Prof, as she was fondly referred to at the University of Nairobi, will be remembered for many things, but mainly for her immense contribution to the fight against HIV/Aids, a cause she was committed to and passionate about.
At the University of Nairobi’s Faculty of Medicine building, students and employees gather around a table at the far end of its second floor corridor. They are in mourning.
“I will miss her... I was eagerly awaiting her class last week but she didn’t show up... Why did she have to leave so soon without a proper goodbye?” one student asked, standing next to the portrait of Elizabeth Ngugi, a woman they say has gone too soon.
Her condolence book, sitting on the table between brightly burning candles perhaps offering them some sort of closeness and an opportunity to ‘talk’ to her one last time.
Soon, the candles will be extinguished.
Prof Ngugi, an astute HIV researcher and advocate, will be gone forever, but her candles will still be alight in the hearts of many Kenyans whose lives she touched through her work.
Prof, as she was fondly referred to at the University of Nairobi, will be remembered for many things, but mainly for her immense contribution to the fight against HIV/Aids, a cause she was committed to and passionate about.
As a trained nurse in the 1980s, Prof Ngugi had witnessed, first-hand, the ravaging health effects of HIV (then considered a mysterious disease) on Kenyans who sought medical assistance in public facilities she worked in.
Upon joining the University of Nairobi (UoN) as a lecturer in 1986, she hit the ground running, targeting adult and children commercial sex workers in Kenya’s informal settlements who she believed were the most vulnerable to the disease. But they did not have access to HIV prevention information and services as they had been shunned by the community.
As the director of the Strengthening STI/HIV/Aids — a long standing UON partnership with the Canadian University of Manitoba — project between 1991 to 2006, she would visit slums in Nairobi, creating awareness on HIV and promoting condom use as preventive measures.
“And it was not an easy task especially since the women got more money from unprotected sex. But Prof never gave up,” Dr Dismas Ongore, the director of the UoN School of Public Health said.
Moral judgment
Former colleagues describe Prof Ngugi as a woman who believed in the innate goodness of all human beings, irrespective of what they did in life.
This ideology must have given her the desire and commitment to always aim at making people’s lives better without passing moral judgment.
So, even as she preached condom use to these vulnerable populations (or key populations, among the HIV advocates), Prof also inspired and empowered the women to adopt alternative livelihoods that eventually improved their livelihoods while keeping at bay deadly diseases. Many ended up abandoning the commercial sex work.
“Above all, she fought for the dignity and human rights of these women to ensure that they could access HIV-related services and enjoy a good life just as other Kenyans,” said Dr Ongore.
Her persistence finally bore fruit, contributing to the reduction of HIV transmission in the informal settlements, where she worked.
This project is well recognised as an international best practice. Indeed, its community-based approach to HIV prevention has since been replicated in many countries affected by the epidemic.
Long before many developing nations began paying attention to the role of vulnerable groups such as commercial sex workers in HIV prevention, Prof Ngugi was already conducting research and publishing on the subject in top journals globally. Between the 1970s and the time of her death, Prof Ngugi authored about 60 studies published in various journals and magazines.
Her advocacy internationally and locally, contributed to the special status now given to vulnerable groups in Kenya’s HIV prevention road map.
The list has since grown to encompass male and female sex workers, men who have sex with men, and people who inject drugs. They are referred to as key populations in the fight against HIV in Kenya because are key to the prevention efforts.
Indeed, statistics from the most current 2012 Kenya Aids Indicator Survey (KAIS) show that of the 90,000 new HIV infections registered annually, 30,000 are from these ‘key populations’ yet they only make up two per cent of the country’s general population.
It has, therefore, dawned on Kenya’s health sector that these vulnerable populations can no longer be ignored or stigmatised. Reducing transmission rates among them is paramount to the reduction of HIV prevalence.
Through the UoN Centre of HIV Prevention and Research (CHIVPR), which she established in 2006, Prof Ngugi had, until her death, last week, been leading the implementation of a major project in the National Aids and STI Programme (NASCOP) started in 2010 to increasing access to HIV treatment and prevention for key populations in Eastern and Central Kenya.
The project has established 10 drop-in centres for the vulnerable, with a majority of them being integrated in public health facilities to guarantee their sustainability. At the drop-in centres, these groups are counselled, provided with condoms, tested for cervical cancer, screened for any sexually transmitted diseases and treated.
Apart from HIV management services, the centres also offer vocational training and alternative economic empowerment plans to these key populations.
Through her leadership, the project established a strong grassroots network of community health volunteers that reach out to these key populations and refer them to the drop-in centres.
She took the place of a mother to young girls below 18 years, who, due to poverty and other social challenges, were trapped in commercial sex work.
“She was their role model, fighting to liberate them so that they could get education and begin dreaming of a brighter future,” said some of her staff members when the Business Daily visited CHIVPR offices at the university’s Faculty of Medicine at Kenyatta National Hospital (KNH).
They remember her as a “great leader, mentor and disciplinarian” who listened to everyone and practised an open-door policy.
“Prof will be hard to replace in the project but it’s now upon us to honour her legacy by reaching out to these key populations,” they said.
It is through Prof Ngugi’s work with commercial sex workers in Nairobi slums that she came across the ‘Majengo prostitutes’, who despite engaging in unprotected sex with multiple partners seemed to be immune to HIV.
This revelation fuelled the search for a HIV vaccine leading to the launch of the Kenya Aids Vaccine Initiative (KAVI) Institute at UoN, which has been conducting vaccine trials.
Global recognition
Prof Ngugi was also instrumental in the development of a policy and curriculum for the HIV/Aids Common Course offered to all undergraduate students at the university.
In 2006, she was appointed Associate Professor of Community Health Sciences in the School of Medicine at the University of Manitoba while still serving as the director for CHIPVR. She received global recognition in the fight against HIV.
In 2004, she received the United Nations Kenya Person of the Year Award as well as the Order of the Golden Warrior Presidential Award in the same year.
Midwifery syllabus
In 1999, she was a finalist considered for inclusion in the ‘2000 Outstanding Intellectuals of the Twentieth Century’ by the International Biographic Centre at Cambridge in England.
She will also be remembered as the first Kenyan nurse to attain professorship. She began her nursing career in 1960 as the Sister in Charge of paediatric health at KNH and rose to the position of deputy chief nursing officer at the Ministry of Health by 1979 before joining UoN as a lecturer in 1986.
Prof Ngugi also served as the vice chair of the Nursing Council of Kenya between 1978 and 1986 where she spearheaded the development of a syllabus for mid wives and community health nurses in Kenya.
