Mathari Hospital (Part 4)

My trip to Mathari Hospital was illuminating in a number of ways. The biggest one was the stark reminder of the stigma that accompanies mental health issues.

I bet there’s a reason we evolved to be afraid of people who were mentally unstable yet in this I am reminded of a dear friend who called me to remind me that if your ears are painful, you see an ENT doctor. So too, she reminded me, of mental health issues. A part of me wishes it were that simple.

At Mathari, you have to wait till 0800 to pay for services but you need a number from a clinic to do so. Getting a number means being there before 0800 and having to wait some more to see a GP once you pay. We wasted so much time waiting (to pay, to see a doctor, to be tested) that the 5 hours between 0800 and 1300 dragged on forever.

I wonder about someone who is a wage labourer and would essentially have lost a day’s work. Who would compensate them for the day? How can we make accessing such services the sort of endeavour that doesn’t take away your livelihood?

One of the reasons I went to Mathari was the cost of psychiatric care in private institutions. Like a lot of Kenyans, I found the charges prohibitive and needed an option. Even accounting for the tests, drugs and two sets of registration, I still spent less than KSh 1,000 during the trip. Is this accessible for everyone? It might not be, but it’s a fraction of what a private provider would charge you.

The Mental Health Act was last reviewed in 1989, from what I could gather. In the room in which I saw the psychiatrist, there was a poster with the ‘Mental Health Rights of an Individual’ on it. Yet I felt that between the law and best practice, the things we know fall through the cracks.

One of the romantic notions I had going in was that the staff at this institution would be able to deal with patients such as myself without the stigma that society attaches to mental illness. How ridiculous of me, I later realised. These people are you and I; one’s attitude doesn’t magically transform when they go through school. Hence the disbelief when I speak for myself (who would bring themselves here?), the doctor who doesn’t understand why someone would come to the institution she works at (the whole point of an education is to escape public services) and the nurse who won’t say the word psychiatry.

Because I don’t believe in private solutions to public problems (and yes, mental health issues are public matters), the question for me is how to make things more bearable. Here are my suggestions:

Let’s make mental health help available at the lowest level so that a person doesn’t have to go far from their home and workplace to access these services. This may take a while, but it would be great to work towards it.

Let’s make a place like Mathari more efficient. Put the masses of students and members of staff to work checking vitals, conducting tests, giving directions. Have more payment points so I don’t have a long wait every time I have to pay for something. Create a designated area for adult psychiatric patients so minors don’t have to interact with people having psychotic breaks.

Talk about mental health care. Let’s talk about it in the same way we talk about diabetes, or a toothache. Maybe then we can care for each other with empathy and something approximating normalcy instead of the treatment so easily accorded people in settings like these.

The one thing I’d like to highlight that gave me hope was the sight of friends and family accompanying people who were there for psychiatric services. My mother, the men and women there present. The morning I spent at Mathari she too spent and if it speaks to nothing other than her love for me, I am grateful.

Hopefully, we (patients, patients’ friends and family, everyone really) can move out of the shadows. Remember this: drugs, consultation, waits are things you can pay for and legislate. Empathy, kindness, even handedness, the knowledge that a college degree neither exempts you from these issues nor makes you rich enough to afford private care… These things we need to work towards.

This is my little thing.

Note: This post is part of #CuminWrites366, my year-long attempt to write a post a day. Find the rest over at readability.com/cuminwrites/

Questions, comments, suggestions or thoughts on mental health? Send them to cuminwrites@gmail.com 🙂

Mathari Hospital (Part 2)

Maximum. So named because it’s where people who are under some armed protection are admitted. (Now is probably a good time to say that there are security guards everywhere. I can’t quite tell if it’s a factor of the psychiatric services on site or if I’m just sensitive to it.) There were APs and prison guards; making for a strange environment.

The lab and x-ray services are in a basement area that looks pretty run-down. There’s an abandoned feel to it, haunted even. Probably apt in the days after Halloween.

The tests took a while to be done and there was a strange moment as the most senior person censured the lab technicians for not following procedure (ensure payment before conducting a test, in this case). Once they were done, though, I was able to carry them back to the doctor.

Some context: I’m generally good at reporting my symptoms and I had told the GP I may have anaemia (the fatigue I had been experiencing was a factor) or I may be clinically depressed (ditto). She sent me to the lab to rule out anaemia &, because I am a woman, pregnancy, before we moved to step two.

When I got back, I gave another GP my results & repeated the things I had said before then I was sent to the psychiatry clinic. The GP gave a nurse my file, the nurse sat me down and asked me in Kikuyu who I had come with. “A friend” I said in English, “my mother” I corrected myself.

She went outside, called my mother aside and told her she needed to speak to her. “She’s been told to go to the other side for this,” she said in Kikuyu, pointing at the word ‘psychiatry’ as she said ‘this’. My mum, being who she is, read the word out loudly to force it out of her. The nurse was mum; we were now firmly on the silence track, the valley of the shadow of the unspeakable thing.

Next up: the psychiatric clinic

Note: This post is part of #CuminWrites366, my year-long attempt to write a post a day. Find the rest over at readability.com/cuminwrites/

Questions, comments, suggestions or thoughts on mental health? Send them to cuminwrites@gmail.com 🙂