May/June 2016
19
HEALTH LAW
meeting researchers in Kenya, interviewing
study participants proved more difficult.
Respecting confidentiality, study personnel
would not reveal the identity of their
human subjects.
Since I couldn’t get to human subjects
through researchers, I figured I needed
to be direct. I remembered reading in
newspapers years earlier about a group of
prostitutes in Nairobi who seemed to have
a resistance to HIV. One evening, I had the
opportunity to meet sex workers in some
privacy. This happened in the bathroom of
a Nairobi disco called Florida 2000.
Florida 2000 was a popular nightclub
for dancing and, for a certain segment of
Western tourists, picking up prostitutes. The
police hang around outside, taking bribes
to see nothing. I introduced myself to the
women around me and asked questions.
Many knew what I was talking about,
and some agreed to tell me about their
experiences—but not right then. I should
come find them in the daytime, they
said. Most of them lived in an area called
Majengo.
I had gone to Florida 2000 with a Kenyan
friend, Jabes Otieno, age 23, an occasional
hip-hop DJ. He had grown up poor north
of Nairobi, and he knew how to navigate
the rough parts of the city. When I asked
him about Majengo, he told me, “A lot of
bad things happen there. People have less
respect for you if you live there, even if you
are not doing bad things.” But he agreed to
go there with me and translate.
We took a bus from downtown Nairobito
Pumwani Road, a stretch of packed dirt
dividing one huge group of dwellings from
another. The living spaces are made of a
mixture of mud and dung pressed against
walls of criss-crossed sticks, with roofs of
corrugated tin. The wall of one person’s
house is also the wall of his neighbor’s.
The 1989 census estimated that 13,000
people lived in Majengo, which occupies
less than one-quarter of a square
kilometer. It has is no electricity or
running water—except when it rains and
then there is water everywhere. Nothing
stays dry: Roofs leak, walls seep dampness,
latrines flood, and the winding paths
between structures turn to mud. Living
there, it is not easy to be healthy.
Reportedly, 95 percent of the sex workers
in Majengo are HIV positive.
4
Despite this
high infection rate, lots of men come here
to buy sex, partly because it is cheap. The
women I met told me that they see 5–10
men a day and charge 70 Kenyan shillings,
more if the man does not want to use a
condom. Sometimes, though, the woman
does not get paid at all. If a man decides not
to pay, or if he beats her, there is nothing to
stop him. The police do not go to Majengo,
at least not for official purposes.
We weren’t able to locate the same women
I had met at Florida 2000. Many women
were sitting on short stools in the labyrinth
of alleyways, selling sex—but none would
speak to me. Finally, someone told us to go
to Majengo’s community clinic.
Like the rest of the slum, the building
has no clean running water. Unlike its
neighbors, however, the clinic is a solid
two-story structure that has doors and light
switches—although the electricity is shut
off more often than not. There, we met the
clinic nurse, Islam Ahmed Kabocho.
Unlike the doctor, who only visits the
clinic a few times a week, Islam lives close
to the people he cares for. I asked him why
no one outside would talk with me about
the blood draws. “They are afraid,” he said.
“They are told not to talk about that.” But
the people in Majengo trust Islam—it is due
to the strength of their trust in him that
some came to meet me.
Islam arranged for me to meet a few
women in a room on the clinic’s second
floor. There is very little privacy in
Majengo, but we found some in that room.
Islam explained that the women would
feel safe coming to the clinic. “No one
will question them if they come here,” he
said. “And up here, no one will know that
they are talking to you.” Although I did not
understand the source, it was clear that fear
is a large part of these women’s lives.
Jacinta and Vedestina came together. Islam
had told them that a student from America
wanted to hear about their experiences.
Although they clearly trusted him, when
they came into the room that first day, I
felt their apprehension. Jabes tried to put
them at ease; he spoke with them in Swahili
while I prepared the tea I had brought.
I had picked up certain points of the
culture’s etiquette: Inviting guests entailed
at least offering tea. I was very much aware,
however, that such efforts could not dispel
my foreignness. Would I affect Jacinta and
Vedestina as Morris had been affected by his
employers? Would I, unintentionally, direct
what they would say or how they would say
it? I knew that my act of observation could
change what was to be seen.
I hoped that Jabes would mitigate the
incongruity of my presence. He understood
what life was like in Majengo. He made the
women laugh. He is a remarkable person,
sharp-witted, and compassionate. Without
him, these interviews would not have been
possible.
With Jabes translating, I explained to the
women who I was and what I hoped to
accomplish by talking with them—I told
them that I might want to share what
they told me with other people outside of
Kenya. Both agreed to tell me about their
experiences.
I had prepared a release form written in
both my language and theirs, as would be
appropriate in the United States; it was
4. Davies K, “Prostitutes Offer AIDS Vaccine Hope.”
The Associated Press
, November 8, 1997; New York.
The conduct of research ought not to play upon
existing prejudices and social inequities; it is not easy,
however, to envision how researchers in developing
countries can diminish the authority they represent.
