Just recently, Nairobi County governor Mike Sonko airlifted Kenya’s boxing legend Congestina Achieng from her rural home to Nairobi for specialised treatment. Sonko’s came after a video clip of Congestina surfaced on social media. In the video, Congestina who has been suffering mental problems for long, could be seen being played around by people.
The Nairobi County boss took Congestina to Mathari mental hospital where she was to undergo treatment and rehab, but is she safe at the facility? The senate health committee released a report about the facility, that puts it in a worrying state. According to the report, the hospital, Kenya’s only mental teaching and referral facility, has dilapidated buildings and lacks toilets, bathroom and proper drainage.
Appearing before the Senate committee, Health Cabinet Secretary Sicily Kariuki did not deny the issues raised, acknowledging that the facility had suffered “perennial” neglect.
She said that the national government alone could not upgrade the hospital to a standard where it offers patients an acceptable level of care. The CS said that the ministry only built three extra wards and upgraded the laundry.
She revealed that the ministry owes the hospital Sh40 million, which is being disbursed in instalments, and appealed to the health committee to increase the funding.
The financial challenges are compounded by the National Health Insurance Fund’s (NHIF) allocation of only Sh300 for three months per patient, when the most basic care costs Sh1,500 per session. In fact, the ministry has had to step in to demand that the NHIF pay the Sh105million owed to the hospital.
A doctor at the hospital said: “Regarding the NHIF, it is particularly sad for patients who are addicts since the capitation is just Sh60,000 per year, when it actually costs Sh135,000 to stay here for a month, even on these subsidised rates.”
Cases of patients slipping back into addiction in the course of treatment have been reported, and some never make it out alive.
Ms Kariuki said that since most of the patients lack identification documents, the NHIF cannot provide medical cover for them.
The Senate committee also raised concern about congestion in the maximum security unit, which hosts suspects with mental illnesses, mentally ill offenders or those who develop mental illnesses while in prison.
This section of the hospital was built in 1978 — when the country’s population was a fifth of what it is now — and has never been upgraded to accommodate the increasing number of patients.
The Prisons Service “dumps” patients at the facility, and does not contribute to cater for their food or treatment.
Currently, there are seven patients who need round-the-clock care, who were abandoned by relatives, and have been in the hospital for more than two decades.
Despite the serious cases the hospital manages, often requiring in-depth diagnostic examinations, the facility was, surprisingly, passed over in the provision of CAT scans and imaging equipment by the national government. Equipment such as CAT scans and MRIs would rule out brain injuries and other diseases, which often complicate, or manifest in patients, as mental illnesses.
Patients at Mathari have been left out of the medical procedures used in other parts of the world to improve the quality of life of mental patients.
Mathari does not have procedures such as electroconvulsive therapy (ECT), often used on severely depressed patients in a catatonic state, meaning they cannot move, eat or talk. ECT, often performed under general anaesthesia, sends acceptable levels of electric currents through the brain to “awaken” it by triggering a brief seizure and change in brain chemistry.