Healthcare workers are praised globally for fighting Covid-19. However, away from the headlines, many are tackling more personal battles; mental health and vaccine hesitancy.
Kenyan doctors were already overstretched before the pandemic. The ratio of doctors to patients in Kenya is 1 doctor to every 6,335 patients according to latest data from the Kenya Medical Practitioners and Dentists Board. This is way high considering that the World Health Organization recommends a ratio of 1 doctor to 1000 patients.
According to the World Health Organisation (WHO), before the pandemic hit, one out of almost eight billion people lived with mental health issues. More than 264 million people were affected by depression, and suicide was the second-leading cause of death among young people after road accidents.
While there is little data on how Covid-19 is increasing mental illness, a survey of 12,000 women in low-income communities in Uganda and Zambia found an increase in persistent stress, anxiety and depression.
StrongMinds , an American non-profit organization that treats depression amongst women and adolescents in low-income communities in sub-Saharan Africa conducted the survey in July 2020.
Although trained to work through crisis, the pandemic is like nothing healthcare workers have ever faced and it is taking a toll on them.
Although healthcare workers can profit from the protection from the jab, vaccine hesitancy is still a problem.
Dr Were Onyino, president of the Kenya Medical Association (KMA) attributed the vaccine hesitancy among healthcare professionals to a lack of involvement and public education.
In a random poll carried out by KMA, 28 percent of health workers interviewed were not willing to take the Covid-19 shot, doubting its safety.
And now experts are warning that cases of, depression and distress have increased. Dr Edith Kamaru Kwobah, a consultant psychiatrist at Moi Teaching and Referral Hospital in Eldoret explains that the ‘third wave of the pandemic’ has impacted more on people when it comes to mental health.
Dr Kwobah further explained that healthcare workers still remain vulnerable as the pandemic is threatening mental health in several ways.
“Now more than ever, people are threatened with the idea of death since Covid-19 started. Our mental wellness is stretched in many ways.”
According to her, anxiety is a psychological, physiological, and behavioural state induced by a real or imagined threat to wellbeing or survival.
32-year-old Dan (surname withheld) ,a healthcare worker in Nairobi, is stressed. He lost sleep most nights and was often impatient with people.
Nairobi, where, Dan works is the epi-center of the outbreak in the country. “I was used to seeing accident cases at the emergency room being anaesthetised, but with coronavirus, you see the patient losing the ability to breathe. It is not easy.”
Two weeks earlier, he had lost several colleagues to the Covid-19 pandemic. The days that followed became more distressful. He would work long hours to try to forget the ordeal.
But the agony persisted. “I was angry all the time. I suffered more panic attacks,” says Dan. When he finally went for a routine checkup, he was diagnosed with a mental disorder.
He explains that visiting a psychiatrist, “was one of the best decisions, I made in my life.” He has since gone through an overwhelming journey of self-discovery.
According to Dan, the stress management techniques and treatment he went through saved his life and have prevented him from relapsing or being depressed.
A recent WHO study reveals that Covid-19 is associated with neurological and mental complications such as delirium, agitation, stroke, insomnia, anxiety or depression.
The many restrictions imposed to slow down the spread of the virus – physical distancing, lockdowns, closure of “non-essential” businesses, travel restrictions – also led to increased levels of stress, anxiety and depression.
WHO Director General Tedros Adhanom said the effect would last for many years to come.
Kenya’s Ministry of Health says the number of mental health cases have increased during the Covid-19 pandemic. According to the country’s mental health task force, 25 percent of out-patients and 40 percent of in-hospital patients suffer from mental health issues such as depression. The numbers paint a gloomy picture.
However, Dr Kwobah, explains that not all anxiety is bad unless it is excessive and interfering with your normal functioning.
“Excessive anxiety is a threat to physical and mental wellness,” she added noting that general symptoms include worry, fear, nausea, and shortness of breath, sweating feet or hands.
But even those who have been battling mental health issues are facing a double tragedy.
Leah Esuko, 55, and her son Caleb Munene, 23, from Kanja village, Embu County are both mentally ill. Esuko developed mental illness at a young age, while the son’s came as a result of substance abuse leading to drug-induced psychosis.
But coping with stress and anxiety brought about by the Covid-19 pandemic is slowly taking a toll on their recovery process.
She is among people whose jobs were affected by the pandemic. She used to do laundry and household chores for people. But with the pandemic, she says, “nobody is now willing to invite us into their homes.”
“On a good day I used to make between Ksh 200-300. My house rent is Ksh 800.With little offers I am now forced to even do laundry for as little as Ksh100 to be able to meet the cost for my rent,” Esuko says.
Esuko and her son are part of about 17 mentally ill patients who have been enrolled at Kanja health centre where they receive medication and psychosocial support under a program run by Medicines Sans Frontiers (MSF).
Nancy Mutai, a mental health Mentor and Trainer at an MSF project in Embu county says that stigma at both the community and health facility levels is a major challenge in tackling mental health.
Mrs Mutai explains that the MSF project covers health promotion and patient support on non-communicable diseases and mental illnesses in the 11 facilities within Embu County.
“We aim to empower the clinical officers and the nurses to be able to identify these cases, manage the simple ones and refer the complicated cases to level 5 facilities.”
“We are also training the Community Health Volunteers (CHVs) to create awareness in the community so that they can identify those patients and refer them to facilities where they can get help,” explains Mutai.
She noted that if people cannot handle stress, they end up having mental challenges. However, she says, some mental illnesses are genetic.
“When movement is restricted to contain the spread of Covid-19 , several people lose their jobs leading to loss of income.” states Mutai.
She further adds that, “unlike other health emergencies or diseases, mental health continues to receive little attention from the government.”
But all is not lost, more Kenyans are seeking help and speaking up about it.
Battling mental illness
Dr Kwobah explains that there are several ways of managing anxiety , such as self-awareness, self-care, engaging in social support and managing frustrations among others.
“Self-awareness of body responses and processes, including feelings, desires and urges to act, plus awareness of thoughts and thinking patterns is vital in individual’s interaction,“ she adds.
Focus on self-care is also vital. Self-care is a conscious act one takes in order to promote their own physical, mental, and emotional health.
“Learn to take a break from Covid-19 news, budget for self-pampering experience and prioritise healthy meals,” advices Dr Kwobah.
National and county governments need to embrace and support mental health programs through funding for medication and awareness creation.
“We need a sustained advocacy to enable communities understand mental illness is just like any other disease,” explains Mrs Mutai.
In early November 2020, the government had reigned in with the elevation of Mathare National Teaching and Referral hospital to handle increasing cases of mental illness across the country especially during the Covid-19 pandemic.
Dan will soon end his mental treatment, but a touch of reminiscence and regret remain. “I miss those days when I didn’t fear anything. I don’t think I will ever be like I was before.”
What journalist should do:
- Talk to Kenyans living with mental illnesses and highlight the challenges they face. Also tell success stories to encourage the population.
- Investigate the impact of psychosocial support programs in major health institutions for healthcare workers during the Covid-19 pandemic and how it is helping in mental illness management.
- Check out the national budget allocated towards mental health, and if it has been used for the intended purpose and the impact it has created.
- Tell stories of organisations involved in mental health illness interventions across the country to enable people seek help before it is late?
- Check our List Of Experts for this and other topics