“I just want to live as me”: Health, stigma, and resilience in Kenya

Peer educators are crucial to bridging access to health care

Key populations in Mombasa face a disproportionate burden of health and social challenges. According to the 2024 Mombasa Key Populations Study supported by Doctors Without Borders/Médecins Sans Frontières (MSF), over 60 percent live below the poverty line, and more than one-third have no monthly income at all. Food insecurity is rampant—six in 10 reported going without food for two or more days in the week prior to the study.

Half of all key populations surveyed reported experiencing stigma in health care settings sometimes or often. This stigma has real consequences: Those who “often” experienced stigma were 3.6 times more likely to report poor access to care.

MSF is trying to bridge these gaps by training members of affected populations to act as peer educators, who raise awareness in their communities about the services offered and share basic health information. Peer educators are not just service providers—they are community leaders, mental health advocates, and agents of change.

“We’re not outsiders”

Bridget, 27, is a peer educator originally from Uganda. They work at the Bamburi Youth Friendly Space, helping connect queer and intersex individuals with health care services. “Queer people have a lot of challenges in Kenya,” they explain. “People fear what they don’t understand.”

Due to discrimination, a large proportion of queer people in Mombasa are unemployed. “They’re able to come to this place, where it’s welcoming and free.”

Bridget’s work is about more than just referrals—it’s about trust. “When it comes to the queer community, you make them feel comfortable. You tell them, ‘I’m also part of your community. You’re not an outsider.’”

They have seen firsthand how this approach transforms lives. “Peers who were previously shy now seek services. They’re open to saying, ‘I’m intersex, I’m a trans woman, I need health services.’ That gives me hope.”

“It’s okay not to be okay”

Madina, 28, became a peer educator after surviving a traumatic divorce and the stigma that followed. “My parents accepted me with my son, but generally in my community divorce is stigmatized. People would call me names, gossip about me. It pushed me to the edge—I contemplated taking my own life,” she says. But with the support of her family and a local youth organization, she found out about the possibility to train to become a peer educator. 

“Being a peer educator is a passion,” she says. “Whatever happened to me, happened because I didn’t have the knowledge back then. Now I can share that knowledge and maybe save a life.” Her message to others is simple, “It’s okay to not be okay. Prioritize your mental health.”

“I just want to live as me”

Dee*, 24, is a trans woman who was outed by her family when they found out about her gender identity. “They said I was a bad omen. They threw my clothes outside and told me to leave,” she recalls. Homeless and rejected, she turned to sex work to survive. “I’ve been a sex worker since 2019.”

As a trans woman, Dee has faced severe violence. A scar in her forehead reminds her about the time when five men brutally beat her up. She has had to change housing endless times while living in Mombasa. When the landlords realize her gender identity, they terminate the rental agreements abruptly. When she talks about a safe space, she is not talking only about emotional safety— but about a space free from physical violence. 

MSF offers free, non-discriminatory health care to key populations in Mombasa, and Dee found support from these services. “I had a psychologist to talk to every Wednesday. MSF gives services without judgment.” Now a peer educator herself, Dee reaches out to other trans people who are afraid to seek care. “I can deliver condoms, lubricants, tell them where to get PrEP (medication to prevent HIV transmission). I feel so proud. As a trans person, I can deliver.”

Her dream? “I just want to live as me. I want a safe space for trans people.”

“Health is the one thing you can’t buy”

Sally*, a sex worker and peer educator, comes from a deeply religious family that doesn’t know about her work. “If they knew, they would cast me out,” she says. She tells about the gender-based violence sex workers face. “It eats emotionally, it eats psychologically, it eats physically. It’s really draining. Most of us end up having suicidal thoughts,” Sally says. With MSF she has received psychological support and has taken HIV tests. 

Mombasa is a conservative region where due to religious reasons many people have negative attitudes toward key populations. This forces many to hide their identity with severe consequences. 

“Most key populations hide,” Sally says. “Even if they get sick, they don’t have the courage to go to a hospital and speak out about themselves.” Sally is determined to help those who hide. To her, being a peer educator means spreading awareness to people who do not have information. 

Sally brings creativity and empathy to her work. “Sometimes I act out scenarios, bring theater into it. I want people to feel included.” She’s also trauma-informed, careful with her words and actions. “People have different triggers. You have to be gentle.”

“Health is the one thing you can’t buy,” she adds. “Even if you’re a billionaire, you can’t buy health. So whatever MSF is doing, it has 100 percent support from me. No health, no wealth.” 

Sally feels that being a peer educator is also a way to soothe her inner child. “I never had someone to guide me. So I thought, why don’t I give to others what I was lacking?”

*Names have been changed.