Inside Mathari through the eyes of a Kenyan Student of medicine. You are in for a ride in this Psychiatric unit. Buckle up!

Mental health. A term that you most probably heard a couple of times especially in the recent years. Outside there, mental health is mainly coined towards prevention. However, within the walls of Mathari National Teaching and Referral Hospital (MTRH), it is a totally different story. The question changes from how do we prevent to how do we treat? Sometimes even in the too late cases.

Before 3rd year in medical school, I had never been to any mental institute leave alone the biggest in Kenya, MTRH. Mathari came up in jokes and casual conversation with friends.

“‘Wewe unafaa kupelekwa Mathari”

“Huyu anakaa msee wa mathari“

“Haiya, kwani umepotea mathari“

Mathari is name too common. Every Kenyan knows about it. Everyone knows that when one can no longer hold in the ‘demons’ then Mathari is the place to go or to be taken. Contrary to popular opinion, not everyone in Mathari is sick in the head. Mental illness not only entails violence, inappropriate dressing and appearance but also subtle and extremely calm presentations. You know, at times too much silence fits into the description of ‘crazy’. If there is something I am learning in this psychiatric rotation is that silence is deceiving; the most silent are the last you want to talk to.

As a student of medicine, interacting with patients is the art our Attendings and lecturers work so hard to inculcate. The truth of the matter, however, is that it is not easy. They say it takes practice and of course it is easier for them to say so keeping in mind some have over twenty years of experience.

With patients in Mathari, there is an obvious barrier to communication and holding a conversation but a thin line of sensitivity is also never to be crossed. Some illnesses present with thought dissociation; you might be having a conversation about their parents and then suddenly they start taking about a bird in the sky. Some create new words(neoligism) while others just mix up words in no coherent way(word salad). Some have hallucinations and delusions; they will read out and a book which in invisible to you and even get mad that you are not participating in what they are doing.

Let me tell you my friends, my very thin patience has been stretched countless times. I have had to constantly remind myself that they are sick and it is not intentional.

On the flip side, Mathari is not always depressive. there are some good and funny times. For example, how often does a man go down on one knee and ask you to marry them? Mentally stable or not?

“Sister, will you marry me?“

My rotation in psychiatry is not even close to coming to an end. who knows, i mIght become somebody’s wife in here.

*******

Another one from the psychiatric unit on this blog.

Oh and by the way it is Mathari and not Mathare….I learnt that this year as well

I still insist, psychiatry is not my thing.

Adios my friends, see you next week on Tuesday.

Faith