Mental health in Kenya

One woman’s dedication to improve mental health treatment and understanding in Kenya

By Liz Lockhart

Mental Healthy feels privileged to introduce you to a woman who is working to change the face of mental health in Kenya, a country that, to date, has not yet been able to rise to the challenges which surround mental health understanding, treatment and acceptance.  Sitawa Wafula has been corresponding with Mental Healthy so that we can highlight the plight of sufferers of mental illness in her country.

Life in Kenya

We asked Sitawa  for a snapshot of daily life in Kenya and she explained that Kenya is one of 52 countries in Africa, situated on the east of the continent.  It has 47 tribes and its national language is English and Kiswahili.  Kenya is best known as an amazing holiday destination with beautiful scenery distributed throughout the country from its mountains and beaches to its wildlife.  The population of Kenya is 38 million with the majority being young people below the age of 30.

When asked about mental health in Kenya, Sitawa says that it is ‘one of those tabooed topics’.  There are a lot of myths about the causes of mental illnesses, the main one being that it is concerned with witchcraft, which is, she tells us, well fuelled in this African setting.  Due to this kind of thinking, coupled with a lack of government influence in terms of administration and legislation, the management of mental illness has fallen to non-government organisations.  These organisations are more concerned with research of specific illnesses rather than general mental health conditions.  Sitawa adds that there is much ignorance in the general population about mental health.

Campaign for change

Despite having her own battles with poor mental health, Sitawa is campaigning to change awareness and legislation surrounding mental health in Kenya.  She recalls that when she had her first incidence of mental illness she received misdiagnosis and was totally misunderstood by those around her.  She tells us that, for others, it is worse with families becoming so desperate they commonly resort to ‘chaining or locking up’ their loved ones and in some cases they abandon them altogether.

Sitawa explains that there is a huge gap between the treatment of those who live in rural areas compared to those who can access expensive services in the city.   These services are generally only offered by private practices , mainly situated in Nairobi, which makes them ‘exclusive’ to those who can financially afford them.  The Government owned facilities are overcrowded and out of reach for those who live outside Nairobi..  In Sitawa’s case she had to drop out of education as her family used up the money set aside for schooling to help to pay for treatment, check-ups and medications.

For the people of Kenya, the stigma which surrounds mental illness is a huge issue which, according to Sitawa, is mainly caused through ignorance.  She says ‘We do not have proper mechanisms and support systems to get the word out that mental health rights are human rights.’  She adds that having a mental illness should be just like having any other illness. 

Through a campaign called ‘One Mind Lend Your Voice’ which Sitawa administers, it is hoped that people with mental illness will no longer be branded and labelled.  The work of this campaign aims to reduce stigma using poetry, music and talks within universities and other educational establishments.  They hope to make people aware that those with mental illness can achieve the same things as others. 

The following video may be a trigger to some so we only advise watching if you are in a sound frame of mind. We hosted it with this feature because we believe in Sitawa's message. The words 'I am a human with dignity and worth... Don't call me by a label, call me by my name' touched us deeply and we want to use our platform to further this powerful message.

Video: Call me by my name (trigger warning)

Sitawa says that she usually starts her talks by saying ‘My name is Sitawa Wafula and I have a mental illness’ which causes people to either think that she is about to launch into a comedy sketch or they just feel very uncomfortable.  She and her team then go through the signs, symptoms, causes, triggers and how to live with mental illness.   She also uses her own experiences to demonstrate the point.

A new Bill to change mental health legislation

Currently Sitawa, in collaboration with other stakeholders in mental health, is working towards the drafting and later the  implementation of a new Bill which it is hoped will change the treatment of mental illness in Kenya.  She explains that this 'will be a much needed breath of fresh air for people suffering with mental illness.’  She adds that 'it will take care of staff issues, the legislation of who is meant to do what, where and when.  It will make sure that affordable and quality health care is available at all levels. 

'.

The Bill touches on prevention, treatment and care, and last but not least rehabilitation.  Other areas which are covered are the roles and responsibilities of care givers.  Sitawa tells us that care givers include nurses, doctors and the mothers who have, through fear and misunderstanding, resorted to chaining their children to trees in a bid to stop them from hurting themselves.  She says ‘It is a collective effort.  We need mental health care down to the primary level (which now is the county level) all the way to the grass roots.  Awareness creation is also very important.  Ignorance is not always bliss.  We are looking to work with even more groups in all parts of the country to make sure the mental health manual is everyone’s  secondary bible.  There is no health without mental health.’

Other considerations laid out in The Bill are the administration and care of the property of people with mental illness.  The Bill looks at this and gives directions on it.  Article 22 of The Bill talks about the conditions of mental health facilities which, currently, are dire, with some patients sleeping on floors.   Sitawa emphasises that people with mental illness must be treated with dignity.  She says ‘They are not animals – hell! I know animals that live better than the rest of us but we are not asking for you to carry us in a bag like a chihuahua  –just basic human rights.’

Article 37 centres on the restraint and seclusion of mental health patients.  Sitawa tells us that this caused much debate as to who, what, why and how.  Should there be home seclusion?  She says that she has heard of people being locked up in facilities for up to 40 years and forgotten.  Forgotten by their families who feel it is better to forget than to face society.

We asked if this bill would be implemented throughout the whole of Kenya.  Sitawa tells us that once all the stakeholders have given their views on The Bill, she and her team will be pushing for it to be taken to parliament for debate and implementation.  She is calling on all Kenyans to help them  by putting their names to a petition to make sure that it goes through in its entirely.  ‘It just has to go through’ says Sitawa.   ‘We feel that the support, understanding and awareness of others around the world will be of great benefit.’

Keep up to date with Sitawa and her work via her blog: http://sitawa.blogspot.com

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