Homa Bay County has the highest HIV prevalence in Kenya — between 26% and 27%, compared to a national average of around 5–6%. This epidemic has devastated the middle generation: the working-age adults who would ordinarily support their parents. What remains are elderly grandparents —often grandmothers — raising orphaned grandchildren alone, in poverty, with no income and no safety net.Some homes are headed by children as young as ten.

Traditional practices have compounded the crisis for women. Many elderly women in Homa Bay live alone after becoming widows or after families relocated to urban centres. Some live in remote compounds with neighbours far away, leaving them unseen and unsupported for weeks at a time.
Women who resist or survive harmful inheritance practices often end up living entirely alone.

Across Homa Bay, younger generations have left for Nairobi, Kisumu, and Mombasa in search of livelihoods, education, and opportunity.When the young leave, their connection to the elderly who remain can weaken and, eventually, dissolve. In most Kenyan counties, migration is offset by a larger adult population at home. In Homa Bay, where the HIV crisis has already thinned the adult generation,
there are fewer people remaining in the village to begin with.

With a poverty rate of 40% and no meaningful rural pension or state support system, elderly people in Homa Bay have no financial buffer against illness, hunger, or isolation. There is no system waiting to catch them when family support fails.