• Traditional beliefs make people regard the mentally ill as bewitched, abandon them
• However, a care provider has proven that they can be nurtured back to healthy state
As a mason, Kioko used to complement his mother’s income. She is a house help. The two were the breadwinners in their family of six.
To show his love, the mason bought his mother her first mobile phone.
However, along the way, Kioko started developing migraines and before they knew it, he was on the streets wandering aimlessly.
The mother, after months of trying to keep him in check, gave up on him and let the world take its course. Her son had developed mental illness.
And that is how the Mombasa Women Empowerment Network came into the picture. The network has been rounding up and treating mentally ill people roaming the streets of Mombasa, a venture that started in January this year.
Out of the cumulative 90, 65 have recovered, with some able to go into small-scale business, its chairperson Amina Abdalla says.
“When we found Kioko, he was in bad shape. But after two months, Kioko can now understand who he is and is aware of what is going on around him. He has recovered and shared his story with us,” she says.
Abdalla traced Kioko’s mother, who was elated to learn that her firstborn son has recovered from his mental illness.
Just like Kioko, Nana, 84, has been roaming the streets of Mombasa for over five decades.
“In the last three months we have been staying with Nana, she has recovered. She now goes to the toilet by herself, she cleans herself, showering twice a day and she is now enemies with dirt. She eats well now,” Abdalla says.
Ibrahim now is the prefect at the facility. He has become like the guardian and protector of the ‘family’ at the facility.
The lanky man used to roam the streets of Mvita subcounty, scavenging for food.
“He was violent when we picked him three months ago. Today, he is my biggest help. He takes care of the others. Whenever there are problems, he is the one who informs me,” Abdalla says.
It is was a joy for us to see that an 80-year-old mentally challenged person who had Covid-19 was managed until he recoveredMwen chair Amina Abdalla
They are three of 39 people who were picked from the streets of Mombasa county suffering from mental illness, but who are recovering at a facility in Shanzu, where they are being housed currently.
Abdalla says the mentally ill are the most neglected people in society and have no one to take care of them.
With the current Covid-19 pandemic, she fears they might be the silent assassins, albeit unwittingly.
“These are our brothers, who unfortunately have the biggest risk of contracting and spreading the disease because they do not know how to wear a mask or sanitise.
“They roam everywhere, scavenging for food from garbage areas, which exposes them to all manner of diseases, which they can spread to other people,” Abdalla says.
They also have rights to healthcare just like any other Kenyan, she says.
Dr Muinga Chokwe, a psychiatrist, says the mentally ill are the elephant in the room in the fight against Covid-19.
He says mental health is all about the well-being of the people, but for years, this has been neglected by the government.
He says the state of mental units across the country is proof of the neglect.
“Mental health units, including Mathari, the biggest, are usually in a very bad situation,” Chokwe says. “Mental health is at the back burner.”
The Covid-19 pandemic, he says, is like a wake-up call to the government.
“People are committing suicide, abusing drugs and alcohol and behaving abnormally, more so during this time because their mental well-being has been interfered with,” Chokwe says.
He says many Kenyans are not adhering to the strict Covid-19 guidelines because of their mental well-being.
“Risky behaviour is all about mental well-being, which is one concept of mental health,” the psychiatrist says.
He says it is high time people start talking about mental health.
COUNTY REACHES OUT
The Mombasa government has taken the cue from Abdalla and is now partnering with her to take care of mentally ill people.
The county has been providing some medicine to the patients at Abdalla’s facility, which had to be relocated to Shanzu from the Kenya Coast National Polytechnic, where she started.
This is because the institution has to prepare for resumption of classes and has to expand the hostels.
Aisha Abubakar, the Public Health chief officer, says the society has neglected the mentally ill people and the county has come in to ensure they are taken good care of.
She says the county is carrying out a research to ascertain the number of people affected by mental illness in Mombasa.
“The number at the moment is not known because most people do not come out to say they are mentally ill,” Abubakar says.
Abdalla says she felt inspired to start the project after it bothered her seeing one mentally challenged woman hanging around her neighbourhood, almost naked, for quite a while.
She says she used to give her food, water and sometimes clothes, which she would wear for a week or two before reverting to her other tattered clothes that did little to hide her womanhood.
“It got me thinking. I have seen people suffer from cerebral malaria, lose it and after some time they are normal. Couldn’t this be just one of these cases? I then started doing my research, which showed me mental illness is a disease that can be cured,” Abdalla says.
When she was convinced she could do it, she sought the necessary permission from the county and national governments and started by rounding up 25 mentally challenged people from the streets.
“I stayed with them for about three months, treating them at Port Reitz, and after they recovered, I released them to their families who were known,” she says.
She tapped into her humanity and found the strength to do this.
“People look at disability to be about the physical aspect only, in most cases. They forget that there is mental disability. The government has forgotten these people,” she says.
She says the mentally challenged are not considered as Persons With Disability (PWDs), who the government recognises and even have positions in Parliament for them to be recognised and represented.
Taking care of the mentally ill, she says, requires courage and understanding.
