Mental health care for 5,000+ patients in Kenya

by Bread and Water for Africa UK
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Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
Mental health care for 5,000+ patients in Kenya
The 2021 Award
The 2021 Award

In September Kamili has been honoured to receive the 2021 UN Interagency Task Force on NCDs (UNIATF) Award, for their exceptional work in providing community mental health services and for their commitment to battling the stigma surrounding mental health.

About the UNIATF Task Force

The impact that non-communicable diseases (NCD's) and mental health issues impose on all countries in the world are still on the rise and currently, about 70% of all deaths around the world are related to NCD's. Considering that most NCD's or at least their outcome could be prevented through access to proper healthcare, this is an incredibly high percentage. They not only have severe impacts on an individuals life but also on countries as a whole, due to the high burden of social and economical losses. 

Addressing and reducing the impact of NCD's has therefore been included in the agenda of the 'Sustainable Development Goals', with the target to reduce premature mortality from NCDs by one-third through prevention and treatment, and promoting mental health and wellbeing by 2030. To promote and achieve these goals the task force is therefore joining together over 40 UN agencies, supporting governments in addressing NCDs and establishing a platform for cooperation of governments and non-governmental actors. The strategy is based on 4 pillars: Supporting governments to increase their capacity of action, mobilizing resources, promoting partnerships and acting as an example for reform.

Hope for the future

Receiving the award is therefore not only an honour for Kamili and their hard work, moreover, it is another step towards fighting the stigma surrounding mental health in Kenya. Despite their efforts, mental health services in Kenya remain poor and only 0.1% of the governments budget is dedicated to improving the access to mental health facilities. Kamili has big goals and wants to increase its outreach, by having trained mental health nurses in all 47 counties by 2023. This award hopefully increases the government's recognition of mental health as a public health issue and the urgency for action.

The Kamili Team
The Kamili Team
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In general, the future is looking bright for mental health in Kenya, as despite the pandemic all three Kamili clinics in Kangemi, Gachie and Lower Kabete have run throughout the year.  This was coupled to our moving into the new clinic, which will provide the privacy its patients deserve and an excellent working environment for the staff.

Consultations

There has been a constant supply of medicine despite the rising number of patients, and we were able to offer consultation services were offered all year. As we reported in the last update, this meant we held a total of 1,785 psychological consultations: One of our consulting doctors: Dr. Hinga, even provided food (unga, beans and rice) to patients during every visit.

Savings and loan scheme to help patients rebuild their lives

Twenty-five patients and carers benefited from the loan scheme, borrowing a total of KES 1,667,745. (£11,207.09). This was used to set up income-generating activities in order to improve their livelihood. These range from establishing sewing, fast food and bead ornament outlets to building houses to rent out. At the close of the year, patients had accumulated a total of KES 2,250,110 (£15,120.53) in savings. 

 

Mental Health: Nurses’ training scheme

 

This year our nurse scholarship flier was sent out in collaboration with the Ministry of Health and the National Nurses Association of Kenya (NNAK), so we received a record number of applications, including some from the prison service. Out of 136 applicants, were able to offer places to 41 nurses on the Kamili Scholarship, and a total of 32 sponsored scholars finally joined the training scheme, as nine deferred to this year. Classes started virtually in September 2020. 

Given the shortfall in applicants we will need to train Community Health Volunteers to bridge the gap, who will assist in early detection of mental health issues and do appropriate referrals. 

A government-recognised community mental health curriculum

We have been in discussion with the University of Nairobi and Kenya Medical Training College to submit proposals of how we can develop a Community Mental Health curriculum for Community Health Workers, and expect to have the first CHWs in training by September 2021.

So all in all, we are moving forward in treating mentally-ill patients in Kenya

Vocational training
Vocational training
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The new Clinic
The new Clinic

A move into new premises – more training for mental health nurses, government recognition for training, and more patients new premises

As we reported last October, thanks to your support we have completed our new mental health facility, so we can offer more nursing, counselling and social work students, and fulfil health regulations about keeping staff and patients safe during Covid. It has also enabled us to see an ever-increasing number of patients.

Mental Health Nurses’ Training: This year we were able to offer 41 nurses a Kamili training scholarships. Classes began – virtually – in September, so there will be  Kamili trained nurses in 38 of the 47 Counties after the current class graduates in August 2021. Our vision is to reach all the 47 counties by 2023.

The Community Health Workers’ Training: We hope a mental health module in training courses for Communities Health Workers (CHW), will be included in national CHW courses beginning in September (2021). We hope that this, coupled with the Community Health Service Bill that officially recognises CHWs will help raise the profile of Mental Health Nursing as a career in Kenya. 

More clients – more consultations Between October and December 2020, the number of clients increased from 3850 to 4,254. We held 1785 psychological consultations: 775 new patients and 1,010 return reviews. 

