Behind the white perimeter walls of Mathari National Teaching and Referral Hospital (MNTRH), seen from the busy Thika Highway, where thousands of people pass by daily, lies a facility shrouded in misconceptions.
The misconception that MNTRH is meant for mad people may be one of the most common ringtones in many people’s minds. The other fallacy could be that patients here are chained because they are extremely violent.
Consequently, when someone tends to behave irrationally, you are likely to hear expressions like, “This is a Mathari case.”
Take the case of a driver, Donald Mugambi, who had just dropped some visitors at this hospital; it was the first time to visit the facility. He then sat pensively in his vehicle, occasionally pacing back and forth from a bench on the lawns in front of the hospital’s administration block.
After about two hours, Mugambi reveals his bewilderment.
“I’m not seeing what I thought I would,” he says, laughing hysterically.
“I was imagining that I would see very many violent people walking about without clothes and shouting all over,” added Mugambi.
The hospital’s motto, “Healing minds, restoring lives, and touching families,” also seems to portray the facility as a haven for the broken souls, yet MNTRH is a hospital, just like the Kenyatta National Hospital, Moi Teaching and Referral Hospital-Eldoret, and Jaramogi Odinga Teaching and Referral Hospital-Kisumu, among others.
To lend credence to this, Kenya News Agency sought the views of Ignatius Wambio (not his real name), who was just leaving Mathari Hospital, having been attended to.
Interestingly, Wambio was not suffering from any mental disorder. You could easily spot that his right arm was bandaged and in a sling.
Upon inquiry he said, “I fell and landed on my right hand. My elbow also absorbed the impact; my arm was almost paralyzed.
Wambio says that he initially attended at the Kenyatta University Teaching and Referral Hospital but was later on referred to Mathari for physiotherapy, since the cost here is more pocket-friendly. He remains open regarding his condition that compelled him to commence sessions at the mental health facility.
However, when a request was made to him for a camera interview, Wambio remained reluctant, though he is scheduled for more visits to this hospital, for fear of what the public might conclude about him should it be known that he sought medical attention in a hospital, often referred to in derogatory terms.
The stigma associated with mental illness remains appalling and individuals and families shun seeking mental health services due to subsequent isolation and discrimination by the wider society.
On his part, the hospital CEO Dr. Julius Ogato said, “As much as we deal with physical illnesses, our specialty is in diseases or disorders of the mind, which are associated with cognitive functions, emotional processing and overall 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 further justifies how apt the hospital motto is, saying, ‘Our core business is to heal minds, so that we restore the social and economic functioning of a person, and by so doing, we touch families.’
“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,” he added.
“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,” says Dr. Ogato.
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 also healed.
The facility dates back to 1901 when it was established as a smallpox isolation centre. Around 1910, it was transformed into a mental hospital. The hospital currently 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.
And since there’s limited-service delivery in mental healthcare at the county level, MNTRH serves as a referral centre for lower-level hospitals and therefore attends to clients from all over the country.
In 2013, it was added the onus of being a comprehensive referral hospital and the general outpatient medical services offered by other hospitals are also available at MNTRH.
The hospital has undergone significant milestones. “It’s now a semi-autonomous government agency,” says Dr. Ogato, adding, “We are even in transition so that it can be a fully semi-autonomous government agency.”
The hospital has a total of 544 mental healthcare staff including 364 clinical officers and 180 support staff comprised of drivers, cooks, accounts and procurement officers, among others.
Dr. Ogato recognizes that the ideal staffing is 1,416, hence a shortfall of over 850 workers. The facility’s inpatient capacity is 700, with 10 male and five female wards. The male wards are more often than not full while the female ones sometimes have empty beds.
The hospital also supports the country’s justice system. Some of the wards are for criminal offenders, where we have more men at about 80 percent and females at about 20 percent, added Dr. Ogato.
At the same time, the hospital receives between 560 and 700 visitors per day, most of them being patients 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, among others.
Human traffic either into or out of the facility is considerable. This is aided by clearly marked streams for medical personnel and students, patients, visitors and cab drivers.
However, 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 specialized treatment programs for specific disorders like schizophrenia and depression. Others are bipolar mood, anxiety and drug and substance abuse disorders, among others.
The facility is also a training ground for aspiring mental health professionals. The Kenya Medical Training College (KMTC) has pitched camp on the hospital’s premises by setting up a campus.
Additionally, several students from various universities including the University of Nairobi are pursuing their studies at the facility.
One of the consultant psychiatrists at the hospital is Dr. Victoria Wamukhoma, who has worked here for the last 10 years. Dr. Wamukhoma serves as the head of clinical services and wishes that the myriads of misinformation about the hospital cease once and for all.
She says help for the mentally ill patients is readily available because over the years, the facility has been instrumental in offering the right support and treatment to thousands of patients with mental illness.
Recovery from mental illnesses has been feasible for the victims, leading to resumption of productive lives after undergoing treatment, she adds.
According to the psychiatrist, follow-up treatment is equally 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,” said Dr Wamukhoma.
“The new patients with mental illnesses that we receive in this hospital on an annual basis average around 12,000-13,000 people,” she added.
The hospital’s data indicates that the prevalence of mental illnesses has been increasing in the country. “Every year, the figures go up by around 1,000-1,500,” said Dr. Wamukhoma. Adding, “This increase, just like other illnesses, is attributed to the nation’s soaring population.”
Meanwhile, the Mathari National Teaching and Referral Hospital stands as a beacon of hope, providing 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.
However, in many parts of the country with a high prevalence of HIV, such as Butula subcounty, Busia those infected have embraced a culture where seeking help for their condition is seen as a sign of strength but not weakness. They freely talk about it.
Likewise, mental health professionals feel that conversations about mental health need to be normalized. The citizenry, they say should be educated about different mental conditions to ensure that everyone has access to the support they need.
For over 110 years, the MNTRH has been playing a crucial role in touching families. The hospital is out to dispel myths surrounding mental illness, amidst hopes a day will come when seeking help for mental well-being will be as ordinary as seeking treatment for any other ailment.
By William Inganga
