The idea for this project came about in 2021, when one of our teams became aware of the difficulties in accessing health care that certain groups were facing in Mombasa.
The following year, we launched our first actions on the ground. Today, we welcome young people and adolescents to centers designed especially for them, where we offer basic health care, sexual and reproductive health services, and mental health support. But our mission doesn't stop there: In addition to providing medical care, we also ensure that we offer crucial social support, helping those who come through our doors to connect with the resources and services they need, even beyond what we can offer in our clinics.
In Mombasa, we work with key populations in particular, a group defined by the Joint United Nations Programme on HIV and AIDS (UNAIDS) as men who have sex with men, transgender people and those with diverse gender identities or expressions, people who use drugs, and sex workers. MSF also works with other vulnerable groups like young people experiencing homelessness, as well as those living with disabilities. These identities and experiences can often intersect, which further increases vulnerability.
All too often, the people we work with have already found themselves excluded from the mainstream health care system. When they seek help, they face discrimination. We see this every day. That's why we have put communities at the heart of our project. In constant dialogue with the people who use the centers we support, we constantly adapt our activities to people’s real needs, which enables us to assess their tangible impact.
In Mombasa, our community-based strategy consists of peer-centered approach, where individuals from the same social groups—often people with shared experiences—are trained to provide support, education, and health care services to their peers. This method is particularly effective in reaching marginalized and high-risk communities and plays a key role in combating prejudice, particularly among health care staff.
Too many people from these vulnerable communities still avoid treatment for fear of being judged or mistreated by those who should be providing them care. And outside the centers, stigma remains a constant challenge. That's why we also document the violence—whether physical or sexual—that is committed against those we support.
In such an environment, MSF's identity takes on its full meaning. We are there first and foremost to provide direct access to health care, but also to amplify voices from overlooked communities. Sometimes that means bearing witness on their behalf. On a daily basis, it means being at their side and offering a space for free expression, so that they themselves can claim their rights, denounce discrimination, and demand the respect and dignity they deserve. Because access to health care should be a fundamental right for everyone, without exception.
