Behind the white perimeter walls of Mathari National Teaching and Referral Hospital, seen from the busy Thika Highway, where thousands of people pass by daily, lies a world shrouded in misconceptions.
This hospital is meant for mad people, may be one of the most common perceptions. Another could be, The patients here are chained because they are extremely violent. If someone seems to behave irrationally, you might hear, “This is a Mathari case.”
A driver, Donald Mugambi, has just dropped some visitors off at this hospital. It’s his first time here. He’s been pensively sitting in the vehicle, occasionally pacing to and from a bench in the lawns in front of the administration block. After about two hours, he reveals his bewilderment.
“I’m not seeing what I thought I would,” he says, laughing hysterically. “I was imagining that I’d see very many violent people walking about without clothes and shouting all over,” he says. “I’m quite surprised.”
The hospital’s motto is: Healing minds, restoring lives and touching families. Though inanimate, it sounds as though the motto is pleading with the public, “Don’t have a mistaken belief about me. Don’t stigmatise me. I’m a hospital, just like any other.”
Offering credence to this plea, Ignatius Wambio* (not his real name) is just leaving the hospital, having been attended to. Interestingly, he’s not suffering from a mental disorder. His right arm is bandaged and in a sling.
“I fell and landed on my right hand. My elbow also absorbed the impact,” he says. “My arm was almost paralysed.” He says he was initially attended to at the Kenyatta University Teaching and Referral Hospital. “It’s the one that referred me here for physiotherapy since the cost here is more pocket-friendly.”
On a one-to-one, Wambio is conversational regarding his condition that compelled him to begin having sessions at the mental health facility. However, when a request is made to him for an interview on camera, he’s reluctant.
He’s scheduled for more visits to this hospital. Perhaps he discerns what the public might conclude about him, should it be known that he sought medical attention in a hospital often referred to in a derogatory manner as a mental one.
The stigma associated with mental illness remains a formidable barrier. Cultural beliefs, misconceptions and low public awareness compound the problem. There’s fear that individuals and families may be ostracised or discriminated against if they seek mental health services.
Wambio has noticed that the senses of his arm are slowly returning. He lightly flexes the fingers of his right hand.
“A few days ago, I couldn’t do this,” he says. He’s hopeful that with time, the reflexes of his arm and the dexterity of his fingers will be fully restored due to the therapy he’s receiving at Mathari.
TOUCHING FAMILIES
Mathari Hospital CEO Dr Julius Ogato says, “In as much as we deal with physical illnesses, our speciality is in diseases or disorders of the mind, which are associated with cognitive functions, emotional processing and behaviour.”
Dr Ogato explains that if the faculties of someone’s mind are severely affected, psychosocial dysfunction sets in, leading to detachment from their families and community. The mental health specialist connects the dots of the hospital’s motto.
“Our business is to heal minds, so that we restore the social and economic functioning of a person, and by so doing, we touch families,” he says.
Someone with severe mental illness may wander from home and be compelled to sleep on the streets. If he’s a parent, his children are left social orphans because he’s not able to meet the obligations of a parent.
“When we treat this person, and he regains his social and intellectual functioning, and goes back to undertake the duties and obligations of a parent, then we touch this family,” Dr Ogato says.
When mental disorders strike, Mathari Hospital proves to be the asylum to provide the therapy that may lead to recovery, enabling a patient to resume living a productive life. The family and community where the patient hails from are healed, too.
The facility dates back to 1901, when it was established as a smallpox isolation centre. Around 1910, it was transformed into a mental hospital.
It is a teaching and referral hospital,
just like Kenyatta in Nairobi, Moi in Eldoret, Coast in Mombasa and Jaramogi in
Kisumu.
The hospital stands tall as the country’s premier psychiatric facility, operating at the forefront of mental healthcare. It is a tertiary care referral hospital for mental illnesses and substance use disorders.
Since there’s limited-service delivery in mental healthcare at the county level, Mathari Hospital serves as a referral centre for lower-level hospitals and, therefore, attends to patients from all over the country.
