Peter Njane was still in college when he first started volunteering with Ishtar, a community-based organization in Nairobi, Kenya. During that time in 2003, the organization was little more than a group of individuals getting together and discussing issues around being LGBTQ in the East African country.
"I would come and help organize events," Njane told NBC Out. "At that particular time the organization wasn't that active."
Today, Njane is the organization's director, and Ishtar is a full-fledged community health care clinic focused on health issues pertaining to men who have sex with men (MSM). Ishtar also has the distinction of being the first health care clinic in Kenya run by gay men that serves a population primarily of gay men.
"Everyone is from the community — from the receptionist, the nurse, even the health care provider," Njane said. "We were happy that we were the first community health clinic that gave services run by the community and for the community."
Stigma against the LGBTQ community in Kenya is high, with sex acts between two men still criminalized under the Kenyan Penal Code. And in 2016, a Kenyan court upheld the act of forcible anal examinations to determine one's sexual orientation.
Discrimination for the community can be especially challenging when seeking health care, particularly as it pertains to one's sexual activity or seeking treatment for HIV.
"We have a lot of issues of discrimination, because [many times] health care workers are just employed, they are not sensitized [to the LGBTQ community]," Njane explained. "They're just coming in to get [their paycheck]."
Njane saw a need for a clinic where gay and queer men in Nairobi could come for services without the fear of judgment, and in 2014 after receiving funding, Njane was able to turn Ishtar into the type of clinic that he wanted it to be.
Staffed by gay men and members of the community, Ishtar provides a host of preventive services, including health education, HIV counseling and testing, screening and treatment for sexually transmitted infections, and advice and open forum discussions.
"People are comfortable [coming to us], because the things they are going through are the same things we are going through," Njane said. "We understand their issues."
Njane shared the story of a gay Ugandan man who came to the clinic after being sick for more than a year. The man lived in a refugee camp outside of Nairobi and was suffering from a severe case of anal warts. Although Ishtar doesn't provide treatment services, the organization was able to make room in their budget to send the man to a private hospital for treatment.
"It was so fulfilling for me," Njane said of being able to help. "I almost shed a tear with how much the guy was suffering."
Njane said one of the biggest challenges Ishtar faces is how to deal with the referrals the organization gives to its members, especially when members expect to be able to receive all the services they need from Ishtar.
"We have not been able to give antiretroviral therapy to those people who are HIV-positive, because we are not able to give treatment at the moment," Njane said. "What we will do is refer our members to either an NGO we have negotiated with or a government facility."
But Njane explained that many times individuals refuse to go to the referral out of fear of judgment or discrimination.
"They think they will not be treated well," Njane said. "Or they say, 'I don't want to come out there and talk about my sexuality.'"
It's a challenge Ishtar is trying to address. Specifically, the organization is trying to strategize the best way to follow up with members to ensure that when a member is sent to a referral that treatment is indeed received.
"We have been able to reach 4,200 members since we started in 2005. Out of the 4,200, we try to maintain contact with 2,500," Njane explained. "From those 2,500, the [HIV] positive rate is about 12 percent. So we really need to know what we can do with these members to ensure they receive care and retain it."
It's a challenge Njane is confident Ishtar can tackle — especially considering the obstacles the organization has already overcome.
"I think for me, having grown in this movement, having seen the organization grow into a full-fledged clinic — we used to work as volunteers and now we have a full-fledged staff — it has been a success story," Njane said.
But Njane is quick to point out that the success and livelihood of Ishtar is always dependent on the political climate of the country, as well as the organization's ability to sustain funding.
"You should know in Africa, things change," he said. "Politics change. We are now in an election year."
Njane said for the past five years Ishtar has had a good working relationship with the Kenyan government, but points to neighboring Tanzania, where he says health care clinics for MSM and other LGBTQ programming have been shut down after the past election.
"We don't take anything for granted," Njane said. "But I think for Kenya, I'm looking for a brighter future for the community. We have people who are courageous enough to speak for the [LGBTQ] community and stand by it. And people respect that."