How Mombasa doctor promotes mental health as Kenyans battle pandemic

A Mombasa doctor has emerged the Covid-19 heroine at the Ellen Johnson Sirleaf Presidential Center for Women and Development for her work on mental health during the pandemic.

Dr Winnie Kitetu, a clinical psychologist at the Aga Khan Hospital in Mombasa, was feted for using her expertise to support women and families with remote counseling via phone or video call.

Dr Kitetu has been offering guidance on dealing with domestic abuse and parenting issues during the pandemic.

During the lockdown, the psychologist offered guidance on keeping loneliness at bay.

Dr Kitetu was nominated by Dr Hemed Twahir, the Medical Director at the Aga Khan Hospital in Mombasa.

“Dr Kitetu joined the hospital about two years ago when we realised we needed to expand our mental health care services. When the pandemic hit Kenya in March, little did we know she would prove herself one of our greatest human resource assets,” said Dr Twahir.

He said the trauma that has come with the pandemic has required deliberate efforts in addressing mental health issues affecting both patients and staff.

Thanks to Dr Kitetu’s efforts, he said, Aga Khan has made significant progress in the area.

Statistics

The Federation of Women Lawyers (Fida-Kenya) reported a spike of cases of gender-based violence across the country due to the pressures of the pandemic, with Western and Coast regions leading.

On April 15, Fida-Kenya launched a toll free number, 0800720501. It said that by November 30, it had processed 5,027 cases, a majority being incidents of defilement, domestic violence, child custody and maintenance services as well as counselling and mental health due to stress brought on by the pandemic.

“Kenyans are stressed due to loss of jobs and income and families are spending much more time together as children are at home. All these factors are making our country stressed,” Fida-Kenya Executive Director Anne Ireri said recently in Mombasa.

“Focus should be on the pandemic and access to justice to ensure Kenyans do not suffer ... to keep the society healthy. We have been on the frontline, campaigning for mental health during the pandemic.”

Source of inspiration

Dr Kitetu began her career as a pharmacist but her interest in mental health development pushed her to study to study clinical psychology.

“I spent the first five years working in the casualty department at one of Kenya’s busiest national referral hospitals. Patients would come to the window to receive their medication and I would see people receiving repeat prescriptions for ailments such as ulcers, or sleeping medication, but they weren’t aware of the underlying psychological issues that could also have been causing their ailments,” she explained.

“That’s what inspired me to go back to school in 2005 to take a course in psychology.”

After completing the course and while still working, she pursued a Master of Science in Clinical Psychology, which she acquired in 2009.

When her father died, Dr Kitetu stepped away from work in order to deal with the effects of the loss. Thereafter she began working as a consultant in clinical psychology at various hospitals.

But in 2013, she took a short break from her medical career and tried her hand at politics, vying for Kitui County woman representative. She came second in the general election.

“She returned to working as a Clinical Psychologist. I later began my PhD program and became a Clinical Psychologist resident at the Aga Khan Hospital in Mombasa,” said Dr Kitetu.

According to Dr Kitetu, mental health plays an important role in one’s overall health and wellbeing.

“There is no health without mental health. It encompasses the emotional, psychological and social well being,” she said.

“It drives how we think, feel and behave. The right mental attitude helps us deal with daily pressures, have more positive relationships, be more productive in life, and beat stresses. Good mental health also brings courage and compassion — it allows one to connect, think, and behave the right way.”

The strategy

When the pandemic hit Kenya, forcing the government to enforce containment measures, the Aga Khan Hospital in Mombasa strategised on how to help Kenyans battling mental health.

Dr Kitetu began by connecting with groups at community level through tele-consultations, helping them understand the actions they needed to take to stay well and survive, and how to deal with their children’s prolonged stay at home due to the suspension of learning.

Her main focus at the hospital shifted to helping staff —doctors and nurses — cope with the effects of the pandemic.

Dr Kitetu said the main psychological issues resulted from bereavement.

“I helped equip staff to deal with the loss of relatives and patients, and with their own anxieties. Additionally, I produced videos so that people could understand what was happening to their mental health and how they could best deal with their emotional, physical and cognitive symptoms,” she said.

The psychologist also noted that the pandemic has been a trigger for people with underlying mental health issues, hence her involvement in addiction counselling.

Dr Kitetu said substance use and abuse increased during the lockdown.

“I helped people deal with symptoms like insomnia, which were being triggered by anxiety. The pandemic’s toll on mental health has also extended to children, with some experiencing forms of night terrors, which is an additional source of stress for parents, particularly when there is so much misinformation on the internet,” she explained.

“Overall, I see my role as one of intervening in order to help people better understand what our brains are going through at this time. The pandemic affects people in different ways, from hospital staff who need to keep working when a patient dies and educators and parents who need guidance on supporting children, to corporate clients need help with bereavement when a colleague passes away due to the pandemic,” she said.

Coping with challenges

Dr Kitetu, like many others in this and other fields, has faced challenges in her work amid the pandemic.

To ensure her own mental wellbeing, she remained connected with people and focused on her own goals.

She further set boundaries about when to answer calls from her patients, who sometimes sought counselling outside work hours, including weekends.

She also exercised for 30 minutes every morning.

“I have not always found things easy during the pandemic. The lockdowns made me feel lonely, especially as I was in another county, away from my family – my husband is currently in Nairobi and my children work internationally - but we connected each weekend via Zoom, which really helped,” she said.

Dr Kitetu further said it is important to build and maintain habits of self-care and undergo medical examinations every year. She recommended joining physical or virtual community groups.

“It is too easy to be lonely at the moment so it is important to connect with other people. I love listening to music and watching comedies and laughing. Even when things aren’t going well, you can always work at improving your mental health,” she said.

The doctor urged Kenyans to cultivate an “attitude of gratitude” and find positivity where they can. She found hers through maintaining her faith and connecting with younger women in the community, with whom she shared laughs and stories, which helped keep her spirits up.

Men versus women

Dr Kitetu noted that women suffer a range of gender-specific mental health problems, including postpartum depression and that the pandemic has worsened matters for them, for reasons including intimate partner violence and the breakdowns of relationships.

“What has affected many women, in particular, is being forced to isolate on their own and the subsequent realisation that they can live without being in abusive relationships. I have been offering guidance on how to permanently leave abusive situations,” she said.

She also noted that more men than women have died during the pandemic, perhaps due to their lifestyles, as more of them smoke or drink alcohol, or because of a genetic predisposition.

With regard to men’s mental health, Dr Kitetu said they are devastated by the loss of employment or source of livelihood, which has happened a lot during the pandemic.

“This can really affect a person’s willpower and self-esteem. This has been magnified during the quarantine period, through a sense of quarantine fatigue that can also lead to substance abuse and domestic violence,” she said, but added that while the pandemic has affected men and women differently, the effects are often intertwined.

Dr Kitetu advised African women to build contingencies, always have an alternative plan, walk hand-in-hand with their families as they pursue their ambitions, push themselves beyond their comfort zones and network.

According to the mental health expert, through networking, one can meet a mentor who can help build ambitions even further.

She also urged women to keep themselves visible, stay positive and maintain that “attitude of gratitude”, to increase their self-esteem and reduce fear.

“While it is important to retain a sense of humility, it is equally important to let go of the imposter syndrome. It’s something I have suffered and struggled to overcome,” she said.

“Finally, women must also face up to and push away any sense of shame. Success can be found when you embrace your imperfections and vulnerabilities.”

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