"According to our data most of our patients who come from the beach who are fisherman, around 70 percent of them usually test positive," says Dr. Morris Juma. Doctors in this Bondo hospital are overwhelmed by the sheer volume of sick people they receive everyday from the beaches. "According to what we have realised it is because of the activities that go on in the beach", he elaborates. In this fishing industry, the men man the boats, but the business is run by women. This has created an exploitative process called the Jaboya system. It describes the sexual relationship between the fishermen and the women who buy their fish. Women who offer sex to the fishermen stand a better chance of getting fish. "When fishermen come from the lake I buy their fish, but in order to guarantee that you get fish you must also develop a sexual relationship. Without sex there is no guarantee that you will get any fish." says Julia, one of the female fish sellers.
With many still sceptical of or indifferent to the existence of HIV, it is up to campaigners like Lazarus Ouma to preach the preventative message. "The spread still goes on, because they are not aware," he explains, brandishing a sex education penis prop.