When rounded up, they are washed and cleaned, with their hair and nails cut. They are given food before being left to sleep to get the much-needed rest.
The next day, the mentally ill people are tested for Covid-19. “Health officers from the county come and take their samples for testing. While awaiting their results, we isolate them from one another and the rest,” Abdalla says.
By the time of penning this article, 55 mentally challenged people had passed through the programme since Kenya recorded its first Covid-19 case on March 13.
Five of the 55, including an 80-year-old, tested positive for Covid-19. They were all asymptomatic.
“We had to isolate them from the rest. We set up an isolation room at the facility and had a dedicated health officer for them,” Abdalla says.
To manage the positive cases, Abdalla says, they had to boost their immune systems by giving them food with nutritional value as advised by the health officers from the Mombasa government.
“We gave them greens, Vitamin C and medication for about three weeks, after which they turned negative after three more tests,” Abdalla says.
“It is was joy for us to see that an 80-year-old mentally challenged person who had Covid-19 was managed until he recovered. Because the government has not been very keen on this group of people,” Abdalla says.
Thirty of the 55 have fully recovered from their mental illness and have been discharged.
However, eight of the discharged are still at the facility in Shanzu because their family members are unknown. These will stay at the facility for the foreseeable future.
Abdalla plans to have them trained on some income-generating ventures so they can start a new life. They will be provided with start-up capital for these ventures when they are fully ready for it.
Abdalla says all costs fall on her. Well-wishers have started chipping in on food, but it is not constant. She has to buy soap, charcoal and other personal items.
“I also have to pay the workers, which is very hard, considering I have to delve deep into my own pockets,” Abdalla says.
She says those who recover give her motivation and the strength to continue serving this group that society has neglected.
Some of the patients, after one month, get much better and start talking.
“Some remember who they are and where they come from. They tell us about their families and even how to contact them. Some remember even their families’ phone contacts,” Abdalla says.
Tracing of the families then starts. Those traced are invited and are counselled.
Most family members say they cannot afford the fees required to admit their patients to mental institutions like the Port Reitz Mental Hospital in Port Reitz.
“At Port Reitz, admission only requires about Sh10,000. Most people cannot afford this, especially now that this coronavirus pandemic has destroyed the economy,” Abdalla says.
Abdalla says after staying with the mentally challenged for a month or two, some of their relatives, including close family members, show up wanting to know about their progress.
“This shows most of these people have families who only neglect them because of their condition. In most cases, the family members say they have been bewitched and cannot recover, which is not true,” Abdalla says.
I have treated people who are employees in companies, who have been successful in life, but something goes wrong and they end up mentally illPsychiatrist Dr Muinga Chokwe
MIRED IN MYTHS
Psychiatrist Chokwe says this is the biggest misconception that makes people neglect the mentally ill. Where mental health becomes weak, he says, people go to traditional beliefs and practices.
“That is when they say one is bewitched and do not go to hospital,” Chokwe says. Mental illness, he says, can be treated.
“It is only that these people do not have access to healthcare or treatment. I have treated people who are employees in companies, who have been successful in life, but something goes wrong and they end up mentally ill,” Chokwe says.
He says treatment is expensive because the drugs are expensive and need follow-up, challenges that make many people give up on the mentally ill.
“We don’t have community psychiatric healthcare, whereas in the community, there should be healthcare workers who are trained and can be able to intervene,” he says.
Abdalla says the biggest challenge comes when the families of the mentally challenged people want nothing to do with them even after they recover.
“In most cases, they believe they have been bewitched and that even after they recover, they will retard. So they say it is a waste of time and money to take care of them. That is why some relapse and go mad again, ending up back in the streets,” she says.
She says it takes a lot of courage and determination to handle the mentally challenged persons.
They go to the toilet whenever they feel like and wherever they are, she says, adding that they also eat a huge amount of food.
“They do not eat like you and me. They eat four or five times what you and me eat. In a day, they may use, in most cases, one bale of maize flour,” Abdalla says.
This makes it even more expensive to take care of them. She pays Sh65,000 per month in rent at the Shanzu facility.
“Apart from that, we use vegetables worth Sh5,000 a week, charcoal worth Sh6,000 a week, among other things,” she says.
For medication, she uses Sh10,000 worth of medicine a week, and she also has to pay the nine workers she has employed to take care of the patients.
The workers work in day and night shifts because there has to be workers at the facility 24/7.
A psychiatrist, Charles Mwangome, checks on the patients three times a week, with one full-time nurse also available.
“It is the psychiatrist who advises when to stop a certain medication and when to introduce another,” she says.
The county government had been helping her with the provision of medicine but this has since stopped because of unavailability of the medicines. She has to buy from private facilities.
“Every month, I need at least Sh250,000 to sustainably run the programme. But I thank God because He has been faithful because I get by,” she says.
She says some families accept their people back, but some reject them. This has made her come up with a counselling programme for the family members so they can accept them back and continue with medication.
There is also a response team that follows up on those discharged after recovery. The team closely monitors their progress.
“Once we notice there are issues, we bring them back to our facility,” she says.
In conclusion, Abdalla says the mentally challenged are also human beings.
Edited by T Jalio