with it. But at what cost to the public health system?

It seems those who are against the programme, are seeing this from one narrow angle. 

I remember a Daily Nation feature by Arthur Okwemba in March, where religious leaders were quoted saying that they regretted their previous approach to fighting HIV, after realising that using a moral lens just did not work.

They realised, 27 years after HIV was first diagnosed in Kenya, that their method contributed to among other things silence, denial, inaction and mis-action, and undermined national HIV prevention, treatment and care efforts.

According to the 2008 Kenya Aids Indicator Survey, 100,000 people are infected with HIV every year. 

While married people account for the highest rate of new infections at 44 per cent; Drug users specifically account for 3.8 per cent of the new infections.

Sharing needles among drug abusers is a major HIV transmission route. So what better way to reduce this transmission among drug users who cannot drop the habit, than needle replacement programmes that provide them with sterile needles and remove contaminated needles from circulation?

Anyone who is committed to promoting safer practices and to zero new infections, would support any programme that will help reach that mark sooner rather than later.

It is probably more expensive to treat a person living with HIV than it is to provide free needles.

You may not agree with all the interventions to fight the virus, but if something works, we should embrace it.

The Catholic Church had, for a long time, been opposed to the use of condoms, but last year in a book by Peter Seewald titled: Light of the World: The Pope, the Church and the Signs of the Times, Pope Benedict XVI hinted at a change in stance. He said contraceptives could be used in exceptional circumstances to reduce infections among certain groups.

What about you? Are you going to be part of the problem, or are you going to support a solution?