When Patricia Wanjiru decided to go into prostitution, she says all she wanted was money to look after her three children.
Had she known what that lifestyle would bring, however, she would have thought twice about it, for in the search for what she calls “a decent lifestyle”, she also increased her chances of getting cervical cancer due to the many sexual encounters she had.
The end of her marriage had not only left her with three children to feed on her own, but also marked the beginning of a life that was filled with unhappiness and a deep and dark void.
However, every time she looked at her children, she knew she had to get up and do something for them.
Aged just 26, she had made decisions that had changed her life for the worse — like starting a family at a young age and settling down with a man who would soon leave her — and she was just about to make yet another mistake.
WORK AS A HOUSEHELP
“A friend, seeing what I was going through to feed my children, told me she would introduce me to her daughter, who worked in Kilifi and needed a househelp,” she remembers.
The proposal did not sound that bad, she thought to herself. And this would not be the first time she would be working as a househelp; she had done it before, soon after giving birth to her first born at the age of 15, so she knew her way around homes.
“My mother never took me to school,” she says, “and that is probably the reason I got pregnant that early. It was while I was working as a househelp that I met a man with whom I would have the other two children.
“My brother lived on the streets before he was rescued by a Good Samaritan who took him through school. This was not the kind of life I wanted for my children.”
Wanjiru, therefore, boarded a bus to Mombasa, where she hoped to start life afresh. She got to the coastal city at night and a stranger offered to accommodate her for the night.
WORK IN MASSAGE PARLOUR
“The following day, she told me I could work for her friend instead of going all the way to Kilifi and took me to a house that I later learnt was in Kisauni. It was a big, four-bedroom maisonette in which lived a Tanzanian woman.
“After the initial introductions, the Tanzanian told me she didn’t want a househelp, but a ‘fresh’ girl to work in her massage parlour.
“That, of course, was not what I had come to do in Mombasa, but at least I could earn some money. The first week, the woman taught us how to do a massage, but said what brought in more money were the ‘extras’. The thought that my children would go hungry and probably turn out to be just like me made me work daily, earning Sh300 for every client I got.
“I didn’t have a phone to call my mother, no fare to go back home, and anyway, I wouldn’t have managed to run away because we were locked in the house, which had high gates that were always locked. We slept there, ate there, and the clients came there.
“After saving for a few months, I sent a taxi driver to buy me a second-hand phone and started sending my mother the little money that I could spare.”
Her job became a daily routine, and even though she sometimes felt that it was not worth the abuse, she justified it by reasoning that at least it was keeping her and her children off the streets.
However, after staying at the parlour for a few months, the footfall dropped and business took a dip. A client told her that a strip club nearby was looking for dancers and off she went to start yet another sad chapter of her life.
Strip clubs do not like predictability as the customers always want something “fresh”, and so she was booted out after just a few weeks on the gangplank.
She worked from the streets for two years, and then one morning she noticed that something was not right; she was bleeding heavily, so heavily that she fainted a couple of times before she decided to go to hospital. An ultrasound found a mass located in the cervical area and the doctor told her to go for a biopsy.
ANOTHER VICTIM
In December 2012, Wanjiru, who had left her Nakuru home in search of a better life, was diagnosed with cervical cancer.
With that simple diagnosis, she became yet another victim of a disease that has overtaken breast cancer as the most commonly diagnosed type of cancer in women in Kenya today. It also leads all the other forms of cancer in mortality, according to Globocan 2012 estimates.
Two years ago, about 4,802 new cases were reported, compared to 4,465 for breast cancer, which ranked top in previous years. Experts indicate that the cervical cancer figures might be even higher as most women are ashamed to come out after diagnosis due to the stigma attached to the disease.
‘‘I couldn’t continue working, so I made the long journey back home,” remembers Wanjiru. “And then I broke the news to my mother that I was sick and that I was doing something at the coast that she might not approve of. I think she was scared at first. And then angry. She told me she didn’t want to see me, and that I would soon die.
“I was shocked. I had run home hoping to find solace, but instead I found tough love. Luckily, my brother, who had been rescued from the streets years earlier, came to my rescue.
“He introduced me to an Indian man who had educated him to Form Four. The man extended his magnanimity to me and sent me to Kenyatta National Hospital, offering to pay all my medical bills.”
