The recent Kenyan mall terrorist attack left me wondering about mental health care in Kenya. Most of us saw the horrific images and heard the terrifying stories from the security of our homes or offices. Those who survived the ordeal or live in Nairobi were not so fortunate. Many of them will be left with lasting scars that cannot be address through immediate crisis counseling alone.
There has been acknowledgement of the lingering aguish victims and their family members may continue to experience but little has been discussed about how Kenya—a health-resource challenged developing nation—might deal with this reality. Post-traumatic Stress Disorder (PTSD), depression, and anxiety are very common illnesses for those who experience acute stress and bereavement, especially when disturbing event stems from intentional human acts. Children are particularly vulnerable this.
This void in public discourse and media coverage about the long-term mental health implications may be reflective of general cross-cultural attitudes towards the topic on the African continent. Even for recent African immigrants in the US, mental health seems to be a topic that is left in the closet.
Mental Health Perceptions & Africa
A person’s understanding of illness is influenced by society and an individual’s immediate culture. This also sways the amount of support –or judgment—one might receive from others after an illness diagnosis. For Kenyans and other Africans this means living in societies that hold stigmas against all forms of mild or severe forms of mental illness.
In sub-Saharan Africa, patients with serious needs are often institutionalized and cared for with little input towards rehabilitative treatment. Depression also tends to be viewed as Western illnesses that Africans do not suffer but can mimic when they become too westernized, and anxiety merely the results of allowing oneself to worry too much.
Additionally, for Africans it also means living in cultures that are guided by traditional healers who are likely to define their illness as a spiritual illness—being possessed by spirits or demons for example. These create barriers to seeking care and social support. Illnesses such as depression, PTSD, and anxiety are for the most part treated with silent suffering.
In addition to the socio-cultural barriers, like most developing nations Kenya has a poor health system that struggles to provide basic care for the majority of its citizens. Public health issues such as HIV/AIDs, malaria, mal-nutrition, maternal child care and others are seen as priorities while mental health is not. Not surprisingly, Kenyan youth who seek careers in healthcare are not exactly encouraged to pursue psychology or psychiatry.
We can’t overlook the role of the first responders from organizations like Kenyan Red Cross, Kenyan Psychological Association, or volunteer counselors and psychologists who have stepped in to help those affected, but we also have to acknowledge the reality of the Kenyan context and what this means for the country.
Why it Matters
Psychiatrist Frank Njenga, a leading advocate and champion for Kenyan mental health care, recognizes the challenges he faces in his country. He points out that national health cannot exist without mental health and the added costs that come without its prioritization.
For example, depressed mothers are likely to not adequately care for their children’s nutritional needs or get them immunized; other suffers my respond by engaging in risky behavior that may result in an unplanned pregnancy, HIV/AIDs, or malaria.
Those suffering from PTSD may respond to stressors through violence, or neglect duties and decrease national productivity. All of these ultimately place an added strain to already struggling health system and undermine existing efforts towards recognized health priorities. With the vast tragedies of the mall attack, what will this reality mean for Kenya?
After having suffered through 1998 U.S. embassy bombings, perhaps Kenya fairs better than most sub-Saharan African nations when it comes to long-term mental health attitudes and care. Living in the U.S., I’ve gotten used to seeing mental health as an integral part of response when tragedy occurs. Coping methods, therapists, and toll free 800 numbers are repeatedly woven into public conversations and news coverage.
Especially when children are involved, much attention is given and many resources are put towards supporting their long-term mental health care. I would like to see the same for Kenya.
What Could it Mean
I am left wondering how much support those affected in Kenya will receive. On a larger scale, will governments start to allocate more support for mental health and set firm policies that support mental health utilization? Or, will development organizations increase its inclusion in priority goals?
And perhaps more importantly, on the individual level, what role can Africans in the diaspora and on the continent take in shaping attitudes that fully support health?
I am a Malawian-American with a passion for promoting a balanced presentation of African culture, history, and news. My curiosity and appreciation of world cultures led me to an undergraduate degree in Sociology and Anthropology with an exploration of Africa/African-American studies and the role of communication. I also hold an M.A. in Communication and have pursued a career in global health communication and social marketing. “History is written by the winners and those who bother to write” is a phrase that inspires me to write (melded from George Orwell and Winston Churchill’s words).