Celestine Ndege is a worried woman. As a counsellor and HIV advocate who has been living positively since 2000, she is concerned about the withdrawal of critical HIV care staff from government health facilities.

Although the county has recalled some staff under the USAID Tujengee Jamii (UTJ) project, she is still wary about the sustainability of recalling staff for a short period of time.

"I am afraid that we will go back to where we came from - a period of increased stigma, isolation and lack of critical tools to reduce the spread of the virus," says Ms Ndege.

"We have heard that the current stock of HIV drugs will last for the next seven months. What will happen then? If people don't know where to get the drugs, it could cause psychological distress and contribute to increasing mental health problems," she says.

The Nakuru County government was forced to lay off more than 450 workers on January 31.

The layoffs affected critical programmes such as HIV prevention, maternal and child health (RMNCAH), water, sanitation and hygiene (WASH) and nutrition.

Ms Ndege believes that many patients will revert to traditional methods of treatment, such as herbal medicine.

In fact, she says, an elderly patient recently confided in her that if the drug shortage is not addressed, she would rather stop taking her medication and leave it to the younger generation.

Support groups are also platforms that people have come to rely on as safe places to share their journeys and challenges.

"Support groups are usually safe spaces for patients, and without adequate support groups, there will be no support groups. A large number of funded support groups are likely to collapse, leaving only a few self-organised groups that patients have created independently. Where will the patients from these groups go?" she asks.

"We're praying that these issues are addressed quickly, otherwise we're at great risk," she says.

Nakuru county Chief Officer of Public Health Services, Joyce Ncece.

Photo credit: Leleti Jassor/Mtaa Wangu

According to the Chief Officer of Public Health Services, Joyce Ncece, more than 360 health workers have been recalled under a limited 90-day waiver.

"We have been given a 90-day waiver for life-saving services. After this period, we will meet again to discuss the next steps," says Ms Ncece.

Among the key personnel who have been referred are nurses, laboratory technicians, health records officers, mentor mothers and fathers, and specialist counsellors.

Going forward, Ms Ncece says the services will no longer be stand-alone but integrated, ensuring sustainability even with future funding, donor support or should donors decide to come back.

"We are determined to make things work for everyone so that no one is left behind, and that means integrating services so that no one is left out," she says.

"In the first few weeks, we hadn't integrated patients' data into the system and they had to carry files. We understood that this could create a kind of stigma by making patients stand out, but the problem has been solved," Ms Ncece says.

Youth most vulnerable to HIV infection due to lack of awareness

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Bret Sanya