We held Group Therapies for patients struggling with illicit drugs, and workshops for teenagers and their caregivers. In addition we facilitated a two-day awareness sensitization of mental health services at Kitengela Sub-county hospital, carried outdoor-to-door outreach services; and held monthly support group for married couples.

We also held monthly health talks to reduce the stigma of mental health, improve patient compliance, lower the rate of relapse and increase the number of patients who will eventually come off medication completely. These talks also encourage patients to adopt more healthy lifestyles, and help prevent conditions such as diabetes, hypertension and HIV and AIDS.

We believe this has all contributed to improving our patients’ quality of life with an increased number enrolling for occupational therapy skills, starting up businesses thanks to loans from Kamili Savings and Loaning scheme. A highlight was when one patient was nominated for TV and Radio awards for his gospel music talents.

 

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Team Kamili equipped with PPE to stay save.
Team Kamili equipped with PPE to stay save.

Makena is epileptic and has been attending clinic at Kamili for the last 10 years. She is a mother of two and has been doing well on medication. She managed to train as a social worker through a grant courtesy of Kamili’s partnership with Cheshire Disability Services Kenya. Kamili’s Savings and Loaning scheme enabled her to get a loan and to start a business in chicken farming.

She secured a lucrative tender of supplying chicken and chicken products to Kenchic. The tender has however been cancelled following government restrictions on eateries – the main market where Kenchic’s processed chicken was sold. Makena could hardly find another market for the chicken and as such has suffered huge losses. She hopes that the government will lift its restrictions on the hospitality industry to allow her back into business. We have however, advised her to scale down her operations for now. 

Key Milestones: Despite the new challenges faced by the current pandemic, Kamilli is doing its best to continue providing excellent mental health services during this difficult time. As the pandemic has major impacts on many households, and strongly affecting the poorest families, many have a drastic decrease in income, with less funds to spend on travelling and medical services. The increasing financial difficulties as well as the uncertainties we face during this pandemic in general, impose an increased risk on patient’s health.

Kamili has put in the greatest efforts to navigate through this challenge and to ensure the staff as well as the patients’ health and wellbeing is cared for. A new outreach clinic in Kitenglala, Kajido county has been set up, to reach more patients and to minimise the burden of having to travel long distances. The main clinic in Lower Kabete was extended to provide better services and to be able to adhere to the social distancing measures recommended by the government. Extra nurses were hired to ease and avoid congestion of patients. All staff have been provided with PPE equipment, to ensure everyones safety. Patients not able to buy masks themselves receive free cloth masks, made locally during sewing classes by the participants of Kamili’s own livelihoods programme.

New ways of communications have been established, to ensure continuity of care and to avoid relapse due to failure of attending health services. Patients now receive phone calls to encourage them to visit local health services, if they cannot afford to travel to the main clinic.

Nevertheless the clinic has seen 5 new patients every day and between march and July - a total of 226 new patients.

Ground floor of the new clinic
Ground floor of the new clinic
Consultation Room
Consultation Room

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Maryanne* came to Kamili in August 2012 needing a lot of support. A single mother of three daughters aged, 22, 16 and 8 years, Maryanne was first diagnosed with Peuperal psychosis after she delivered her first born, and later after several years in and out of hospital a diagnosis of Schizo-affective disorder was made. 

On her arrival at Kamili a holistic recovery programme was put together and we are pleased to say that she hasn’t had a major relapse which required admission into hospital since her arrival. Her initial plan involved medication but Maryanne was keen to move away from taking medication and has successfuly reduced her prescriptions and is now supported monthly with counselling and is doing really well. 

During her time at Kamili, as she continued to improve, Maryanne enroled in the savings and loans scheme on offer and put her talent for making home-made detergents, hawking second-hand clothes and farming pigs to good use. By being able to generate her own income and benefit from the loans scheme she has been able to put her eldest daughter through boarding high school, who is now only 1 year away from completing her exams. 

Key Milestones: The nurses scholarship scheme continues to thrive and grow with 32 applications for an available 8 places this year. It is clear the demand is high and much more can be done as funding increases and we increase our reach. Despite great setbacks resulting from COVID-19 the clinic remained open, with strict safety measures in place, and clients have continued to receive treatment throughout this time. We continue taking care of in excess of 11,106 patients and their carers. There is a sharp rise in patient numbers since most of the government facilities have restrictions taking on mental health patients during the current pandemic period.

We have continued monthly mental health talks across several outreach clinics in Nairobi which has resulted in a  reduction in stigma and discrimination; and encouraged patients to engage in healthy lifestyles.

 

*Patients' names may have been changed to protect their privacy.

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Bread and Water for Africa UK

Location: London - United Kingdom
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Project Leader:
Sylvia Costantini
London, Westminster United Kingdom
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