San Francisco Chronicle - Monday, November 13, 2000
David Gough

Mabunde says he has come to terms with the loss of his wife and his own imminent death, but he is still pained by the manner in which he found out about his HIV status and the events that followed.

Early last year, Mabunde was sent by his employer, a Nairobi-based engineering firm, for a "routine medical checkup" in which a doctor took a blood sample. Without his knowledge, the doctor tested it for HIV and sent the results to his employer.

Mabunde was later called into his boss' office, informed that he was HIV positive and told to pack up his things and vacate the premises. The company that had employed him for the past two years as an electrical engineer no longer wanted him.

"I felt bitter and I felt cheated. But most of all I felt scared," said Mabunde, who used to live in a comfortable middle-class neighborhood but now resides with his children in a Nairobi slum.

Mabunde is not alone. His experience is a sad fact of life in a nation where the economic strain of treating AIDS has caused many employers to take drastic action. Some companies even require an HIV test as a condition of employment. As a result, infected Kenyans are routinely sacked from their jobs, says Nairobi attorney Paul Amollo. "The numbers run well into the thousands. It is deplorable and morally indefensible," he said.

Amollo became interested in the issue after his cousin died of AIDS in 1995, the same year HIV prevalence reached 25 percent of the population in Nairobi, according to the World Health Organization.

"I started looking at the law and how it relates to HIV/AIDS," he said. "What I learned shocked and disturbed me."

In Kenya, state firms and parastatals -- companies that are partly owned by the government -- are required by law to provide health care. Private companies, although not legally obligated to offer coverage, typically do so. But no law exists to protect workers who are fired for contracting a serious illness.

Health Minister Sam Ongeri concedes that Kenya's increasing population and the growing demand for health care have outstripped the government's ability to provide effective services to control a disease such as AIDS.

Cabinet Minister Marsden Madoka says that Kenya currently spends $2.6 million a day in medical expenses to treat HIV/AIDS patients and that the epidemic has cost the economy $10 billion since it first broke out here in 1984.

To be sure, treatment for AIDS is an expensive burden for even large companies in Kenya.

A recent study indicated that the cost of treating AIDS patients has increased 10-fold over the past eight years. Factor that into an economy where the annual per-capita income is $340, and it is not difficult to understand the motive of companies that fire HIV-positive employees.

"Paying medical bills of staff members with AIDS could finish (many of) them off," said Omollo.

In 1996, the Nairobi City Council, one of the capital's biggest employers with roughly 18,000 employees, suspended its free medical health care coverage after it became apparent that it was spending more money treating employees than it spent on health services for the general public.

Dr. David Omollo, the council's assistant health officer, describes the impact of AIDS on city government as nearly "catastrophic," though he wouldn't say how many employees have HIV. He estimates that the medical cost for each worker from the time the disease is diagnosed to the time of death is between $5,000 and $7,000.

"I believe that (AIDS) is capable of decimating the entire council (City Hall government)," said Omollo, whose grimy office hasn't been painted in years. Most recently, the Kenya Ports Authority announced that it has 462 employees suffering from AIDS and that the company has lost 581 employees to AIDS-related diseases in the past five years. Authority officials say they spend about $3 million a month on medical bills.

Surprisingly, not a single lawsuit has been brought against an employer for firing a worker infected with HIV.

Attorney Amollo believes the absence of laws to protect employees does not preclude a lawsuit since the Kenyan constitution bans all forms of discrimination. But he has yet to find a willing plaintiff, even though he has offered his services free of charge.

AIDS remains a taboo subject in Kenya, and victims are discouraged from seeking legal recourse for fear of societal condemnation.

"I came to realize that this was a major breach of human rights and want to launch a test case to force legislation on the issue," Amollo said.

The Federation of Kenya Employers announced new guidelines in September, calling on employers to dispense with mandatory pre-employment HIV tests.

"As with many other illnesses, persons with HIV-related diseases should be able to work until declared unfit to work by a registered medical practitioner," said Wilfred Kiboro, the federation's chairman.

Meanwhile, Mabunde shrugs his shoulders when asked who will take care of his children when he is gone.

"I know that I will die soon," he said. "I don't have family here or any money to leave to my children."

Chronicle Foreign Service., This report is one in an occasional series on the global AIDS epidemic.

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