Just outside of Nairobi, the Mathare National Teaching and Referral Hospital sits aside from the neighborhood around it, the only mental hospital in all of Kenya. Spacious grounds and colorful mosaics suggest a tranquil environment, but the reality inside its gates couldn’t be farther from this calming impression. Patients and caretakers alike endure a dilapidated mental health system that cannot supply adequate care for those thousands of Kenyans who need it. 

With a capacity of 1500 patients, Mathare takes in people with a variety of mental disorders, many of them severe. Nurses risk their safety everyday when they come into work. Multiple staff members report aggressive assault and rape from patients, from whom they have little protection. Some patients are so violent that security guards hesitate to go where nurses must. For the danger they face, their duties are both menial and grueling. Lacking toilets, patients defecate into buckets that are regularly emptied by nurses.

Kenya faces two public health crises: COVID-19 and mental illness. Unfortunately, the first exacerbates the second. One in four Kenyans suffer from a mental illness at some point in their lives, but very few seek treatment. For an even greater number, treatment is unavailable. Kenya has only 88 psychiatrists, 427 psychiatric nurses, and 10 social workers. For a family that lives in a rural area or lacks the financial means, treatment in a facility like Mathare is impossible. 

Mental health is poorly understood in Kenyan society. Misinformation takes the place of professional advice when a person behaves abnormally. Even many professionals spread false information. When asked to list examples of mental illness, Dr. Kamou Kanyoro, a consultant at the Mathare hospital, included “lesbianism, homosexuality, and masturbation.” Traditional healers are consulted before such professionals, however, since there is such short supply. Many explain disorders like paranoid schizophrenia with demons or evil spirits. Treatments can be accordingly religious.

Father John Pesa is famous for spiritually healing the mentally ill. His Holy Ghost Coptic Church of Africa holds dozens of patients with a variety of conditions, despite Father Pesa lacking any qualifications. His treatment of patients is draconian and extreme. One 17-year-old was kept shackled in chains and underfed for 25 months, alongside the other patients. Only in October did a court rule that Father Pesa owed the patient 500,000 Kenyan shillings ($4,590) in compensation since his treatment constituted psychological torture. But still, Father Pesa continues to accept patients. 

The Psychiatric Disorder Organization (PDO) works to change this environment. It provides counseling and other mental health services for those who otherwise can’t access them. It assists COVID-19 first responders in handling the stress of the pandemic. It hosts a Youth Empowerment Seminar (YES) that educates children and adolescents about mental illness and self-care. The program places a special emphasis on LGBT issues.

The PDO takes on a mighty task in reforming Kenya’s mental health infrastructure. Help from the government, though late, will soon be coming. President Uhuru Kenyatta recognized the mental health crisis in his State of the Nation address and announced an executive order to reconstruct the Mathare hospital into a “semi-autonomous specialized hospital.” Experts hope the attention will lead to lasting improvements to Kenya’s mental health facilities. But help remains far-off for those patients still in chains. 

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Michael is an undergraduate student at Haverford College, dodging the pandemic by taking a gap year. He writes in a variety of genres, and his time in high school debate renders political writing an inevitable fascination. Writing at Catalyst and the Bi-Co News, a student-run newspaper, provides an outlet for this passion. In the future, he intends to keep writing in mediums both informative and creative.