At KNH, doctors told her that they would have to remove her cervix and uterus, after which they would start her on chemotherapy and radiotherapy.
SEXUAL CONTACT
While staying in Nairobi for the treatment, a relative offered to accommodate her and her youngest child, while the other two stayed at a children’s home in Nakuru.
“It broke my heart every time I visited my children and they asked when they would come home with me. I never had a ready answer for them, no matter how well I prepared myself before going visiting.
“When I learnt that one of my boys was being molested by the older ones in the children’s home, my world came crushing down. I had let my children down and there was nothing I could do to help them.”
Eventually, she decided to take the children to Nairobi, where she stayed with a relative.
“I knew I was already a burden to my aunt and that bringing two more children to her house was overstretching her generosity, but what could I do? I just hoped to get well, get a job and start living with them,” she says.
Cervical cancer is caused by the human papilloma virus (HPV), which lingers in men and women for months or even years. They transmit it to their partners through sexual contact. In men, it causes genital warts and throat and tonsil cancers.
“It is not a disease for prostitutes,” says Dr Nelly Mugo, the head of the sexual, reproductive, adolescent and child health programme at the Kenya Medical Research Institute (Kemri), responding to a question on whether Wanjiru’s sexual activity could have been her undoing.
“Even married, faithful women get cervical cancer if their partners engage in risky sexual behaviour or if the women got exposed to HPV earlier in life and it remained dormant.’’
GIRLS AGED NINE
All women, therefore, are potentially at risk of developing cervical cancer at some point in their life and, according to the World Health Organisation (WHO), the most common risk factors include early age of first intercourse, having multiple sexual partners, and having a weakened immune system.
Anyone who is sexually active can get HPV, even if you have had sex with only one person, but it is treatable. One can also develop symptoms years after they had sex with someone who is infected, making it difficult to know when one was first infected, WHO reports.
Dr Mugo says the period between HPV infection and cervical cancer is five to 10 years, adding that the disease is killing women who need not die in the first place.
“We need to move from the stigma attached to cancer. Women are ashamed of talking about it. They start by having a discharge and keep to themselves and by the time they start bleeding, the cancer has spread.”
East Africa has a high HPV prevalence and the best bet for Kenyan women to protect themselves is to go for vaccination and use condoms, says Dr Mugo.
The vaccine against cervical cancer was launched in 2013 in Kitui County on a pilot project targeting girls from the age of nine. About 16,000 girls were vaccinated, but a report on the success of the project is yet to released.
Globally, experts are pushing for vaccination of boys to tame the spread of the virus and prevent genital warts and penile, vaginal, anal, tongue, and throat cancers, which are also caused by the HPV.
The virus can be passed on even when an infected person has no signs or symptoms, but having it does not necessary mean one has advanced to cervical cancer.
SH80,000 FEE
At the time of doing this interview, Wanjiru was scheduled for another procedure called vaginal brachytherapy — where pellets of radioactive material are shot into the birth canal to treat any cancerous tissue — but she was thinking of delaying it because she could not raise the Sh80,000 fee.
Her donor had helped her pay for the surgery, chemotherapy, and radiotherapy, and that was “more than I could ask of him”.
“The doctors are optimistic that I will get well after undergoing two sessions of brachytheraphy, but the treatment has to be done in a private hospital because the machine at Kenyatta broke down,” she said, adding that she had sought financial help from many cancer organisations, but most had no funds or had long queues of other needy patients on the waiting-list.
The United States’ CDC estimates that HPV causes 19,000 cancers in women and 8,000 cancers in men each year. The common symptoms of cervical cancer include abnormal bleeding, such as between periods or after intercourse, a vaginal discharge and discomfort during intercourse. Women who have already hit menopause may experience bleeding.
“We know what to do, we have the vaccine, Kenyan women don’t have to suffer in silence. Cervical cancer can be completely prevented,” says Dr Mugo. Wanjiru wraps it off by saying that if she had known about cervical cancer years ago, she would not be going through what she is today.
“This disease has taught me many lessons in life; and I don’t want any young woman to go through what I have. My children should not suffer because I am ill, since I want a better life for them.”
-nation.co.ke
