As you walk through Kibera, a gust of burning charcoal and car exhaust ruffles your senses. And then, the scent of fried fish sweeps over you. Up ahead, a mama is selling fish on the street, swatting away unwelcome flies. As you move towards her, dust from the road chases you, clings to your clothes, and stains your shoes red. Your eyes fixed on the ground as you navigate the alleyway and bypass muddy streams. Locals urge you to face forward and duck where roofs are low, but the sounds of children, roosters, and drivers compromise your concentration.

Compared to its surroundings, a Kiberan may sound soft-spoken, but each carries something essential to the voice of Kibera. Together, a message of survival and a spirit fortified through overcoming years of suppression, violence, poverty and epidemics
resonate loudly.
Kibera is famously known as the biggest slum in Africa, but the people from Kibera refer to it as “kijiji,” which means village in Swahili. The friction between “slum” and “kijiji” captures the ingenuity of the human will: when individuals are faced with impossible circumstances, they overcome first out of necessity and later evolve to inspire and support others through their challenges. In these relationships, the story of a vibrant community emerges.

MSF arrived in Kibera in 1997 to address the HIV epidemic. While treatment was available in countries like the United States, it was still not available in Kenya due to the high prices of HIV drugs. This meant that for people living in Kibera at the time, having HIV was a death sentence. All around, stigma was high and fear was even greater. People living with HIV were afraid of dying and those who didn’t have HIV were afraid of getting it. Without education about the virus, myths around transmission spread and people living with HIV were ostracized. MSF worked closely with the community to provide treatment for HIV and opportunistic infections liked tuberculosis (TB), and to advocate for broader access to HIV drugs.

Over the next 20 years, our operations expanded to provide primary care, maternal and child health, and treatment for non-communicable diseases (NCDs) like hypertension and diabetes. Thanks to the dynamics of the community, we were also able to pioneer new support group models and counseling services to help people manage their chronic
diseases and address mental health and sexual
gender-based violence (SGBV).


This book documents the history of MSF in Kibera, featuring the people we’ve met along the way. For example, someone like Siama who was shunned from her community when they discovered she had HIV. Yet in spite of the stigma she faced, she continued to openly talk about her status and later went on to mobilize hundreds of people to advocate for better access to HIV treatment and better treatment of people living with HIV. And someone like Sally, who discovered her life’s calling in health promotion after surviving a suicide attempt. Through these narratives, we piece together a message about transformation–what it means to overcome challenges, and how the transformation of a single individual can go on to transform a whole community.