In 2013, it was added the onus of being a comprehensive referral hospital. General outpatient medical services offered by other hospitals are also available at Mathari.
The hospital has undergone significant
milestones. “It’s now a semi-autonomous government agency,” says Dr Ogato. “We
are in transition so that it can be a fully semi-autonomous government agency.”
COMPREHENSIVE SERVICES
The hospital has 544 workers, mostly mental healthcare staff. “The clinical workers who deal directly with patients are 364,” Dr Ogato says.
Supportive staff are 180. They include
drivers, cooks, accounts and procurement officers. Dr Ogato says the ideal
staffing is 1,416 workers. There’s a shortfall of more than 850 staff.
The facility’s inpatient capacity is 700. There are 10 male and five female wards. The male wards are more often than not full. The female one sometimes have empty beds.
The hospital also supports the country’s justice system. Some of the wards are for criminal offenders. “We have more men at about 80 per cent, and females at about 20 per cent,” Dr Ogato says.
“Between 560 and 700 patients per day visit the hospital,” Dr Ogato says. Most of them are people with mental and drug-related disorders.
About 100 others are general outpatients who come for dental, lab, X-ray, and other outpatient services like diabetes and hypertension management.
Human traffic either into or out of the facility is considerable. The streams are of medical personnel and students, patients, visitors and cab drivers. Even though the facility’s compound is fairly expansive, it craves expansion, going by the few buildings under construction.
The comprehensive range of services at the hospital includes specialised treatment programmes for specific disorders, such as schizophrenia, depression, bipolar mood, anxiety and drug and substance abuse disorders.
The facility is also a training ground for aspiring mental health professionals. The Kenya Medical Training College has pitched camp on the hospital’s premises by setting up a campus. Several students from various universities, including the University of Nairobi, are pursuing their studies here.
One of the consultant psychiatrists at this hospital is Dr Victoria Wamukhoma. She’s been working here for more than 10 years. She’s the head of clinical services. How she wishes that the myriads of misinformation about the hospital would cease!
She knows that for mentally ill patients, help is available because she and her colleagues have been instrumental in offering the right support and treatment to thousands of patients with mental illness.
Recovery from mental illnesses has been feasible for them, leading to the resumption of productive lives.
MENTAL ILLNESSES RISING
Follow-up treatment is essential in managing mental health. “Every year, we have up to 150,000 people who have mental illnesses coming back to this hospital to be checked up,” Dr Wamukhoma says.
Adding, “The new patients with mental illnesses that we receive in this hospital on an annual basis average around 12,000 to 13,000 people.”
The hospital’s data indicates that the
prevalence of mental illnesses has been increasing. “Every year, the figures go
up by around 1,000 to 1,500,” Dr Wamukhoma says. This increase, just like other
illnesses, is attributed to the nation’s soaring population.
The Mathari National Teaching and Referral Hospital stands as a beacon of hope. It provides crucial services to hundreds of thousands of patients annually.
Sadly, shame and misunderstanding continue to prevent countless others from seeking the help they desperately need, leading to more severe and chronic conditions.
In many parts of the country with a high
prevalence of HIV, such as Butula, those infected have embraced a culture where
seeking help for their condition is seen as a sign of strength, not weakness.
They freely talk about it.
Likewise, mental health professionals feel that conversations about mental health need to be normalised. The population should be educated about different mental conditions to ensure that everyone has access to the support they need.
For over 110 years, Mathari Hospital has been playing a crucial role in touching families. The hospital is out to dispel myths surrounding mental illness. The hope is that, one day, seeking help for mental well-being will be as commonplace as seeking treatment for any other ailment.
MATHARI HOSPITAL AT A GLANCE
544: Workers, mostly mental health medics
364: Clinical workers
180: Support staff
1,416: Ideal number of workers
850+: The shortfall of staffing
700: Inpatient capacity
15: Wards (10 male, 5 female)
560-700: Mental/drug abuse patients per day
100: General outpatients
