A sex workers gets checked for STIs and HIV in a van set up in an area where sex workers are prevalent. A sex workers gets checked for STIs and HIV in a van set up in an area where sex workers are prevalent.

Mobile clinic: Kenya Red Cross

Evening visit to the Kisumu “beer belt”, which is essentially an ugly downtown street filled exclusively with brothels, bars, and cheap short-stay (1 hour-) hotel room. Everyone here comes for cheap sex (can go as low as 200 shilling) and cheap alcohol. Every woman seen in this area is most likely a sex worker.

In the heart of the area a white shiny van has landed. Financed through the Global Fund, this mobile clinic is fully equipped with testing equipment, running water, microwave, fridge, generator, inspection room, etc.

Previously vans like these were targeting the general population. Today, the strategy has changed and the only target group now is sex workers. It works on an appointment basis.

Here is how it works: Sex workers are identified through outreach workers who operate in the area. If a sex worker has a health issue or concern that needs to be addressed, the outreach worker makes an appointment for them to come to the van at a designated day/time. The van is usually there in the evenings, because during the day the CSWs usually sleep. The proximity of the van to their working place is an added incentive. Also, the client may be reluctant to go to a regular clinic because of possible stigmatization. The van on the other hand is specifically targeting this group, so the CSWs are more likely to show up. Which is crucial, because otherwise if there’s a barrier to go for consultation there is a risk that CSWs walk around with symptoms for weeks, which is what happened in the past.

Tonight, health education is provided to the clients in hotel rooms that have been reserved for this purpose. This includes instructions on condom use, dealing with violence and abuse. Flyers are handed out. The van is positioned right in front of the hotel. After the health education, the women go downstairs and enter the van for consultation, STI screening, family planning services, even TB screening.

Women as young as 15 have come for these services.

The van usually stays in a single place for 3-5 days, then moves on to another place or town.