In Kenya's rural heartland, the dusty Masai town of Narok, a few hours west of Nairobi, struggles against HIV/AIDS. Some people walk up to 95 miles for HIV testing and counseling from the local nongovernmental organization Pillar of Hope -- the first to offer voluntary HIV services in the predominantly pastoral Rift Valley district of western Kenya.

"We realized it was really hard for the government to combat HIV/AIDS and, unless we the people in the villages came up with systems to fight it, the gap of needs not being met would just get wider," said Joseph Kapila, the organization's only paid staff member and a former social worker.

NGOs have played a considerable role in helping to drastically cut the price of antiretroviral treatment, but the drugs are still beyond the reach of most Kenyans. Some private companies and state sectors provide antiretroviral treatment for their employees. Doctors Without Borders is providing treatment for over 7,000 people, most of them paying patients, and the Kenyan government has promised that 25,000 will be receiving treatment by 2005. At least 200,000 Kenyans need antiretroviral drugs, said Gichinga Ndirangu of Health Action International-Africa.

"People need to access treatment, but they can't do that if they don't know their status," said Allan Ragi, executive director of the Kenya AIDS NGOs Consortium. Pillar of Hope sought financial support and training in counseling from the British-based NGO Action-Aid, and received technical training from CDC to carry out HIV tests. "People talk about changing their behavior, but that doesn't happen until they decide to go for a test," Kapila said.

The World Health Organization and UNAIDS estimated that 15 percent of Kenyans were living with HIV/AIDS at the end of 2001. However, Bettina Schunter, head of mission for Doctors Without Borders in Kenya, said that 30-35 percent of people were HIV-positive in some areas, and she believed the national rate was closer to 20 percent.

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